Lesson 1Session 11: Interpersonal trust rebuilding: communication skills, boundaries, and rebuild social supportsThis session focuses on rebuilding trust and social supports. Clients practise communication skills, setting firm boundaries, and choosing safe relationships 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, and review key TF-CBT tools for long-term upkeep and quick 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, linking thoughts, feelings, and behaviours. Clients learn to spot automatic thoughts and trauma beliefs, readying for 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 targets 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 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, and learn to face rather than avoid situations keeping PTSD going.
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 examine responsibility, hindsight bias, and moral injury, using cognitive methods and kind views to update distorted meanings and self-judgements.
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 practise challenging unhelpful views and start exploring trauma meanings, including safety, trust, control, esteem, and closeness 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, measures outcomes, and remaining goals. It sets a maintenance plan, schedules follow-ups, and boosts self-efficacy, noting gains and prepping for future challenges without 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 education on PTSD and trauma memory, explains TF-CBT reasons, and introduces grounding and breathing 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 do imaginal exposure or trauma narrative with peak processing. Focus is on detailed recounting, emotional involvement, and restructuring stuck points, keeping safety and managing distress levels.
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 focuses on assessment, joint case formulation, and initial safety planning. It introduces education on common trauma responses, normalising symptoms and 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 work. It stresses managing distress, using grounding, and dissociation safeguards, including pacing, tolerance windows, and stop signals.
Clarifying goals of imaginal exposureReviewing coping and grounding skillsSetting distress and SUDS monitoringPlanning dissociation precautionsEstablishing stop and pause signals
