TF-CBT and Racial Socialization


TF-CBT and Racial Socialization Implementation Manual

This manual addresses strategies for implementing Trauma‐Focused Cognitive Behavioral Therapy (TF-CBT+RS, Metzger, Dandridge, Cohen, & Mannarino, 2023) and Racial Socialization for Black youth ages 3-17 years and their parents and/or other caregivers who experience racial-related stress or trauma as well as other types of significant trauma.

Integrating Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Racial Socialization for Traumatized Black Youth

Black youth in America are at elevated risk for experiencing trauma, including racial trauma, and for developing posttraumatic stress disorder (PTSD) and other related mental health and medical problems. Through our SAMHSA-funded National Child Traumatic Stress Network (NCTSN, grant, Allegheny General Hospital’s Center for Traumatic Stress in Children & Adolescents hosted a 12-month Learning Community focused on integrating TF-CBT with Racial Socialization for Black youth who experience trauma, including racial trauma. Racial Socialization incorporates a variety of systematic strategies and behaviors that Black families use to instill resilience and positive racial identity. This Learning Community greatly benefited from prior work developed by Isha W. Metzger, Ph.D., and colleagues (Metzger et al, 2021);

The Learning Community consisted of 28 clinicians, supervisors and trainers from six NCTSN centers: Allegheny General Hospital (Pittsburgh, PA), Center for Children and Families (Durham, NC), Dee Norton Low Country Children’s Advocacy Center (Charleston, SC), Healing Hurt People, Drexel University (Philadelphia, PA), Georgia Center for Child Advocacy (Atlanta, GA), and PACTS (Philadelphia, PA). All members had completed prior TF-CBT training and consultation. Goals of the Learning Community were to 1) collaboratively discuss how to integrate Racial Socialization strategies into TF-CBT for Black youth who experience trauma including racial traumas, using clinical cases seen by members of the Learning Community; 2) treat Black youth using these integrated strategies and assess treatment outcomes for PTSD; and 3) develop an Integrated TF-CBT and Racial Socialization Implementation Manual.

The Learning Community began with a full-day training on Racial Socialization and Racial Trauma by Dr. Metzger ( This was followed by monthly calls. During each call, one of the teams presented a clinical case of a Black youth receiving integrated TF-CBT +RS that one of their clinicians was providing, focusing on how to integrate Racial Socialization into a specific TF-CBT PRACTICE component; team members discussed successes and how to address challenges. Each month, data were collected from clinicians with regard to youth they were seeing through the project. Additionally, participants completed the Therapist Racial Trauma Efficacy Scale at the beginning and the end of the Learning Community to assess changes in our perceptions of changes in our personal efficacy in treating racial trauma.

The outcomes of this Learning Community have been very positive. Clinicians reported significant increases in their perceived efficacy related to treating racial trauma. Black youth who have completed treatment in the project to date have reported highly significant improvement in PTSD symptoms. In response to many inquiries about this project, we are creating this page to disseminate resources and information about implementing TF-CBT + Racial Socialization for TF-CBT therapists who are interested in this application. In the coming months we will post more resources, including the TF-CBT + Racial Socialization Implementation Manual. We are very excited about this application, and look forward to providing more information and resources on this page in the near future.

Metzger, I. W., Anderson, R. E., Are, F., & Ritchwood, T. (2021). Healing Interpersonal and Racial Trauma: Integrating Racial Socialization into Trauma-Focused Cognitive Behavioral Therapy for African American Youth. Child Maltreatment, 26(1), 17–27.

Books for Children

All Are Welcome

Alexandra Penfold; Illustrated by Suzanna Kaufman

Description: This picture book celebrates diversity by showing how children in one classroom all grow and learn from each other’s traditions.

Amazing Grace

Mary Hoffman; Illustrated by Caroline Binch

Description: Grace loves to act, but one day some kids tell her she can’t play the part of Peter Pan because of the way she looks. Grace’s grandmother helps this young girl realize that with effort anything can be achieved. It’s an inspiring and heartwarming story.

Bright Eyes, Brown Skin

Cheryl Hudson & Bernette Ford; Illustrated by George Cephas Ford

Description: Four African American children interact with one another in a preschool environment, exploring their facial features, skin tones, what they wear, what they do, and how they learn from and enjoy each other. A happy book and nice addition to preschool and kindergarten classrooms.

Chocolate Me!

Taye Diggs; Illustrated by Shane W. Evans

Description: This book can prompt a discussion about racial bullying. Dr. Aisha White, Director of the P.R.I.D.E Program at the University of Pittsburgh says that parents should read it first themselves, get ready to answer tough questions about bullying, and make sure they can give important context about racism in America. “We don’t recommend that anyone start reading this book with a child unless they’ve had some practice and are prepared to have useful and productive conversation,” says Dr. White.

The Day You Begin

Jacqueline Woodson; Illustrated by Rafael López

Description: National Book Award winner Jacqueline Woodson and two-time Pura Belpré Illustrator Award winner Rafael López bring this inspiring story to life about finding the courage to connect. It’s about how sometimes you can feel like an outsider, but sharing out stories can bring us together.

Hair Love

Matthew A. Cherry; Illustrated by Vashti Harrison

Description: This sweet story is about a little girl with beautiful hair. When her dad has to help style it for a special occasion, he has a lot to learn, but is ready for the challenge since he loves his daughter so much.

I Believe I Can

Grace Byers; Illustrated by Keturah A. Bobo

Description: This gorgeously illustrated book lets all kids know that, no matter their background, they can love and believe in themselves.

Intersection Allies: We Make Room for All

Chelsea Johnson, Latoya Council, Carolyn Choi; Illustrated by. Ashley Seil Smith; Foreword by. Dr. Kimberlé Crenshaw

Description: The brainchild of three women-of-color sociologists, IntersectionAllies, is a smooth, gleeful entry into intersectional feminism. The nine interconnected characters proudly describe themselves and their backgrounds, involving topics that range from a physical disability to language brokering, offering an opportunity to take pride in a personal story and connect to collective struggle for justice. The group bond grounds the message of allyship and equality. When things get hard, the kids support each other for who they are: Parker defends Katie, a genderfluid character who eschews skirts for a superhero cape; Heejung welcomes Yuri, a refugee escaping war, into their community; and Alejandrea’s family cares for Parker after school while her mother works. Advocating respect and inclusion, IntersectionAllies, is a necessary tool for learning to embrace, rather than shy away from, difference. Featuring gorgeous illustrations on every page by Ashley Seil Smith, as well as powerful introductions by activist and law professor Dr. Kimberlé Crenshaw, who coined the term “intersectionality,” and Dr. Ange-Marie Hancock Alfaro, author of Intersectionality: An Intellectual History.

Let It Shine: Stories of Black Women Freedom Fighters

Andrea Davis Pinkney; Illustrated by Stephen Alcorn

Description: Rosa Parks refused to give up her seat on a bus and sparked a boycott that changed America. Harriet Tubman helped more than three hundred slaves escape the South on the Underground Railroad. Shirley Chisholm became the first black woman elected to the U.S. House of Representatives. The lives these women led are part of an incredible story about courage in the face of oppression; about the challenges and triumphs of the battle for civil rights; and about speaking out for what you believe in– even when it feels like no one is listening. Andrea Davis Pinkney’s moving text and Stephen Alcorn’s glorious portraits celebrate the lives of ten bold women who lit the path to freedom for generations. Includes biographies of Sojourner Truth, Biddy Mason, Harriet Tubman, Ida B. Wells-Barnett, Mary McLeod Bethune, Ella Josephine Baker, Dorothy Irene Height, Rosa Parks, Fannie Lou Hamer, and Shirley Chisholm.

Let the Children March

Monica Clark-Robinson; Illustrated by Frank Morrison

Description: In 1963 Birmingham, Alabama, thousands of African American children volunteered to march for their civil rights after hearing Dr. Martin Luther King Jr. speak. They protested the laws that kept black people separate from white people. Facing fear, hate, and danger, these children used their voices to change the world. Frank Morrison’s emotive oil-on-canvas paintings bring this historical event to life, while Monica Clark-Robinson’s moving and poetic words document this remarkable time.

Let's Talk About Race

Julius Lester, Illustrator: Karen Barbour

Description: As Lester discuss how we all have a story, he brings up questions about why we think race is important and what it means to have a racial identity. This gorgeous book – great to read with kids of any age – allows for open-ended conversation and questions.

Malcolm Little: The Boy Who Grew Up to Become Malcolm X

Ilyasah Shabazz; Illustrated by. Ag Ford

Description: Malcolm X grew to be one of America’s most influential figures. But first, he was a boy named Malcolm Little. Written by his daughter, this inspiring picture book biography celebrates a vision of freedom and justice. Bolstered by the love and wisdom of his large, warm family, young Malcolm Little was a natural born leader. But when confronted with intolerance and a series of tragedies, Malcolm’s optimism and faith were threatened. He had to learn how to be strong and how to hold on to his individuality. He had to learn self-reliance. Together with acclaimed illustrator AG Ford, Ilyasah Shabazz gives us a unique glimpse into the childhood of her father, Malcolm X, with a lyrical story that carries a message that resonates still today – that we must all strive to live to our highest potential.

My Hair is a Garden

Cozbi A. Cabrera

Description: When Mack gets teased and taunted at school about her unruly hair, she turns to her neighbor Miss Tillie for comfort and help. To help make learn to care for her hair – and appreciate herself – Miss Tillies uses the metaphor of her lush garden to show Mack the many kinds of beauty and all the nurturing they require.

Not My Idea: A Book about Whiteness

Anastasia Higginbotham

Description: Not My Idea: A Book About Whiteness is a picture book about racism and racial justice, inviting white children and parents to become curious about racism, accept that it’s real, and cultivate justice.

The Proudest Blue: A Story of Hijab and Family

Ibtihaj Muhammad, S. K. Ali; Illustrated by Hatem Aly

Description: A powerful, vibrantly illustrated story about the first day of school — and two sisters on one’s first day of hijab — by Olympic medalist and social justice activist Ibtihaj Muhammad. With her new backpack and light-up shoes, Faizah knows the first day of school is going to be special. It’s the start of a brand new year and best of all, it’s her older sister Asiya’s first day of hijab — a hijab of beautiful blue fabric, like the ocean waving to the sky. But not everyone sees hijab as beautiful, an din the face of hurtful, confusing words, Faizah will find new ways to be strong. Paired with Hatem Aly’s beautiful, whimsical art, Olympic medalist Ibtihaj Muhammad and Morris Award finalist S.K. Ali bring readers an uplifting, universal story of new experiences, the unbreakable bond between siblings, and of being proud of who you are.

Separate is Never Equal: Sylvia Mendez and Her Family's Fight for Desegregation

Duncan Tonatiuh

Description: Almost 10 years before Brown vs. Board of Education, Sylvia Mendez and her parents helped end school segregation in California. An American citizen of Mexican and Puerto Rican heritage who spoke and wrote perfect English, Mendez was denied enrollment to a “Whites Only” school. Her parents took action by organizing the Hispanic community and filing a lawsuit in federal district court. Their success eventually brought an end to the era of segregated education in California.

Something Happened in Our Town: A Child's Story about Racial Injustice

Marianne Celano, Marrietta Collins, Ann Hazzard; Illustrated by. Jennifer Zivoin

Description: Emma and Josh heard that something happened in their town. A Black man was shot by the police. “Why did the police shoot that man?” “Can the police go to jail?” Something Happened in Our Town follows two families — one White, one Black — as they discuss a police shooting of a Black man in their community. The story aims to answer children’s questions about such traumatic events, and to help children identify and counter racial injustice in their own lives. Includes an extensive Note to Parents and Caregivers with guidelines for discussing race and racism with children, child-friendly definitions, and sample dialogues. Free, downloadable educator materials (including discussion questions) are available at


Lupita Nyong'o: Illustrated by Vashti Harrison

Description: This Coretta Scott King award-winning picture book is about self-esteem and beauty within. It’s a whimsical and heartwarming story about a little girl who learns to embrace her unique self.

Through My Eyes

Ruby Bridges

Description: Six-year-old Ruby Bridges became the first African American to integrate an elementary school. Her memories of that year, when so much hatred was directed at her, makes for a powerful memoir. A 1999 Parents’ Choice Gold Award Winner.