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How to Implement Trauma Focused CBT

Why Trauma-Focused Cognitive Behavioral Therapy?

1. TF-CBT is recognized as being one of the most effective interventions for children who have significant psychological symptoms related to trauma exposures.

A. True

B. False


2. Which of the following are facts about TF-CBT?

A. It works for children who have experienced any trauma, including multiple traumas

B. It is effective with children from diverse backgrounds

C. It has been used successfully in clinics, schools, homes, residential treatment facilities, and inpatient settings

D. It works even if there is no parent or caregiver to participate in treatment

E. All of the above


An Overview of TF-CBT

3. Which of the following statements is NOT made in this paper?

A. TF-CBT is a short-term treatment approach that can work in as few as 12 sessions.

B. TF-CBT may also be provided for longer periods of time depending on the child’s and family’s needs.

C. TF-CBT focuses solely on the child who has experienced trauma.

D. As with any therapy, forming a therapeutic relationship with the child and parent is critical to TF-CBT.


4. Which of the following are typical PTSD symptoms children experience?

A. Intrusive and upsetting memories, thoughts, or dreams about the trauma

B. Avoidance of things, situations, or people which remind them of the trauma

C. Emotional numbing

D. A and B above

E. A, B and C above


5. TF-CBT typically includes parents or caregivers in treatment because when children experience serious traumas, other family members are also affected.

A. True

B. False


6. TF-CBT can only work for children who have a parent available to participate in treatment.

A. True

B. False


7. When is TF-CBT NOT the first or most important therapy needed?

A. When their predominant problems are disruptive behaviors such as defiance, disobedience, aggression, or rule- or law-breaking

B. When a child is severely depressed or suicidal

C. When a child is an active substance abuser

D. A and B above

E. A, B and C above


Implementing TF-CBT

8. Key stakeholders who will directly affect how successfully TF-CBT is implemented in a clinic include:

A. Clinicians who will be asked to provide TF-CBT

B. Finance staff

C. Clinical supervisors and other direct service providers

D. All of the above

E. A and C above


9. Community partners that may provide referrals, as well as social and fiscal support include:

A. Law enforcement professionals

B. Child Protective Services (CPS)

C. Clergy

D. School counselors and teachers

E. All of the above


10. Organizational readiness refers to (choose the best answer):

A. How well prepared the organization is financially

B. How ready the organization is to commit to learning something new

C. How ready an organization is to make the changes required at various organizational levels to successfully implement and sustain a new practice


11. With regard to TF-CBT pre-implementation training, which of the following is important to consider according to this paper?

A. Training therapists

B. Recognizing who besides therapists need to receive some kind of pre-implementation training phase, e.g., administrators, supervisors, receptionists, intake coordinators and others

C. Therapists receive training in three phases: Web-based training; live training; and ongoing expert consultation

D. All of the above

E. A and B above


12. Implementation refers to

A. Actually providing high quality TF-CBT treatment sessions

B. Putting into play the coordinated efforts of staff, clinicians, supervisors, and administrators so that TF-CBT is provided effectively

C. Ensuring TF-CBT is being implemented in a systematic and transparent manner


13. Some key reasons to adopt and implement TF-CBT include:

A. These days the best agencies all use evidence based interventions

B. There are increasing expectations that services must prove effective

C. Results that can be achieved with short-term intervention are more cost effective

D. All of the above

E. B and C above


14. Which of the following is NOT one of the two key requirements for TF-CBT implementation noted in this paper?

A. Organizational leadership that supports use of evidence-based interventions

B. Patients willing to make us of TF-CBT

C. Training and specific ongoing supervision


15. Program administrators should expect that therapists will be able to gain the new skills needed to implement TF-CBT in matter of two or three sessions.

A. True

B. False


16. All TF-CBT clinical supervisors should receive TF-CBT training and should have access to ongoing supervisory expert consultation as part of implementing TF-CBT.

A. True

B. False


17. According to this paper, two key reasons clinical supervisors should support the implementation of TF-CBT are:

A. Clinical supervisors are committed to providing the best services to clients.

B. Implementing TF-CBT is a good way to add a new service to an agency's offerings

C. TF-CBT works for the kinds of traumatized children and problems typically seen in community agencies

D. A and B above

E. A and C above


Delivering TF-CBT

18. With TF-CBT the therapist, parents, and child all work together to identify and attain common goals.

A. True

B. False


19. Knowledge about different cultures helps therapists to differentiate between:

A. Right and wrong attitudes

B. Values that are commonly held by a particular cultural group and idiosyncratic practices or beliefs

C. What works in one culture and not another


20. Three case studies in this paper illustrate the TF-CBT approach of engaging cultural experts to help children and families differentiate between common values within their culture and beliefs that are idiosyncratic or unique to one family.

A. True

B. False


21. Which of the following statements is supported in this paper?

A. A key requirement of TF-CBT is the therapist’s ability to tolerate hearing and talking about children’s trauma experiences.

B. Evidence shows that becoming able to remember and talk about the trauma without extreme distress is central to resolving trauma’s impact.

C. It is crucial for children to see that their TF-CBT therapists can tolerate hearing about their traumatic experiences, as well as their accompanying emotional reactions

D. All of the above

E. A and C above


Maintaining TF-CBT

22. Which of the following statements accurately addresses the concern for fidelity to the TF-CBT process?

A. Therapists should deliver TF-CBT treatment in the sequence in which the components are described in the treatment manual and in training

B. The learning is sequential in that later sessions build on skills learned in earlier sessions

C. Treatment should stick to the schedule, ensuring components never overlap or are repeated

D. All of the above

E. A and B above


23. A concern when TF-CBT is used by a novice therapist without good supervision is that the therapist may simply respond to whatever problems the family presents each week with a variety of different interventions.

A. True

B. False


24. This paper suggests which of the following to support experienced therapists in maintaining fidelity to the TF-CBT process?

A. Persuading them to try the model with a single child to start

B. Pointing out the similarities between TF-CBT and what experienced therapists are already providing to traumatized children

C. Presenting cases of successful TF-CBT treatment of children who had problems or trauma histories similar to those of the children a therapist is seeing

D. All of the above

E. A and C above


Additional Clinical Considerations

25. The TF-CBT components that address symptoms resulting from multiple traumas produce benefits without necessarily being tied to a particular traumatic event.

A. True

B. False


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