Trauma-Focused Cognitive Behavior Therapy: Clinical Considerations for Children and Adolescents

Childhood trauma is no longer the exception; it is the norm. Early development in typically developing children sets the foundation for understanding trauma and its long-term impacts. Attachment Theory gives language to trauma reactions, emphasizes the role of caretakers, and informs trauma treatment methodologies. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), an evidence-based, manualized treatment, is the preferred treatment for the diagnosis of Post-Traumatic Stress Disorder in children and adolescents. This thesis uses a case study design and relevant literature to explore the clinical implications of TF-CBT. All the participants were personal clients at an outpatient community mental health clinic specializing in trauma care. This study analysis underscores the importance of the therapeutic alliance as an unrecognized yet vital step of TF-CBT, the role of attachment and caregivers, areas of cultural sensitivity, and the need for additional diagnoses for children and adolescents. The subjectivity of trauma and the importance of safety pose difficulties for the clinician that require attunement and nuance. The business of psychological trauma dictates and limits a clinician's ability to meet clients' needs. The current study supports the theoretical evidence of social relationships at the core of growth and healing, a key element to supporting survivors of childhood trauma in treatment.