Group trauma-focused CBT

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Jaycox, Langley, Hoover

What it is

It is a time-limited, skills-first CBT programme for children and adolescents with PTSD symptoms after trauma, sometimes with depression or grief as well. It is delivered to small groups of peers and, in the TF-CBT form, to their caregivers in parallel. The skill-building components run in group.…

Format

• students whose severe behaviour problems prevent group participation;
• Group TF-CBT. A full trauma-focused assessment comes first. TF-CBT is "not optimal" for children whose main problems are not trauma-related. Where a comorbid problem takes precedence, treat it alongside or stabilise it first. The East African trial included children aged 7–13 whose parent had died…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Low attendance. Use invitations and reminders, and offer phone versions.
• Distress about the group ending. Name it, and link the student to ongoing support.
• Children who rate everything at the extremes. Use concrete anchors from their own life.
• A child starting to describe graphic content. Redirect gently to the individual session.
• Goals that are about other people's behaviour. Reframe them to what the student controls.

Problems the guide addresses

• Overwhelm and dissociation during narrative or exposure
• Risk, disclosure and safety
• Avoidance, refusal and non-adherence
• Group process problems
• Stuck progress and cognitive work
• Ruptures
• Facilitator strain
• Modality-specific cautions

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.