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TF-CBT vs Standard CBT — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersTF-CBT vs Standard CBTMRCPsych Paper B

A 34-year-old woman with post-traumatic stress disorder and comorbid depressive symptoms asks how individual trauma-focused cognitive behavioural therapy differs from CBT directed primarily at depression. Which therapeutic component most specifically distinguishes the trauma-focused approach?

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Correct answer: E — Deliberate elaboration and processing of trauma memories and trauma-related meanings

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · E = shown as D · B = shown as E

The distinguishing component is deliberate elaboration and processing of the trauma memories and associated meanings. NICE specifies that trauma-focused CBT should process trauma memories and trauma-related emotions, restructure trauma-related meanings, and help the person overcome avoidance. Activity scheduling (A) and work on general negative automatic thoughts (C) are familiar components of depression-focused CBT but do not make an intervention trauma-focused. Relaxation or arousal-management strategies (D) may be included, but are insufficient if trauma memories are not addressed. Trauma-focused CBT is normally delivered individually under NICE guidance, and supportive group discussion alone (E) is not equivalent to a structured, manual-based trauma-focused intervention.

Reference: National Institute for Health and Care Excellence. Post-traumatic stress disorder (NG116), recommendations 1.6.16–1.6.17, 2018; last reviewed 2025. https://www.nice.org.uk/guidance/ng116/chapter/recommendations