Prologue to Trauma-centered subjective Behavioral treatment .


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Introduction to Trauma-focused cognitive Behavioral therapy. Elizabeth Feldman, PhD University of Washington School of Medicine. The origins of TFCBT. Developed for treating sexually abused children Viewed working with parents as an integral part of treatment Esther Deblinger , Ph.D.
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Prologue to Trauma-centered subjective Behavioral treatment Elizabeth Feldman, PhD University of Washington School of Medicine

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The starting points of TFCBT Developed for treating sexually mishandled kids Viewed working with guardians as a necessary piece of treatment Esther Deblinger , Ph.D. Community for Children\'s Support University of Medicine and Dentistry of New Jersey & Judith Cohen, M.D., and Anthony Mannarino , Ph.D. Community for Traumatic Stress in Children and Adolescents Alleghany General Hospital

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Understanding PTSD What is Post Traumatic Stress Disorder? Traumatic Event Avoidance Re-encountering Hyperarousal Interference with every day working

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Example case: Age Gender Race/Ethnicity Home life environment School history Outline of traumatic occasions Current ecological backings Other existing wellbeing related determinations

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Complex PTSD Ongoing, incessant presentation to traumatic occasions. Nobody, confined injury. Indications can be far reaching, however ought to in any case meet criteria for PTSD.

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Common subjects of PTSD Loss of trust in self & others Self-point the finger at Shame & Guilt Anger Relationship challenges Behavior issues School disappointment Difficulty overseeing influence Hopelessness Depression

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Common Caregiver Themes Inappropriate self-fault and blame Inappropriate youngster reprimand Overprotectiveness Overpermissiveness Post Traumatic Stress Disorder/side effects Anger, hostility Hopelessness, stress, misery

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Example case: Age Gender Race/Ethnicity Home life environment School history Outline of traumatic occasions Current natural backings Other existing wellbeing related findings

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Choosing TFCBT RCTs showing adequacy/viability of TFCBT for: Ages 3-18 Boys/Girls Multiple racial/ethnic foundations Varying financial status Single or different injury history Placement with organic guardians or tyke welfare Children with conduct issues

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TFCBT is not for: Clients with extraordinary treatment safe conduct Clients with dynamic self-destructive conduct Clients with extreme psychological inabilities

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TFCBT – A Practice! Appraisal! P sychoeducation and Parenting Strategies R elaxation A ffective expression and direction C ognitive adapting T rauma story and handling I n vivo presentation C onjoint parent kid sessions E nhancing individual wellbeing and future development

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Trauma-centered Cognitive Behavioral Therapy Child\'s Treatment Coping Skills Training: Emotional Expression Cognitive Coping Relaxation Gradual Exposure & Processing Education: Child Sexual Abuse Healthy Sexuality Personal Safety Caregiver\'s Treatment Coping Skills Training: Emotional Expression Cognitive Coping Relaxation Gradual Exposure & Processing Education (like tyke sessions) Behavior Management Joint Sessions Coping Skills Exercises Gradual Exposure & Processing Education Regarding Sexuality and Sexual Abuse Personal Safety Skills Family Sessions From Deblinger & Heflin (1996)

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Assessment Goal: Identify injury history and nearness of injury related indications. 1) Trauma History 2) Internalizing 3) Externalizing 4) Avoidance 5) Re-encountering 6) Hyperarousal 7) Interference with every day working

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Psychoeducation Goal: Normalize manifestations, approve experience and responses, ingrain seek after recuperation. What is injury? What is PTSD? What is TFCBT?

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Parenting Goal: Support guardians to lessen their own push/tension, enhance the tyke grown-up relationship, help the parental figure bolster the youngster\'s recuperation. Adulate Rewards Active Ignoring Time Out Specific for children with PTSD: Confidence in point of confinement setting Not fortifying shirking Coping training

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Relaxation Goal: Create "tool kit" that the customer can use in his/her own particular surroundings to oversee indications. Unwinding is not simply dynamic muscle unwinding and profound breathing… What do you do to unwind? Unwinding versus Trouble Tolerance

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Affective Regulation Goal: Normalize numerous clashing sentiments, educate fluctuating levels of emotions, show vocabulary for discussing traumatic occasions ably. Sentiments Education (what are feelings?) Connecting emotions to traumatic or troublesome occasions Feelings thermometers Learning self-relieving methods

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Cognitive Coping Goal: Essential to help customers/families assess the routes in which injury changed their reasoning and right misshaped contemplations. Ensure customers don\'t characterize themselves by their traumatic encounters. Subjective Processing happens previously, then after the fact the Trauma Narrative. To begin with instruct the ability, then utilize it.

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Cognitive Coping The heart of TFCBT: GOALS: Clarify the contrast between musings, emotions, and practices. Exhibit how contemplations, sentiments, and practices influence each other. musings behavior sentiments

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Trauma Narrative Goal : "To bit by bit open customer to considerations, recollections, and different harmless indications of the damaging knowledge until they can endure those recollections without huge enthusiastic trouble and didn\'t really need to stay away from them." ( Deblinger & Heflin, 1996, p. 71) Comes from Anxiety Framework Un-blending of safe jolts with scholarly uneasiness reaction.

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Trauma Narrative Should include: Before the injury Components of the injury (sections) with particular points of interest, contemplations, emotions, and related recollections The "most exceedingly terrible" part "What I learned" or "What I would tell different children" The future

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Cognitive Processing of the TN: Goal: Identify idle or obvious subjective contortions or unhelpful convictions and test them with the customer. Return to the intellectual triangle, include results Use Socratic addressing Never "tell" the customers to change their convictions

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Common Trauma-Related Thoughts/Feelings Guilt Shame/Disgust Self-Blame Hopelessness Fearfulness Worthlessness Lack of control Depression

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In-Vivo Exposure Goal: Unpair dreaded jolts (triggers) from the educated reaction of nervousness/dread. Cases: The dull Streets Men Use general and particular dread stepping stools, set up homework and practice exercises with reward frameworks.

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Enhancing Safety Goal: Prepare for the future Learn to perceive signs/side effects that demonstrate the requirement for an arrival to treatment Create usable, significant wellbeing arranges Plan for utilizing adapting abilities Consider ecological backings

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Conjoint Sessions Goal: Increased presentation/open door for authority Increase kid & parental figure correspondence Support asking and noting questions Essential to get ready sufficiently (individual with CG and with customer before joint session) Invite arranged inquiries, remarks, input Celebrate achievement!

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Summary Assessment! P sychoeducation and Parenting Strategies R elaxation A ffective expression and control C ognitive adapting T rauma story and preparing I n vivo introduction C onjoint parent youngster sessions E nhancing individual security and future development TFCBT – it works!

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Thank You!

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