TF-CBT - 創傷敘事 II (8)

Inaccurate or unhelpful cognitions should be addressed by:

a. Being supportive of the child's existing beliefs

b. Challenging the child's beliefs

c. Accepting the child's beliefs but urging the child to reconsider them

d. Using thought stopping strategies to distract the child away from these beliefs

b. Challenging the child's beliefs

Encouraging the child to re-evaluate unhelpful or inaccurate beliefs is one of the core elements of processing the trauma narrative.

Due to the complicated and sensitive nature of the trauma narration and processing component, parents should be advised NOT to challenge their child's inaccurate or unhelpful thoughts directly?

a. TRUE

b. FALSE

a. TRUE

Cognitive processing activities can be challenging and usually require patience and strategic questioning. Parents may be too emotional to engage in these activities properly, and so it is the therapist's responsibility to engage in processing activities.

Which statement about cognitive processing with younger children is most accurate?

a. Cognitive processing with children under 6 is impossible due to developmental and cognitive limitations.

b. Younger children may not be able to discuss the evidence supporting their unhelpful beliefs, but they are frequently able to generate alternative ways of thinking.

c. There are surprisingly few differences between cognitive processing methods for children in different age groups.

d. Using familiar strategies like relating stories with a moral to learn is often a helpful way of doing cognitive processing with young children.

d. Using familiar strategies like relating stories with a moral to learn is often a helpful way of doing cognitive processing with young children.

Many children are used to taking lessons from stories they read, even before they can engage in examining their own thoughts or beliefs.

Cognitive processing activities with caregivers:

a. Focus exclusively on helping caregivers understand their child's unhelpful beliefs

b. Should avoid addressing unhelpful thoughts that the parents may have about the impact of trauma, which should be handled in individual treatment

c. Can be initiated by reviewing the child's trauma narrative and discussing caregivers' reactions to it

d. Should always focus on the caregiver's responsibility to protect the child from harm.

c. Can be initiated by reviewing the child's trauma narrative and discussing caregivers' reactions to it

This serves both to help caregivers prepare for the narrative and to explore caregiver reactions to the child's traumatic experiences.

Which of the following statements is most accurate about working with caregivers during this phase of treatment?

a. Parents should be encouraged to talk to the child about the content of the trauma narrative outside of session.

b. Therapists should focus on the caregivers' reactions to the trauma and helping them challenge their problematic beliefs about them.

c. Since most of the therapist's attention is focused on processing the child's narrative, there is very little to discuss with caregivers.

d. The main focus of parent sessions is the discussion of the child's narrative, which gets shared in its entirety with the caregiver.

b. Therapists should focus on the caregivers' reactions to the trauma and helping them challenge their problematic beliefs about them.

Parent sessions do not stop when the child is working on trauma narration and processing. Parents frequently have their own unhelpful and inaccurate thoughts about their child's trauma, and this is the appropriate time to address them.

Brian is a 4 year-old who has created a short, hand-drawn "book" version of his trauma narrative. Brian had walked up to a strange dog in his neighborhood hoping to pet him, but the dog attacked him causing some significant injuries. Brian thinks the dog attacked him because "I'm dumb and shouldn't have tried to pet her." Which of the following methods is most appropriate for helping reduce the "I'm dumb" thoughts that Brian has?

a. Help Brian recognize and challenge his unhelpful thoughts using developmentally appropriate, progressive, logical questioning.

b. Read existing comic books or stories that contain positive messages or "morals" about learning from mistakes.

c. Engage Brian in role play exercises in which he tells others about his thoughts and feelings and tries to convince them they are not dumb.

d. Because of his age, the therapist should just tell Brian what he should say to himself when he feels upset.

b. Read existing comic books or stories that contain positive messages or "morals" about learning from mistakes.

Children Brian's age lack the cognitive capacity to identify and analyze the content and accuracy of their thoughts; it's often useful to use media that they're familiar with (stories, comics) that have relevant lessons or for which the "moral of the story" is relevant to the issues being addressed in treatment.