TF-CBT and Trauma Therapy for Teens in St. Louis
This week we interview our therapist Molly Shaffer, MA, LPC, Certified TF-CBT Therapist, to learn more about anxiety counseling for kids and teens who have experienced trauma. Molly has extensive experience working with anxious, angry kids, utilizing skills building, CBT, and trauma-focused therapy.
Read More: Thought Spirals and CBT for Anxiety
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This is a big question, but briefly, what is trauma therapy and TF-CBT?
There are many different forms of trauma. When an individual experiences trauma, whether it be one time, recurring, or multiple different traumas, they can be affected significantly. Trauma can have long lasting effects on an individual's brain functioning, emotions and responses.
Trauma therapy aims to help individuals recognize symptoms of trauma and face them head on to be able to manage and/or overcome the impact the traumatic event played in their life. While there are lots of different types of trauma therapy, the one I am certified in, and really love, is Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT).
TF-CBT is an evidence-based practice and is a more short-term approach at addressing trauma and its effects. Its goal is to assist individuals in coping with trauma related stress through development of healthy coping skills and to help both children and parents process thoughts and feelings related to the trauma. The model focuses on several different components including psychoeducation, relaxation skills, affect regulation and cognitive processing of the trauma, trauma narrative, conjoint child/parent sessions, and ensuring future safety.
I think it is important to note that there is a big focus on parent and child sessions, to not only help the child process and understand their trauma but also the parents and family.
Why did you decide to become a certified TF-CBT therapist?
Through much of my previous work with children and teens, I have witnessed firsthand the direct effects that trauma can have on them and their families. Trauma significantly impacts children's ways of functioning, behaving and thinking which can alter their relationships, education and overall functioning in daily life due to their continued trauma symptoms. I often saw symptoms go unnoticed or termed behavioral disorders or a “bad kid.” I wanted to try to find a way to help adolescents acknowledge their trauma, learn how to appropriately process the thoughts and feelings associated with it and learn better skills for coping to become successful.
What’s the overlap between trauma therapy and anxiety therapy?
Trauma and anxiety can go hand in hand and have very similar symptoms. Anxiety can worsen your trauma symptoms and vice versa. In terms of therapeutic approaches to anxiety and trauma, the overlap is in the CBT concepts and work. With anxiety and trauma individuals can develop different negative thought patterns or cognitive distortions that impact the way they choose to respond to stress. By using different CBT components with both trauma therapy and anxiety therapy you can combat these negative thoughts and help individuals learn ways of reframing negative thoughts patterns to decrease the trauma or anxious responses that have been developed.
Do you only provide Trauma Focused-Cognitive Behavioral Therapy, or do you use other types of therapy in your sessions?
When working with a trauma case I do follow the model but not with all clients. I use a lot of CBT components in much of my work as well as positive psychology and mindfulness.
Can you use TF-CBT for kids, teenagers, AND college students?
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Research shows that the ideal age range for TF-CBT is between 3-18 years of age.
Do you still use trauma therapy interventions during a virtual counseling session? How do you modify trauma counseling for online therapy?
As far as activities and interventions I think that you can do pretty much anything online that you can do in person with the different programs that we use for virtual counseling. The one issue I find with doing trauma therapy online is confidentiality. Because we talk about such sensitive things, I want to ensure that the child or teen I work with has a private space from home to work in, so that I know they’re protected until they’re fully ready to share information during those joint parent sessions.
What do you wish people knew about getting therapy for anxiety and trauma disorders?
I wish more people knew that help is out there and it is ok to seek it out. Experienced trauma and mental health still seem to have a very negative stigma attached to them, and as a result, people often feel ashamed of their past experiences and especially if they have a trauma history. So, rather than seek help, they continue to utilize behaviors that appear to give them relief in the moment but only further the re-experience of trauma and emotional and behavioral struggles.
As a trauma therapist who also provides anxiety therapy, what overlap do you notice between anxiety, anger management, and conduct issues?
Individuals who struggle with anxiety can sometimes become moody, angry and lash out when they are unable to deal with their fears or other symptoms. When an individual responds to anxiety with aggression or other behavioral issues, I think that the true issue which is anxiety can be overlooked and individuals, especially children, can be termed as aggressive or conduct kids.
Struggling to handle your child’s aggressive behavior?
Therapeutic parent coaching can help! We’ll build skills and give you space to explore what’s going on.
When might a parent consider signing their child up for trauma therapy?
There are many different signs and symptoms of trauma including depression, increased anxiety, irritability, mood swings, aggression, overwhelming fear. When a child presents with increased symptoms that begin to interfere with daily living and performing basic tasks then it may be time to seek out an assessment to look into trauma therapy.
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.
When scheduling a session with you at Compassionate Counseling St. Louis, should I specifically ask for trauma therapy on the consultation call or should we discuss during our first session?
You don’t have to be sure that you want trauma therapy when you’re scheduling at Compassionate Counseling St. Louis, but you can definitely share your interest in learning more about trauma therapy during the consultation call.
Once you’re booked, we will still have a check-in and time to discuss what has been going on, in order to get more of that background information necessary as part of the preparation phase. There is an assessment component to TF-CBT which helps determine experience of trauma and possible symptoms of PTSD and other trauma related symptoms.
Depending on the age of the child, more time may need to be spent with parents in the beginning, to complete the history taking and so we can begin to conceptualize how we will proceed with treatment. You will always be involved and know what is going on every step of the way!
Curious to hear more, or are you a little reluctant about counseling? Compassionate Counseling St. Louis provides specialized anger management and anxiety therapy in St. Louis for kids, teens, and college students. We work in Clayton, MO and serve kids, teens, and college students throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Coeur, Kirkwood, Richmond Heights, and Brentwood. You can set up your free phone screening to see if we’re a good fit for your needs right on our website.
