TF-CBT Tips
Lynn Geiger, Ph.D.
The Cognitive Triangle
 We
are one whole body made of
thoughts, feelings, & behavior
 Usually our thoughts, feelings, & behavior
match
 Usually they are connected or related to
one another
Let’s Try an Experiment
Think of a time you really enjoyed yourself
 How
do you feel?
 How do you act? How do you behave?
 What were you thinking? Remembering it
now what are your thoughts?
 Let’s
try another: Describe a time you felt
really great.
Describe a time that was really unpleasant
for you. (Not the trauma)
 How
do you feel, act/behave, what are
your thoughts
 See
how these are related/connected
with each other
Coping
When faced with unpleasant times, what
are thoughts & actions that can help us?
 Positive self-talk
 Breathing
 Reward
yourself
I Can Do It.
I’m Brave.
Coping cont’d
 Rewards
from others
 Remember
other times of success,
courage, bravery
 Imagine
a cartoon character who is good
at coping
Oh Yes! Oh No
A 4 yr. old girl who had been sexually
abused by Mom’s boyfriend
 He
came to live with us
 He yelled and was mean
 He gave me a present
 He touched me in my vagina
 I told Mommy & he left us
 I still had bad dreams
 I came to see you & feel better
Oh Yes!
Oh No!
Oh Yes!
Oh No!
Oh Yes!
Oh No!
Oh Yes!
Oh Yes! Oh No
A 7 yr. old boy emotionally + physically
abused by step father
 Mom got married to him
Oh Yes!
 He watched me when she
Oh No!
went to work
 He called me names + yelled
Oh No!
and was mean
 He took us shopping
Oh Yes!
 I got nothing
Oh No!
Oh Yes! Oh No cont’d
I
cried with Mom & she was
nice
 He hit me & threw me
across the room
 I told Mom + she said I was
Brave
 She made him leave
 I came to see you and I
got over it
Oh Yes!
Oh No!
Oh Yes!
Oh Yes!
Oh Yes!
Attention
 Mix
up Yes’ and No’s to decrease
superstitious or symmetrical expectations.

That if a positive event occurs it will be
followed by a negative event.
Anger
 Early
on we understand anger as a scary,
hurtful, threatening, unsafe feeling
 As adults we learn about constructive
anger versus destructive anger
So use metaphors, symbols for kids such as
Dragons
 All dragons breathe fire.
 Generally, dragons want the fire to be
safe/ to breathe the fire out safely.
Dragons
 If
you were a dragon what would you do?

Where could you go if you feel angry?
What can you o to get the anger (fire) out?
What’s safe for you to show anger – not to
hurt others when angry?


Dragons cont’d
 Just
like when the dragon can feel their
fire starting to get too hot, can you feel
the anger in you starting to build?
 Turn
and breathe our fire out over the
“lake”
 Connection between breathing for anger
management and breathing for relaxing
Anger - Volcano
Anger – Volcano
 Also
can be used as example of safe
expression of anger

Volcanoes erupt, that’s just what they do
sometimes
 Kids
can draw pictures of what’s erupting
from their volcano
 Volcanoes don’t want to hurt villagers so
they warn them to keep them safe
Anger - Volcano
 One
warning sign from a volcano is steam
 What
warning signals do you get that
you’re going to explode?
Barnyard Friends
 Sometimes
a longer relaxation time is
needed so I use a guided visualization
 Imagine we are taking a trip to a farm:
 If
you see it, you can put it away
Resiliency Training
 Crisis
Care Network – crisiscare.com
 “Hope
is Alive”
Positive Adaption to Trauma
 Accept
the unexpected
 Believe in your child’s strength
 Believe in YOUR strengths
 Assume recovery
 Seek transformational coping
Believe in You