TF-CBT CERTIFICATION EXAM QUESTIONS AND ANSWERS
TF-CBT CERTIFICATION EXAM QUESTIONS
AND ANSWERS
Question 1
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."
Correct Answer
1. Alexa's statements are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
Question 2
How should the therapist proceed? (Alexa case)
Correct 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.
Page 1 of 23
, TF-CBT CERTIFICATION EXAM QUESTIONS AND ANSWERS
Question 3
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.
Correct 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.
Question 4
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.
Correct 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.
Page 2 of 23
, TF-CBT CERTIFICATION EXAM QUESTIONS AND ANSWERS
Question 5
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.
Correct 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.
Question 6
Which component of TF-CBT sometimes needs to be implemented out of order,
usually toward the beginning of treatment?
Correct 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
Page 3 of 23
TF-CBT CERTIFICATION EXAM QUESTIONS
AND ANSWERS
Question 1
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."
Correct Answer
1. Alexa's statements are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
Question 2
How should the therapist proceed? (Alexa case)
Correct 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.
Page 1 of 23
, TF-CBT CERTIFICATION EXAM QUESTIONS AND ANSWERS
Question 3
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.
Correct 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.
Question 4
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.
Correct 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.
Page 2 of 23
, TF-CBT CERTIFICATION EXAM QUESTIONS AND ANSWERS
Question 5
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.
Correct 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.
Question 6
Which component of TF-CBT sometimes needs to be implemented out of order,
usually toward the beginning of treatment?
Correct 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
Page 3 of 23
