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Trauma-Focused Cognitive Behavioral Therapy: Addressing the Mental Health of Sexually Abused Children
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 TF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of TF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources 8. References

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3. Target Population

TF-CBT is most appropriate for use with sexually abused children ages 3 to 18 and parents or caregivers who did not participate in the abuse.

Appropriate Populations for Use of TF-CBT

Appropriate candidates for this program include:

• Children and adolescents with a history of sexual abuse who:
  • Experience PTSD
  • Show clinically significant levels of depression, anxiety, shame, or other dysfunctional abuse-related feelings, thoughts, or developing beliefs
  • Demonstrate behavioral problems, especially age-inappropriate sexual behaviors
• Children and adolescents who have been exposed to other childhood traumas (e.g., exposure to domestic violence, traumatic loss of a loved one)
• Nonoffending parents (or caregivers) of the victims of sexual abuse or trauma

Meaningful assessment is important in selecting which children may benefit from TF-CBT and to inform the focus of the intervention. The assessment should specifically address PTSD, depressive and anxiety symptoms, and sexually inappropriate behaviors, as these have been found to be most responsive to TF-CBT in multiple studies.

Limitations for Use of TF-CBT

TF-CBT may not be appropriate or may need to be modified for:

• Children and adolescents whose primary problems include conduct problems or other significant behavioral problems that existed prior to the trauma, and who may respond better to an approach that focuses on overcoming these problems first.
• Children who are acutely suicidal or who actively abuse substances. The gradual exposure component of TF-CBT may temporarily worsen symptoms. However, other components of TF-CBT have been used successfully to address these problems. It may be that for these children, the pace or order of TF-CBT interventions needs to be modified (as has been done in the Seeking Safety model; Najavits, 2002), rather than that TF-CBT is contraindicated for these populations.
• Adolescents who have a history of running away, cutting themselves, or engaging in other parasuicidal behavior. For these teens, a stabilizing therapy approach such as dialectical behavior therapy (Linehan, 1993) may be useful prior to integrating TF-CBT into treatment.

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You are in section: Table of Contents 1. What Makes TF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of TF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources 8. References

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This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare Information Gateway.

Updated on December 10, 2007