Conceptual Application of Trauma-Focused Cognitive Behavioral Therapy to Treat Victims of Bullying

Bullying is a critical pediatric public health problem; estimates across diverse methodologies generally indicate that roughly 36% of youth are bullied. Although policy initiatives aim to address the universal prevention of bullying, and school-level secondary prevention programs aim to reduce the occurrence of bullying, tertiary prevention and intervention programs that mitigate the negative consequences experienced by victims of bullying remain an understudied need. The nature of bullying (that it occurs as events, leaves children feeling unsafe, and engenders emotional distress) and the association of bullying with posttraumatic stress symptoms among youth suggests that trauma treatment for bullying is promising. This manuscript presents the rationale for treating victims of bullying with trauma-focused cognitive behavioral therapy (TF-CBT), describes the components of TF-CBT, and discusses how to use TF-CBT specifically for bullying. Conducting research on treatment outcomes when using TF-CBT for bullying is critical to evaluate its efficacy and effectiveness in this group. Behavioral clinical trials would provide evidence for whether TF-CBT reduces the mental health harm experienced by youth victims of bullying. This evidence is an essential step to address the public health problem of bullying because the scientific literature currently does not have a well-established individual-level treatment for victims of bullying that mental health providers in diverse settings can deliver, despite individuals' beliefs that health care providers are important sources of help for youth who have been bullied.