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Home > Trauma-Focused Cognitive Behavioral Therapy: Addressing the Mental Health of Sexually Abused Children > 1. What Makes TF-CBT Unique
Trauma-Focused Cognitive Behavioral Therapy: Addressing the Mental Health of Sexually Abused Children
1. What Makes TF-CBT UniqueTF-CBT addresses the negative effects of sexual abuse and other traumatic events by integrating several therapeutic approaches and treating both child and parent in a comprehensive manner. Addresses the Effects of Sexual Abuse and TraumaIn the immediate as well as long-term aftermath of sexual abuse, children are at risk of developing significant emotional and behavioral difficulties (see, for example, Briere & Elliott, 2003; Berliner & Elliott, 2002; Chadwick Center, 2004). For example, victims of sexual abuse often experience:
These symptoms can impact the child's daily life and affect behavior, school performance, attention, self-perception, and emotional regulation. To date, numerous studies have documented the effectiveness of TF-CBT in helping children overcome these and other symptoms following child sexual abuse and similar traumatic experiences (e.g., Deblinger, Lippman, & Steer, 1996; Cohen & Mannarino, 1996a, 1996b, 1998a, 1998b; Deblinger, Stauffer, & Steer, 2001; Cohen, Deblinger, Mannarino, & Steer, 2004). The program helps children to process the traumatic memories, overcome problematic thoughts and behaviors, and develop effective coping and interpersonal skills. (See also Effectiveness of TF-CBT.) Treats Nonoffending Parents in Addition to the ChildRecognizing the importance of parental support in the child's recovery process, TF-CBT includes a treatment component for parents (or caregivers) who were not abusive. Children and parents first participate separately in therapy and then attend several joint child-parent sessions. The parent component teaches stress management, parenting, and communication skills. As a result, parents are better able to address their own emotional distress associated with the child's trauma, while also supporting their children more effectively. Integrates Several Established Treatment ApproachesTF-CBT combines elements drawn from:
TF-CBT uses well-established cognitive-behavioral therapy and stress management procedures originally developed for the treatment of fear, anxiety, and depression in adults (Wolpe, 1969; Beck, 1976). These procedures have been used with adult rape victims with symptoms of PTSD (Foa, Rothbaum, Riggs, & Murdock, 1991) and have been applied to children with problems with excessive fear and anxiety (Beidel & Turner, 1998). The TF-CBT protocol has adapted and refined these procedures to target the specific difficulties exhibited by children who are experiencing PTSD symptoms in response to sexual abuse or other childhood traumas. In addition, well-established parenting approaches (e.g., Patterson, 2005; Forehand & Kotchick, 2002) also are incorporated into treatment to guide parents in addressing their children's behavioral difficulties. Successful in Various Environments and Appropriate for Multiple TraumasTF-CBT has been implemented successfully in urban, suburban, and rural environments and has demonstrated success with Caucasian, African-American, and Hispanic children from all socioeconomic environments. It has been adapted for Latino and hearing-impaired populations. In addition, recent research findings suggest that TF-CBT may be preferable to less directive treatment approaches for children who have a history of multiple traumas (e.g., sexual abuse, exposure to domestic violence, physical abuse, as well as other traumas) and those with high levels of depression prior to treatment (Deblinger, Mannarino, Cohen, & Steer, in press). The model also has been tested with children who are experiencing traumatic grief after the death of a loved one (Cohen, Mannarino, & Knudsen, 2004; Cohen, Mannarino, & Staron, in press).
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