Understanding AF-CBT
What is AF-CBT?
AF-CBT is a trauma-informed, evidence-based treatment for children aged 5-17 and their caregivers. It strengthens family relationships by addressing individual and family problems related to:
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Family conflicts
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Behavior problems, including physical aggression in children
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Anger and verbal aggression in children or adults, including emotional abuse
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Harsh physical discipline, physical aggression, or child physical abuse, or
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Child trauma-related symptoms secondary to any of the above
These issues may be demonstrated by the child/adolescent and/or an individual caregiver, and/or they may be present in the family system. AF-CBT targets the child/adolescent, caregiver, and the larger family context by including both the child and caregiver in treatment. It combines multiple theoretical approaches into one cohesive model to reduce conflict and coercion and improve relationships between school-aged children and their caregivers.
AF-CBT involves three phases of treatment:
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Engagement and Psychoeducation
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Individual skills building
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Family applications
Following AF-CBT, caregivers report less child-to-parent and parent-to-child violence, children demonstrate fewer externalizing behaviors and show improvement in social competence, and families report less conflict and more cohesion. Additionally, outcomes include lower risk for physical abuse and repeated physical abuse, with children reporting increased sense of safety.
Target client population:
A family with any of the following may benefit from AF-CBT:
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the child/adolescent may have behavior problems consistent with ODD or Conduct Disorder
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the caregiver may have anger management problems,
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and/or the family may have aggressive, volatile or coercive behaviors that put them at risk.
The following criteria may help screen which families may benefit from AF-CBT:
BACKGROUND CRITERIA
• A child, age 5-17, can participate now or soon
• A caregiver (e.g., biological, adoptive, foster, or kinship) can participate now or soon
• Both caregiver and child have an adequate capacity or repertoire to learn/benefit from AF-CBT
CLINICAL CRITERIA
• The Family has frequent conflict(s) and/or arguments OR
• A Caregiver shows anger (hostility), uses physical force/discipline (coercion), and/or has allegation/history of child physical abuse OR
• A Child shows anger, has behavior problems (e.g., defiance, aggression, explosiveness), has trauma symptoms/PTSD after physical discipline/abuse, and/or has prior exposure to harsh discipline/physical abuse
A case is eligible if ALL 3 Background Criteria and 1 Clinical Criterion are met.
Many eligible families also experience other challenges such as living in different residences, domestic disputes, substance use, incarceration, and/or prior traumatic experiences. A broad range of families are appropriate for AF-CBT.
AF-CBT Training Model
Learning Community: Intensive Skills Training
Provisionally Licensed as a Mental Health Provider or Pre-Licensure?
Many of my trainees complete AF-CBT training and consultation while building their experience toward licensure, then meet the remaining requirements as they advance in their careers. The full licensure path typically takes 2–3 years after graduate training, so starting your AF-CBT training now gives you a real head start on your career helping trauma-exposed children. The clinical skills you learn in training are easily transferable to many treatment applications.
The Path to National Certification
Becoming a Nationally Certified AF-CBT Clinician requires:
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Master's degree or higher in a mental health discipline
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Active mental health license in your state or province (or working toward licensure, see above)
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Completion of the one-year AF-CBT training program
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Pre-requisites: Pre-training Survey and Foundations of AF-CBT asynchronous, online course (2.5 CE's, no fee)
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Attending live training (two or more days) with an approved national trainer - online, virtual trainings are typically offered over four half-days of training (14 CEs)
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Participating in at least 9 of 12 monthly group consultation calls and sharing 2 case presentations
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Submitting 2 AF-CBT sessions for Audio Review - Passing scores of 80% or higher will count toward the 2 required submissions for national certification*
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Completing the Post-Training Survey
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Completing two AF-CBT treatment cases with two separate families:1) at least 50% of the content in each of the 3 phases must be delivered, and 2) at least 1 child and 1 caregiver in the same family is included in each of the three phases of treatment.
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Using a standardized trauma symptom measure pre- and post-treatment with each case
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Passing the AF-CBT Therapist Certification Program Knowledge Test
There is a certification application process, and the AF-CBT developers charge $75 for the Knowledge Questionnaire, which requires a score of at least 80% to pass.
*If clinicians did not achieve at least 80% fidelity score on audio review for their two training cases, 2 additional audio files may be submitted for review (up to a maximum of 4). A fee of $100 for each fidelity review must be paid before an additional file can be submitted or reviewed.
