Tf-cbt QUESTIONS WITH COMPLETE 100% VERIFIED SOLUTIONS 2024/2025, Exams of Medicine

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Tf-cbt QUESTIONS WITH COMPLETE

100% VERIFIED SOLUTIONS

2024/

What is the typical length of a full course of TF-CBT? 12 - 25 sessions A typical course of TF-CBT should take somewhere between 3-5 months of reqular weekly sessions.

. How often should TF-CBT treatment sessions be conducted? Once a week or more frequently Weekly sessions are the TF-CBT standard, and treatment can be delivered more frequently if circumstances make that possible. For what age range of children has TF-CBT been found to be effective? 3 - 18 years Research demonstrating TF-CBT's efficacy has included children as young as 3 and as old as 18. Which of the following statements is NOT true for TF-CBT? All children who have experienced at least one potentially traumatic event are good candidates for TF- CBT Simply experiencing a trauma does not make a child a good candidate for TF-CBT; trauma-related symptoms must be present, as well. Lila is a 10-year-old girl referred to you by a school counselor due to misbehavior in school and decreased academic performance that both have become serious problems over the past 3 months. Your trauma assessment revealed that she had been in a serious car crash about three years ago, suffering some minor physical injuries. Neither she nor her parents report any other traumatic events. Her mother reported no difficulties related to the car crash and Lila's score on a standardized measure of PTSD symptoms was in the low normal range. Is Lila a good treatment candidate for TF-CBT and why? No, she does not have clinically significant trauma-related problems that require trauma-focused treatment. TF-CBT should be provided to kids who have experienced trauma AND who report some symptoms of PTSD Which of the following is a TF-CBT treatment goal for participating parents and caregivers? To increase caregiver support of the child, parenting skills, and parent-child communication Some of the other response options may be ancillary benefits of TF-CBT in some cases, but they are not explicit treatment goals. Which of the following is NOT a problem that should be managed prior to beginning TF-CBT?

Child has significant academic problems and is failing Issues that pertain to the safety of the child or others in the child's environment need to be addressed prior to beginning TF-CBT. Academic problems generally do not rise to this standard. What treatment elements should be included in every session of TF-CBT? Parenting Skills and Gradual Exposure The trauma should be discussed in every session of TF-CBT (as the PRAC skills are applied to trauma- related problems, for example), and parent sessions should include some discussion of parenting Which TF-CBT treatment components make up the Integration/Consolidation Phase of treatment? In Vivo Mastery, Conjoint Sessions, and Enhancing Future Safety and Development Integration/Consolidation is the final phase of TF-CBT treatment and includes all the components after the creation and processing of the Trauma Narrative. Samuel is a 14-year-old boy with a cognitive disability who functions at about the level of a 5-year- old. He was referred to you by a child welfare worker after a report of physical abuse by his mother. Your trauma assessment found that Samuel had a long history of significant physical abuse by both his parents. Samuel reported that when his parents beat him, it was his fault because he did something wrong, and that he usually deserved the punishment. He often felt guilty about causing his parents to hit him and ashamed of himself for being bad. A standardized measure of PTSD symptoms completed by his current caregiver, an aunt, was in the high normal range. Is Samuel a good treatment candidate for TF-CBT and why? Yes, Samuel's problems with guilt, self-blame, and shame are clinically significant trauma related problems that can be treated with TF-CBT. Despite Samuel's disability, he is functioning at a developmental level for which TF-CBT is appropriate, and his self-blame and emotional symptoms are appropriate treatment targets. What are the two components of treatment fidelity? Adherence and Competence The degree to which therapists provide treatment "with fidelity" is dependent on how closely they follow the prescribed treatment model (adherence) and their skill in delivering the treatment components (competence). Which of the following is a main purpose of the psychoeducation module? Helping children and caregivers understand common reactions to trauma exposure is one of the main functions of this module. All of the following are important aspects of the psychoeducation module EXCEPT: Assessing the child's trauma symptoms and appropriateness for TF-CBT Initial assessment of symptoms occurs prior to treatment onset. Which statement reflects an element of psychoeducation pertaining to physical abuse?

Physical abuse and punishment are not the same thing. Physically abused kids often struggle to understand the difference between "punishment" and "abusive discipline." Which statement below is the most accurate regarding how to choose therapeutic activities within the Psychoeducation module? Therapeutic activities will vary across cases, depending in part on the developmental age of the child. Activities aimed at conveying psychoeducation need to be targeted at the child's developmental level, not necessarily his or her chronological age. Dr. Johnson is seeing Alaina, a 9 year-old child sexual abuse victim, for TF-CBT. They are in the process of creating Alaina's trauma narrative, and she is providing very little information about what happened to her during and after the trauma. Dr. Johnson is not sure whether Alaina's difficulties represent trauma-related avoidance or simply a deficit in the ability to tell a story with a high level of detail. Which technique could Dr. Johnson have used during the Psychoeducation phase of treatment to give her a clearer understanding of Alaina's abilities? a baseline/neutral narrative task Using the baseline/neutral narrative task early in treatment provides an excellent insight into the child's natural narrative abilities and provides a comparison to how easily s/he talks about the trauma. Mrs. Sands is bringing her daughter Tonette in for TF-CBT treatment of symptoms related to witnessing community violence. Mrs. Sands was expecting to drop Tonette off for her session each week, run errands, and then come back to the office to pick her up. Mrs. Sands is a little bit surprised to find out that the therapist expects to meet with her for part of the session each week. Which of the following messages should the therapist be sure to communicate to Mrs. Sands about TF-CBT? The TF-CBT treatment model emphasizes the importance of working as a team with caregivers. A key element of psychoeducation is communicating clearly what the treatment model is, and what the expectations are for children and caregivers. Active ignoring is a strategy that is designed to help parents: Avoid responding to their child's unharmful, inappropriate behavior Ignoring deprives the child of attention that might reinforce the undesirable behavior. One important aspect of parental praise for a child's behavior is: To praise specific types of desired behavior When it comes to praise, the more behaviorally specific it is, the more impact it has. Which of the following strategies is a recommended first-step strategy for responding to a young child when the child disrespectfully makes angry or defiant verbalizations directed at the parent? Active ignoring Ignoring involves the lowest level of parental effort and is a good first step method for shaping young kids' behavior, especially when it is followed by praise or positive attention to good behavior.

The primary goal of time out is to: Punish the undesirable behavior by depriving the child of attention Time out places a child in an aversive (though not painful) setting that is designed to reduce the behavior that preceded it; that's how punishment works. Mr. Gaboury is bringing his 12-year-old grandson in for TF-CBT following a physical assault at school. Mr. Gaboury is very focused on the behavior problems his grandson is experiencing. During an early parent session, he says that his grandson "has become a budding juvenile delinquent! I know that he has some nightmares and things, but until he stops being so aggressive I don't think any kind of therapy will be helpful." What important parenting message should the therapist convey to Mr. Gaboury? Behavior problems in many cases are the product of trauma symptoms, not a separate issue Helping caregivers understand the potential connections between trauma exposure and behavior problems is a critical focus of parenting skills training, especially early in treatment. Which of the following is a good example of using "differential attention" in parenting? Ignoring some undesired behaviors and using specific praise for desired behaviors instead Differential attention is based on the idea that children will engage in behaviors that are rewarded (with praise) more than behaviors that are ignored. The best time to begin practicing controlled breathing with children is: When they are calm Much like learning any new skill, it's easier to develop relaxation mastery in situations that are not stressful and build up to using them when needed. In controlled breathing children are asked to: Exhale more slowly than they inhale Exhalation should be deliberate and slow, which controls the general pace of breathing. During Progressive Muscle Relaxation (PMR), children are asked to: Tense and relax their muscles The opposing processes of tensing and relaxing are the key aspects of PMR. Which of the following statements about alternative relaxation methods is most accurate: Mindfulness exercises and everyday activities like reading can be used as relaxation tools. In addition to controlled breathing an progressive relaxation, mindfulness excercises and common, everyday activities can be suggested as helpful ways to reduce arousal. James is a 14 year old who witnessed his best friend get shot and killed. He reports a lot of problems sleeping, feels anxious 'all the time,' and can't concentrate on his schoolwork. Which of the following would be an appropriate relaxation strategy? Meditation The other options here may be good coping strategies and may distract James from his worries and

memories, but they are not likely to decrease his physical arousal, which is the focus of relaxation activities. What is the primary goal of teaching relaxation strategies to TF-CBT clients? To help the child manage their physical symptoms of fear and anxiety TF-CBT teaches several coping strategies, and relaxation efforts are aimed specifically at reducing physiological arousal symptoms common in trauma victims. Which of these techniques involve teaching children how to recognize emotions, describe bodily reactions that are part of these emotions, and act out emotions in session? Feelings identification Feelings identification focuses on labeling emotion names and understanding their expressive components. Nine-year-old Jessica has learned the names and facial expressions associated with several different emotions, but she continues to have difficulty managing intense feelings of anger. Which of the following interventions to help Jessica manage her anger is most appropriate within a TF- CBT framework? Encourage the parent to discuss their feelings with you and try to address them in parent sessions Caregiver emotion can be an important factor to consider and should be addressed directly with parents outside the child's presence. Which of the following is Affective Identification and Expression NOT designed to teach children? How to emotionally process the traumatic event Emotional processing of the traumatic event happens later in TF-CBT when the Trauma Narrative is created and discussed. When children find it hard to discuss their own feelings, it is often helpful to: Discuss the feelings of other children or imaginary characters from books Children are often able to discuss others' feelings more easily than their own, so talking about how others feel may help some kids gain insight into their own emotions. Nine-year-old Jessica has learned the names and facial expressions associated with several different emotions, but she continues to have difficulty managing intense feelings of anger. Which of the following interventions to help Jessica manage her anger is most appropriate within a TF- CBT framework? Help Jessica develop a handful of strategies for self-soothing that are situationally appropriate There is no "one-size-fits-all" strategy for managing emotions in every situation. Different contexts will require different coping strategies. What are the three legs of the TF-CBT Cognitive Triangle? Thoughts, feelings and behaviors The purpose of the "cognitive triangle" is to teach about the connections between thoughts/cognitions, feelings, and behavior.

Felix is a 15-year-old, Spanish-English bilingual young man. He learned English when he was 11 years old. He is receiving TF-CBT for physical abuse that happened when he was 4 and living in El Salvador. Which statement is most accurate about how to work with Felix in the Affective Identification and Regulation module? The therapist should ask Felix to list trauma-related emotion words in both English and Spanish. Because Felix "remembered" his trauma before he learned English, he may have more words for what happened to him in his native Spanish. Asking him Spanish emotion names, that he can they try to translate for you, may help you gain a greater understanding of his emotional experience. Cognitive coping techniques do NOT involve direct discussion of: Emotional reactions to the abuse Although emotions are discussed as part of the "cognitive triangle," cognitive coping techniques are aimed at countering inaccurate, unrealistic, and unhelpful thoughts. When teaching cognitive coping to a school-aged child, it is best to use examples taken from The child's life experiences Using real-life examples is best for a child who is school-age or older; younger children might need examples taken from other media. The cognitive triangle is designed to teach children that: Behavior, feelings, and cognitions are related to one another The point of the triangle is to demonstrate the interconnectedness of thoughts, feelings, and behavior. Cognitive coping tries to decrease problem thoughts by: Identifying, challenging, and replacing them Cognitive coping is intended to help children recognize unhelpful/inaccurate thoughts and challenge them with more accurate or helpful ones. Samantha is a 15-year-old girl who was physically abused by her mother for several years. She continues to blame herself for what happened and believes that if her mother really cared about her, she would never have done this. As a result, she does not believe anyone will ever love her. Which of the following statements should guide the therapist's actions? These thoughts may be accurate but they are unhelpful and should be addressed directly. Samantha's thoughts are likely to be accurate, but they make her feel worse. In the Cognitive Coping module, alternative and accurate thoughts that do not produce negative emotions should be identified and discussed. Which of the following describes the suggested order for effectively obtaining information from a child when developing a trauma narrative? Ask, Listen, Repeat, Write Down The therapist should Ask an open-ended question, Listen to the child's response; Repeat the response back to the child, and then Write Down the answer in the narrative When creating the trauma narrative with the child, the clinician should:

Be listening for examples of distorted, unhelpful thoughts in the child's account of what happened One of the main goals of eliciting thoughts and feelings when creating the narrative is to identify unhelpful and inaccurate thoughts that produce symptoms of PTSD and/or depression. Which statement about developmental expectations for the creation of the trauma narrative is correct? The ability to create detailed narratives can vary considerably across school-aged kids. Child distress is actually a reason to complete a trauma narrative, not to avoid it. Repeated exposure to trauma-related memories will help the child learn to manage trauma-related distress. When a child has more than one type of traumatic event (e.g., sexual abuse and physical abuse), to avoid overwhelming the child it is recommended to do the trauma narrative on only one of these events. FALSE Trauma narratives for youth with multiple trauma exposures should include elements from all the traumas that most significantly contribute to children's symptom presentation (i.e., intrusive thoughts, avoidance). 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 mastery? Provide psychoeducation about in vivo activities in case avoidance returns, and proceed to Conjoint Session planning. Some discussion of avoidance behaviors and how to handle them should they emerge later is the best strategy here, but the full module need not be implemented. Where on the hierarchy of feared stimuli should the therapist begin the in vivo mastery exercises? With whichever item the child, caregiver, and therapist think is most appropriate This should be a joint decision with input from all parties. Michelle, 11, witnessed her mother get stabbed at home and has lingering fears about ambulances and siren noises. They remind her of the night her mother was attacked. She has created a hierarchy of feared situations with her therapist. At the high end of the hierarchy is seeing an ambulance close up with the siren blaring. At the bottom is seeing a picture of an ambulance. Several other items fall between these extremes. How should the therapist begin working on helping Michelle overcome her fears? Michelle, her caregiver, and the therapist should make a detailed plan to expose Michelle to an item from the middle of the hierarchy first. When beginning work on a fear hierarchy, avoid choosing a item that may be too stressful or one that may be so easy that completing it does not seem like an achievement. Starting somewhere near the middle of the hierarchy is a good rule of thumb. Dray, 15, and his mother are working through an exposure hierarchy related to his exposure to community violence. It's going pretty well, but Dray's mother tells you she doesn't know what to say when he says he can't stay in the exposure exercise any more. What suggestion should the therapist give her? Ask Dray if he can tolerate another 30 seconds in the situation before leaving. If he says no, then leave. Encouraging Dray to try to tolerate a little more time in the situation can increase his sense of mastery, but he should never be forced to do so if he feels like he can't.

Which of the following is an indication that the family is not ready to participate in parent-child sessions? Caregiver shows a high level of distress when discussing the child's traumatic experience Caregiver readiness needs to be demonstrated by maintaining a reasonably calm demeanor when listening to or talking about the child's trauma. Which of the following is NOT consistent with the rationale for having parent-child sessions? These sessions provide opportunities for caregivers to explain how they overcame their self-blame The focus of conjoint sessions should be on the child's progress and mastery of the trauma, not the parents. Parents should receive validation for their progress in parent sessions with the therapist. Which of the following is true about conjoint parent-child sessions where the Trauma Narrative is shared? The sessions should be carefully planned ahead of time in order to reduce the possibility of any unexpected reactions or problems. A common mistake that novice TF-CBT therapists make is under-preparing for conjoint sessions. Both the child and the caregivers should know what to expect and be ready for these sessions. How should safety planning address what to do when a child tells a grown-up about a possible trauma, but the grown-up does not believe the child's story? The child should continue to tell trusted adults from the safety plan until someone takes action. This is a basic tenet of safety planning; tell until an adult takes some kind of protective action. During a conjoint session, a caregiver makes an inappropriate comment. What is the best initial step to take? Reframe the comment to prompt more appropriate behavior from caregiver, if possible Caregivers may need to be reminded about the purpose of the conjoint session; if the behavior continues, however, terminating the session may be necessary until additional preparation can be done. Which of the following is NOT a goal of conjoint parent-child sessions? To allow the child to understand the caregiver's feelings about the traumatic events. The caregiver's feelings about the trauma are important topics for the therapist and caregiver to address, but they are not something the child needs to be concerned about. The Conjoint Session is very much focused on the child's emotional needs, not the caregiver's. What are the most important keys to successful conjoint parent-child sessions? Preparation and practice with both the child and the caregiver prior to parent-child sessions. Preparation is key; Conjoint sessions can be very powerful emotional experiences, and it's important to try to minimize the possibility of any unexpected or "surprise" reactions. This can be achieved with practice. Which of the following is the main reason that discussion of safety issues is conducted at the end of TF-CBT?

Fully processing the trauma narrative before talking about safety helps to avoid confusion about self- blame Generally, you want to avoid discussing risk reduction strategies until the child has had an opportunity to work through any issues he or she might have related to self-blame. Which of the following statements about creating safety plans is true? Safety plans should be discussed with and practiced by youth and caregivers in session Enacting safety behaviors in session should increase the child's (and caregiver's) confidence that they can be acted on when needed. The primary long-term goal of the Enhancing Safety module is focused on: Minimizing additional risk for repeat victimization Repeat victimization is very common for trauma-exposed children, and the main purpose of the module is to try to reduce the child's risk for exposure to additional trauma. Which of the following statements best explains why therapists are instructed to praise children's responses to their previous traumas as part of the enhancing safety component? Praising the child's response reinforces the idea that the child was not responsible for preventing the trauma Highlighting a positive aspect of the child's reaction to trauma reinforces appropriate messages about who is at fault for the traumatic event. In addition to safety planning to reduce the risk of future victimization, what is another important topic to cover during this component? What each family member learned during therapy It is always a helpful review/refresher to discuss what the child and caregiver got out of TF-CBT participation.