The information in this program outline is provided by the program representative and edited by the CEBC staff. The Trauma-Focused Coping (TFC) program has been rated by the CEBC in the area of: Trauma Treatment (Child & Adolescent).

• Types of Maltreatment: Physical Abuse, Sexual Abuse, Physical Neglect, Emotional Abuse, Exposure to Domestic Violence
• Target Population: Children and adolescents in schools who have suffered a traumatic exposure (e.g., disaster, violence, murder, suicide, fire, accidents)

TFC targets the internalizing effects of exposure to trauma in children and adolescents, with an emphasis on treating posttraumatic stress disorder (PTSD) and the collateral symptoms of depression, anxiety, anger, and an external locus of control [i.e., tendency to attribute one’s experiences to fate, chance, or luck]. The intervention utilizes social learning theory and a skills-oriented cognitive-behavioral approach that is carried out in 14-week sessions of gradual exposure, moving from psycho-education, anxiety management skill building, and cognitive coping training to finally trauma narrative and cognitive restructuring activities.

The goals of Trauma-Focused Coping include:

• Reduction/end of PTSD, depression, and anxiety symptoms.
• Reduced anger expression.
• A move to internal locus of control (i.e., tendency to believe that one has control one’s own destiny).

The essential components of Trauma-Focused Coping include:

• Psychoeducation
• Anxiety Management
• Anger Coping
• Grief Management
• Individual Pull-outs (Narrative Exposure)
• Group Narrative Exposure
• Affective Processing
• Relapse Prevention
• Group Intervention
  

Trauma-Focused Coping (TFC) was designed with a child component that addresses the following presenting problems and symptoms:

• PTSD, depression, anxiety, and anger

Age range: 9 – 18

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Family members must be aware and supportive of their child’s involvement in the school or clinic based groups.  Meeting with family members prior to starting the group, midway, and at the end of treatment is encouraged.In schools, guidance counselors or school social workers can co-lead the TFC groups with a clinician. Principals can attend last session to hand out celebratory certificates.

Trauma-Focused Coping (TFC) was not designed with a parent/caregiver component.

Trauma-Focused Coping (TFC) was designed to be conducted in a group setting, and has been tested for use in a group setting.

Recommended group size:

4-10

Testing References:

March, J. S., Amaya-Jackson, L., Murray, M. C., & Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. Journal of the American Academy of Child and Adolescent Psychiatry, 37(6), 585-593.

Recommended Intensity:

14 group sessions (40-50 minutes) + 1½ hour pullout

Recommended Duration:

3½ to 4 months

This program is typically conducted in a(n):

• Community Agency
• Outpatient Clinic
• Residential Care Facility
• School

Trauma-Focused Coping (TFC) includes a homework component:

Every session children are assigned skills to practice which are reviewed in following session.

Trauma-Focused Coping (TFC) has materials available in a language other than English:

French

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

The typical resources for implementing the program are:

Manuals, space, trained personnel, flip charts, and blackboard/dry erase board

Mental health provider with a Master’s Degree and license are required for the group lead. Co-lead can be Bachelor's level guidance counselor. TFC is a trauma-specific cognitive-behavioral therapy (CBT) model with the majority of the same practice components of other trauma-specific CBT evidence-based models. Experience with these models serves as an excellent resource prior or in augmentation of TFC.

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contacts:

• Ernestine Briggs-King, PhD, Director, Trauma Evaluation and Treatment Program
  Duke University Medical Center
  dept.: Trauma Evaluation and Treatment Program
  Brigg014@mc.duke.edu
  phone: (919) 419-3474 x228
• Robert Murphy, PhD, Executive Director
  Duke University Medical Center
  dept.: Center for Child and Family Health
  Robert.Murphy@duke.edu
  phone: (919) 419-3474 x291

Training is obtained:

Clinicians with cognitive-behavioral therapy (CBT) aptitude and work with schools may only need the treatment manual and accompanying implementation manual. In addition, 2-day trainings with/without additional phone consultation are available on-site.

Number of days/hours:

This is negotiable—1-2 days is the usual.

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being