Table 1.
TF-CBT PRACTICE and Grief-Focused Components
| Session | Components (delivered in parallel, concurrent groups1) | Guardian Only |
|---|---|---|
| 1 | Psychoeducation: grief, trauma, and PTS | Parenting skills (PS): Praise |
| 2 | Relaxation; affective expression and modulation: strategies in relation to trauma cues | PS: Positive child-guardian time |
| 3 | Cognitive coping: Cognitive triad; Correcting maladaptive cognitions | PS: Effective instructions |
| 4 | Rationale for Trauma narration; Neutral narration (practice with a fun event beginning to end, with details, feelings, and thoughts) | |
| IS21 | 1:1 individual trauma narrative (TN) meeting separately with child and guardian | |
| 5 | TN review, each child individually (not in group format); Group relaxation activities; Preparation for conjoint TN sharing | PS: Rewards |
| IS2 | 1:1 individual TN | |
| 6 | TN review; Preparation for conjoin TN sharing | PS: Positive attention and ignoring; In vivo mastery: overcoming generalized trauma-related fears |
| IS3 | 1:1 individual TN | |
| 7 | TN review; Cognitive processing of trauma (common child thoughts) | |
| 8 | In vivo mastery; Conjoint child-guardian session3: Share child’s TN | |
| 9 | Acknowledge the death/what has been lost; Address ambivalent feelings in the relationship, as appropriate; In vivo mastery; Conjoint: Children share ambivalent feelings activity with the guardians | PS Review |
| 10 | Preserve positive memories; In vivo mastery; Conjoint: Share positive memories activity | |
| 11 | Develop new relationships: commit to ongoing positive relationships; In vivo mastery; Conjoint: Share relationships activity | |
| 12 | Enhancing Safety & Treatment closure: TF-CBT review and planning for future reminders |
1
60-minute groups for child and guardian, delivered separately and concurrently, covering common components and some guardian only components. Guardian-child conjoint activities where noted.
2
Individual Sessions (IS) conducted at the child’s home or a community space; approximately one hour.
3
Guardians came into children groups, sat with their individual child and engaged dyadically for approximately 20 minutes of the hour session. Guardians were prepared to normalize feelings and provide support and praise.