Home > Abuse-Focused Cognitive Behavioral Therapy for Child Physical Abuse > 2. Key Components

Abuse-Focused Cognitive Behavioral Therapy for Child Physical Abuse
Issue Brief

Author(s):  Child Welfare Information Gateway

Year Published:  2007

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You are in section: Table of Contents 1. What Makes AF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of AF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources for More Information

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2. Key Components

AF-CBT is a short-term treatment typically provided over the course of 12 to 24 hours during 3 to 6 months (although treatment may last as long as determined necessary). Treatment generally is provided in an outpatient or in-home setting, but it may be used in residential settings (e.g., group home, residential treatment facility) or other placement settings (e.g., foster care) when the parent or caregiver is in regular contact with the child. Treatment includes separate individual sessions with the child and parent. Joint sessions with the child and parent also are held. Where relevant, family interventions may be applied before, during, or after the individual services. Following a brief outline of treatment goals, the key components in each treatment area are listed below.

Goals

Generally, the goals of AF-CBT treatment are to:

• Reduce parental anger and use of force
• Promote alternative (nonaggressive) discipline approaches
• Minimize risks for additional abusive incidents
• Enhance the child's coping skills and overall adjustment
• Encourage prosocial problem-solving and communication in the family

Treatment for School-Aged Children

The school-aged child-directed therapy elements include the following:

• Identifying the child's exposure to and views of family hostility, coercion, and violence
• Understanding the child's perceptions of the circumstances and consequences of the physical abuse
• Educating the child on topics related to child welfare and safety, child abuse laws, and common reactions to abuse
• Discussing healthy vs. unhealthy coping
• Training in techniques to identify, express, and manage emotions appropriately (for example, anxiety management, anger control)
• Training in interpersonal skills to enhance social competence
• Developing social support plans

The treatment program for children incorporates the use of specific skills, role-playing exercises, performance feedback, and home practice exercises.

Treatment for Parents (or Caregivers)

Parent-directed therapy elements include:

• Identifying views on violence, physical punishment, and sources of stress
• Understanding the role of parental and family stressors that may contribute to conflict
• Examining the role of expectations related to child development and general attributions that may promote coercive interactions
• Identifying and managing reactions to abuse-specific triggers, heightened anger, anxiety, and depression to promote self-control
• Training in effective discipline strategies (e.g., time out, attention reinforcement) as alternates to the use of physical force

The treatment program for parents incorporates the use of specific skills, role-playing exercises, performance feedback, and home practice exercises.

Treatment for Families (or the Parent and Child)

Parent-child or family therapy elements include:

• Conducting a family assessment using multiple methods and identifying family treatment goals
• Discussing a no-violence agreement
• Clarifying attributions of responsibility for the abuse and developing safety plans, as needed
• Training in communication skills to encourage constructive interactions
• Training in nonaggressive problem-solving skills with home practice applications
• Involving community and social systems, as needed

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You are in section: Table of Contents 1. What Makes AF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of AF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources for More Information

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Updated on October 9, 2009