I am currently reading a book on TF-CBT for children. The authors define "short term" residential settings as 4-12 months. Can TF-CBT be used in more acute settings, such as when the patient is on the unit for 10-30 days? It seems like it would be difficult to employ in such a short period. If not TF-CBT, how should trauma be addressed when a patient is on a unit 10-30 days? Or is it best to focus solely on stabilization of the issue that brought them in, such as suicidality, self-injury, etc?
I'm guessing you're not a TF-CBT trained provider? As in, you did a 2 day training, with the follow-up consult calls? If you have done that, you can approach the trainer who did your consult calls and ask about the viability of instituting the TF-CBT model in such a short amount of time. 30 days would seem doable, depending on the trauma. TF-CBT is a 10 step model (A PRACTICE is the acronym for all the respective steps) built on exposure, and some traumas would be too intense to process in that fashion. Also, there should be the coordination with the family to share the trauma narrative (which can easily take 3 sessions to write or compose) for the in vivo exposure and conjoint sessions, the "I" and "C" of "A PRACTICE." I wouldn't think you could do it in less time that 10 sessions, whether you did that in 10 days or 30. Some clients won't be able to handle going that fast, or there are ongoing traumas and multiple traumas, you'll need at least 13 or 14 sessions to get through the model. If you don't do this, when you reassess using the CPSS, UCLA or the CATS, you'll notice that you don't have the decrease desired from the original assessment below clinically significant for PTSD (the A of A PRACTICE). I'm a certified TF-CBT provider, and while it's great that the musc.edu site for TF-CBT has spread the word some, and even let some practitioners whet their appetite for the approach, we've noticed in our community that there are many therapists that are using the info to poorly administer the treatment, and aren't trained in doing it. The assessment (pre and post) is the first to go! Convenient, because it would tell them how it's not working if they did it. We haven't noticed any therapists that can administer the model well without the training.