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Therapeutic and psychological pathways:

What works and why

Once the immediate crisis has been stabilized and initial reports have been made, the longer road of recovery begins. This section outlines what the research tells us about effective therapeutic intervention for both survivors and their parents. 

Healing is not one-size-fits-all. Many children benefit from a combination of therapies over time. Counselling, supportive relationships, movement, creativity, time in nature, healthy routines, and opportunities for joy can all contribute to recovery. Work with qualified professionals to create a plan that meets your child's unique needs and evolves as they grow.

The gold standard: Trauma-focused cognitive behavioural therapy (TF-CBT) 

Recent systematic reviews and clinical guidelines identify trauma-focused cognitive behavioural therapy (TF-CBT) as one of the most strongly supported treatments for children and adolescents experiencing trauma-related symptoms, including PTSD following sexual abuse.

Australia’s national PTSD guidelines give trauma-focused CBT a strong recommendation for children and adolescents with PTSD. In Canada, the National Guidelines for Canadian Child Advocacy Centres/Child & Youth Advocacy Centres emphasize access to specialized, evidence-informed, trauma-focused mental health services for children and youth who have experienced abuse, as well as support for non-offending family members.

Together, these recommendations reflect a strong body of evidence supporting trauma-focused treatment as an important part of recovery for children and adolescents experiencing trauma-related symptoms.

What makes TF-CBT distinct from many other therapeutic approaches is its explicit inclusion of a supportive caregiver. The model typically includes individual sessions for both the child and caregiver, as well as structured conjoint sessions where they work together with the therapist. Caregivers learn many of the same skills their child is learning, helping them reinforce coping strategies and provide support outside of therapy. Research suggests that caregiver involvement and support can play an important role in a child’s recovery following trauma.

TF-CBT has been shown to reduce PTSD symptoms, feelings of shame, and abuse-specific parental distress, with improvements maintained at 6- and 12-month follow up ( addressing the specific emotional landscape of CSA – particularly shame, which is often under addressed in general trauma treatments (Deblinger et al., 2006). 

Accessing TF-CBT in Canada

The best starting point for accessing TF-CBT is your regional Child Advocacy Centre. CACs exist across Canada and provide both direct therapeutic services and referral pathways. In provinces or communities where a CAC is not available, your family physician, or pediatrician can refer you to a trauma-specialized psychologist or social worker. The Canadian Centre for Child Protection also provides resource guidance and support for families navigating the mental health system.

Ask specifically for a therapist with training in TF-CBT and experience treating child sexual abuse. Not all trauma therapists have this specialization, and the specificity matters.

Support for you as a parent

Your therapeutic needs are distinct from your child's, and they deserve equal attention. Therapists who work with parents of CSA survivors often use a combination of individual trauma therapy, psychoeducation about vicarious trauma, and secondary PTSD, and support groups with other non-offending parents. 

The 2026 Bond University research (McGillivray et al., 2026) points to two specific areas to address with your own therapist: self-compassion (learning to treat yourself with the same care you are extending to your child) and emotion regulation (developing tools to manage the intense feelings that will surface without letting them overwhelm your capacity to be present). These are learnable skills, not character traits you either have, or do not.

Because a disclosure can affect the whole family, some families benefit from support that addresses both the child’s needs and the wellbeing of non-offending caregivers.

Other evidence-based or evidence-informed options

Every child is different, and there is no single therapy that works best for everyone. While Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is one of the most extensively researched treatments for childhood trauma, many children benefit from other evidence-informed approaches depending on their age, symptoms, personality, and preferences. A trauma-informed therapist can help determine which approach is most appropriate.

Eye movement desensitization and reprocessing (EMDR)

EMDR helps the brain process traumatic memories that may feel "stuck." Rather than focusing extensively on talking about the trauma, EMDR uses guided bilateral stimulation (such as eye movements, tapping, or alternating sounds) while the child recalls aspects of the experience in a safe, structured way. Research suggests EMDR can reduce symptoms of post-traumatic stress, anxiety, and distress in many children and adolescents.

May be helpful for:

• PTSD symptoms

• intrusive memories

• nightmares

• anxiety

• older children and adolescents

Child-parent psychotherapy (CPP)

CPP focuses on strengthening the relationship between a young child and their caregiver after trauma. The therapist works with both the child and caregiver together, helping rebuild safety, trust, and secure attachment. CPP is designed for infants, toddlers, preschoolers and young children and focuses on the caregiver-child relationship following trauma.

May be helpful for:

• children under six

• attachment concerns

• developmental trauma

• caregiver-child relationships
  

Complementary approaches

Play therapy

Children often communicate through play before they can fully express their experiences with words.

Trauma-informed play therapists use toys, art, storytelling, and imaginative play to help children process difficult emotions in developmentally appropriate ways. Play therapy should ideally be provided by clinicians with specialized training in childhood trauma.

May be helpful for:

• younger children

• emotional expression

• anxiety

• behavioural concerns

Somatic (body-based) therapies

Trauma is experienced not only in thoughts and emotions but also in the body. Somatic therapies help children notice and regulate physical sensations associated with stress and fear through movement, breathing, grounding exercises, mindfulness, and body awareness. This work can be done through experiences like somatic yoga, body-based regulation exercises, sensorimotor psychotherapy and other body based modalities. Many families find these approaches helpful alongside traditional talk therapy.

May be helpful for:

• chronic anxiety

• hypervigilance

• emotional regulation

• children who struggle to talk about their experiences

Art therapy

Some children find it easier to express thoughts and feelings through drawing, painting, sculpture, or other creative activities than through conversation.

Art therapy provides a safe, non-verbal way to explore emotions while building coping skills and resilience.

May be helpful for:

• younger children

• children who have difficulty expressing emotions verbally

• anxiety

• self-esteem

Music therapy

Music can help children regulate emotions, reduce anxiety, and safely express difficult experiences through listening, singing, songwriting, or playing instruments. Research suggests music therapy may support emotional regulation and stress reduction when integrated into a broader treatment plan.

Animal-assisted therapy

Working alongside specially trained therapy animals can help children feel calmer, increase emotional safety, and reduce anxiety during the healing process. Some Child Advocacy Centres and counselling programs include therapy dogs during interviews or counselling sessions. Equine-assisted therapy is another option that some children find meaningful.

Family therapy

Trauma affects the entire family. Family therapy can improve communication, strengthen relationships, address misunderstandings, and help family members learn how to support one another throughout recovery. Family therapy is often used alongside individual therapy rather than instead of it.

Mindfulness and self-regulation programs

Many trauma-informed clinicians teach children practical regulation skills, including:

• deep breathing

• grounding techniques

• mindfulness

• progressive muscle relaxation

• visualization

• movement

These techniques help calm the nervous system and increase a child's sense of safety.

Which therapy is best?

There is no single "best" therapy for every child. The most appropriate treatment depends on many factors, including:

• your child's age

• developmental stage

• trauma history

• symptoms

• personality

• cultural background

• family involvement

• the therapist's training and experience

The therapeutic relationship also matters. Children are more likely to engage in treatment when they feel safe, respected and understood, alongside receiving care that is appropriate for their needs and provided by a clinician with relevant training.

A note about complementary therapies

Many families also explore complementary approaches such as:

• yoga

• mindfulness

• massage therapy (when appropriate and welcomed by the child)

• nature-based therapy

• equine-assisted therapy

• drumming

• expressive arts

• meditation

While many families report these approaches are helpful, they should complement—not replace—evidence-based trauma treatment, particularly when a child is experiencing significant symptoms related to sexual abuse.

Page Sources | All References

for additional reading and listening

• Trauma-Focused Cognitive Behavioral Therapy — National Child Traumatic Stress Network
  A parent-friendly overview of TF-CBT, including who it is designed for, how treatment works and the role parents and caregivers can play in recovery. The resource explains that TF-CBT combines individual work with the child and caregiver with child-parent sessions.
  Learn about Trauma-Focused Cognitive Behavioral Therapy

• What Can My Child/Adolescent Expect from TF-CBT? — TF-CBT Certification Program
  A practical overview for families explaining what children may experience during TF-CBT and how parents and caregivers participate in treatment. It includes information about coping skills, difficult thoughts and feelings, communication, safety and caregiver support.
  Read the TF-CBT guide for families

• TF-CBT Resources — TF-CBT Certification Program
  A collection of information, workbooks and resources related to Trauma-Focused Cognitive Behavioral Therapy for children, adolescents and caregivers. Some materials are designed for clinicians, but families may find the collection helpful for understanding what TF-CBT involves.
  Explore TF-CBT resources

• Post-traumatic Stress Disorder: Psychological Interventions for Children and Adolescents — World Health Organization
  An evidence-based overview of recommended psychological treatments for children and adolescents with PTSD, including trauma-focused cognitive behavioural therapy and EMDR.
  Read the World Health Organization guidance