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Trauma-Focused Cognitive Behavioural Therapy

Trauma is a deep emotional response to a highly distressing event or events, leading to a wide range of adverse effects on our physical and mental health. The trauma may involve abandonment, domestic violence, physical or sexual abuse, grief, and loss. Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is an evidence-based approach designed to address and treat trauma-related difficulties. Developed by Cohen, Mannarino, and Deblinger, TF-CBT uses cognitive-behavioural principles and exposure techniques to prevent and treat posttraumatic stress, depression and behavioural issues.

Various research and studies recognise TF-CBT as the leading trauma therapy, alongside EMDR (Eye Movement and Desensitization and Reprocessing) therapy. It is especially effective for the treatment of children and youth trauma survivors.

TF-CBT's goal is to process the distorted beliefs or attributions developed from the trauma that results in the survivors' negative emotional and behavioural responses or thoughts. While TF-CBT uses Cognitive Behavioural Therapy (CBT) principles and techniques, it differs from traditional CBT because the TF-CBT approach is trauma-focused. It also includes a family therapy component in its intervention. TF-CBT therapist also includes creative elements such as play, journal writing and puppetry as innovative tools to treat the trauma and PTSD. The TF- CBT therapist also works with the survivors and their caregivers to provide holistic intervention to the trauma survivors.

The core component of TF-CBT is the acronym PRACTICE:

  • Psychoeducation and parenting skills

  • Relaxation techniques

  • Affective expression and regulation

  • Cognitive coping and processing

  • Trauma narrating and processing

  • In-vivo exposure and practice with triggers

  • Conjoint parent-child sessions

  • Enhancing safety and future growth

TF-CBT therapists aim to provide a supportive environment for children, teens and families to talk about the traumatic experiences and identify maladaptive thoughts or behaviour and relationship challenges. They work with their clients through creative activities such as play and journal writing. The TF-CBT therapists also help their clients develop skills to cope with ordinary life stressors as they move past the traumatic experiences. As a co-joint intervention, the TF-CBT therapist works with the parents or caregivers of the trauma survivors to develop skills to cope with their distress and painful emotions. TF-CBT also provides training to the parents or caregivers on effective communication, stress management and positive parenting. The family therapy component supports parents in decreasing emotional distress and depressive symptoms and increases their capacity for child management and support.

The long-term aftereffects of trauma can be severe. Children or adolescents deprived of learning positive coping strategies develop negative psychological symptoms, including depression, substance abuse, Post-Traumatic Stress Disorder (PTSD) or anxiety disorder, among others. They may also struggle with low self-esteem or self-image, a sense of worthlessness or powerlessness, and feeling unsafe in this world. Thus, speaking with a therapist or counsellor about seeking treatment for the family relating to trauma is essential for you and your child's healing.

Restoring Peace Counselling & Consultancy offers TF-CBT alongside other trauma therapy such as EMDR, brainspotting and play therapy. For more information, please visit our website at or Whatsapp at +65 8889 1848.

Keywords: Singapore, mental health, therapy services near me, therapy, therapist, counselling, trauma, CBT

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