TF CBT CERT EXAM 2026 STUDY GUIDE
COMPLETE TRAUMA FOCUSED COGNITIVE
BEHAVIORAL THERAPY CONCEPTS AND
PRACTICE QUESTIONS
◉ 2. How should the therapist proceed? (Alexa case) Answer: 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.
◉ 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. Answer: 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.
◉ 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. Answer: 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.
◉ 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. Answer: 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. Which component of TF-CBT sometimes needs to be
implemented out of order, usually toward the beginning of
treatment? Answer: a) Trauma Narrative, particularly if a child is
extremely anxious.
COMPLETE TRAUMA FOCUSED COGNITIVE
BEHAVIORAL THERAPY CONCEPTS AND
PRACTICE QUESTIONS
◉ 2. How should the therapist proceed? (Alexa case) Answer: 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.
◉ 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. Answer: 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.
◉ 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. Answer: 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.
◉ 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. Answer: 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. Which component of TF-CBT sometimes needs to be
implemented out of order, usually toward the beginning of
treatment? Answer: a) Trauma Narrative, particularly if a child is
extremely anxious.
