Improving treatment fidelity: Factors that predict trauma-focused cognitive behavioral therapy component use

This study examined the utilization of trauma-focused cognitive behavioral therapy (TF-CBT) treatment components, as well as factors that predicted therapist TF-CBT component use. Participants were 264 TF-CBT-trained mental health therapists. The most frequently used components, as reported by therapists, were affect regulation, relaxation, and psychoeducation about trauma, while the least frequently used were in vivo exposure, conjoint sessions, and caregiver involvement. Results of a hierarchical linear regression indicated that therapist self-efficacy and child trauma clinical beliefs (i.e., clinical structure and verbal capacity) positively predicted therapist TF-CBT component use. Perceived barriers to TF-CBT use negatively predicted therapist TF-CBT component use. Implications for counseling practice and future research directions are included.