How to Find the Right Therapist for a Child with PTSD

Many therapists claim to have training in treating trauma-related mental health issues. Unfortunately, some of these therapists do not use evidence-based and/or trauma-informed approaches. To ensure your child gets the best care, it is important that the therapist you choose: 1) practices evidence-based therapy, 2) is trained in trauma-specific therapies, and 3) works in a trauma-informed setting.

• Trauma-focused means that the therapy is specialized for trauma and PTSD.
• Evidence-based means shown in studies to be better than other therapies in reducing children’s PTSD.
• Trauma-informed care means that all procedures and policies are designed to make families who have been though trauma feel understood, safe, and empowered.

Effective Treatment for Trauma-Related Emotions and Behavior

Cognitive behavioral therapy (CBT) suggests a 3-way relationship between body reactions (e.g., racing heart), negative thoughts (e.g., “Everyone will think I am stupid if I ask a question in class”), and behavioral responses (e.g., avoidance). For people exposed to trauma, these responses are often reactions to thinking and feeling they are in danger. It is common for individuals who have experienced trauma to feel like they are in danger, despite now being safe. Trauma-specific therapy is provided to help relieve the negative consequences of trauma. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and 123 Alternatives for Families: A Cognitive Behavior Therapy (AF-CBT) are two trauma-specific therapies designed to help children, adolescents, and their parents or caregivers. It is important to note that parents and caregivers play an essential role in these treatments.

TF-CBT is an evidence-based therapy with the strongest research evidence of any therapy for traumatized youth. TF-CBT helps youth by teaching a variety of skills to help manage emotions, develop healthy coping skills, and rebuild a sense of safety and security. Therapists who deliver TF-CBT also dedicate individual sessions to parents/caregivers. In these sessions, caregivers learn parenting strategies, how to manage their emotions, and how to best support their child’s recovery.

AF-CBT is an evidence-based therapy. It focuses on both the key risks for child abuse (e.g., coercive parenting practices, anger, hyperarousal, negative child attributions) and the consequences of negative parent or caregiver behavior on the child (e.g., child aggression, poor interpersonal skills/functioning, intense emotional reactions). A major goal of AF-CBT is to improve the relationship and communication within families that have experienced conflict. 

When trying to find a trauma therapist for your child, you may want to ask:

1. How do you decide what therapy or strategies a new client needs?

Listen for: initial intake assessment/evaluation, matching results to treatment plan.

2. What therapy or strategies do you provide for children with PTSD?

Listen for: cognitive-behavioral therapy; coping skills for anxiety, sadness, and anger; talking directly about the trauma; exposure to reminders of the trauma.

3. What is your training in evidence-based trauma therapy?

Listen for: graduate courses; webinars; live learning sessions by experts; supervision or consultation while working with families; certification in a trauma therapy like TF-CBT.

4. What is your experience doing evidence-based trauma therapy?

Listen for: work with children and adults, individuals and families, and diverse types of trauma; measured reductions in PTSD and other trauma symptoms.

5. How do you involve parents/caregivers in the therapy process?

Listen for: parents/caregivers are involved in assessment and therapy; they participate in therapy sessions to learn skills and help the children face their fears.

6. How do you monitor a client’s progress during therapy?

Listen for: repeated assessment of the problem identified during the initial intake; adjusting treatment based on assessment results.

Finding a TF-CBT and AF-CBT Therapist
The following search tools can help you find a TF-CBT and AF-CBT therapist:

The TF-CBT National Therapist Certification Program Find a Therapist Tool
https://tfcbt.org/therapists/
This is the official directory of TF-CBT certified therapists from the TF-CBT national therapist certification program.

The AF-CBT Find a Therapist Tool
https://www.afcbt.org/whereisAFCBT
This is the official AF-CBT website with a list of providers in the United States and internationally.