Trauma-Focused CBT (TF-CBT) for Kids
Trauma Turns The World Upside Down.
Living with a traumatized child can feel like riding a never-ending rollercoaster. Seemingly tiny things set off huge meltdowns. Your child's emotions are so strong, and they go from “zero to sixty” in a heartbeat. Old behavior problems might resurface again that you thought you’d left behind in the preschool years. Your child just doesn't seem like the kid you used to know.
How can you put the world back together for your child after things have fallen apart? How can you help them get back to feeling the way they did before?
Trauma-Focused CBT Can Help Kids in North Carolina.
If you are on this page, you may be looking for therapy for a child whose world was shaken by trauma. Maybe your child just shared something worrying with you, and you’re trying to find the right help. Or, it’s possible you’ve been living through this difficult situation for months or even years. You've even sought out other forms of therapy only to see your child continue to struggle.
Trauma-Focused Cognitive Behavioral Therapy helps kids bounce back after a trauma. It’s one of the most researched forms of therapy out there for kids with PTSD, and it proves to be effective again and again. Keep reading to learn more about TF-CBT, and how it could help your child.
“Anything that’s human is mentionable, and anything that’s mentionable can be more manageable.”
What Makes a Child a Good Candidate for TF-CBT?
TF-CBT is meant for kids who have PTSD symptoms after surviving a traumatic event. Do you see your child in any of the following situations?
Behavior problems from when your child was younger, like nightmares and potty training issues, are coming back again.
Your child’s mood swings quickly and intensely, and you don’t always understand why.
The school is calling about dropping grades, poor attention, or picking fights when this wasn’t a problem before.
Your child never wants to talk about what happened. Or they share their story at inappropriate times, like when you’re in line at the grocery store.
Your child’s outlook on life has changed since the trauma, and they seem angry, sad, or hopeless.
If your child is dealing with problems like these, they may be a great fit for TF-CBT. This therapy is designed especially for kids who:
Are between the ages of 3 and 18
Experienced a traumatic event such as abuse, serious illness, an accident, domestic violence, or separation from a parent
Remember their trauma experience
Are in a safe place now, and ready to work through what happened
How Does TF-CBT for Kids Work?
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is the best known and most researched form of child trauma therapy. It is a version of cognitive behavioral therapy, another popular form of counseling. This style of therapy helps people understand how their thoughts and actions affect their feelings. The research shows TF-CBT is very effective for kids with PTSD, from the preschool years all the way through the late teens.
TF-CBT is a structured therapy program that guides children and parents, step by step, through healing from trauma. A child in TF-CBT might do the following things:
Learn facts about trauma and how it affects the body, to understand they are not alone
Practice coping skills to deal with anxiety and flashbacks
Learn ways to manage angry outbursts, along with their parents
Create their own story about their trauma experience and share this with a parent
How Is Trauma-Focused CBT Different Than Other Therapy?
Kids who have PTSD need a therapy approach that is designed especially for them. They need coping skills to help manage their symptoms in the short-term, as well as a way to make sense of their experience in the long-term. This kind of work helps them to be less bothered by their bad memories. For many children, regular talk therapy is not the most helpful way to recover from trauma.
Sometimes, children come to my counseling office for TF-CBT after trying another kind of therapy. They tell me they never talked openly about the trauma. They didn’t have any structure to their therapy sessions, and played or talked as they saw fit. That’s not how TF-CBT works. While there are chances to play and create art, there’s also structure. This gives kids the tools they need to handle and talk about their trauma.
Kids often feel ashamed or guilty about what happened to them. Trauma is so overwhelming that many children will never speak about it—even if they want to—unless an adult brings it up first. Kids need to know that their therapist can handle these tough conversations.
If My Child Brings Up All These Past Memories, Could It Make Things Worse?
It can be scary to think about sending your child to therapy to talk about their worst memories. Sometimes, parents ask me if it’s necessary to dredge up the past, especially if their child isn’t mentioning it. We all want kids to get back to feeling “normal” again. If we don’t bring it up, will children eventually forget about what happened?
As difficult as it is, kids who talk about their trauma experience do better in the long run than those who don’t. Talking about their memories in therapy helps children become less sensitive to them. In time, the memories don’t feel so big or overwhelming anymore: they’re just a part of the past.
Why Talking About Memories In TF-CBT Helps Kids Heal
Talking about these memories also gives therapists a chance to spot misunderstandings. For example, it’s common for children to believe they thought or did something to cause their trauma. If the child’s story is never spoken aloud, they might carry that guilt with them for many years.
In TF-CBT, we talk about these memories slowly and gradually, in a safe way. Before we start talking about the trauma, kids learn tools to help them manage any feelings that might come up. Some children may notice their symptoms get more intense at first. However, in the long run talking about trauma brings relief.
Imagine that your child has scraped her knee, and it’s very painful. You can either ignore the scrape, or clean it and bandage it. Cleaning it is very painful, but it helps to prevent infection. TF-CBT is the same way. By bringing the trauma to light and making it okay to talk about, we can help a child heal.
TF-CBT for Kids (Ages 3-12)
Young kids are much more likely to believe a trauma is all their fault. They see themselves as the center of the universe. So, they assume their thoughts and feelings cause things to happen in the outside world. This is called magical thinking, and it helps kids explain the unexplainable. If parents are fighting or a family member had an accident, the child thinks they must be the reason why.
TF-CBT helps children learn that what happened is not their fault. It helps children tell their story from their own point of view, and to learn that their feelings are valid. TF-CBT for young kids is more playful and creative. Children can “tell” their story in words, drawings, comic strips, or through play.
As a parent, you can expect to be more involved in TF-CBT for young children. Your child’s therapist will meet with you periodically to talk about their progress. They can also help you problem-solve any difficult situations at home. By the end of therapy, your child won’t need to share their story with a counselor anymore. She’ll know that you’ll be there to listen any time she needs you.
TF-CBT for Teens (13-18)
Teens with PTSD face some challenges that younger kids don't. They often describe feeling numb or hopeless. It's hard for them to care about anything anymore. Teens need coping skills to manage the strong feelings of anger, fear, and shame caused by trauma. Without these skills, they may turn to drug abuse, alcohol, or self-harm to deal with their pain. Teens are also more likely to think about or attempt suicide following a trauma.
On the other hand, teens also have some advantages when it comes to trauma therapy. It’s easier for them to put their feelings into words. They can think at a more advanced level that makes them a great fit for TF-CBT. Teenagers are old enough to think about their own thoughts—a skill called metacognition. In TF-CBT, teenagers can learn to spot the ways that trauma has altered their thinking. They can identify triggers for their symptoms, and develop a more positive and balanced worldview.
TF-CBT with teens usually requires less involvement from a parent. Teenagers can work independently with their therapist to learn healthy coping skills. Over time, they can rely on these skills instead of resorting to unhealthy or unsafe ones. Parents can meet alone with the counselor to figure out how to handle anger, defiance, or other struggles that are common with teenagers.
An end goal of TF-CBT is to help parents and teens see eye-to-eye and communicate better. This way, teens can feel safe coming to their parents with difficult stuff in the future.
Considering TF-CBT For a Child or Teen in Charlotte, NC?
I’d love to help. I’m a counselor who specializes in helping kids, preteens, and early teenagers with trauma. My child therapy office is located in Davidson, NC, so it’s convenient for Lake Norman families to meet in person. I also provide online therapy all over North Carolina, Florida, and New York.
Kids are so resilient, and it is amazing to see them grow by leaps and bounds over a short period of time. In counseling, we explain trauma in a way that children can understand. They learn they aren’t alone with their feelings. I’m nationally certified in TF-CBT, and have training in a few other trauma therapies, too. I like to incorporate play and drama therapy into my work with kids, so that our therapy process doesn’t get overly think-y.
Our local crisis agencies, like Pat’s Place Child Advocacy Center here in Charlotte, often recommend TF-CBT for kids with trauma. If you’d like to learn more, please contact me with any questions or to request an appointment.
Learn More About Trauma-Focused CBT
If you want to know more about how trauma affects children and teens, check out my Help for Trauma page. You can also get tips there for how to support your child at home.
If your child has recently shared that they may have been abused, I strongly encourage you to reach out to your local Child Advocacy Center for help.
For further reading about trauma-focused CBT, check out the official TF-CBT website. You can also look over my blog posts that mention TF-CBT:
TF-CBT for Preschoolers: Therapy for Early Childhood Trauma
PTSD in Teens: Signs and Symptoms to Look Out For
What Are the Symptoms of PTSD in Children?
Other Child Counseling Services in Davidson, NC
In addition to TF-CBT for kids with trauma, I offer a few other services for kids in the Lake Norman area. You can learn more about them here:
CBT for Anxiety | Play Therapy | Child Counseling | Online Therapy | D&D Social Group
