TF-CBT TEST PAPER ALL 2026/2027 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Affective Regulation Module - Developmental Considerations - ✔✔Young Children
For younger children and/or children with verbal or other delays, additional time may be
necessary in teaching the child the names for a wider range of emotions (e.g., beyond
feeling "good" or "bad"). For example, a child may know what it feels like to be
embarrassed, but may not have learned the word "embarrassment" before. For these
kids, the practice of labeling various emotions in session and repetitive role-playing may
be helpful.
School Age Children
School age children, like younger children, enjoy affect identification and modulation
activities that involve movement and activity. School age children often are also
beginning to differentiate between emotional expression in different contexts, such as
home and school. Older elementary school age children may be able to engage in a
"mask" activity, where they create artistic masks to describe emotions that they show
others, emotions that they show their caregivers only, and emotions they keep to
themselves (inside of mask). These masks can be used to facilitate open discussion
between children and caregivers regarding the safety of healthy emotional expression
with the caregiver.
Adolescents
Teens should be expected to master the identification of a wide range of emotions
during this module, including more complex emotions than what's expected of younger
children. Don't forget to include a wide range of positive emotions, as well.
Given adolescents' abstract thinking abilities, adolescents can describe and sort
emotions based on a number of different dimensions to deepen their learning.
Examples include: feelings I like to have vs. feelings I don't like to have; feelings I show
others vs. feelings I hide from others; feelings I know how to deal with vs. feelings that
are hard to manage. Self-conscious emotions, like shame and guilt, may be more ce
✔✔Cognitive Coping Module - Review difference between thoughts and feelings -
✔✔This may have been touched on in Affect Identification and Regulation, but should
be reviewed here. If the child does not always recognize the difference between
thoughts and feelings, this distinction should be explained. The easiest way to do this is
to generate social scenarios that are relevant to the child, prompting the child to identify
feelings and thoughts, and providing corrective information and feedback.
✔✔Cognitive Coping Module - Outline Cognitive Triangle - ✔✔On a piece of paper,
draw a triangle with the words, "Thoughts," "Feelings," and "Behaviors" (or "Actions")
arranged at the corners. Older children can be instructed to draw the triangle
themselves and write the words. Point out that the three words are all connected by the
triangle because that's how it works in real life - thoughts, feelings, and behaviors are all
related to one another. Making reference to the previous module, where the "feeling"
,and "doing" parts of emotions were discussed, might be helpful: now you are adding
thoughts to make a triangle.
✔✔Cognitive Coping Module - Use examples of how thoughts impact behavior -
✔✔Generally, this works best by using an example that you ask the child to imagine
himself or herself in. The example should be taken from the child's own, real-life
experiences, if possible, and should describe a situation in which an inaccurate or
unhelpful cognition might seem "normal;" for example, thinking "they are making fun of
me" when the child meets friends who begin laughing when they the child walks up. It's
a good idea to have several scenarios ready - some that involve inaccurate thoughts,
and others that involve accurate but unhelpful (e.g., "I'm no good at something")
thoughts. In each example, be sure to describe each aspect of the triangle of connected
thoughts, feelings, and behaviors.
✔✔Cognitive Coping Module - Generate scenarios and have the child identify the
thoughts, emotions, and behaviors - ✔✔Ask the child for example situations in which he
or she recently became upset or engaged in avoidance behavior. Have the child identify
thoughts, feelings, and behaviors that took place. It is important first to just have the
child label what actually happened, rather than immediately suggest more accurate or
helpful thoughts. Each scenario can be diagrammed on a separate sheet of paper or
different triangles.
✔✔Cognitive Coping Module - Help the child identify thoughts that may be inaccurate or
unhelpful to help generate more accurate or helpful ones - ✔✔Once you and the child
have identified thoughts, discuss whether those thoughts are accurate and helpful.
Some questions you can ask to help clarify these issues include:
Is the thought true? How do you know?
Is this thought helpful or unhelpful? How do you know?
What kind of emotions and behavior does this thought lead to?
Does thinking this help you feel good about yourself?
Does thinking this help you in your relationships with friends and family?
Does thinking this help you in your daily life?
Does thinking this help you accomplish your goals?
As these questions are discussed, ask the child to consider what other thoughts might
have been possible in that situation, what the feelings and behavior might have been if
the thought had been different, and whether that new thought would be more accurate
or helpful. Some kids are very slow to identify new thoughts, and they might need help
coming up with more helpful ones. In some cases, you may want to pose questions to
the child to elicit more helpful thoughts or hints, or you can make suggestions in the
form of education. But be careful not to just "tell" the child what to think. This activity
lays the foundation for addressing trauma-related thoughts and feelings later in
treatment (see Trauma Narration and Processing II).
✔✔Cognitive Coping Module
, Discuss how to apply this skill in real life - ✔✔It is important to tie the skill into the child's
everyday experience, not just treat it as some unusual exercise they only do in therapy
and on paper. Be explicit in how the technique applies to their lives and trauma-related
symptoms
✔✔Cognitive Coping Module - skills beyond the triangle - ✔✔Although introducing and
explaining the cognitive triangle is important, other cognitive coping activities are also
useful for many children. Positive self-talk, in particular, can be encouraged for
managing stressful situations or trauma reminders. Help the child identify positive or
motivating messages and instruct them to say these expressions to themselves at times
of stress or when experiencing a trauma reminder. Some examples might include "I can
cope with this," "I know some skills to control my feelings," or even "This situation won't
last long, so I can make it."
✔✔Cognitive Coping Module - HW - ✔✔Practice will depend to a large degree on the
developmental level of the child. Generally speaking, we don't recommend giving
practice forms to fill out (e.g., "A-B-C" thought tracking sheets) to anyone who is
younger than 13 or so. However, some 10-12 year-olds do complete these types of
assignments successfully, so you need to be the judge of your client's abilities. The goal
of these homework assignments is to help the child practice identifying his or her
automatic inaccurate and unhelpful thoughts and then to begin to challenge them and
try to replace them with accurate and more helpful thoughts.
For older children (e.g., teenagers), worksheets identifying thoughts, feelings, and
behaviors can be created. Initially, teenagers can be instructed to simply record what
actually happened. When they get the hang of it, the worksheets can become
increasingly complex to include generation of alternative thoughts, feelings, and
behaviors.
✔✔Cognitive Coping - Early Childhood - ✔✔The "cognitive triangle" will not be
particularly useful for most kids younger than about 6 or 7. Cognitive research tells us
that 3-year-olds are generally not able to link thought-feeling-behavior chains, and 4-5-
year-olds are only a little bit better. However, even very young children can understand
the concrete idea of cause and effect, or 'what made that happen?' This can be useful
when trying to get a better appreciation of young children's thought processes. Working
with this age group on "cognitive coping" activities often makes use of story books ("The
Little Engine That Could," is one example of an age-appropriate picture book for
encouraging positive thinking), cartoon balloons to fill in thoughts, feelings, or actions
(like in comic books), and positive self statements (e.g., "I am special;" "I am brave;"
"I'm not good at soccer but I'm really good at catching a ball;" "I make mom happy when
I give her a hug;" "I'm a hard worker"). In addition, while the cognitive triangle may be a
bit too complex for young children to understand, they often can understand the
connection between what they say to themselves (or what their brain says to them) and
how they feel.
SOLUTIONS RATED A+
✔✔Affective Regulation Module - Developmental Considerations - ✔✔Young Children
For younger children and/or children with verbal or other delays, additional time may be
necessary in teaching the child the names for a wider range of emotions (e.g., beyond
feeling "good" or "bad"). For example, a child may know what it feels like to be
embarrassed, but may not have learned the word "embarrassment" before. For these
kids, the practice of labeling various emotions in session and repetitive role-playing may
be helpful.
School Age Children
School age children, like younger children, enjoy affect identification and modulation
activities that involve movement and activity. School age children often are also
beginning to differentiate between emotional expression in different contexts, such as
home and school. Older elementary school age children may be able to engage in a
"mask" activity, where they create artistic masks to describe emotions that they show
others, emotions that they show their caregivers only, and emotions they keep to
themselves (inside of mask). These masks can be used to facilitate open discussion
between children and caregivers regarding the safety of healthy emotional expression
with the caregiver.
Adolescents
Teens should be expected to master the identification of a wide range of emotions
during this module, including more complex emotions than what's expected of younger
children. Don't forget to include a wide range of positive emotions, as well.
Given adolescents' abstract thinking abilities, adolescents can describe and sort
emotions based on a number of different dimensions to deepen their learning.
Examples include: feelings I like to have vs. feelings I don't like to have; feelings I show
others vs. feelings I hide from others; feelings I know how to deal with vs. feelings that
are hard to manage. Self-conscious emotions, like shame and guilt, may be more ce
✔✔Cognitive Coping Module - Review difference between thoughts and feelings -
✔✔This may have been touched on in Affect Identification and Regulation, but should
be reviewed here. If the child does not always recognize the difference between
thoughts and feelings, this distinction should be explained. The easiest way to do this is
to generate social scenarios that are relevant to the child, prompting the child to identify
feelings and thoughts, and providing corrective information and feedback.
✔✔Cognitive Coping Module - Outline Cognitive Triangle - ✔✔On a piece of paper,
draw a triangle with the words, "Thoughts," "Feelings," and "Behaviors" (or "Actions")
arranged at the corners. Older children can be instructed to draw the triangle
themselves and write the words. Point out that the three words are all connected by the
triangle because that's how it works in real life - thoughts, feelings, and behaviors are all
related to one another. Making reference to the previous module, where the "feeling"
,and "doing" parts of emotions were discussed, might be helpful: now you are adding
thoughts to make a triangle.
✔✔Cognitive Coping Module - Use examples of how thoughts impact behavior -
✔✔Generally, this works best by using an example that you ask the child to imagine
himself or herself in. The example should be taken from the child's own, real-life
experiences, if possible, and should describe a situation in which an inaccurate or
unhelpful cognition might seem "normal;" for example, thinking "they are making fun of
me" when the child meets friends who begin laughing when they the child walks up. It's
a good idea to have several scenarios ready - some that involve inaccurate thoughts,
and others that involve accurate but unhelpful (e.g., "I'm no good at something")
thoughts. In each example, be sure to describe each aspect of the triangle of connected
thoughts, feelings, and behaviors.
✔✔Cognitive Coping Module - Generate scenarios and have the child identify the
thoughts, emotions, and behaviors - ✔✔Ask the child for example situations in which he
or she recently became upset or engaged in avoidance behavior. Have the child identify
thoughts, feelings, and behaviors that took place. It is important first to just have the
child label what actually happened, rather than immediately suggest more accurate or
helpful thoughts. Each scenario can be diagrammed on a separate sheet of paper or
different triangles.
✔✔Cognitive Coping Module - Help the child identify thoughts that may be inaccurate or
unhelpful to help generate more accurate or helpful ones - ✔✔Once you and the child
have identified thoughts, discuss whether those thoughts are accurate and helpful.
Some questions you can ask to help clarify these issues include:
Is the thought true? How do you know?
Is this thought helpful or unhelpful? How do you know?
What kind of emotions and behavior does this thought lead to?
Does thinking this help you feel good about yourself?
Does thinking this help you in your relationships with friends and family?
Does thinking this help you in your daily life?
Does thinking this help you accomplish your goals?
As these questions are discussed, ask the child to consider what other thoughts might
have been possible in that situation, what the feelings and behavior might have been if
the thought had been different, and whether that new thought would be more accurate
or helpful. Some kids are very slow to identify new thoughts, and they might need help
coming up with more helpful ones. In some cases, you may want to pose questions to
the child to elicit more helpful thoughts or hints, or you can make suggestions in the
form of education. But be careful not to just "tell" the child what to think. This activity
lays the foundation for addressing trauma-related thoughts and feelings later in
treatment (see Trauma Narration and Processing II).
✔✔Cognitive Coping Module
, Discuss how to apply this skill in real life - ✔✔It is important to tie the skill into the child's
everyday experience, not just treat it as some unusual exercise they only do in therapy
and on paper. Be explicit in how the technique applies to their lives and trauma-related
symptoms
✔✔Cognitive Coping Module - skills beyond the triangle - ✔✔Although introducing and
explaining the cognitive triangle is important, other cognitive coping activities are also
useful for many children. Positive self-talk, in particular, can be encouraged for
managing stressful situations or trauma reminders. Help the child identify positive or
motivating messages and instruct them to say these expressions to themselves at times
of stress or when experiencing a trauma reminder. Some examples might include "I can
cope with this," "I know some skills to control my feelings," or even "This situation won't
last long, so I can make it."
✔✔Cognitive Coping Module - HW - ✔✔Practice will depend to a large degree on the
developmental level of the child. Generally speaking, we don't recommend giving
practice forms to fill out (e.g., "A-B-C" thought tracking sheets) to anyone who is
younger than 13 or so. However, some 10-12 year-olds do complete these types of
assignments successfully, so you need to be the judge of your client's abilities. The goal
of these homework assignments is to help the child practice identifying his or her
automatic inaccurate and unhelpful thoughts and then to begin to challenge them and
try to replace them with accurate and more helpful thoughts.
For older children (e.g., teenagers), worksheets identifying thoughts, feelings, and
behaviors can be created. Initially, teenagers can be instructed to simply record what
actually happened. When they get the hang of it, the worksheets can become
increasingly complex to include generation of alternative thoughts, feelings, and
behaviors.
✔✔Cognitive Coping - Early Childhood - ✔✔The "cognitive triangle" will not be
particularly useful for most kids younger than about 6 or 7. Cognitive research tells us
that 3-year-olds are generally not able to link thought-feeling-behavior chains, and 4-5-
year-olds are only a little bit better. However, even very young children can understand
the concrete idea of cause and effect, or 'what made that happen?' This can be useful
when trying to get a better appreciation of young children's thought processes. Working
with this age group on "cognitive coping" activities often makes use of story books ("The
Little Engine That Could," is one example of an age-appropriate picture book for
encouraging positive thinking), cartoon balloons to fill in thoughts, feelings, or actions
(like in comic books), and positive self statements (e.g., "I am special;" "I am brave;"
"I'm not good at soccer but I'm really good at catching a ball;" "I make mom happy when
I give her a hug;" "I'm a hard worker"). In addition, while the cognitive triangle may be a
bit too complex for young children to understand, they often can understand the
connection between what they say to themselves (or what their brain says to them) and
how they feel.
