Since so many of my posts lately have been about childhood anxiety, I decided I would give a bit of attention to writing about how I treat childhood trauma. First let me say that I am very passionate about helping children recover from traumatic events. When I worked at Children’s Hospital in Los Angeles, I worked solely with children who had experienced trauma. I was involved in teaching, training, supervision and research of childhood trauma and PTSD. This may sound like a strange thing to feel so passionate about but I truly feel privileged to help children and their families move through this healing journey.
One of the reasons I love providing this support is because I use a treatment protocol that is powerful and effective in helping children. So even though I am often helping children who have experienced very sad or awful events, I feel hopeful because I know that I have tools and interventions that will help.
The treatment approach that I utilize is called Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT. TF-CBT is considered one of the gold standard treatments for treating children after a trauma. Organizations such as the National Child Traumatic Stress Network, International Society for Traumatic Stress Studies, and the American Psychological Association have all listed TF-CBT as an evidence-based treatment for childhood trauma with the highest levels of research backing.
So, what is TF-CBT and how will it help my child?
Let’s start with the treatment components and what they look like….
The Components fit into the acronym of PRACTICE:
· Psychoeducation – In this stage the therapist provides the child (and parent) with education about trauma and how the symptoms of trauma can affect children. This helps not only to provide knowledge but also to comfort the child that his or her reactions are normal.
· Relaxation and Coping Skills – In this stage, we learn coping skills and relaxation skills to help the child manage their symptoms of PTSD.
· Affect Regulation Skills – Here, the child learns ways to manage dysregulated emotions. Support may also be provided separately to the parent to help with parenting skills for these dysregulated emotions.
· Cognitive Coping Skills – The therapist will then help the client change negative or fearful thinking into more healthy or helpful ways of reacting.
· Trauma Narrative and Cognitive Reprocessing – This stage is the hardest and most important stage of therapy. During these sessions, the child will process what happened during the traumatic event and begin to not only desensitize to their traumatic memory but also begin to create new meanings about their trauma.
· In Vivo Exposure to Trauma Triggers – By the time we reach this stage of therapy, the child’s symptoms have often significantly decreased. We then transition to facing feared triggers in his or her regular environment, so they can get back to aa more “normal life” and stop feeling trapped by triggers.
· Conjoint Child-Parent Sessions – As a therapist, I find these sessions very meaningful. In these sessions, the therapist helps the child to share their memories and fears with their parents and guides the parents through providing support and validation.
· Enhancing Safety – Finally, we look toward the future and identify ways to create a sense of safety by identifying ways the child is now safe and can stay safe in the future.
The list above is a very brief and simplistic overview of the TF-CBT model. I hope by reviewing it you notice a few things. First, there is a clear treatment protocol to follow. While this protocol is adapted to each child’s needs, it is helpful to have an evidence-based roadmap to follow in order to make sure we provide the best support.
Second, you will see that the child’s parents are included in therapy. This is critical because not only is the parent the one providing the majority of the support outside of therapy, but also the parent has likely experienced the trauma as well as the child and needs support for how to move forward.
Finally, you will see that we provide the child with plenty of tools before asking them to do the hardest step – facing their traumatic memories. In this way, we slowly prepare the child to take the last (and most important) steps of therapy.
Overall, I hope that this brief summary of how I treat trauma will answer some questions for you as a parent as to how we help a child recover from very traumatic experiences. Mostly, I hope that you feel some hope for your child and know that, no matter what scary or horrible event has occurred, we have powerful tools to help them move forward in life.
Please know - f you are reaching out following an acute trauma, please let me know during your initial contact. At times, I am able to find emergency availability to accommodate a child, teen or adults following a recent trauma.