Trauma-focused Cognitive Behavioural Therapy (TF-CBT)

What Is TF-CBT?

TF‑CBT is a structured, evidence‑based therapy designed to help you process traumatic experiences and reduce symptoms of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). PTSD is a diagnostic label used to describe a particular profile of symptoms that can develop after experiencing or witnessing traumatic events. CPTSD includes the same core symptoms of PTSD, alongside additional difficulties related to emotion regulation, identity, and relationships.

TF-CBT combines the practical approach of CBT with a sensitive trauma focus that supports your understanding of how trauma affects the mind and body, and helps you re-establish a sense of safety in the present through specific memory-processing elements. It is particularly helpful when trauma memories continue to feel vivid, intrusive, or ‘unfinished’, and when they are affecting your daily life, relationships, or sense of self. TF-CBT places great importance on supporting you to reclaim areas of your life that you recognise have been impacted.

How It Works

TF‑CBT helps you understand how trauma impacts thoughts, emotions, physical sensations, and behaviour. We begin by building grounding skills and strengthening your ability to manage distress, so you feel steady and supported before approaching therapy work directly related to trauma memories.

When you feel ready, we gently work with the traumatic memory itself. This involves a structured, collaborative process that helps the brain complete the natural memory processing that was interrupted at the time of the trauma or became ‘stuck’. Through imagery, narrative work, or bringing specific details to mind, the memory becomes ‘updated’, more organised and less threatening. This allows the memory to be stored in a way that reduces the sense that the trauma is still happening now and helps you feel more in control of the memory – able to choose when you bring it to mind rather than it arriving intrusively.

Throughout this process, we use careful grounding and move at a pace that ensures you remain anchored in present-day safety. We also work to gradually update the coping strategies that may have helped you survive the trauma but are no longer serving you, so that you’re able to live more freely and in line with your values.

What It Can Help With

TF‑CBT is effective for PTSD and can also support those experiencing symptoms associated with CPTSD. These may include:

• Re-experiencing symptoms: Flashbacks, nightmares, or unwanted intrusive memories that feel vivid or sensory (for example images, sounds, smells, or physical sensations) that replay aspects of the experience. You may feel as though the trauma is happening again in the present moment.

• Avoidance: Feeling unable to think about the trauma, or avoiding places, peoples, or situations that remind you of it.

• Hyperarousal: Feeling constantly on edge or alert, be easily startled, difficulty sleeping, irritability, or physical tension.

• Shifts in mood and beliefs: Alongside the sense of current threat, you may carry feelings such as shame, self-blame, hopelessness, or feeling disconnected from others.

• Emotional regulation difficulties: You may notice feeling overwhelmed by emotions, taking longer to calm down when you feel upset, or feeling numb or emotionally shut down.

• A disrupted sense of identity: Persistent negative beliefs about yourself, such as feeling of being a failure, feeling worthless or defeated.

• Difficulties in relationships: You may find yourself feeling distant or cut off from others, or finding it hard to stay emotionally close to people.

These symptoms can make daily life feel overwhelming and unmanageable. Many people feel unable to work, engage with hobbies, maintain relationships, or leave the house – not only because of fear of reminders of the trauma, but because the nervous system is still trying to protect you from a perceived threat, leaving you feeling unsettled. TF-CBT helps reduce this sense of ongoing danger and supports you in reconnecting with stability.

TF‑CBT at The Reframe Room

TF‑CBT at The Reframe Room is always guided by safety, compassion, and collaboration. You remain in control of the pace at every stage, and we begin by strengthening grounding and emotional regulation skills so you feel equipped and supported before approaching any trauma work. Many people find that TF‑CBT helps them reconnect with a sense ease in the here and now, and feel more in touch with themselves and the life they aspire to live.