TF-CBT 2026/2027 COMPREHENSIVE EXAM QUESTIONS
AND SOLUTIONS RATED A+
✔✔Which of the following is NOT a therapeutic purpose of creating a Trauma
Narrative? - ✔✔Learning which people, places, or situations to avoid so that trauma
reactions won't be triggered
Avoidance of trauma reminders is not a goal of TF-CBT; all the other options are key
reasons for engaging in trauma narrative development
✔✔LaQuan is a 16 year old young woman referred to you by child welfare due to a long
history of physical abuse and one incident of sexual abuse by caregivers and others.
Your trauma assessment indicated that LaQuan also had been bullied at school and hit,
punched and sexually touched by peers. She also had witnessed many incidents of
violence in the home between her mother and her mother's boyfriend; she has lived her
whole life in a neighborhood that often has violent incidents that frightened her. She
described significant levels of fear and distress for nearly all of these incidents she had
experienced. Which of these traumatic events should be included in her Trauma
Narrative? - ✔✔Determine which events are associated with the most symptoms and
distress and focus on those.
It is often surprising to us which events that children have experienced are associated
with the greatest amount of distress. As you make a plan for trauma narration, focus on
those events that are the most responsible for producing symptoms.
✔✔What should a therapist do when a child begins to feel distressed while constructing
the Trauma Narrative and wants to stop? - ✔✔Pause; remind the child that their distress
is a normal reaction, but that it will get better; encourage the use of stress management
skills they have already learned; then resume narrative development.
Encourage the use of previously-learned PRAC skills to address trauma-related
distress, and then continue (even if briefly) to work on the narrative in order to increase
the child's sense of mastery.
✔✔Inaccurate or unhelpful cognitions should be addressed by: - ✔✔Challenging the
child's beliefs
Encouraging the child to re-evaluate unhelpful or inaccurate beliefs is one of the core
elements of processing the trauma narrative.
✔✔Due to the complicated and sensitive nature of the trauma narration and processing
component, parents should be advised NOT to challenge their child's inaccurate or
unhelpful thoughts directly? - ✔✔TRUE
Cognitive processing activities can be challenging and usually require patience and
strategic questioning. Parents may be too emotional to engage in these activities
properly, and so it is the therapist's responsibility to engage in processing activities.
, ✔✔Which statement about cognitive processing with younger children is most
accurate? - ✔✔Using familiar strategies like relating stories with a moral to learn is often
a helpful way of doing cognitive processing with young children.
Many children are used to taking lessons from stories they read, even before they can
engage in examining their own thoughts or beliefs.
✔✔Cognitive processing activities with caregivers: - ✔✔Can be initiated by reviewing
the child's trauma narrative and discussing caregivers' reactions to it
This serves both to help caregivers prepare for the narrative and to explore caregiver
reactions to the child's traumatic experiences.
✔✔Which of the following statements is the most accurate about working with
caregivers during the creation of the child's Trauma Narrative? - ✔✔Therapists should
focus on the caregivers' reactions to the trauma and helping them challenge their
problematic beliefs about them.
Parent sessions do not stop when the child is working on trauma narration and
processing. Parents frequently have their own unhelpful and inaccurate thoughts about
their child's trauma, and this is the appropriate time to address them.
✔✔Brian is a 4 year-old who has created a short, hand-drawn "book" version of his
trauma narrative. Brian had walked up to a strange dog in his neighborhood hoping to
pet him, but the dog attacked him causing some significant injuries. Brian thinks the dog
attacked him because "I'm dumb and shouldn't have tried to pet her." Which of the
following methods is most appropriate for helping reduce the "I'm dumb" thoughts that
Brian has? - ✔✔Read existing comic books or stories that contain positive messages or
"morals" about learning from mistakes.
Children Brian's age lack the cognitive capacity to identify and analyze the content and
accuracy of their thoughts; it's often useful to use media that they're familiar with
(stories, comics) that have relevant lessons or for which the "moral of the story" is
relevant to the issues being addressed in treatment.
✔✔Which of the following is the best indicator that in vivo mastery exercises are
necessary in TF-CBT? - ✔✔If the child experiences anxiety and avoidance in response
to safe, trauma-related environmental cues
Reducing unnecessary avoidance and cue-related anxiety are the only reasons to
engage in in vivo exposure.
✔✔The exposure exercises used during the in vivo mastery component of TF-CBT
should be: - ✔✔Repeated and controlled, to maximize the likelihood of success
It is important to plan and monitor exposure to feared stimuli so that the child's
experience results in mastery, not increased fear and avoidance.
✔✔Jane, age 9, has completed the Trauma Narrative and is preparing to share it with
her foster mother in treatment. Neither Jane nor her foster mother reports any
continuing avoidance behaviors. What is the best course of action regarding in vivo
AND SOLUTIONS RATED A+
✔✔Which of the following is NOT a therapeutic purpose of creating a Trauma
Narrative? - ✔✔Learning which people, places, or situations to avoid so that trauma
reactions won't be triggered
Avoidance of trauma reminders is not a goal of TF-CBT; all the other options are key
reasons for engaging in trauma narrative development
✔✔LaQuan is a 16 year old young woman referred to you by child welfare due to a long
history of physical abuse and one incident of sexual abuse by caregivers and others.
Your trauma assessment indicated that LaQuan also had been bullied at school and hit,
punched and sexually touched by peers. She also had witnessed many incidents of
violence in the home between her mother and her mother's boyfriend; she has lived her
whole life in a neighborhood that often has violent incidents that frightened her. She
described significant levels of fear and distress for nearly all of these incidents she had
experienced. Which of these traumatic events should be included in her Trauma
Narrative? - ✔✔Determine which events are associated with the most symptoms and
distress and focus on those.
It is often surprising to us which events that children have experienced are associated
with the greatest amount of distress. As you make a plan for trauma narration, focus on
those events that are the most responsible for producing symptoms.
✔✔What should a therapist do when a child begins to feel distressed while constructing
the Trauma Narrative and wants to stop? - ✔✔Pause; remind the child that their distress
is a normal reaction, but that it will get better; encourage the use of stress management
skills they have already learned; then resume narrative development.
Encourage the use of previously-learned PRAC skills to address trauma-related
distress, and then continue (even if briefly) to work on the narrative in order to increase
the child's sense of mastery.
✔✔Inaccurate or unhelpful cognitions should be addressed by: - ✔✔Challenging the
child's beliefs
Encouraging the child to re-evaluate unhelpful or inaccurate beliefs is one of the core
elements of processing the trauma narrative.
✔✔Due to the complicated and sensitive nature of the trauma narration and processing
component, parents should be advised NOT to challenge their child's inaccurate or
unhelpful thoughts directly? - ✔✔TRUE
Cognitive processing activities can be challenging and usually require patience and
strategic questioning. Parents may be too emotional to engage in these activities
properly, and so it is the therapist's responsibility to engage in processing activities.
, ✔✔Which statement about cognitive processing with younger children is most
accurate? - ✔✔Using familiar strategies like relating stories with a moral to learn is often
a helpful way of doing cognitive processing with young children.
Many children are used to taking lessons from stories they read, even before they can
engage in examining their own thoughts or beliefs.
✔✔Cognitive processing activities with caregivers: - ✔✔Can be initiated by reviewing
the child's trauma narrative and discussing caregivers' reactions to it
This serves both to help caregivers prepare for the narrative and to explore caregiver
reactions to the child's traumatic experiences.
✔✔Which of the following statements is the most accurate about working with
caregivers during the creation of the child's Trauma Narrative? - ✔✔Therapists should
focus on the caregivers' reactions to the trauma and helping them challenge their
problematic beliefs about them.
Parent sessions do not stop when the child is working on trauma narration and
processing. Parents frequently have their own unhelpful and inaccurate thoughts about
their child's trauma, and this is the appropriate time to address them.
✔✔Brian is a 4 year-old who has created a short, hand-drawn "book" version of his
trauma narrative. Brian had walked up to a strange dog in his neighborhood hoping to
pet him, but the dog attacked him causing some significant injuries. Brian thinks the dog
attacked him because "I'm dumb and shouldn't have tried to pet her." Which of the
following methods is most appropriate for helping reduce the "I'm dumb" thoughts that
Brian has? - ✔✔Read existing comic books or stories that contain positive messages or
"morals" about learning from mistakes.
Children Brian's age lack the cognitive capacity to identify and analyze the content and
accuracy of their thoughts; it's often useful to use media that they're familiar with
(stories, comics) that have relevant lessons or for which the "moral of the story" is
relevant to the issues being addressed in treatment.
✔✔Which of the following is the best indicator that in vivo mastery exercises are
necessary in TF-CBT? - ✔✔If the child experiences anxiety and avoidance in response
to safe, trauma-related environmental cues
Reducing unnecessary avoidance and cue-related anxiety are the only reasons to
engage in in vivo exposure.
✔✔The exposure exercises used during the in vivo mastery component of TF-CBT
should be: - ✔✔Repeated and controlled, to maximize the likelihood of success
It is important to plan and monitor exposure to feared stimuli so that the child's
experience results in mastery, not increased fear and avoidance.
✔✔Jane, age 9, has completed the Trauma Narrative and is preparing to share it with
her foster mother in treatment. Neither Jane nor her foster mother reports any
continuing avoidance behaviors. What is the best course of action regarding in vivo
