Trauma-Focused CBT (TF-CBT)
in person for Lubbock, TX and virtually for all of Texas
TF-CBT is the most rigorously researched and widely used treatment for childhood trauma. It helps children and adolescents process traumatic experiences — and actively involves parents and caregivers as partners in healing.
Accepting new clients --- Most Insurances Accepted
IS THIS RIGHT FOR YOU?
Who Is TF-CBT For?
TF-CBT was developed for children and adolescents ages 3–18 who have experienced trauma. It may be the right fit if:
-
Your child has experienced abuse, neglect, domestic violence, a traumatic loss, a serious accident, or another traumatic event
-
You've noticed changes in your child's behavior, mood, sleep, or school performance since the trauma
-
Your child is showing signs of PTSD — nightmares, avoidance, hypervigilance, emotional outbursts, or withdrawal
-
Your child has been acting out sexually in ways inconsistent with their development (a common response to sexual abuse)
-
Your child struggles to talk about what happened, but their behavior tells you something is wrong
-
As a parent, you feel helpless, overwhelmed, or uncertain about how to help your child heal
-
Your child has been evaluated and trauma-focused therapy has been recommended
TF-CBT works best when a caregiver is actively involved. Healing isn't something that just happens in the therapy room — it happens in the relationship between your child and the people who love them.
THE APPROACH
How TF-CBT Works
TF-CBT is a structured, short-term treatment developed specifically for children and adolescents who have experienced trauma. Unlike adult trauma treatments that focus primarily on the individual, TF-CBT actively involves a non-offending parent or caregiver as a full participant in treatment. Research consistently shows that caregiver involvement significantly improves outcomes — children heal faster and more completely when the adults in their lives are equipped to support them.
TF-CBT follows a structured sequence of components remembered by the acronym PRACTICE: Psychoeducation about trauma and its effects, Relaxation skills, Affective modulation (managing difficult emotions), Cognitive coping (understanding the connection between thoughts, feelings, and behaviors), Trauma narration and processing (creating and working through the child's trauma story), In vivo mastery of trauma reminders (addressing avoidance), Conjoint child-caregiver sessions (sharing the narrative and practicing skills together), and Enhancing safety and future development. Children and caregivers receive parallel sessions — children work on their components with the therapist while caregivers receive the same skills training. This parallel structure ensures both the child and the caregiver are developing the same tools at the same pace.
The trauma narration component — where the child creates a book, story, or other narrative account of their traumatic experience — is often what parents find most difficult to understand. Why would we ask a child to revisit something so painful? The answer is the same as in Prolonged Exposure: avoidance maintains PTSD. Helping a child articulate their experience in a structured, therapist-guided way allows the memory to be processed rather than pushed away, and the parent's ability to hear and respond to the narrative without falling apart is one of the most healing things a child can experience. TF-CBT is typically completed in 12–25 sessions.
Evidence-Based Care
TF-CBT is endorsed by SAMHSA, the CDC, and the Office of Juvenile Justice and Delinquency Prevention as a top-tier evidence-based treatment for childhood trauma.
80%+ of children completing TF-CBT show significant reductions in PTSD, depression, and behavioral problems — with gains maintained at follow-up
THE PROCESS
What to Expect
Step 1: Reach Out
We'll match your child with a TF-CBT trained therapist. We'll also ensure the therapist is a good fit for your child's age, trauma type, and family situation.
Step 2: Your First Session
Treatment begins with psychoeducation and skill-building — no trauma narration happens until your child has the coping skills to handle it. Your therapist will explain every step before it happens.
Step 3: Start Making Progress
As treatment progresses, most children and families experience a profound shift — the trauma becomes something that happened, not something that defines. Caregivers often report feeling closer to their child and more confident in supporting them.
COMMON QUESTIONS
Frequently Asked Questions
Will my child have to talk about the trauma in detail? -- Your child will eventually create a trauma narrative — but not until they've developed the coping skills to handle it, and not in a way that is simply re-traumatizing. The narrative is structured, therapist-guided, and paced carefully. Many children actually find it empowering to put words to what happened — especially when their caregiver can hear and respond without breaking down. It's one of the most healing moments in TF-CBT.
What is my role as a parent? -- Your role is significant and essential. While your child is in session, you'll receive parallel sessions covering the same skills — psychoeducation, coping tools, and how to support your child at home. You'll be prepared to hear the trauma narrative without your own distress overwhelming your child, and you'll learn how to respond to trauma-related behaviors in ways that help rather than inadvertently reinforce avoidance.
What age range is TF-CBT appropriate for? -- TF-CBT has been validated for children ages 3–18. The format and language are adapted developmentally — younger children use more play-based approaches; older adolescents engage more cognitively. For very young children (under 5), the work is highly play-based and caregiver-centered.
Is TF-CBT effective for sexual abuse? -- Yes — TF-CBT was originally developed for children who had experienced sexual abuse, and it has the strongest evidence base for this population. It is highly effective for reducing the behavioral and emotional effects of childhood sexual abuse, including sexualized behaviors, shame, PTSD symptoms, and behavioral difficulties.
What if my child refuses to talk about the trauma? -- This is very common — and TF-CBT is designed for it. The early phases of treatment focus entirely on skill-building, not trauma discussion. By the time trauma narration begins, most children have developed enough trust, coping skills, and safety that they can engage. The therapist also has many creative approaches — children can express their narrative through drawing, storytelling, poetry, or other forms that feel less directly threatening than talking.
Can TF-CBT be done via telehealth? -- Yes. TF-CBT has been delivered effectively via telehealth and research supports its effectiveness in online formats. The parallel structure with parents and children works particularly well in a home environment. We offer telehealth TF-CBT to families anywhere in Texas.
What if the offending person is a family member? -- This is a common situation in childhood trauma cases, particularly sexual abuse. TF-CBT is specifically designed for non-offending caregivers — parents, grandparents, foster parents — who are not the source of the trauma. Your therapist will work with you to navigate the complexity of family relationships while prioritizing your child's safety and healing.
How long is TF-CBT? -- TF-CBT is a structured, short-term treatment typically completed in 12–25 sessions. The length depends on the complexity of the trauma, the child's age and coping skills, and caregiver involvement. It is one of the shorter effective trauma treatments available — most families see it as a focused course of treatment rather than open-ended therapy.
How do I get started? -- You can reach out through our contact page or click the Get Started button to request an appointment. Taking that first step is often the hardest part — I'm glad you're here.
CONDITIONS WE TREAT
Issues We Treat with Prolonged Exposure
TF-CBT is used at Flatland Counseling primarily for childhood and adolescent trauma of all types.