Trauma-focused Cognitive-behavioral Therapy with children and adolescents: Practice, evidence base, and future directions

Trauma-focused cognitive behavioral therapy (Tf-CBT) is an evidence-based trauma therapy for children and adolescents aged 3-17 years with posttraumatic stress disorder (PTSD). One supportive caregiver is regularly included in the therapeutic process. Tf-CBT consists of eight components and can be summarized by the acronym P.R.A.C.T.I.C.E: Psychoeducation and Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Based on a total of 13 randomized controlled trials, several meta-analyses and systematic reviews confirm the efficacy of Tf-CBT, which received evidence level la in several international guidelines and is therefore recommended as first-line treatment for children and adolescents with PTSD.