Tf-cbt cert Exam Rated A+
Alexa is an 8-year-old girl who disclosed sexual abuse by her two older adolescent
stepbrothers. While developing the first part of her trauma narrative, she wrote "I am a
bad girl. I think they messed up my body. I was really dumb because I never told
anyone." - Answer- 1. Alexa's statements are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
2. How should the therapist proceed? (Alexa case) - Answer- a) Tell Alexa that it is not
her fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narrative and then begin cognitive processing of
the trauma narrative, including her statements.
c) Repeat the earlier components, beginning with Psychoeducation as this is a clear
example of the therapy not "sinking in."
d) Ask Alexa to start the trauma narrative again but this time tell her to only include
details about the sexual abuse, not any statements about herself or any thoughts.
Justin is an 11-year-old boy who witnessed his father brutally attack his mother with a
baseball bat. During the middle of writing his trauma narrative, he wrote that he
intervened and attempted to defend his mother by fighting his father. However, during
individual sessions with his mother, it became apparent that Justin had hidden behind
the sofa and cried during the attack. - Answer- 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Justin about the
inaccuracy immediately.
b) Talk to Justin about the difference between the "truth" and a "lie."
c) Recognize that it is not unusual for children to make fantasy or rescue statements;
allow Justin to complete his trauma narrative and gently challenge his statements.
d) Talk with Justin's father to determine whether Justin or his mother is telling the truth;
then share this information with Justin.
In the example above, there is a concern that the father may have access to the home
and the therapist is worried about Justin's safety. The therapist is concerned about
following the TF-CBT model with fidelity and is not sure whether it is okay to implement
"Enhancing Safety and Future Development" without completing the earlier
components. - Answer- 4. How should the therapist proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Justin and his mother would then blame themselves
for the domestic violence.
c) Engage in short-term safety planning with Justin and his mother.
d) Engage Justin in In Vivo Desensitization as his concern about safety is a cognitive
distortion.
, Monty is a 7-year-old boy who was a victim of sexual abuse for two years by his
adoptive parents. As part of the assessment, he completed the UCLA PTSD Reaction
Index and his total score was in the severe range, including very serious re-
experiencing symptoms. When the therapist discussed the TF-CBT treatment approach
with him, including that he would be writing his story about the sexual abuse, Monty
became excited and began to discuss the trauma in great detail. So, the therapist,
encouraged by Monty's willingness to talk, complied with his wishes and allowed him to
create his trauma narrative over the first three treatment sessions. During and after the
completion of the trauma narrative, Monty's behavior began to deteriorate, including
acting-out sexually, soiling himself, refusing to sleep in his own room, and engaging in
other dangerous behaviors that warranted a short-term hospitalization. - Answer- 5.
What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; initiated Psychoeducation
and subsequent skills-based components before moving to the trauma narrative.
b) Briefly reviewed the initial four TF-CBT components and started the trauma narrative
the next week.
c) Nothing. It is imperative to follow a child's cues and wishes rather than a more
directive approach.
d) Skipped the trauma narrative entirely because it is important to do just the opposite of
what a child believes he/she needs.
6. Which component of TF-CBT sometimes needs to be implemented out of order,
usually toward the beginning of treatment? - Answer- a) Trauma Narrative, particularly if
a child is extremely anxious.
b) Conjoint sessions to share the narrative, especially for older teens or foster children
who resist having their foster parents involved in treatment.
c) Cognitive Coping, especially if a child has distortions about the abuse.
d) Psychoeducation; sometimes this component can be left for later in treatment or
skipped altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problematic
avoidant behaviors
Jody is a 6 year-old girl who was attacked by a dog and left with severe scars all over
her legs. Since the dog attack, Jody has experienced severe PTSD symptoms and
significant oppositional behavior problems. Her mother has felt intense guilt as Jody
almost died from the attack. She now cannot say no to anything her daughter wants.
The mother also reported that Jody's behavior is extremely difficult to manage and the
mother just cannot take her anywhere. Jody has tantrums at the drop of a pin and
becomes fearful when there is any mention of a dog. - Answer- . In the first TF-CBT
session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeducation and express optimism about her ability to help mother and
child in 12 to 16 sessions.
c) Explain to mother that Jody has serious PTSD symptoms and that treatment will likely
continue for 1-2 years.
Alexa is an 8-year-old girl who disclosed sexual abuse by her two older adolescent
stepbrothers. While developing the first part of her trauma narrative, she wrote "I am a
bad girl. I think they messed up my body. I was really dumb because I never told
anyone." - Answer- 1. Alexa's statements are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
2. How should the therapist proceed? (Alexa case) - Answer- a) Tell Alexa that it is not
her fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narrative and then begin cognitive processing of
the trauma narrative, including her statements.
c) Repeat the earlier components, beginning with Psychoeducation as this is a clear
example of the therapy not "sinking in."
d) Ask Alexa to start the trauma narrative again but this time tell her to only include
details about the sexual abuse, not any statements about herself or any thoughts.
Justin is an 11-year-old boy who witnessed his father brutally attack his mother with a
baseball bat. During the middle of writing his trauma narrative, he wrote that he
intervened and attempted to defend his mother by fighting his father. However, during
individual sessions with his mother, it became apparent that Justin had hidden behind
the sofa and cried during the attack. - Answer- 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Justin about the
inaccuracy immediately.
b) Talk to Justin about the difference between the "truth" and a "lie."
c) Recognize that it is not unusual for children to make fantasy or rescue statements;
allow Justin to complete his trauma narrative and gently challenge his statements.
d) Talk with Justin's father to determine whether Justin or his mother is telling the truth;
then share this information with Justin.
In the example above, there is a concern that the father may have access to the home
and the therapist is worried about Justin's safety. The therapist is concerned about
following the TF-CBT model with fidelity and is not sure whether it is okay to implement
"Enhancing Safety and Future Development" without completing the earlier
components. - Answer- 4. How should the therapist proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Justin and his mother would then blame themselves
for the domestic violence.
c) Engage in short-term safety planning with Justin and his mother.
d) Engage Justin in In Vivo Desensitization as his concern about safety is a cognitive
distortion.
, Monty is a 7-year-old boy who was a victim of sexual abuse for two years by his
adoptive parents. As part of the assessment, he completed the UCLA PTSD Reaction
Index and his total score was in the severe range, including very serious re-
experiencing symptoms. When the therapist discussed the TF-CBT treatment approach
with him, including that he would be writing his story about the sexual abuse, Monty
became excited and began to discuss the trauma in great detail. So, the therapist,
encouraged by Monty's willingness to talk, complied with his wishes and allowed him to
create his trauma narrative over the first three treatment sessions. During and after the
completion of the trauma narrative, Monty's behavior began to deteriorate, including
acting-out sexually, soiling himself, refusing to sleep in his own room, and engaging in
other dangerous behaviors that warranted a short-term hospitalization. - Answer- 5.
What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; initiated Psychoeducation
and subsequent skills-based components before moving to the trauma narrative.
b) Briefly reviewed the initial four TF-CBT components and started the trauma narrative
the next week.
c) Nothing. It is imperative to follow a child's cues and wishes rather than a more
directive approach.
d) Skipped the trauma narrative entirely because it is important to do just the opposite of
what a child believes he/she needs.
6. Which component of TF-CBT sometimes needs to be implemented out of order,
usually toward the beginning of treatment? - Answer- a) Trauma Narrative, particularly if
a child is extremely anxious.
b) Conjoint sessions to share the narrative, especially for older teens or foster children
who resist having their foster parents involved in treatment.
c) Cognitive Coping, especially if a child has distortions about the abuse.
d) Psychoeducation; sometimes this component can be left for later in treatment or
skipped altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problematic
avoidant behaviors
Jody is a 6 year-old girl who was attacked by a dog and left with severe scars all over
her legs. Since the dog attack, Jody has experienced severe PTSD symptoms and
significant oppositional behavior problems. Her mother has felt intense guilt as Jody
almost died from the attack. She now cannot say no to anything her daughter wants.
The mother also reported that Jody's behavior is extremely difficult to manage and the
mother just cannot take her anywhere. Jody has tantrums at the drop of a pin and
becomes fearful when there is any mention of a dog. - Answer- . In the first TF-CBT
session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeducation and express optimism about her ability to help mother and
child in 12 to 16 sessions.
c) Explain to mother that Jody has serious PTSD symptoms and that treatment will likely
continue for 1-2 years.
