TF-CBT EXAMINATION SCRIPT 2025/2026 QUESTIONS
WITH ANSWERS GRADED A+
✔✔Enhancing safety and future development - ✔✔The final module is oriented toward
ensuring healthy child and family growth after treatment is over. The focus of sessions
is enhancing family communication and children's personal safety skills, all of which are
designed to minimize risk for future victimization and enhance feelings of self-efficacy
and self-competence.
✔✔parent/caregiver involvement - ✔✔A supportive parent or other caregiver should be
involved in treatment, as well as the child. The participating caregiver often is a parent.
However, when parents are not supportive or available, other caregivers can fulfill this
role. TF-CBT is frequently conducted with caregivers who are relatives (grandparent,
aunt/uncle, adult sibling) or foster parents. All TF-CBT treatment sessions involve both
the child and the supportive caregiver. The structure of sessions varies by treatment
component, the age and developmental level of the child, and other factors. However,
most sessions involve individual time working with the child, some time working with the
parent/caregiver individually, and some time spent working conjointly with the child and
the parent/caregiver.
✔✔gradual exposure - ✔✔One key element of TF-CBT is that every session of the
treatment, from the first part of Psychoeducation through the last Enhancing Safety
session, involves some form of psychological exposure to the traumatic event. This
should not be confused with "flooding," "prolonged exposure," or other intense methods
of remembering and reviewing trauma experiences. Rather, some aspect of the trauma
is referred to and reviewed in every session. In Relaxation, for example, general
relaxation skills are taught, and then specifically applied to trauma-related experiences
of tension and stress. In Affect Identification and Regulation, trauma-related emotions
are identified and discussed. Every component of TF-CBT includes discussion of the
child's traumatic experiences and their effects. This helps improve mastery and sets the
stage for the successful development and processing of the trauma narrative.
✔✔session frequency and length - ✔✔Ideally, TF-CBT should be delivered in weekly
treatment sessions of 60-90 minutes each. However, it is not common for therapists to
have the flexibility in their schedules to have 90 minute sessions. More commonly,
therapists see patients for 45-50 minute sessions, and TF-CBT can be adapted to fit
into that time frame. TF-CBT sessions can be conducted more frequently (e.g., 2
sessions per week), but should not be delivered less frequently (e.g., 1 session every 2-
3 weeks).
✔✔Phases of TF-CBT - ✔✔1. Stabilization
2. Trauma Narrative
3. Integration/Consolidation
,✔✔Stabilization phase - ✔✔The Stabilization phase is comprised of what is termed the
"PRAC" components of TF-CBT, Psychoeducation, Relaxation, Affective Expression
and Regulation, and Cognitive Coping. The development of parenting skills and the use
of gradual exposure techniques are a part of this phase of treatment as well.
✔✔Trauma narrative phase - ✔✔This phase includes the Trauma Narrative and
Processing component. Gradual exposure is a major component of this phase, and both
children and caregivers process their reactions to the child's narrative.
✔✔Integration/Consolidation phase - ✔✔This phase includes the In Vivo Mastery of
trauma reminders, Conjoint Child-Parent Sessions, and Enhancing Future Safety and
Development components.
✔✔True or false: the parenting skills component takes place only in the third phase -
✔✔False. The Parenting Skills component is conducted throughout the treatment
process, as needed, to help caregivers manage child behavior.
✔✔True or false: trauma exposure should only begin taking place in the second phase -
✔✔False. Some form of gradual exposure to the trauma should be a part of every
component and every session of TF-CBT. In the PRAC components, this usually
involves applying newly learned skills to trauma-related symptoms or situations. In other
components, discussion of trauma occurs more directly and naturally.
✔✔Pacing of TF-CBT Sessions - ✔✔Over a course of TF-CBT, about one-third of the
sessions should be devoted to the components that make up the Stabilization phase,
about one-third to the Trauma Narrative phase, and about one-third to the
Integration/Consolidation phase.
✔✔True or false: TF-CBT can be delivered almost anywhere as long as there is fidelity
to the treatment model - ✔✔True
✔✔Two components of treatment fidelity - ✔✔Adherence and competence
✔✔Adherence - ✔✔In all treatment settings, TF-CBT should be conducted as it has
been developed and tested. Important points of adherence to the TF-CBT model are:
-Use TF-CBT with appropriate cases, children who have experienced one or more
potentially traumatic events and who have clinically meaningful symptoms of PTSD as a
result.
-Involve a supportive parent or other caregiver in all components and sessions of
treatment.
-See the family in weekly or more frequent treatment sessions.
-Follow the PRACTICE components
-Spend about one-third of the treatment sessions on the PRAC components
(Stabilization phase), one-third on the Trauma Narrative phase, and one-third on the
treatment components of the Integration/Consolidation phase.
,-Complete treatment in 12-20 sessions.
✔✔Competence - ✔✔A key part of competence is doing these procedures correctly.
Developing clinical competence requires learning the knowledge and skills and
practicing them (ideally, with knowledgeable supervision).
✔✔measuring fidelity and outcomes - ✔✔treatment outcomes should be assessed
regularly, including prior to beginning treatment, during treatment, and at the end of
treatment.
✔✔reviewing assessment findings - ✔✔-go over what the assessment revealed about
the child's functioning to come to a common understanding about what problems
treatment will be focused on.
-should always be done with parents (without child present); can also be done with older
children and adolescents
-less about a "diagnosis" and more about how the child's behavior has been affected;
connect the child's symptoms to the experience of trauma (and/or to reminders of
trauma that the child may be dealing with).
✔✔Components of psychoeducation - ✔✔-review assessment findings
-provide an overview of treatment
-neutral narrative/baseline trauma narrative
-general education about abuse and trauma
-specific information about the traumatic event
✔✔True or false: a baseline narrative is a required element of TF-CBT - ✔✔False;
however, it is helpful to establish a child's ability to tell a story with detail as well as their
ability to tell a story about their trauma
✔✔General education about abuse and trauma - ✔✔It is often useful to begin by getting
a sense of what children know about the particular kind of trauma that they have
experienced. This can be achieved by using a question-and-answer game format in
which a child gets points for answering questions correctly. Be generous with points and
praise even for partially correct responses, and be sure to correct and add
developmentally appropriate information to the child's answers. Some sample questions
might include:
-What is sexual abuse? (or physical abuse, or a disaster, etc.).
-How often do things like this happen?
-Why does this type of trauma happen?
-Why do you think it happened to you?
✔✔Psychoeducation about sexual abuse - ✔✔includes information about the various
types of sexual abuse, why sexual abuse occurs, who perpetrates sexual abuse, how
sexually abused children may feel, sexualized feelings and behaviors, and why children
often don't disclose their abuse. For example, it's important to explain to a sexually
, abused child that sexual abuse often happens because abusers have sexual feelings
for children which most people don't have, that they deliberately choose to sexually
abuse a child even though they know that it's wrong, and that sexual offenders may use
tricks or fear to get what they want from children.
✔✔physical abuse - ✔✔When physically abused children are not in the care of abusive
parents, they may need information on how to tell the difference between appropriate
and inappropriate parental discipline. They may also need help understanding that
psychological abuse (e.g. berating, name calling, excessive yelling, ignoring) is
commonly a part of physically abusive behavior and that this is not an indication of their
worth as a person. For physically abusive families, specific instructions in behavioral
management techniques are likely to be needed (refer to the Parenting Module).
✔✔psychoeducation for kids who have witnessed violence - ✔✔For children who have
witnessed violence between their parents, it's important to provide information so that
they don't blame themselves for their parents' arguments and fights, and to understand
that violence is not an appropriate way to handle disagreements. It may be important to
emphasize that most people can disagree or even get angry without becoming violent.
✔✔psychoeducation for other traumatic events - ✔✔For children who have experienced
several different traumatic events, psychoeducation should include any relevant
information about the specific events. The other components of psychoeducation—sex
education and body safety—may still be important to include. With any type of traumatic
event, it's important to provide information concerning "normal" emotional reactions and
associated cognitions.
✔✔handouts - ✔✔can be useful for psychoeducation, providing handouts about specific
topics for parents to take home
✔✔improving engagement - ✔✔-Ask questions about the patient's and family's
perspective on traumatic events
-Find out what the child or family thinks and knows about mental health and treatment
-instill hope
✔✔sharing information effectively - ✔✔-keep language simple and direct, avoiding
jargon
-include family members beyond caregiver in treatment planning and psychoeducation
-consider using pictures to communicate
✔✔psychoeducation in early childhood - ✔✔With the youngest TFCBT-eligible kids
(ages 3-4), most psychoeducation activities should be geared toward caregivers. But
while very young kids will likely not appreciate concepts related to the prevalence of
trauma, they can still be reassured that their symptoms are normal responses to scary
and upsetting events. A modified version of a game like the "What Do You Know" card
WITH ANSWERS GRADED A+
✔✔Enhancing safety and future development - ✔✔The final module is oriented toward
ensuring healthy child and family growth after treatment is over. The focus of sessions
is enhancing family communication and children's personal safety skills, all of which are
designed to minimize risk for future victimization and enhance feelings of self-efficacy
and self-competence.
✔✔parent/caregiver involvement - ✔✔A supportive parent or other caregiver should be
involved in treatment, as well as the child. The participating caregiver often is a parent.
However, when parents are not supportive or available, other caregivers can fulfill this
role. TF-CBT is frequently conducted with caregivers who are relatives (grandparent,
aunt/uncle, adult sibling) or foster parents. All TF-CBT treatment sessions involve both
the child and the supportive caregiver. The structure of sessions varies by treatment
component, the age and developmental level of the child, and other factors. However,
most sessions involve individual time working with the child, some time working with the
parent/caregiver individually, and some time spent working conjointly with the child and
the parent/caregiver.
✔✔gradual exposure - ✔✔One key element of TF-CBT is that every session of the
treatment, from the first part of Psychoeducation through the last Enhancing Safety
session, involves some form of psychological exposure to the traumatic event. This
should not be confused with "flooding," "prolonged exposure," or other intense methods
of remembering and reviewing trauma experiences. Rather, some aspect of the trauma
is referred to and reviewed in every session. In Relaxation, for example, general
relaxation skills are taught, and then specifically applied to trauma-related experiences
of tension and stress. In Affect Identification and Regulation, trauma-related emotions
are identified and discussed. Every component of TF-CBT includes discussion of the
child's traumatic experiences and their effects. This helps improve mastery and sets the
stage for the successful development and processing of the trauma narrative.
✔✔session frequency and length - ✔✔Ideally, TF-CBT should be delivered in weekly
treatment sessions of 60-90 minutes each. However, it is not common for therapists to
have the flexibility in their schedules to have 90 minute sessions. More commonly,
therapists see patients for 45-50 minute sessions, and TF-CBT can be adapted to fit
into that time frame. TF-CBT sessions can be conducted more frequently (e.g., 2
sessions per week), but should not be delivered less frequently (e.g., 1 session every 2-
3 weeks).
✔✔Phases of TF-CBT - ✔✔1. Stabilization
2. Trauma Narrative
3. Integration/Consolidation
,✔✔Stabilization phase - ✔✔The Stabilization phase is comprised of what is termed the
"PRAC" components of TF-CBT, Psychoeducation, Relaxation, Affective Expression
and Regulation, and Cognitive Coping. The development of parenting skills and the use
of gradual exposure techniques are a part of this phase of treatment as well.
✔✔Trauma narrative phase - ✔✔This phase includes the Trauma Narrative and
Processing component. Gradual exposure is a major component of this phase, and both
children and caregivers process their reactions to the child's narrative.
✔✔Integration/Consolidation phase - ✔✔This phase includes the In Vivo Mastery of
trauma reminders, Conjoint Child-Parent Sessions, and Enhancing Future Safety and
Development components.
✔✔True or false: the parenting skills component takes place only in the third phase -
✔✔False. The Parenting Skills component is conducted throughout the treatment
process, as needed, to help caregivers manage child behavior.
✔✔True or false: trauma exposure should only begin taking place in the second phase -
✔✔False. Some form of gradual exposure to the trauma should be a part of every
component and every session of TF-CBT. In the PRAC components, this usually
involves applying newly learned skills to trauma-related symptoms or situations. In other
components, discussion of trauma occurs more directly and naturally.
✔✔Pacing of TF-CBT Sessions - ✔✔Over a course of TF-CBT, about one-third of the
sessions should be devoted to the components that make up the Stabilization phase,
about one-third to the Trauma Narrative phase, and about one-third to the
Integration/Consolidation phase.
✔✔True or false: TF-CBT can be delivered almost anywhere as long as there is fidelity
to the treatment model - ✔✔True
✔✔Two components of treatment fidelity - ✔✔Adherence and competence
✔✔Adherence - ✔✔In all treatment settings, TF-CBT should be conducted as it has
been developed and tested. Important points of adherence to the TF-CBT model are:
-Use TF-CBT with appropriate cases, children who have experienced one or more
potentially traumatic events and who have clinically meaningful symptoms of PTSD as a
result.
-Involve a supportive parent or other caregiver in all components and sessions of
treatment.
-See the family in weekly or more frequent treatment sessions.
-Follow the PRACTICE components
-Spend about one-third of the treatment sessions on the PRAC components
(Stabilization phase), one-third on the Trauma Narrative phase, and one-third on the
treatment components of the Integration/Consolidation phase.
,-Complete treatment in 12-20 sessions.
✔✔Competence - ✔✔A key part of competence is doing these procedures correctly.
Developing clinical competence requires learning the knowledge and skills and
practicing them (ideally, with knowledgeable supervision).
✔✔measuring fidelity and outcomes - ✔✔treatment outcomes should be assessed
regularly, including prior to beginning treatment, during treatment, and at the end of
treatment.
✔✔reviewing assessment findings - ✔✔-go over what the assessment revealed about
the child's functioning to come to a common understanding about what problems
treatment will be focused on.
-should always be done with parents (without child present); can also be done with older
children and adolescents
-less about a "diagnosis" and more about how the child's behavior has been affected;
connect the child's symptoms to the experience of trauma (and/or to reminders of
trauma that the child may be dealing with).
✔✔Components of psychoeducation - ✔✔-review assessment findings
-provide an overview of treatment
-neutral narrative/baseline trauma narrative
-general education about abuse and trauma
-specific information about the traumatic event
✔✔True or false: a baseline narrative is a required element of TF-CBT - ✔✔False;
however, it is helpful to establish a child's ability to tell a story with detail as well as their
ability to tell a story about their trauma
✔✔General education about abuse and trauma - ✔✔It is often useful to begin by getting
a sense of what children know about the particular kind of trauma that they have
experienced. This can be achieved by using a question-and-answer game format in
which a child gets points for answering questions correctly. Be generous with points and
praise even for partially correct responses, and be sure to correct and add
developmentally appropriate information to the child's answers. Some sample questions
might include:
-What is sexual abuse? (or physical abuse, or a disaster, etc.).
-How often do things like this happen?
-Why does this type of trauma happen?
-Why do you think it happened to you?
✔✔Psychoeducation about sexual abuse - ✔✔includes information about the various
types of sexual abuse, why sexual abuse occurs, who perpetrates sexual abuse, how
sexually abused children may feel, sexualized feelings and behaviors, and why children
often don't disclose their abuse. For example, it's important to explain to a sexually
, abused child that sexual abuse often happens because abusers have sexual feelings
for children which most people don't have, that they deliberately choose to sexually
abuse a child even though they know that it's wrong, and that sexual offenders may use
tricks or fear to get what they want from children.
✔✔physical abuse - ✔✔When physically abused children are not in the care of abusive
parents, they may need information on how to tell the difference between appropriate
and inappropriate parental discipline. They may also need help understanding that
psychological abuse (e.g. berating, name calling, excessive yelling, ignoring) is
commonly a part of physically abusive behavior and that this is not an indication of their
worth as a person. For physically abusive families, specific instructions in behavioral
management techniques are likely to be needed (refer to the Parenting Module).
✔✔psychoeducation for kids who have witnessed violence - ✔✔For children who have
witnessed violence between their parents, it's important to provide information so that
they don't blame themselves for their parents' arguments and fights, and to understand
that violence is not an appropriate way to handle disagreements. It may be important to
emphasize that most people can disagree or even get angry without becoming violent.
✔✔psychoeducation for other traumatic events - ✔✔For children who have experienced
several different traumatic events, psychoeducation should include any relevant
information about the specific events. The other components of psychoeducation—sex
education and body safety—may still be important to include. With any type of traumatic
event, it's important to provide information concerning "normal" emotional reactions and
associated cognitions.
✔✔handouts - ✔✔can be useful for psychoeducation, providing handouts about specific
topics for parents to take home
✔✔improving engagement - ✔✔-Ask questions about the patient's and family's
perspective on traumatic events
-Find out what the child or family thinks and knows about mental health and treatment
-instill hope
✔✔sharing information effectively - ✔✔-keep language simple and direct, avoiding
jargon
-include family members beyond caregiver in treatment planning and psychoeducation
-consider using pictures to communicate
✔✔psychoeducation in early childhood - ✔✔With the youngest TFCBT-eligible kids
(ages 3-4), most psychoeducation activities should be geared toward caregivers. But
while very young kids will likely not appreciate concepts related to the prevalence of
trauma, they can still be reassured that their symptoms are normal responses to scary
and upsetting events. A modified version of a game like the "What Do You Know" card
