Lesson 1Session 11: Interpersonal trust rebuilding: communication skills, boundaries, and rebuild social supportsThis session focuses on rebuilding trust and social supports. Clients practise communication, setting boundaries, and safe relationship choices to fight isolation and trauma-related people problems.
Assessing current relationships and supportsPsychoeducation on trust after traumaAssertive communication skill practiceBoundary setting and saying no safelyPlanning to strengthen social networksLesson 2Session 10: Relapse prevention: coping plan, reducing avoidance, and consolidation of skillsThis session stresses relapse prevention and skill consolidation. Clients refine coping plans, tackle avoidance, review TF-CBT tools for long-term upkeep and quick response to returning symptoms.
Reviewing core TF-CBT skills learnedIdentifying high-risk triggers and cuesDeveloping a written coping planStrategies to reduce future avoidanceEarly warning signs and action stepsLesson 3Session 4: Cognitive model introduction, identifying automatic thoughts and trauma-related beliefsThis session introduces the cognitive model, linking thoughts, feelings, behaviours. Clients spot automatic thoughts and trauma beliefs, prepping for restructuring on guilt, shame, safety.
Explaining the CBT cognitive modelIdentifying automatic trauma thoughtsLinking thoughts, emotions, and behaviorsSpotting trauma-related core beliefsThought records for recent triggersLesson 4Session 3: Sleep and nightmare management, stabilising skills, and behavioural activation overviewThis session targets sleep issues and nightmares, introduces stabilising skills, and behavioural activation overview. Clients learn routines, stimulus control, activity scheduling to cut avoidance and aid recovery.
Assessment of sleep patterns and routinesSleep hygiene and stimulus controlNightmare rescripting introductionDistress tolerance and self-soothingBehavioral activation and activity planningLesson 5Session 6: Gradual in vivo exposure planning (hierarchy) and behavioural experiments for safety beliefsThis session plans gradual in vivo exposure to trauma reminders. Clients build fear hierarchies, test safety beliefs with experiments, learning to face rather than dodge PTSD-keeping situations.
Identifying avoided situations and cuesConstructing a graded fear hierarchyDesigning in vivo exposure tasksBehavioral experiments for safety beliefsCoping plans for exposure homeworkLesson 6Session 9: Cognitive work focused on guilt, shame, and self-blame (processing meanings and responsibility)This session targets guilt, shame, self-blame from trauma. Clients check responsibility, hindsight bias, moral injury, using cognitive methods and kind views to fix distorted meanings.
Mapping guilt, shame, and self-blame themesResponsibility pie and realistic appraisalChallenging hindsight and moral judgmentsDeveloping compassionate self-talkAddressing cultural and moral injuryLesson 7Session 5: Thought monitoring and cognitive restructuring practice; introduce work on meanings of traumaThis session builds thought monitoring and restructuring skills. Clients challenge unhelpful views, start exploring trauma meanings like safety, trust, control, esteem, intimacy.
Daily thought monitoring exercisesEvidence for and against thoughtsGenerating balanced alternative thoughtsExploring trauma meanings and themesHomework planning and review processLesson 8Session 12: Review of progress, outcome measurement, maintenance plan, and follow-up schedulingThis final session reviews progress, measures, remaining goals. It sets maintenance plan, follow-up, boosts self-efficacy, notes gains, preps for challenges post-therapy.
Reviewing symptom change and measuresReflecting on goals and treatment gainsRefining long-term maintenance plansPlanning follow-up and booster optionsEnding therapy and celebrating progressLesson 9Session 2: Psychoeducation about PTSD and trauma memory, rationale for TF-CBT interventions, and introduction to grounding and breathingThis session deepens PTSD and trauma memory education, explains TF-CBT reasons, introduces grounding and breathing to handle arousal, dissociation, distress in and between sessions.
PTSD symptoms and maintaining cyclesTrauma memory, triggers, and remindersRationale for TF-CBT componentsTeaching diaphragmatic breathing skillsSensory grounding and orienting skillsLesson 10Session 8: Imaginal exposure / trauma narrative sessions with peak processing and cognitive restructuringThese sessions do imaginal exposure or narrative with peak processing. Focus on detailed recounting, emotional work, restructuring stuck points, keeping safety and pacing distress.
Structuring the trauma narrative processFacilitating detailed imaginal recountingProcessing emotions during narrationIdentifying cognitive stuck pointsRestructuring key trauma appraisalsLesson 11Session 1: Assessment, formulation feedback, safety planning, and psychoeducation about trauma responsesThis session does assessment, joint formulation, initial safety planning. Introduces trauma response education, normalising symptoms, prepping for TF-CBT structure and goals.
Screening tools and structured trauma assessmentCollaborative formulation and treatment goalsRisk, safety, and crisis response planningPsychoeducation on PTSD and trauma responsesExplaining TF-CBT structure and expectationsLesson 12Session 7: Imaginal exposure or narrative work preparation, managing distress, and dissociation precautionsThis session preps for imaginal exposure or narrative. Stresses distress management, grounding, dissociation safeguards like pacing, tolerance windows, stop signals.
Clarifying goals of imaginal exposureReviewing coping and grounding skillsSetting distress and SUDS monitoringPlanning dissociation precautionsEstablishing stop and pause signals
