<b>PSYCHOEDUCATION</b>: Therapist provided psycho-education (e.g., directive education about the traumatic event, normal reactions to trauma, etc.; education to instill hope)
General info re: abuse, trauma; specific info re: trauma child experienced (GE) and the child's reactions to his/her personal experience of the trauma
Common emotional, behavioral, and physiological responses.
Info about child's symptoms and diagnosis.
Description of components of TF-CBT, session structure, treatment length
Engaged family (e.g., found out what child liked, what motivates the family, etc.)
<b>PARENTING</b>: Therapist provided parenting skills (e.g., praise, selective attention, time out, bx mng plans); ask parent about their reactions to the child's traumatic experience
<b>RELAXATION</b>: Therapist explained the physiology of relaxation and rationale for relaxation techniques; instructed on methods of relaxation
Discuss ways that relaxation skills can help child with trauma reactions (GE); suggest that child use relaxation skills when they have trauma reminders
<b>AFFECT REGULATION</b>: Therapist assisted child in accurately identifying their feelings, and various ways of regulating their emotions (e.g., imagery, thought stopping, positive self-talk)
Accurately identify and express a variety of feelings (positive and negative, in youth's words) (e.g. feelings brainstorm, Color My World, etc.)
Link feelings to situations, body and facial expressions
Teach how to rate intensity levels of emotions (e.g. SUDS, feeling thermometer)
Teach skills of managing emotions and difficult affective states (e.g. positive self-talk, enhancing child's sense of safety, etc.)
Teach skills to identify/cope with array of feelings associated with trauma (GE)
<b>COGNITIVE COPING</b>: Therapist reviewed skill of cognitive coping
Educate child on the distinction and relationship between thoughts, feelings and actions (e.g. acknowledge internal dialogues; introduce cognitive triangle)
Help the child generate alternative thoughts that are more accurate or helpful, in order to feel differently; discuss how to apply to real life
<b>TRAUMA NARRATIVE/COGNITIVE PROCESSING</b>: Therapist worked on a trauma narrative (TN) the child (GE)
Introduce rationale for TN; initiate TN (e.g. title page, timeline/table of contents)
Encourage child, in calibrated increments, to include more details of trauma
Re-read the TN at the beginning of each session (GE)
Ask about and add in thoughts and feelings throughout the TN
Include worst memory/worst moment
Use cognitive processing techniques to modify distortions throughout the TN
Include piece on making meaning (e.g. what they've learned, how they grew)
As TN develops, read each new draft to supportive caregiver in collateral sessions
<b>IN-VIVO DESENSITIZATION</b>: Therapist developed in-vivo desensitization plan for generalized avoidant behaviors
<b>CONJOINT</b>: Conjoint child-parent session: sharing trauma narrative with parent/caregiver
Prepare caregiver and child separately for joint session in which TN is shared
Hold joint session (e.g., re-read TN, model praise, discuss questions prepared by both child and caregiver, praise and celebrate progress made)
<b>ENHANCING SAFETY</b>: Therapist addressed child's sense of safety (e.g. safety skills and safety plan)
Teach personal safety skills and assertive communication; increase awareness
Teach problem-solving skills and/or social skills as needed by the child