TF-CBT MAIN EXAMINATION SET 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔You are providing TF-CBT to a 7 year-old boy who saw his mother's boyfriend (who
was gang involved) shot by a member from a rival gang. This child has also been
exposed to a great deal of domestic violence perpetrated against his mother and has
seen his mom and many other adults use substances. He has been living with a kinship
caregiver, his aunt, for about four months. In the first session you have with this boy and
his aunt, she reports having trouble getting him to listen to directions and commands
and is very frustrated by these behavior problems. She understands he has been
through a great deal but is having a hard time with these behaviors. - ✔✔21. Which is
the BEST way to proceed?
a) Explain to aunt that since trauma impacts feelings and behavior, all the child will need
to improve his behavioral problems are relaxation and affective modulation skills.
b) Explain to aunt that TF-CBT includes parenting skills, and that you will teach her
skills to address his behavior problems. However, you do not start the parenting
component of TF-CBT until after his PTSD symptoms have significantly improved
(around 5-6 sessions into treatment; once he has done most of PRAC).
c) Explain to aunt that only parenting skills will be needed to help address his behavioral
problems.
d) Explain to aunt that relaxation and affective modulation skills for the child in
combination with parenting skills is the best way to address the child's behavior
problems.
✔✔22. If including parenting skills is appropriate, what is the best place to start? - ✔✔a)
Parenting skills are not appropriate; it is more important to get started right away with
individual work with this child to help him learn skills to calm down (Relaxation, Affective
Modulation, Cognitive Coping) so that he can follow directions more easily.
b) Parenting skills are appropriate; you should start with consequences, like time-out,
for not listening.
c) Parenting skills are appropriate; you should start with praise and attention for times
when this boy does listen to commands and directions.
d) Parenting skills are only appropriate if the caretaker is the biological parent.
✔✔A 7 year-old boy who experienced sexual abuse by his uncle over the past several
years recently disclosed this abuse. The uncle is being prosecuted. The boy presented
to therapy exhibiting physical and verbal aggression with peers, school staff, and his
parents. He has had periods of extreme emotional dysregulation that can last up to
several hours. Psychological evaluation indicated a diagnosis of PTSD and serious
behavior problems. The TF-CBT therapist has done the PRAC skills with the child. The
child knows and can use relaxation and affective regulation skills at times but he is still
acting out significantly across many settings. Both parents are actively involved in the
TF-CBT treatment. - ✔✔They have been applying behavior management strategies with
limited success as they mostly "ride through" the tough times with him and keep him
safe when he becomes out of control. With these continued behavioral disruptions, the
, therapist questions whether she should move on and begin the Trauma Narrative (TN)
with the child.
23. Which of the following is LEAST important to consider when making this decision?
a) The child's current "stability level" and safety in his home environment. The therapist
considers whether the child is stable enough to proceed with the trauma narrative.
b) Regular attendance at the next sessions.
c) The child's level of parental support and availability. The therapist considers whether
the parents will provide additional support throughout the time the child is working on
the Trauma Narrative.
d) Whether the child has some affective regulation skills and can use his
"feelings/anxiety thermometer" to help gauge his level of anxiety.
e) Since this child has disruptive behaviors, the trauma narrative should not be included
in his TF-CBT treatment.
✔✔A 10 year-old girl and her 9-year old brother present for treatment. Both children
were severely physically abused by their stepfather and experienced some abuse by
the biological mother as well. They now live with their supportive grandmother who is
involved in weekly therapy with the children. Both children are engaged in developing
their Trauma Narratives (TN) individually but both also want some therapy sessions
together to share parts of their narratives with each other and to learn coping skills for
their various PTSD symptoms. - ✔✔24. Some potential benefits of joint coping skills
sessions may be more rapid skill acquisition, with practice and reinforcement from
sibling (e.g., practicing using deep breathing and/or specific, soothing emotional
regulation techniques when distressed, reminding each other to use these skills, etc.)
a) True
b) False
✔✔25. A potential risk of sharing parts of their Trauma Narratives together in joint
sessions is secondary traumatization or vicarious trauma, wherein one sibling develops
posttraumatic stress symptoms (e.g., intrusive thoughts of the sibling's abuse) related to
hearing the details of the abuse his/her sibling experienced. - ✔✔a) True
b) False
✔✔26. In the above scenario, in response to the children's request, it would be
advisable to suspend the development of their individual narratives and have the
children create one joint narrative together. - ✔✔a) True
b) False
✔✔A 12 year-old male is brought to your clinic to receive TF-CBT by his new foster
parent who is complying with the CPS case manager's recommendation/referral. The
boy was physically abused by his biological father, emotionally neglected by his
stepmother, and is unaware of his substance-abusing mother's whereabouts. The boy
appears "shut-down" and is mildly aggressive in his verbal interactions at his new
QUESTIONS AND SOLUTIONS RATED A+
✔✔You are providing TF-CBT to a 7 year-old boy who saw his mother's boyfriend (who
was gang involved) shot by a member from a rival gang. This child has also been
exposed to a great deal of domestic violence perpetrated against his mother and has
seen his mom and many other adults use substances. He has been living with a kinship
caregiver, his aunt, for about four months. In the first session you have with this boy and
his aunt, she reports having trouble getting him to listen to directions and commands
and is very frustrated by these behavior problems. She understands he has been
through a great deal but is having a hard time with these behaviors. - ✔✔21. Which is
the BEST way to proceed?
a) Explain to aunt that since trauma impacts feelings and behavior, all the child will need
to improve his behavioral problems are relaxation and affective modulation skills.
b) Explain to aunt that TF-CBT includes parenting skills, and that you will teach her
skills to address his behavior problems. However, you do not start the parenting
component of TF-CBT until after his PTSD symptoms have significantly improved
(around 5-6 sessions into treatment; once he has done most of PRAC).
c) Explain to aunt that only parenting skills will be needed to help address his behavioral
problems.
d) Explain to aunt that relaxation and affective modulation skills for the child in
combination with parenting skills is the best way to address the child's behavior
problems.
✔✔22. If including parenting skills is appropriate, what is the best place to start? - ✔✔a)
Parenting skills are not appropriate; it is more important to get started right away with
individual work with this child to help him learn skills to calm down (Relaxation, Affective
Modulation, Cognitive Coping) so that he can follow directions more easily.
b) Parenting skills are appropriate; you should start with consequences, like time-out,
for not listening.
c) Parenting skills are appropriate; you should start with praise and attention for times
when this boy does listen to commands and directions.
d) Parenting skills are only appropriate if the caretaker is the biological parent.
✔✔A 7 year-old boy who experienced sexual abuse by his uncle over the past several
years recently disclosed this abuse. The uncle is being prosecuted. The boy presented
to therapy exhibiting physical and verbal aggression with peers, school staff, and his
parents. He has had periods of extreme emotional dysregulation that can last up to
several hours. Psychological evaluation indicated a diagnosis of PTSD and serious
behavior problems. The TF-CBT therapist has done the PRAC skills with the child. The
child knows and can use relaxation and affective regulation skills at times but he is still
acting out significantly across many settings. Both parents are actively involved in the
TF-CBT treatment. - ✔✔They have been applying behavior management strategies with
limited success as they mostly "ride through" the tough times with him and keep him
safe when he becomes out of control. With these continued behavioral disruptions, the
, therapist questions whether she should move on and begin the Trauma Narrative (TN)
with the child.
23. Which of the following is LEAST important to consider when making this decision?
a) The child's current "stability level" and safety in his home environment. The therapist
considers whether the child is stable enough to proceed with the trauma narrative.
b) Regular attendance at the next sessions.
c) The child's level of parental support and availability. The therapist considers whether
the parents will provide additional support throughout the time the child is working on
the Trauma Narrative.
d) Whether the child has some affective regulation skills and can use his
"feelings/anxiety thermometer" to help gauge his level of anxiety.
e) Since this child has disruptive behaviors, the trauma narrative should not be included
in his TF-CBT treatment.
✔✔A 10 year-old girl and her 9-year old brother present for treatment. Both children
were severely physically abused by their stepfather and experienced some abuse by
the biological mother as well. They now live with their supportive grandmother who is
involved in weekly therapy with the children. Both children are engaged in developing
their Trauma Narratives (TN) individually but both also want some therapy sessions
together to share parts of their narratives with each other and to learn coping skills for
their various PTSD symptoms. - ✔✔24. Some potential benefits of joint coping skills
sessions may be more rapid skill acquisition, with practice and reinforcement from
sibling (e.g., practicing using deep breathing and/or specific, soothing emotional
regulation techniques when distressed, reminding each other to use these skills, etc.)
a) True
b) False
✔✔25. A potential risk of sharing parts of their Trauma Narratives together in joint
sessions is secondary traumatization or vicarious trauma, wherein one sibling develops
posttraumatic stress symptoms (e.g., intrusive thoughts of the sibling's abuse) related to
hearing the details of the abuse his/her sibling experienced. - ✔✔a) True
b) False
✔✔26. In the above scenario, in response to the children's request, it would be
advisable to suspend the development of their individual narratives and have the
children create one joint narrative together. - ✔✔a) True
b) False
✔✔A 12 year-old male is brought to your clinic to receive TF-CBT by his new foster
parent who is complying with the CPS case manager's recommendation/referral. The
boy was physically abused by his biological father, emotionally neglected by his
stepmother, and is unaware of his substance-abusing mother's whereabouts. The boy
appears "shut-down" and is mildly aggressive in his verbal interactions at his new
