Alternatives for Families: An Alternative Family Cognitive Behavioral Therapy (AF-CBT) offers families alternative approaches for learning positive coping and self-control skills, effective and safe discipline strategies, useful family problem-solving abilities and communication abilities as well as techniques for dealing with anger or conflict management.
This training is open to agencies who wish to integrate AF-CBT into their work and is given priority to teams led by supportive Senior Leaders.
Games
Games are an integral component of AF-CBT, helping the patient learn to recognize and regulate his or her emotions in various forms, from role playing to video gaming. Studies have proven the effectiveness of video gaming in encouraging emotional recognition and containment; especially because these situations elicit real feelings, teaching patients how to manage them in various contexts.
The AF-CBT Session Guide is one of the primary materials therapists use during sessions. Topic at a Glance Forms provide easy reference points during sessions for easy use by therapists.
Eye contact
Alternatives for Families (AF) is an evidence-based treatment designed to enhance relationships between children and their caregivers. It addresses contributors of conflict and abuse such as harsh parenting practices, family aggression, heightened life stress events, as well as its clinical consequences such as child behavior problems or trauma symptoms. AF can be implemented across a range of settings including child protection centers and schools.
Family Therapy (FT) is typically completed within 6-9 months (24 sessions). Treatment entails meeting together for psychoeducation, skill-building and parenting components of treatment; then individually with their therapist for trauma exposure and family problem-solving components. Therapists work to identify negative patterns of interaction; teach new skills; and support implementation of these new abilities into daily life.
This study assessed the sustained application and short-term outcomes of Abuse-Focused CBT (AF-CBT, also formerly known as Abuse-Focused Therapy) among families referred to a community-based child protection program. Practitioners received training in AF-CBT through a Learning Collaborative as well as additional EBT training; practitioners routinely applied AF-CBT with 52 families studied; several treatment procedures received high ratings by family members despite this high usage rate; however there was considerable variance in terms of delivery content delivery across cases.
Results revealed that, after controlling for pretreatment outcome variables and unique content of other EBTs, greater delivery of AF-CBT Abuse content was related to improved outcomes on standard parent rating scales, specifically regarding child-rated externalizing problems, parental anxiety, and child anger. Both clinician and parent ratings of discharge adjustment at discharge were positively associated with increasing use of this type of material AF-CBT Abuse specific material – providing direct evidence of its sustainability and early clinical benefits in community practitioners working with physically abused children and their families. These results provided direct evidence of its sustainability and early clinical benefits when used by community practitioners regularly using it routinely used by practitioners working directly with physically abused children and their families.
Discussions
AF-CBT, also known as Abuse-Focused CBT, is an evidence-based treatment for physical abuse of children and family aggression/conflict in families. AF-CBT was included in the National Child Traumatic Stress Network’s initial EBT dissemination efforts in 2002, and has since been adopted by numerous agencies. This exploratory study explored its sustainability and outcomes several years after practitioners trained in this intervention were provided with training on it.
The authors conducted a Learning Collaborative on Abuse-Focused CBT and found that five years after completion, all practitioners reported using it often or very much and believing it relevant for their cases. All participants of this training received significant support from agency leadership as well as high levels of abuse-specific CBT content training from their agencies. Furthermore, their study assessed whether practitioner level content level (general vs abuse specific) had any correlation to outcomes.
Results indicated that AF-CBT general content did not correlate to pretreatment CBCL externalizing problems or TSCC anxiety scores, yet was related to lower posttreatment TSCC anger and social competence scores. Abuse-specific content led to significant decreases in pretreatment CBCL externalizing problems and TSCC anger scores.
AF-CBT is an evidence-based practice designed to assist families in managing emotions, resolving disputes and increasing parenting abilities. This course is tailored for families that are experiencing behavioral issues related to aggression/violence, substance use and domestic violence within their household. The ultimate goal is to prevent maltreatment of children while simultaneously encouraging positive relationships between their caregivers/parents/caregivers and them. AF-CBT therapy services can be found through trained providers. Individual therapy sessions and group family sessions may be provided. Therapists use various discussion techniques to assist parents/caregivers and their children discuss emotions and behavior issues as well as identify solutions. During these discussions, the therapist assists adults in setting goals and creating effective parenting strategies. Furthermore, she works to address any negative coping or maladaptive beliefs regarding themselves or their child before working closely with family to implement new behaviors into their home environment.
Individual sessions
Alternatives for Families (AF) is a cognitive-behavioral therapy approach designed to bring the whole family into treatment and teach them new communication techniques that will increase effectiveness. This therapy may reduce hostility, prevent conflict escalation, modify dysfunctional beliefs that underlie family issues and build trust among family members. Activities like the Genogram Game and Spoon Game help families understand each other more clearly while strengthening bonds among siblings.
AF-CBT training aims to strengthen relationships between children and their caregivers, particularly in families that experience conflict, physical force/discipline/aggression, child abuse or related family behavior problems. It can be delivered across various settings including outpatient, residential and home-based care settings.
Learning and behavioral theory, family systems analysis, cognitive therapy and developmental victimology all play a part in this approach to abusive parenting/caregiving. Key risk factors identified as being coercive parenting practices, negative attributions for caregiver behavior and family conflict as potential points of abuse; as well as consequences such as child aggression or reduced social functioning due to abusive parenting/caregiving are also examined here.
AF-CBT employs a short-term, goal-oriented approach that addresses specific behaviors and communication problems in families. Therapists provide family members with various skills for improving family interactions such as verbal/nonverbal communication, problem-solving techniques and stress management techniques. Furthermore, they encourage participants to identify maladaptive thoughts about themselves or others using tools such as thought records and behavioral experiments in order to alter them.
One study investigated the correlations between using AF-CBT and perceived clinical outcomes at discharge. More specifically, more use of general content of AF-CBT was associated with improved measures of child externalizing behaviors; greater use of abuse-specific content resulted in improved parent ratings of their child’s anger problems and anxiety issues.
AF-CBT typically lasts 6-9 months and involves individual sessions for each child, parent, and caregiver. Sessions usually last 50 minutes each. In the initial few sessions of treatment, parents meet individually with their children for psychoeducation and skill-building; later in treatment children meet together with both their parents/caregivers for family communication and problem solving.
