For What Population Is AF-CBT Appropriate?
Appropriate candidates for AF-CBT include caregivers whose reliance on physical aggression/force or level of anger/hostility raises management, clinical, or safety concerns, children and adolescents who exhibit externalizing behavior problems (e.g., aggression or oppositional behavior) and limited social competence, or families who present with heightened conflict and volatile relationships.
Children exposed to physical force/coercion are at risk for developing significant psychiatric, behavioral, and adjustment difficulties, many of which may persist through adolescence and young adulthood. And, they are at significant risk for physical abuse or re-abuse. AF-CBT is also appropriate for children with behavior problems or disorders (e.g., ODD, CD), even if they have not been involved in physically aggressive or abusive interactions.
With its integration of interventions for caregivers and children/adolescents, AF-CBT seeks to reduce caregiver/family risk factors for physically coercive/abusive behavior and ameliorate the consequences of these experiences for children, at both the individual and family-context levels.
Children and caregivers are both important participants in treatment. AF-CBT is most suitable for school-aged children (age 5-15) who exhibit some level of behavioral or emotional dysfunction, and for caregivers who may resort to uncomfortable or unsafe levels of physical coercion or punishment. To use AF-CBT with preschoolers or adolescents, the content and materials can be adapted for the appropriate developmental level.
AF-CBT has been equally successful in treating children identified as Caucasian and African-American. This approach is currently being used with families of varying backgrounds and cultures (e.g. Native American, Hispanic, Asian, African). The AF-CBT Session Guide has incorporated content suggested by numerous therapists from diverse cultural and ethnic backgrounds. It is important for therapists to approach AF-CBT from the cultural and personal framework of each client. Therapists should be knowledgeable about clients’ cultures and respectful of diverse backgrounds and beliefs. When working with parents/caregivers who rely upon physical force or discipline, therapists are encouraged to discuss and incorporate the cultural context/appropriateness of certain views/practices to promote child safety and welfare, and family adjustment. In doing so, it is important for therapists to maintain a respectful professional stance toward families in their efforts to promote understanding and clinical recovery.