TF-CBT EXAM STUDY GUIDE WITH
ACCURATE ANSWERS 2026
COMPLETE REVIEW PACKAGE
◉ 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.
ACCURATE ANSWERS 2026
COMPLETE REVIEW PACKAGE
◉ 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.
