Implementing Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) With Preteen Children Displaying Problematic Sexual Behavior

Problematic sexual behavior (PSB) is a fairly common presenting concern among preteen children with histories of trauma. Unfortunately, relatively little information about these concerns are provided in training programs and clinicians often report lacking the skills and confidence to intervene when PSB is present. Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), on the other hand, is a well-known and well-validated intervention for children who experienced maltreatment and trauma. Current evidence-based treatment techniques for PSB are primarily cognitive-behavioral in nature and easily delivered within the standard TF-CBT protocol. This paper reviews the empirical and theoretical premises of evidence-based treatment techniques for PSB and discusses how the clinician can implement them within the context of TF-CBT, while maintaining fidelity to the TF-CBT protocol. Conducting an assessment to determine the appropriateness of this form of treatment is examined as well as recommendations on addressing safety issues that may be identified during assessment.