COMPLEX PTSD
COMPLEX PTSD
TF-CBT is a components-based model that consists of individual sessions for the child, collateral sessions with the caregiver, and conjoint sessions that involve both the child and caregiver (Ascienzo, et. al., 2019, p. 1658).
The components of TF-CBT are:
Psychoeducation and Parenting skills
Relaxation skills
Affect regulation
Cognitive coping and Cognitive processing of the trauma narrative
Construction of a trauma narrative
In vivo mastery of trauma reminders
Conjoint child-caregiver sessions
Enhancing future safety
Lewey, et. al. (2018) studied the effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in adolescents and children with C-PTSD. Empirical studies have shown that TF-CBT is a highly effective therapy modality for young children who have experienced sexual abuse, suffering from PTSD, anxiety, depression, and feelings of mistrust and shame. TF-CBT also helps children and parents create new skills to manage symptoms of C-PTSD. Research also shows greater increases in better parenting practices and child behavior problems.
TF-CBT can bse uses in a variety of settings and with many different populations. Recent studies have shown that the trauma narrative component is the most effective means of decreasing parental distress and child anxiety.
Research (Redman & Piedfort-Marin, 2017; Smith, Dalgleish, & Meiser‐Stedman, 2019) shows that a phased approach to TF-CBT is the best option for both children and adults. This approach is widely accepted in the US and in Europe and is recommended by the National Institute for Health and Care Excellence (2018) .
Phased TF-CBT is done in three steps.
Phase 1 focuses on stabilization which includes creating a safe environment, secure working relationship with the clinician, and by reducing self-regulation problems and by improving emotional social and psychological competence. Experts agree that the stabilization phase is especially important for C-PTSD clients.
Phase 2 focuses on trauma memories
Phase 3 focuses on integration, rehabilitation, and preparing for a new way of living.
Kaminer & Eagle (2017) completed a meta-analysis of evidence-based treatments for posttraumatic stress disorder and complex posttraumatic stress disorder. They found that CBT interventions for for C-PTSD (whether of child or adult onset) advocates a multimodal, phase-based approach, starting with the development of emotion regulation and interpersonal skills using Dialectical Behavioral Therapy (DBT) based techniques and then moving on to more traditional TF-CBT treatments such as Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT) to address PTSD symptoms.