TF-CBT and Trauma Therapy with Compassionate Counseling St. Louis Therapist Molly Shaffer, LPC
At Compassionate Counseling St. Louis, we provide trauma therapy to kids, teens, and college students all over Missouri. One approach that our St. Louis therapist team uses is called Trauma Focused Cognitive Behavioral Therapy or TF-CBT. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a researched and structured approach designed to help children, adolescents, and their caregivers process and overcome traumatic experiences.
Today we are connecting you with Compassionate Counseling St. Louissenior therapist, Molly Shaffer, LPC. Molly is a certified TF-CBT practitioner and is sharing more about what TF-CBT is and how she integrates this in her approach to trauma therapy.
Image Credit: Unsplash Michał Parzuchowski @mparzuchowski
What interested you in working with trauma?
What interested me most in working with trauma was learning more about trauma and its impact on children and adolescents, both in immediate trauma responses and the long-term emotional, behavioral, and relational effects.
I think that many children and families can feel stuck in the effects of traumatic experiences, often carrying feelings of fear, shame, confusion, or helplessness long after the event itself has passed. With that I really wanted to become a source of support and healing for those individuals and families. I want to help children and adolescents recognize that while trauma may be a part of their story, it does not define who they are or determine their future. Through support, understanding, and evidence-based interventions, I hope to help individuals regain a sense of safety, confidence, and empowerment in their lives.
Are there different kinds of trauma? And, if so, are there any kinds of trauma that TF-CBT is not a good fit for?
Yes there are different "types" and "categories" of trauma. The types include: acute, chronic, complex (these are just ones we focus on for TF-CBT).
Acute trauma is a single experience of a specific trauma.
Chronic trauma is repeated or ongoing experience of specific traumas over time.
Complex trauma is exposure to multiple traumas or prolonged experiences of trauma over time.
TF-CBT can be effective for all types of trauma but its effectiveness can vary depending on the severity and nature of the trauma that has been experienced.
TF-CBT has been shown to be effective for children and adolescents who have experienced sexual abuse, physical abuse, violence exposure (domestic abuse/community violence), grief and loss or multiple complex traumas. TF-CBT is not effective for adults who have experienced trauma or developmental trauma.
When do you not recommend TF-CBT?
When a child’s behavior concerns were present before experiencing trauma. Also, individuals who struggle with substance abuse or experience frequent suicidal thoughts, gestures or attempts as there can be worsening of symptoms through the trauma narrative and exposure components.
How old does a child need to be to be able to use TF-CBT with them?
TF-CBT is utilized with children, adolescents and young adults from the ages of 3-21 years old.
How do you involve caregivers or family members in the TF-CBT process when treating children?
Parent/caregiver involvement is a big component to the TF-CBT approach. Initially parents are provided much psychoeducation on trauma and its effects to help them understand the difference between anxiety and trauma, recognize potential trauma responses, and understand what their child is experiencing. Parents are also taught many of the regulation skills the child is working on in session so that continued practice can occur at home, but also to support caregivers in difficult moments and increase coregulation! Parent are also involved in conjoint sessions where the child can share the trauma narrative (part of the desensitization process) to normalize the experience and response, to practice coping skills together and build connection, support and future safety plans
What is one tool you love for helping kids with big feelings regulate their emotions and behaviors when their feelings are getting big?
One tool I love for helping kids regulate big feelings is teaching breathing techniques. Breathing is one of the most effective ways we can help calm the nervous system and regulate the body when emotions begin to feel overwhelming. I especially enjoy using fun, child-friendly breathing exercises to teach belly breathing, such as “smell the (insert favorite food), cool off (insert favorite food),” or rainbow breathing. Making it playful helps children engage with the skill and practice it more consistently. For older adolescents I like to practice the 4,7,8 breathing method.
I also like incorporating physical movements because many children experience big emotions physically in their bodies. Movement can help release built-up energy and bring the nervous system back to a calmer state. Some examples include wall pushes, animal walks, stretching, shaking out arms and legs, jumping jacks, etc. I think combining breathing and movement can be especially helpful for children who struggle to sit still or verbalize what they are feeling in the moment.
What would you want parents to know when they are considering trauma therapy for their child?
When beginning TF-CBT, I think it is very important for parents and caregivers to understand both the process and what to expect throughout treatment. I provide parents with information about the phases and goals of TF-CBT, as well as psychoeducation regarding the specific type of trauma experienced and common trauma responses children may demonstrate.
It is also important for parents to know that, as treatment begins and children start processing traumatic experiences, they may temporarily observe an increase in emotions, behaviors, or trauma-related responses. This can occur because children are beginning to discuss and work through experiences that they may have avoided, suppressed, or struggled to express previously. As traumatic memories and emotions are explored in a safe therapeutic environment, children can become more emotionally reactive, dysregulated, anxious, irritable, or behaviorally expressive for a period of time. While this can be difficult for families, these responses are often a normal part of the healing process rather than a sign that treatment is worsening symptoms.
Throughout TF-CBT, children are simultaneously learning coping skills, emotional regulation strategies, and ways to process their experiences more safely and effectively. With continued support, consistency, and progression through treatment, these trauma responses typically decrease and overall functioning and emotional regulation improve.
Want to Work with Molly?
Molly Shaffer, LPC
Thinking about exploring trauma therapy in St. Louis for your child?
Molly is Trauma Focused CBT certified and is supervising another wonderful St. Louis therapist at Compassionate Counseling St. Louis, Kayla as she completes the final phase of her TF-CBT certification.
Schedule your free 15-minute consultation call to help you decide if TF-CBT at Compassionate Counseling St. Louis is the right next step for you and your child.
If you are wondering about child trauma therapy options, teen trauma therapy options, or St. Louis TF-CBT resources, we’d love to talk about how St. Louis therapy at Compassionate Counseling St. Louis can help. Reach out to us at hello@compassionatecounselingstl.com. As anxiety experts providing St. Louis therapy, we love working with kids, teens, college students and parents to help manage their anxiety, stress, and anger. Compassionate Counseling St. Louis is located in Clayton, MO and works with families by offering both in-person counseling and online therapy throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Couer, Kirkwood, Richmond Heights, and Brentwood. We also provide online therapy Missouri -wide to teens and college students. You can set up your first free consult on this website, on our consultation page.