Tf-cbt Cert Ques ons and answers Newest RATED A+
2025/2026 NEW!!
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 narra ve, she wrote "I am a bad girl. I think they
messed up my body. I was really dumb because I never told anyone." - Answers 1. Alexa's
statements are examples of:
a) Healthy or func onal thoughts.
b) Cogni ve distor ons.
c) Cogni ve reali es.
d) Accurate but unhelpful thoughts.
2. How should the therapist proceed? (Alexa case) - Answers a) Tell Alexa that it is not her
fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narra ve and then begin cogni ve processing of the
trauma narra ve, including her statements.
c) Repeat the earlier components, beginning with Psychoeduca on as this is a clear example of
the therapy not "sinking in."
d) Ask Alexa to start the trauma narra ve again but this me tell her to only include details
about the sexual abuse, not any statements about herself or any thoughts.
Jus n is an 11-year-old boy who witnessed his father brutally a0ack his mother with a baseball
bat. During the middle of wri ng his trauma narra ve, he wrote that he intervened and
a0empted to defend his mother by figh ng his father. However, during individual sessions with
his mother, it became apparent that Jus n had hidden behind the sofa and cried during the
a0ack. - Answers 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Jus n about the inaccuracy
immediately.
b) Talk to Jus n 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
Jus n to complete his trauma narra ve and gently challenge his statements.
d) Talk with Jus n's father to determine whether Jus n or his mother is telling the truth; then
share this informa on with Jus n.
In the example above, there is a concern that the father may have access to the home and the
therapist is worried about Jus n'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 comple ng the earlier components. - Answers 4. How should
the therapist proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Jus n and his mother would then blame themselves for the
domes c violence.
c) Engage in short-term safety planning with Jus n and his mother.
d) Engage Jus n in In Vivo Desensi za on as his concern about safety is a cogni ve distor on.
Monty is a 7-year-old boy who was a vic m of sexual abuse for two years by his adop ve
parents. As part of the assessment, he completed the UCLA PTSD Reac on 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 wri ng
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 narra ve over the first three treatment sessions.
During and a@er the comple on of the trauma narra ve, Monty's behavior began to
deteriorate, including ac ng-out sexually, soiling himself, refusing to sleep in his own room, and
engaging in other dangerous behaviors that warranted a short-term hospitaliza on. - Answers
5. What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; ini ated Psychoeduca on and
subsequent skills-based components before moving to the trauma narra ve.
b) Briefly reviewed the ini al four TF-CBT components and started the trauma narra ve the next
week.
,c) Nothing. It is impera ve to follow a child's cues and wishes rather than a more direc ve
approach.
d) Skipped the trauma narra ve en rely because it is important to do just the opposite of what
a child believes he/she needs.
6. Which component of TF-CBT some mes needs to be implemented out of order, usually
toward the beginning of treatment? - Answers a) Trauma Narra ve, par cularly if a child is
extremely anxious.
b) Conjoint sessions to share the narra ve, especially for older teens or foster children who
resist having their foster parents involved in treatment.
c) Cogni ve Coping, especially if a child has distor ons about the abuse.
d) Psychoeduca on; some mes this component can be le@ for later in treatment or skipped
altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problema c avoidant
behaviors
Jody is a 6 year-old girl who was a0acked by a dog and le@ with severe scars all over her legs.
Since the dog a0ack, Jody has experienced severe PTSD symptoms and significant opposi onal
behavior problems. Her mother has felt intense guilt as Jody almost died from the a0ack. She
now cannot say no to anything her daughter wants. The mother also reported that Jody's
behavior is extremely difficult to manage and the mother just cannot take her anywhere. Jody
has tantrums at the drop of a pin and becomes fearful when there is any men on of a dog. -
Answers . In the first TF-CBT session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeduca on and express op mism about her ability to help mother and child in
12 to 16 sessions.
c) Explain to mother that Jody has serious PTSD symptoms and that treatment will likely
con nue for 1-2 years.
d) Strongly encourage Jody to talk about the details of the dog a0ack, no ma0er how much
anxiety this strategy would cause.
, 8. In order to help the mother respond to Jody's behavior problems, it is important to: -
Answers a) Engage in cogni ve processing to encourage mother to accept responsibility for
the dog a0ack.
b) Examine Jody's early childhood experiences to determine the source of her opposi onal
behaviors.
c) Encourage mom to ignore Jody when she complies with mother's requests and give Jody lots
of a0en on when Jody whines and does not get her way.
d) Remind mom that she is ac ng in Jody's best interest when she spanks Jody for having
temper tantrums.
e) Encourage mom to praise Jody for listening to mom, not pay a0en on to Jody's whining, and
give Jody consistent me outs for temper tantrums.
9. Jody probably developed temper tantrums a@er the dog a0ack because: - Answers a) The
dog a0ack caused her cor sol levels to drop leading to anger.
b) Out of compassion for her daughter, the mother began to overindulge Jody and not set
appropriate limits.
c) Jody misses playing with dogs.
d) Jody is dissocia ve and her anger is expressed when she "zones out."
You have been working for about a month with Keisha, a 13-year-old girl. She has a history of
sexual abuse by both her paternal and maternal uncles. Currently, she is living with her
biological parents who are estranged from their families of origin. According to Keisha, her
parents have a history of domes c violence; specifically, they are verbally aggressive to one
another and her father has hit her mother "once or twice." Keisha has a lot of strengths; she is
bright and sociable but has withdrawn from her friends and done poorly at school since the
sexual abuse started (at age 11). She and her mother became quickly engaged in treatment.
Keisha learned and prac ced the relaxa on skills and affec ve expression and modula on
exercises. She also understands the cogni ve triangle and has been able to apply it to her
struggles with her friends. Your plan for the next session is to begin the trauma narra ve and pr
- Answers 10. Which of the following might be a dysfunc onal trauma-related thought for
Keisha?
a) Some of the men in my family have a lot of problems.
2025/2026 NEW!!
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 narra ve, she wrote "I am a bad girl. I think they
messed up my body. I was really dumb because I never told anyone." - Answers 1. Alexa's
statements are examples of:
a) Healthy or func onal thoughts.
b) Cogni ve distor ons.
c) Cogni ve reali es.
d) Accurate but unhelpful thoughts.
2. How should the therapist proceed? (Alexa case) - Answers a) Tell Alexa that it is not her
fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narra ve and then begin cogni ve processing of the
trauma narra ve, including her statements.
c) Repeat the earlier components, beginning with Psychoeduca on as this is a clear example of
the therapy not "sinking in."
d) Ask Alexa to start the trauma narra ve again but this me tell her to only include details
about the sexual abuse, not any statements about herself or any thoughts.
Jus n is an 11-year-old boy who witnessed his father brutally a0ack his mother with a baseball
bat. During the middle of wri ng his trauma narra ve, he wrote that he intervened and
a0empted to defend his mother by figh ng his father. However, during individual sessions with
his mother, it became apparent that Jus n had hidden behind the sofa and cried during the
a0ack. - Answers 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Jus n about the inaccuracy
immediately.
b) Talk to Jus n 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
Jus n to complete his trauma narra ve and gently challenge his statements.
d) Talk with Jus n's father to determine whether Jus n or his mother is telling the truth; then
share this informa on with Jus n.
In the example above, there is a concern that the father may have access to the home and the
therapist is worried about Jus n'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 comple ng the earlier components. - Answers 4. How should
the therapist proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Jus n and his mother would then blame themselves for the
domes c violence.
c) Engage in short-term safety planning with Jus n and his mother.
d) Engage Jus n in In Vivo Desensi za on as his concern about safety is a cogni ve distor on.
Monty is a 7-year-old boy who was a vic m of sexual abuse for two years by his adop ve
parents. As part of the assessment, he completed the UCLA PTSD Reac on 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 wri ng
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 narra ve over the first three treatment sessions.
During and a@er the comple on of the trauma narra ve, Monty's behavior began to
deteriorate, including ac ng-out sexually, soiling himself, refusing to sleep in his own room, and
engaging in other dangerous behaviors that warranted a short-term hospitaliza on. - Answers
5. What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; ini ated Psychoeduca on and
subsequent skills-based components before moving to the trauma narra ve.
b) Briefly reviewed the ini al four TF-CBT components and started the trauma narra ve the next
week.
,c) Nothing. It is impera ve to follow a child's cues and wishes rather than a more direc ve
approach.
d) Skipped the trauma narra ve en rely because it is important to do just the opposite of what
a child believes he/she needs.
6. Which component of TF-CBT some mes needs to be implemented out of order, usually
toward the beginning of treatment? - Answers a) Trauma Narra ve, par cularly if a child is
extremely anxious.
b) Conjoint sessions to share the narra ve, especially for older teens or foster children who
resist having their foster parents involved in treatment.
c) Cogni ve Coping, especially if a child has distor ons about the abuse.
d) Psychoeduca on; some mes this component can be le@ for later in treatment or skipped
altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problema c avoidant
behaviors
Jody is a 6 year-old girl who was a0acked by a dog and le@ with severe scars all over her legs.
Since the dog a0ack, Jody has experienced severe PTSD symptoms and significant opposi onal
behavior problems. Her mother has felt intense guilt as Jody almost died from the a0ack. She
now cannot say no to anything her daughter wants. The mother also reported that Jody's
behavior is extremely difficult to manage and the mother just cannot take her anywhere. Jody
has tantrums at the drop of a pin and becomes fearful when there is any men on of a dog. -
Answers . In the first TF-CBT session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeduca on and express op mism about her ability to help mother and child in
12 to 16 sessions.
c) Explain to mother that Jody has serious PTSD symptoms and that treatment will likely
con nue for 1-2 years.
d) Strongly encourage Jody to talk about the details of the dog a0ack, no ma0er how much
anxiety this strategy would cause.
, 8. In order to help the mother respond to Jody's behavior problems, it is important to: -
Answers a) Engage in cogni ve processing to encourage mother to accept responsibility for
the dog a0ack.
b) Examine Jody's early childhood experiences to determine the source of her opposi onal
behaviors.
c) Encourage mom to ignore Jody when she complies with mother's requests and give Jody lots
of a0en on when Jody whines and does not get her way.
d) Remind mom that she is ac ng in Jody's best interest when she spanks Jody for having
temper tantrums.
e) Encourage mom to praise Jody for listening to mom, not pay a0en on to Jody's whining, and
give Jody consistent me outs for temper tantrums.
9. Jody probably developed temper tantrums a@er the dog a0ack because: - Answers a) The
dog a0ack caused her cor sol levels to drop leading to anger.
b) Out of compassion for her daughter, the mother began to overindulge Jody and not set
appropriate limits.
c) Jody misses playing with dogs.
d) Jody is dissocia ve and her anger is expressed when she "zones out."
You have been working for about a month with Keisha, a 13-year-old girl. She has a history of
sexual abuse by both her paternal and maternal uncles. Currently, she is living with her
biological parents who are estranged from their families of origin. According to Keisha, her
parents have a history of domes c violence; specifically, they are verbally aggressive to one
another and her father has hit her mother "once or twice." Keisha has a lot of strengths; she is
bright and sociable but has withdrawn from her friends and done poorly at school since the
sexual abuse started (at age 11). She and her mother became quickly engaged in treatment.
Keisha learned and prac ced the relaxa on skills and affec ve expression and modula on
exercises. She also understands the cogni ve triangle and has been able to apply it to her
struggles with her friends. Your plan for the next session is to begin the trauma narra ve and pr
- Answers 10. Which of the following might be a dysfunc onal trauma-related thought for
Keisha?
a) Some of the men in my family have a lot of problems.
