Answers| Actual Complete Exam| Already Graded A+
(Just Released)
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." ✔Correct Answer-1. Alexa's
statements are examples of:
a) Healthy or functional thoughts.
b) Cognitive distortions.
c) Cognitive realities.
d) Accurate but unhelpful thoughts.
2. How should the therapist proceed? (Alexa case) ✔Correct 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. ✔Correct
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. ✔Correct 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. ✔Correct 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? ✔Correct Answer-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
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. ✔Correct Answer-. 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.
c) Explain to mother that Jody has serious PTSD symptoms and that treatment will likely continue for
1-2 years.
d) Strongly encourage Jody to talk about the details of the dog attack, no matter how much anxiety
this strategy would cause.
8. In order to help the mother respond to Jody's behavior problems, it is important to: ✔Correct
Answer-a) Engage in cognitive processing to encourage mother to accept responsibility for the dog
attack.
b) Examine Jody's early childhood experiences to determine the source of her oppositional
behaviors.
c) Encourage mom to ignore Jody when she complies with mother's requests and give Jody lots of
attention when Jody whines and does not get her way.