TF-CBT CERTIFICATE EXAM
Questions and Answers
1. Alexa is an 8-year-old girl who disclosed sexual abuse by her two
older adolescent stepbrothers. While developing the first part of her
trauma narrative, she wrote "I am a bad girl. I think they messed up my
body. I was really dumb because I never told anyone.": 1. Alexa's statements
are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
2. 2. How should the therapist proceed? (Alexa case): a) Tell Alexa that it is not
her fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narrative and then begin cognitive processing of the trauma
narrative, including her statements.
c) Repeat the earlier components, beginning with Psychoeducation as this is a clear example of the
therapy not "sinking in."
d) Ask Alexa to start the trauma narrative again but this time tell her to only include details about the sexual
abuse, not any statements about herself or any thoughts.
3. Justin is an 11-year-old boy who witnessed his father brutally attack
, his
mother with a baseball bat. During the middle of writing his trauma
narrative, he wrote that he intervened and attempted to defend his
mother by fighting his father. However, during individual sessions
with his mother, it became apparent that Justin had hidden behind the
sofa and cried during the attack.: 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Justin about the inaccuracy immediately.
b) Talk to Justin about the difference between the "truth" and a "lie."
c) Recognize that it is not unusual for children to make fantasy or rescue statements; allow Justin to complete
his trauma narrative and gently challenge his statements.
d) Talk with Justin's father to determine whether Justin or his mother is telling the truth; then share this
information with Justin.
4. In the example above, there is a concern that the father may have
access
to the home and the therapist is worried about Justin's safety. The
therapist is concerned about following the TF-CBT model with
fidelity and is not sure whether it is okay to implement "Enhancing
Safety and Future Development"
without completing the earlier components.: 4. How should the therapist
proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Justin and his mother would then blame themselves for the domestic
violence.
,c) Engage in short-term safety planning with Justin and his mother.
d) Engage Justin in In Vivo Desensitization as his concern about safety is a cognitive distortion.
5. Monty is a 7-year-old boy who was a victim of sexual abuse
for two years by his adoptive parents. As part of the assessment,
he completed the UCLA PTSD Reaction Index and his total score
was in the severe range, including very serious re-experiencing
symptoms. When the therapist discussed the TF-CBT treatment
approach with him, including that he would be writing his
story about the sexual abuse, Monty became excited and began to
discuss the trauma in great detail. So, the therapist, encouraged by
Monty's willingness to talk, complied with his wishes and allowed him
to create his trauma narrative over the first three treatment sessions.
During and after the completion of the trauma narrative, Monty's
behavior began to deteriorate, including acting-out sexually, soiling
himself, refusing to sleep in his own room, and engaging in other
dangerous behaviors that warranted a short-term hospitalization.: 5.
What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; initiated Psychoeducation and
subsequent skills-based components before moving to the trauma narrative.
b) Briefly reviewed the initial four TF-CBT components and started the trauma narrative the next week.
c) Nothing. It is imperative to follow a child's cues and wishes rather than a more directive approach.
d) Skipped the trauma narrative entirely because it is important to do just the opposite of what a child
believes he/she needs.
, 6. 6. Which component of TF-CBT sometimes needs to be implemented
out of
order, usually toward the beginning of treatment?: a) Trauma Narrative, particularly
if a child is extremely anxious.
b) Conjoint sessions to share the narrative, especially for older teens or foster children who resist
having their foster parents involved in treatment.
c) Cognitive Coping, especially if a child has distortions about the abuse.
d) Psychoeducation; sometimes this component can be left for later in treatment or skipped altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problematic avoidant behaviors
7. Jody is a 6 year-old girl who was attacked by a dog and left with
severe
scars all over her legs. Since the dog attack, Jody has experienced
severe PTSD symptoms and significant oppositional behavior problems.
Her mother has felt intense guilt as Jody almost died from the attack.
She now cannot say no to anything her daughter wants. The mother
also reported that Jody's behavior is extremely difficult to manage and
the mother just cannot take her anywhere. Jody has tantrums at the
drop of a pin and becomes fearful when there is any mention of a dog.: . In
the first TF-CBT session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeducation and express optimism about her ability to help mother and child in 12 to 16
sessions.
Questions and Answers
1. Alexa is an 8-year-old girl who disclosed sexual abuse by her two
older adolescent stepbrothers. While developing the first part of her
trauma narrative, she wrote "I am a bad girl. I think they messed up my
body. I was really dumb because I never told anyone.": 1. Alexa's statements
are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
2. 2. How should the therapist proceed? (Alexa case): a) Tell Alexa that it is not
her fault and immediately begin to process her statements.
b) Allow Alexa to complete her trauma narrative and then begin cognitive processing of the trauma
narrative, including her statements.
c) Repeat the earlier components, beginning with Psychoeducation as this is a clear example of the
therapy not "sinking in."
d) Ask Alexa to start the trauma narrative again but this time tell her to only include details about the sexual
abuse, not any statements about herself or any thoughts.
3. Justin is an 11-year-old boy who witnessed his father brutally attack
, his
mother with a baseball bat. During the middle of writing his trauma
narrative, he wrote that he intervened and attempted to defend his
mother by fighting his father. However, during individual sessions
with his mother, it became apparent that Justin had hidden behind the
sofa and cried during the attack.: 3. How should the therapist proceed?
a) Due to the problems associated with "false memories," confront Justin about the inaccuracy immediately.
b) Talk to Justin about the difference between the "truth" and a "lie."
c) Recognize that it is not unusual for children to make fantasy or rescue statements; allow Justin to complete
his trauma narrative and gently challenge his statements.
d) Talk with Justin's father to determine whether Justin or his mother is telling the truth; then share this
information with Justin.
4. In the example above, there is a concern that the father may have
access
to the home and the therapist is worried about Justin's safety. The
therapist is concerned about following the TF-CBT model with
fidelity and is not sure whether it is okay to implement "Enhancing
Safety and Future Development"
without completing the earlier components.: 4. How should the therapist
proceed?
a) Meet with the child's father and discuss the safety concerns.
b) Do not discuss safety because Justin and his mother would then blame themselves for the domestic
violence.
,c) Engage in short-term safety planning with Justin and his mother.
d) Engage Justin in In Vivo Desensitization as his concern about safety is a cognitive distortion.
5. Monty is a 7-year-old boy who was a victim of sexual abuse
for two years by his adoptive parents. As part of the assessment,
he completed the UCLA PTSD Reaction Index and his total score
was in the severe range, including very serious re-experiencing
symptoms. When the therapist discussed the TF-CBT treatment
approach with him, including that he would be writing his
story about the sexual abuse, Monty became excited and began to
discuss the trauma in great detail. So, the therapist, encouraged by
Monty's willingness to talk, complied with his wishes and allowed him
to create his trauma narrative over the first three treatment sessions.
During and after the completion of the trauma narrative, Monty's
behavior began to deteriorate, including acting-out sexually, soiling
himself, refusing to sleep in his own room, and engaging in other
dangerous behaviors that warranted a short-term hospitalization.: 5.
What should the therapist have done instead?
a) Listened to Monty for a few minutes and redirected him; initiated Psychoeducation and
subsequent skills-based components before moving to the trauma narrative.
b) Briefly reviewed the initial four TF-CBT components and started the trauma narrative the next week.
c) Nothing. It is imperative to follow a child's cues and wishes rather than a more directive approach.
d) Skipped the trauma narrative entirely because it is important to do just the opposite of what a child
believes he/she needs.
, 6. 6. Which component of TF-CBT sometimes needs to be implemented
out of
order, usually toward the beginning of treatment?: a) Trauma Narrative, particularly
if a child is extremely anxious.
b) Conjoint sessions to share the narrative, especially for older teens or foster children who resist
having their foster parents involved in treatment.
c) Cognitive Coping, especially if a child has distortions about the abuse.
d) Psychoeducation; sometimes this component can be left for later in treatment or skipped altogether.
e) In Vivo Mastery, such as in cases of school avoidance or other highly problematic avoidant behaviors
7. Jody is a 6 year-old girl who was attacked by a dog and left with
severe
scars all over her legs. Since the dog attack, Jody has experienced
severe PTSD symptoms and significant oppositional behavior problems.
Her mother has felt intense guilt as Jody almost died from the attack.
She now cannot say no to anything her daughter wants. The mother
also reported that Jody's behavior is extremely difficult to manage and
the mother just cannot take her anywhere. Jody has tantrums at the
drop of a pin and becomes fearful when there is any mention of a dog.: . In
the first TF-CBT session, the therapist would typically:
a) Give Jody the freedom to talk about anything she likes throughout the session.
b) Provide psychoeducation and express optimism about her ability to help mother and child in 12 to 16
sessions.
