Lesson 1Session 11: Interpersonal trust rebuilding: communication skills, boundaries, and rebuild social supportsThis session centres on rebuilding interpersonal trust and social supports. Clients practise communication skills, firm boundary setting, and safe relationship choices to combat isolation and trauma-related interpersonal challenges.
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 patterns, and revisit key TF-CBT tools to aid long-term upkeep and prompt action if symptoms return.
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, connecting thoughts, feelings, and behaviours. Clients learn to spot automatic thoughts and trauma-related beliefs, readying for later restructuring and meaning work on guilt, shame, and 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 addresses sleep issues and nightmares, introduces stabilising skills, and overviews behavioural activation. Clients learn routines, stimulus control, and activity planning to cut avoidance and aid mood and trauma 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 create a fear hierarchy, test safety beliefs with behavioural experiments, and learn to face rather than avoid situations sustaining PTSD symptoms.
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, and self-blame from trauma. Clients review responsibility, hindsight bias, and moral injury, using cognitive methods and kind perspectives to update distorted meanings and self-views.
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 cognitive restructuring skills. Clients practise challenging unhelpful views and start exploring trauma meanings, including safety, trust, control, esteem, and intimacy themes.
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, outcome measures, and leftover goals. It completes a maintenance plan, sets follow-up contacts, and boosts self-efficacy, noting gains and readying for future hurdles without ongoing 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 expands psychoeducation on PTSD and trauma memory, explains TF-CBT rationale, and introduces grounding and breathing skills to handle arousal, dissociation, and 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 involve imaginal exposure or trauma narrative with peak processing. Focus is on detailed recounting, emotional involvement, and cognitive restructuring of stuck points, while ensuring safety and managing 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 emphasises assessment, joint case formulation, and initial safety planning. It introduces psychoeducation on common trauma responses, normalising symptoms and prepping clients 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 trauma narrative. It stresses distress management, grounding use, and dissociation safeguards, including pacing, tolerance monitoring, and stop signals.
Clarifying goals of imaginal exposureReviewing coping and grounding skillsSetting distress and SUDS monitoringPlanning dissociation precautionsEstablishing stop and pause signals
