User:Hhmilius/Trauma focused cognitive behavioral therapy

Sections that were edited *My edits are in bold*
Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. This treatment was developed and proposed by Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger in 2006. The goal of TF-CBT is to provide psychoeducation to both the child and non-offending caregivers, then help them identify, cope, and re-regulate maladaptive emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced or witnessed traumatic events, including but not limited to physical or sexual victimization, child maltreatment, domestic violence, community violence, accidents, natural disasters, and war. More recently, TF-CBT has been applied to and found effective in treating complex posttraumatic stress disorder.

Psychoeducation and parenting skills. Information about trauma responses and reminders are given, normalized, and validated. Caregivers are also given strategies to respond to these trauma responses. Education on trauma reminders (e.g., the cues, people places etc associated with the trauma event) helps explain to children and caregivers how PTSD symptoms are maintained. '''An additional goal of many psychoeducation sessions is to explain the role of the brain in PTSD symptomatology. Generally, the amygdala, or the "fear center" of the brain, is hyper-responsive, and the prefrontal cortex, which is involved in processing, decision making, and down-regulation, is less active, or even reduced in volume. Usually, the prefrontal cortex will work to process the signals sent through the amygdala, assisting in regulated responding to stressful events. These connections have been found to be reduced in patients with PTSD, further explaining the heightened levels of fear responding to trauma reminders. This information can be broken down in several "child-friendly" methods (e.g., the hand model of the brain ) and efficiently leads into the second module of TF-CBT: relaxation.'''

Relaxation. The child and caregiver are educated on skills that inform relaxation in order to cope with their stress responses. '''Some examples of techniques taught are progressive muscle relaxation, paced breathing, or guided visualization. '''

Affective Expression and Regulation. This component assists the child in becoming more comfortable or knowledgeable regarding the expression of feelings and thoughts, so that they may practice and develop skills in order to manage their stress response. The caregivers are educated on these skills and encouraged to practice using the emotion-language taught in session when trauma reminders are brought up at home.

Cognitive Coping. This component helps both the child and caregiver recognize maladaptive thoughts, feelings, and behaviors and replace them with more accurate responses. '''This section can be more challenging for clients, particularly for younger children. The cognitive triangle (thoughts, feelings, and behaviors) is used to exemplify how these processes interact. Children are then guided through the identification of negative everyday thoughts (e.g., I sit alone at lunch because no one likes me), and these skills are then adapted to negative thoughts surrounding the traumatic event (e.g., "this happened to me because I am a bad kid"). '''

Many children are exposed to multiple events, or chronic trauma. These persistent experiences of traumatization impact a child's ability to form primary attachments, which may lead to an array of difficulties and is often referred to as "complex trauma." Complex trauma has sometimes been viewed as more difficult to treat, as its characterized by heightened levels of affective dysregulation, difficulties with attachment security, dissociation, and a fragmented sense of self. More recent research has identified TF-CBT as an effective approach for treating children with complex posttraumatic stress, one article finding that those with complex PTSD showed a greater reduction in their symptoms following treatment than those who had non-complex PTSD. '''In the United States, the concept of complex trauma is recognized, but it is not considered a distinct diagnosis based off of the text revised version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR). Countries other than the United States who use the International Classification of Diseases (ICD) have recently recognized complex PTSD (CPTSD) as its own disorder in the ICD-11 revised edition. The benefits of its inclusion in the ICD-11 are that it may lend to more individualized treatments that better address the nature of the trauma, as well as contribute to the research pool surrounding stress-related disorders. Some listed challenges, especially in light of its consideration to be added to the DSM-5, were that complex trauma may function better as a purely dimensional disorder, which is not reflective of the current diagnostic system, and that there is not enough identified psychometric properties to warrent its inclusion. '''