Trauma focused cognitive behavioral therapy

Once the disorder has set in, how do you rewire a brain that is convinced it is still in danger?

The most robust, rigorously tested evidence we have is for specific psychological therapies, namely trauma-focused cognitive behavioral therapy, or TFCBT, and prolonged exposure, or PE.

Prolonged exposure sounds intensely intimidating for a patient whose entire pathology is based on avoiding the trauma.

What does that actually look like in a therapist's office? You have to take them back into the citadel, past the ringing bells, and force them to look at the frozen clock.

You can.

And even those, my wonderful colleagues who do TFCBT, and I do it at times as well, although I'm not as well-trained as I should be, but it's not always the case that a trauma narrative is done in trauma-focused CBT.

There's many other ways in which the child and their caregivers are helped to understand the reactions as ways of reacting that are exactly what I'm talking about because of that kind of internal alarm.

and ways that they can then turn that alarm down and so that it's not a just ready to go off and interfering with concentration or attention or triggering hyper arousal or reactive behavior so I think that the important thing that we figured out is if you know, if you're working with a kid and they have and they meet criteria for one of those disruptive behavior disorders, that if you also know enough about their life story and are being careful and doing a kind of behavior analytic approach of looking for what is what are the discriminative stimuli that are associated with the problem behavior and the consequences, that may then unfortunately reinforce that behavior.

So like I used to be trained, not, I didn't get, what is it, certified because I was at a job when I did it.

I went through thorough training on TF-CBT for children, trauma-focused CBT for kids.

And one of the things that I remember that they drilled in our head In some agencies, unless it's complex trauma, more than one traumatic experience, they are only allowed to bill for 15 sessions, which means that we have to convey to the child and to the caregiver and the parent that, hey, we are going very direct here outside of the intake because we got $15.

sessions, right? I cannot stray away from the evidence-based practice.