Phone: +1 (209) 262-4387

Hours: Mon-Sat: 9 am to 7 pm

Trauma-focused Cognitive Behavioral Therapy


Trauma-focused cognitive behavioral therapy (TF-CBT) is evidence-based psychotherapy or counseling that focuses on the needs of children and adolescents with post-traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. The process of addressing the details of children’s traumatic experiences is gradual and phase based. The goal of TF-CBT is to provide a treatment to both the child and the non-offending caregiver and help them to identify and cope with emotions, thoughts, and behaviors in order to return to a state of balance and regain trust. TF-CBT includes individual sessions for both the child and the parents, as well as parent-child joint sessions. TF-CBT has been proven to effectively reduce symptoms of PTSD, depression, anxiety, externalizing behaviors, sexualized behaviors, and feelings of shame in traumatized children. TF-CBT has been shown to improve positive parenting skills and support of the child through the enhancement of parent-child communication.

Facts You Should Know About Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

In TF-CBT, interventions specifically tailored to meet the needs of children and adolescents experiencing emotional and psychological difficulties as a result of a trauma are integrated with humanistic, cognitive behavioral, and familial strategies. This treatment is short-term and generally lasts no more than 16 sessions, as more than 80% of traumatized children see improvement in this time.

TF-CBT’s main application is the treatment of post-traumatic stress. The goal of this therapy is to help survivors of trauma, whether the trauma was a single occurrence or multiple events, address and resolve the distress resulting from these events and ultimately decrease the negative behavior patterns and emotional responses often developing as a result of sexual abuse, physical abuse, or other trauma. Children and adolescents who have experienced these traumas may find TF-CBT an effective method in the process of returning to a healthy state of functioning.

Research shows children and adolescents experiencing severe emotional repercussions due to trauma frequently respond well to this technique. To date, 11 empirical studies conducted on the impact of TF-CBT on adolescent survivors of trauma have demonstrated its usefulness in reducing symptoms of depression, anxiety, and PTSD. Randomized clinical trials comparing TF-CBT to play therapy, child-centered therapy, and supportive therapy show TF-CBT to yield greater gains over fewer sessions. Studies done up to two years after the conclusion of TF-CBT demonstrated these gains to be sustained over time.

TF-CBT may not be appropriate for children and adolescents who have significant conduct or other behavioral concerns that were present before the trauma may not receive significant benefit from TF-CBT and may see greater improvement with approaches in which they are first helped to overcome these difficulties.

What Are Trauma Symptoms

We use the term trauma symptoms to refer to emotional, behavioral, cognitive, physical, and/or interpersonal difficulties directly related to a traumatic experience. These symptoms may correspond to symptoms of PTSD, depression, anxiety, avoidance, self-injurious behaviors, sexual behaviors, bullying, aggression, poor sleep, increased startle, stomach aches, headaches, social withdrawal, decline in school, and/or substance use problems. Children with trauma symptoms may experience a profound change in the way they see themselves, their role in the family, and the world as a result of their exposure to one or more traumatic events.

Trauma symptoms often occur in response to trauma reminders, sometimes called triggers. These can be sights, sounds, smells, or other cues that remind the child of their trauma. When the child is confronted with a trauma reminder, they may experience feelings similar to those experienced during the original trauma. This can lead the child to think and act as if the trauma were recurring, even though they are safe.

Children and teens are often brought to treatment because of behavioral or emotional dysregulation rather than because of their trauma history. Since parents and other adults often do not understand that these emotional and behavioral problems are related to the child’s previous trauma experiences, it is critical to make connections between trauma reminders or triggers that the child is experiencing and the child’s presenting symptoms.

Stages Of Treatment

Typically, one-third of the total treatment is devoted to each phase of treatment.


The stabilization and skill-building phase begins with a focus on psychoeducation about the dynamics, prevalence, impact, and treatment of the experienced trauma, working toward developing skills to manage trauma reminders.

Trauma Narrative

The details of the child’s traumatic memories are gradually introduced, discussed and written about over the course of this middle phase of treatment. We use techniques such as storyboarding, cartoon strips, or poster boards, to allow for verbal and non-verbal expression.


The final phase of treatment then focuses on the integration and consolidation of what has been learned, with an emphasis on enhancing direct parent–child trauma-related communication, safety skills development, and the mastery of new behaviors and emotional responses.

What To Expect

Sessions are structured by the therapist to introduce interventions that are relevant to the particular stage of treatment. For example, during the Stabilization Phase of therapy, a child session may begin with a review of coping skills that the child was encouraged to practice between sessions; continue with a new skill component; then provide role play and practice of that skill; ending with a discussion with child and parent about what the child is encouraged to practice during the coming week. This is a planned progression towards the next stage of therapy.


Since TF-CBT is a skills and strengths-based model, its components typically need to be practiced by the child and parent in order to be effective. We use the acronym PRACTICE to remind the child and family of the core TF-CBT components and the value of practicing them for the duration of treatment and beyond. A good deal of the therapy work associated with TF-CBT will occur between sessions, when parents and children are asked to practice certain skills at home. In the following list, the components of PRACTICE are arranged in relation to the phase of treatment:

P Psychoeducation and Parenting skills
R Relaxation
A Affective modulation
C Cognitive coping
T Trauma narration and processing
I In vivo mastery of trauma reminders
C Conjoint child–parent sessions
E Enhancing future safety and development

Professional Therapy with a Client Focus

There are times in life when we can feel off balance and can’t seem to snap out of it. When our own natural support system just isn’t enough, it may be time to reach out to a professional counselor to start the process of therapy. We have created a safe, comfortable and professional environment to discuss the issues in your life. We recognize the importance of a good therapeutic relationship and strive to build a positive rapport. We treat each client with respect and dignity.


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The Trauma Narrative

Although there is considerable gradual exposure in the earlier TF-CBT components, developing the trauma narrative is more intensive and extensive. One of the goals of creating the trauma narrative is to unlink thoughts, reminders, or discussions of the traumatic event from overwhelming negative emotions such as terror, horror, extreme helplessness, avoidance, anger, anxiety, shame, or rage. Over the course of several sessions, the child is encouraged to describe more and more details of what happened before, during, and after the traumatic event and the thoughts and feelings during these times. As the child is sharing his/her story in some type of format, the therapist is responding with validation, support, encouragement, and gentle questions. These components can allow the child to successfully integrate the trauma experience and its meaning into a larger optimal self-concept.


Benefits Of Parents Involvement

Parents are often traumatized themselves by the child’s traumatic experience. For example, if there was a trauma event, such as a house fire, the parent also experienced the trauma and may have their own stress symptoms. The TF-CBT components are typically provided separately to children and parents in individual sessions, with conjoint child–parent session time focused on practicing skills, and later on, toward the end of therapy, providing opportunities for open communication about the trauma experienced.

Including parents in therapy provides such parents with skill-building components that may help them cope better. From their own healing they are better equipped to model positive change and encourage their children in practicing effective coping skills. However, if a parent is having significant impairment with their own mental health issues, their own individual therapy may be advised.

The most immediate and influential environment for most children is that of their families. Parents can have an important impact on whether, to what degree, and how quickly children recover from trauma-related problems. They can also influence whether children’s improvements are temporary or whether these gains are sustained long after the end of treatment. We view parents as an important source of support and reinforcement for children’s progress both during treatment and subsequently.


Our Team

Our mission is to improve the quality of lives for individuals with behavioral and emotional challenges by providing exceptional mental health services using the most up-to-date, evidence-based practices helping our clients to become more active and productive members of the community.

About us

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Why choose a therapist at Abalance Client-Centered Counseling?

Our office is dedicated to providing the best mental health services to ALL people in our community regardless of income.

We have a team of professionals that are continually sharpening their skills as mental health providers and attend regular training from the Clinical Director. Having a competent and knowledgeable therapist is only part of it.

We are also a group of caring and compassionate people that strive to make your time with us a safe, comfortable and rewarding experience.

  • Anxiety Disorders
  • Depression Disorders
  • Grief And Loss Issues
  • Child Therapy

Frequently Asked Questions

Yes. ABALANCE CLIENT-CENTERED COUNSELING is accepting new clients ages 5-9. We are only offering Teletherapy Sessions to people in the Central Valley.

No. You can contact us directly and we will get your insurance eligibility established and schedule your first appointment. Your Health Plan may require an additional call to get a registration number after you have already established as a client in our office. We have a team here to help guide you through these things if you need assistance.

Yes, we currently accept HPSJ and CCAH MediCal Insurances only. For other insurances, we provide an out-of-network option for you to bill your insurance and get reimbursed for up to 80% of your therapy costs in our offices.

No, we treat mild/moderate symptoms for a variety of issues, but not alcohol and drug issues. If you have an addiction or are seeking sobriety, we refer out to a professional that treats substance abuse.

Weekly sessions are the best care option for mental health outcomes, but we also provide an every other week option, or Teletherapy if you have a hectic schedule.

We treat children with mild-moderate symptoms as early as age 5. We have a special online program for younger children ages 5-9. And we have weekly sessions for older kids and teens, utilizing our HIPPA Compliant Telehealth System.

why choose us

Abalance Client-Centered Counseling is dedicated to providing effective mental health counseling to our community in the Central Valley.


We have over 20 years of clinical experience to provide the most effective treatment options. Our team of therapists have specialized training in Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT).

About Us

Professional Counselors

We recognize the importance of a good therapeutic relationship and strive to build a positive rapport with each client. And we treat each client with respect and dignity.


Well Counselling

You will learn skills of mindfulness and how to balance thoughts and feelings; and begin to build insight into your issues and have a plan to reinforce your goals.



Teletherapy is provided by using long-distance technologies so that clients and therapists do not have to be in the same place at the same time.

Balanced Approach

We strongly believe in creating a balance of decreasing negative issues while at the same time increasing the positive things in each of our clients.

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Our office is dedicated to providing the best mental health services to ALL people in our community regardless of income.

Abalance Client-Centered Counseling
Provides Convenient and Effective Teletherapy in The Central Valley California

Phone: (209) 262-4387


SATURDAY: 9:00 AM – 5:00 PM

SUNDAY: Closed

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