關注創傷的認知行為療法

JR （not his real name） was very bitter when he came to the emergency shelter at Family Connection， Inc.， in Birmingham， AL. He’d clashed with his mom and her boyfriend and experienced physical abuse. He didn’t want a relationship with his mom anymore and suffered from low self-esteem. He thought his mom had chosen the boyfriend over him， and he felt no one would ever choose him.

To help JR come to terms with the things he’d gone through， clinical staff at Family Connection used a popular evidence-based practice called Trauma-Focused Cognitive Behavioral Therapy. TF-CBT， as it’s called， helps youth see how post-traumatic stress manifests itself in their thoughts， emotions and behaviors. The therapy’s goal is to provide an outlet for youth to find what works for them—what soothes them and lets them heal emotionally.

In JR’s case， “We worked through all those feelings， and got Mom involved in counseling too，” says Residential Program Director Brandi Horton. “She ultimately ended up breaking up with the boyfriend and making changes for herself too once she saw how her behaviors were affecting her son.”

TF-CBT is typically delivered in 12 to 16 therapy sessions. Therapist and youth can work one-on-one， in joint sessions with a parent or caregiver， or in a group setting. The therapy includes the following steps：

Assess trauma. The therapist looks into the youth’s history of traumatic exposure， post-traumatic stress disorder symptoms， and behavior.

Define goals. The therapist and youth make a plan for how they will measure progress over time and how they will know the young person is better.

“Normalize” symptoms to reduce self-blame. The therapist enables the young person to draw a dotted line between past experiences and the actions they take every day， so they won’t just think they are “bad” people.

Involve caregivers， if possible. Parents and caregivers often naturally block out family trauma and minimize it because they don’t want to think about it， as JR’s mom had likely done. But it's critical to train adults invested in young people’s recovery on how to react when young people show symptoms of trauma， says Creeden. And involving them in the process allows them to see what it means for young people to get better. That can help the adults heal， too.

Teach coping methods. The therapist introduces young people to practices they can use every day， such as relaxation and mindfulness techniques.

In the end， TF-CBT enabled JR to return home. His relationship with his mom blossomed， and he became more involved in school， Horton says.