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Therapy

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STEP 1


ORIENTATION
  • We will describe the TF-CBT therapy components to your family
  • Our therapist will work with you to better understand your needs and identify a history of traumatic exposure
  • We will work together to establish common goals of therapy and identify you and your child’s goals and indicators of success
  • We encourage caregiver to share their perspective about child’s needs and clarify goals and the mechanisms of treatment: It is important you come every week!

STEP 2


EDUCATION AND REACTIONS
  • It is not your fault!
  • We will teach, normalize, and validate trauma symptoms and discuss exposure to trauma while improving the relationship among family members
  • We may read and play with books, games, internet search, YouTube video, and role plays to educate
  • We will practice important therapeutic skills to include: praise, one-on-one time, selective attention/ignoring, avoiding power struggles, rewards, and consequences.
  • There may be some activities we ask you to do at home and discuss when we meet again and we may ask to observe interactions with kids, practice and coach new skills.

STEP 3


FEELINGS AND AFFECT MODULATIONS
We will work together to help kids identify feelings and develop a vocabulary to use outside of the session and in session, understand they can feel different/conflicting feelings at once- normalize multiple simultaneous feelings, and teach the “Cognitive Triangle”: the association between thoughts, feelings, and behaviors

We will work together to identify feelings at different intensities and identify things to do when feeling sad, down, mad, anxious, etc., and to identify feelings associated with the traumatic event, when it happened, and thinking about it now.

STEP 4


RELAXATION
We will provide you with skills to use in your home and school to manage distress.
We will create a “toolbox” to refer back to when working on your narrative.
We will help you learn the difference between relaxation and distress tolerance and identify and bolster current skills that you’re already using (hobbies, music, sports, etc.)
We may play relaxation games, teach yoga, mindfulness, guided imagery, controlled breathing, progressive muscle relaxation, and listen to music to help guide your relaxation.

STEP 5


POSITIVE IMAGERY AND THOUGHT
Our goal is to make sure you define you, not your trauma. We want to identify unhelpful and inaccurate thoughts.
We will work together to help you and your caregiver to see and evaluate ways trauma exposure may have changed your views of self, the world, family, or your future, and identify more helpful or more accurate ways to think about traumatic exposure, self, world, family, and future and work on consistently replacing old thoughts with new thoughts.

STEP 6


COGNITIVE PROCESSING
We will continue together to work with the Cognitive Triangle: Relationship between Thoughts, Feelings, and Behavior. We will work together to identify thoughts, feelings, and behaviors in hypothetical, non-trauma related real life scenarios (lunchroom, birthday, etc) to identify more helpful or accurate ways to think and feel better when thoughts are associated with distressful feelings or behavior.

We may read books, do handouts that identify/label thoughts, feelings, and behaviors, play thought, feeling, and behavior games.

STEP 7


SHARING THE NARRATIVE
We will work together to identify unhelpful cognitions that need to be processed, separate harmless trauma reminders or triggers from fear, and reduce avoidance that interferes with daily functioning.

We have many different ways to help you retell your story such as: comic strips, collages, drawings, posters, radio shows, songs, raps, poems, or videos.

We may celebrate what you have done with a trusted adult and allow that adult to hear your perspective.

We may identify helpful coping skills for caregiver, if needed.

STEP 8


ENHANCING SAFETY
We will work together to provide a safety plan to help you and your caregiver feel safer and confident, develop a safety plan in the event of self-injury, suicidal thoughts, etc. and teach safety skills that client can use in the future when not longer attending therapy.

STEP 9


GRADUATION
We will celebrate your success!

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