Trauma Focused Cognitive Behavioral Interventions: Trauma Informed Care
Channel: Doc Snipes
Date: 2017-04-17

Learn how to use CBT to enhance resilience and safety when addressing trauma.
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Cultural Considerations
~    Meet the child and family where they are by presenting information in a way in which they can relate it to their own belief system.
~    Assess general beliefs about the trauma
~    Focus on the events THEY perceive as traumatic
~    Tailor the psychoeducational information so the family can be more receptive to it.
~    General views of mental health and mental health treatment should be assessed and addressed.
~    Demystify
~    Destigmatize/normalize

Parent Sessions
~    Provide a rationale and overview of the treatment model.
~    Educate parents about the trauma.
~    Talk about:
~    The child's trauma-related symptoms
~    How early treatment helps prevent long-term problems
~    The importance of talking directly about the trauma to help children cope with their experiences.
~    Reassure parents that children will first be taught skills to help them cope with their discomfort and that talking about the trauma will be done slowly, with a great deal of support and discussion.
~    Help the caregiver understand their role in the child's treatment, since this treatment model emphasizes working together as a team.
~    Parent input, questions, and suggestions are welcome
Stress Management Techniques
~    Controlled Breathing
~    Helps slow heart rate
~    Triggers “rest and digest”
~    Thought Stopping

Stress Management Techniques
~    Relaxation Training
~    Persons of Asian and Hispanic origin tend express stress responses in more somatic (i.e., physical) terms
~    When deciding how to present relaxation techniques, be creative.
~    Have the child help you to integrate elements into the technique to make it more relevant to them.
~    Have the child identify methods that he/she uses to relax (drawing, listening to music, walking…)
~    Be sensitive to children’s wishes if they do not wish to close their eyes or lie down
~    Parents can often also benefit from relaxation training
Feelings Identification
~    Helps therapist judge child’s ability to identify and articulate feelings
~    Teaches the child how to rate the intensity of the emotion
~    Teaches how to express feelings appropriately in different situations
~    Some children may have difficulty initially identifying and/or discussing their own feelings.
~    Try discussing the feelings of other children or characters from books or stories
~    Help children identify how they experiences emotions if they seem detached from the experience.
~    Introduce the difference between thoughts and feelings.
~    Many children describe thoughts when asked to identify feelings
~    How would you feel? I would want to run away.

Summary
~    TF-CBT  can be an effective intervention for children or adolescents whose primary presenting issue is trauma-related emotional or behavioral dysregulation
~    TF-CBT is not appropriate for clients who are actively suicidal, severely depressed or currently abusing substances.
~    TF-CBT starts with psychoeducation, then teaches stress management and coping skills to aid in the management of distressing feelings.
~    Psychoeducation helps to clarify inappropriate information children may have
~    Feelings identification helps participants start effectively labeling and communicating their feelings

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