Structured, evidence-based trauma therapy for adults, children and young people at Harley Street
Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)
After a difficult experience, the mind and body can hold onto it long after the danger has passed. Nightmares, avoidance, feeling on-edge, sudden waves of feeling that seem to come from nowhere — these are not signs that something is wrong with you. They are how the brain protects itself when it hasn’t yet been able to process what happened. Trauma-Focused Cognitive Behavioural Therapy — TF-CBT — is one of the most well-researched and effective therapies we have for helping people recover from trauma. Our therapists deliver it with the warmth, care and pace that trauma work requires.
What is Trauma-Focused CBT?
TF-CBT is a structured, evidence-based adaptation of Cognitive Behavioural Therapy (CBT) designed specifically for people affected by trauma. It combines the practical, skills-based approach of CBT with careful trauma-focused work, delivered in phases so you’re never overwhelmed.
Like standard CBT, TF-CBT focuses on the connection between thoughts, feelings and behaviours — but with careful adaptation for trauma. You learn skills to manage the effects of trauma (like difficulty sleeping, anxiety, or emotional overwhelm), gradually make sense of what happened, and rebuild a sense of safety and confidence in yourself. It’s structured enough to feel contained, and flexible enough to fit your story.
TF-CBT is recommended by the National Institute for Health and Care Excellence (NICE) and the World Health Organization as a first-line treatment for post-traumatic stress disorder (PTSD), particularly in children and young people. It’s one of two evidence-based trauma therapies we offer — the other is Eye Movement Desensitisation and Reprocessing (EMDR).
What TF-CBT can help with
TF-CBT is used to support people experiencing:
- Post-traumatic stress disorder (PTSD)
- Complex trauma from childhood experiences
- Trauma from accidents, medical events, assault or abuse
- Trauma-related anxiety, low mood and sleep difficulties
- Grief following a traumatic loss
- Post-traumatic stress disorder (PTSD)
- Complex trauma from childhood experiences
- Trauma from accidents, medical events, assault or abuse
- Trauma-related anxiety, low mood and sleep difficulties
- Grief following a traumatic loss
You don’t need a formal PTSD diagnosis for TF-CBT to help. If a difficult experience is affecting how you or your child live day-to-day, it’s worth talking to us.
TF-CBT and EMDR — how they differ
At Harley Mind Care, we offer both TF-CBT and EMDR — two of the most evidence-based trauma therapies available. Both are recommended by NICE. Both work. But they work in different ways, and some people respond better to one than the other. Your first appointment is designed to explore which is likely to fit best for you or your child.
How TF-CBT works
TF-CBT is a structured talking therapy. You'll learn to understand the impact of trauma, develop coping skills, gradually process the memory of what happened (through talking, writing, or drawing), and rebuild confidence step by step. It's collaborative and skills-based.
How EMDR works
EMDR uses bilateral stimulation — guided eye movements, tapping, or audio tones — while you bring difficult memories to mind. It doesn't require you to describe what happened in detail. It's less about learning skills and more about reprocessing the memory itself.
Which is right for me?
Both work well. Some people prefer TF-CBT because it's structured, gradual, and skills-focused — they know what to expect at each stage. Others prefer EMDR because it doesn't require them to talk about what happened in detail. Sometimes clinicians recommend starting with TF-CBT for the coping skills phase, then adding EMDR for memory processing. Sometimes a course of one is all that's needed. Your therapist will help you decide together.
TF-CBT for adults
Our adult TF-CBT service is designed for people who want a structured, gradual approach to trauma recovery. Sessions are typically weekly or fortnightly, and treatment length depends on what you’re working with. For focused trauma work, TF-CBT can be relatively brief. For complex or long-standing trauma, it takes more time and is delivered in careful stages.
TF-CBT usually starts with building coping skills and stabilising day-to-day life. Only when this foundation is in place does the therapy move on to processing the trauma memory itself. This preparation phase is essential — it means you have the resources to work with difficult material without being overwhelmed.
TF-CBT for children and young people
TF-CBT has the strongest evidence base of any trauma therapy for children and adolescents. It was originally developed for young people, and it works because it’s practical, structured, and gives children a sense of control. Sessions include play, drawing, storytelling and talking — chosen based on your child’s age and what feels manageable to them.
Parents and carers are an active part of the treatment. TF-CBT includes parent sessions where you learn how to support your child, manage difficult moments at home, and reinforce what your child is learning in therapy. This parental involvement is one of the reasons TF-CBT is so effective with young people.
We work regularly with children affected by medical trauma, family adversity, difficult experiences at school, and developmental trauma — including children who are neurodivergent.
What happens in a session
Your first appointment (90 minutes)
The first appointment gives your therapist time to understand what's brought you to therapy, explore your trauma history in a paced and safe way, and begin planning the work. You will not be asked to process difficult memories in detail in this first appointment — this is about understanding, planning, and building the trust that trauma work depends on.
The phases of TF-CBT
TF-CBT is delivered in structured phases — sometimes remembered by the acronym PRACTICE. Your therapist will move through these at the pace that works for you. Broadly, the phases are:
01
Psychoeducation — understanding trauma and its effects
02
Psychoeducation — understanding trauma and its effects
03
Psychoeducation — understanding trauma and its effects
04
Psychoeducation — understanding trauma and its effects
05
Psychoeducation — understanding trauma and its effects
06
Psychoeducation — understanding trauma and its effects
07
Psychoeducation — understanding trauma and its effects
08
Psychoeducation — understanding trauma and its effects
Not every case includes every phase — your therapist tailors the approach to what you need.
Ongoing sessions (50 minutes)
Follow-up sessions are 50 minutes and typically weekly or fortnightly. Sessions include reflective conversation and experiential practices — imagery, breathing, chair work — that help build self-compassion in a felt way, not just as an idea. Your therapist will guide the practices and adapt them to what works for you.
How long does TF-CBT take?
For children and young people with a single-incident trauma, TF-CBT often takes 12 to 16 sessions. For adults, treatment length varies more. Single-incident trauma work in adults can be shorter (8 to 16 sessions). Complex trauma — particularly from childhood, or where multiple experiences are involved — typically takes 20 sessions or more, delivered in phases with careful attention to stabilisation.
Your therapist will discuss expected length with you at the start, review progress along the way, and adjust the plan if needed.
How we deliver TF-CBT
TF-CBT can be delivered virtually (via secure video) or in person at 10 Harley Street. Both formats work well for most clients. Some prefer starting in-clinic to build the therapeutic relationship, then moving to virtual for convenience. Your therapist will discuss what works best for you at your first appointment.
Session Fees
Session type
VIrtual
In-Clinic
Initial appointment (90 minutes)
£230
£280
Ongoing session (50 minutes)
£150
£190
Fees are the same for adults and for children and young people. We accept self-pay clients and are recognised by all major UK health insurers including Vitality, BUPA, AXA, Aviva and Cigna.
FAQ
FAQs
- Can TF-CBT make things worse?
In careful, structured therapy, TF-CBT is very safe. Because it works with difficult memories, feelings can come up between sessions — this is why coping skills come first and why the therapy is delivered in phases. Your therapist will make sure you leave each session feeling steady.
- Do I need a referral from my GP for TF-CBT?
No. You can book directly with us as a self-pay client, or through your health insurance if you have cover.
- Does TF-CBT work for children the same way as adults?
The core principles are the same, but the delivery is very different. For children, TF-CBT includes parents as an active part of treatment, uses play and drawing alongside talking, and paces the work carefully according to the child's age and developmental stage. Our therapists are experienced in working with children and young people across NHS CAMHS and private practice.
- How is TF-CBT different from EMDR?
Both are evidence-based trauma therapies but they work differently. TF-CBT is a structured talking therapy where you build skills, gradually process the trauma through talking or writing, and rebuild confidence in phases. EMDR uses bilateral stimulation and doesn't require detailed talking about what happened. Some people prefer one over the other, and both are effective.
- How is TF-CBT different from regular CBT?
Regular CBT is a general talking therapy for a wide range of difficulties. TF-CBT is a specific adaptation designed for trauma. It has a structured phase-based delivery, a strong focus on safety and stabilisation, and specific techniques for gradually processing traumatic memories. Regular CBT can be used for trauma but TF-CBT is the specialist adaptation.
- Is TF-CBT right for me or my child?
TF-CBT has one of the strongest evidence bases of any trauma therapy, particularly for children and young people. But not everyone responds to it, and some people benefit more from EMDR or other approaches. Your first appointment is designed to explore what will work best.
- Will I have to talk about what happened in detail?
Eventually, yes — but only when you're ready, and only in the way that works for you. TF-CBT is delivered in phases, and the memory-processing work happens after you've built coping skills and feel steady day-to-day. Some people talk. Some write. Children may draw or use play. Your therapist will guide the pace throughout.
Ready to talk to us?
Reaching out about trauma can feel like a big step. Our admin team is used to first conversations that feel tentative, and there’s no pressure to have all the details ready. Whether you’re ready to book, wondering whether TF-CBT or EMDR would suit you better, or want to check whether your insurance covers it, please get in touch.
Our approach to trauma care
Trauma work is at the heart of what we do. TF-CBT and EMDR are our two primary trauma therapies, and we’re set up to help you choose between them or use them in combination. Our clinicians work together to make sure every client is matched with the therapy that fits them best, and we can adjust the approach within a course of treatment if needed.
We believe trauma should never be treated as a checklist. Our clinicians take time to understand the person as well as the experience, and we adapt the therapy accordingly. That includes being thoughtful about pace, being clear about what to expect, and being honest about what will and won’t help.
Related therapies
Depending on your needs, one of these approaches might work alongside or instead of TF-CBT:
Eye Movement Desensitisation & Reprocessing (EMDR)
The alternative evidence-based trauma therapy we offer
Cognitive Behavioural Therapy (CBT)
For anxiety, depression and related difficulties that often accompany trauma
Compassion Focused Therapy (CFT)
For the shame and self-criticism that trauma can leave behind