Washington State CBT+ Initiative

Funding: Department of Social and Health Services (DSHS) Mental Health Division (Federal Block Grant Funding, 2009 – present)
Agencies/Departments Involved in the Initiative: Harborview Sexual Assault and Traumatic Stress Center (HCSATS), University of Washington’s Department of Psychology and Department of Public Behavioral Health and Justice Policy (PHBJP)
Trainers & Consultants: Lucy Berliner, LICSW, Laura Merchant, LICSW, Shannon Dorsey, Ph.D., Nathaniel Jungbluth, Ph.D.

The DSHS Mental Health Division funds training in TF-CBT for clinicians working in mental health agencies that have contracts with their local Regional Support Network (RSN). The WA State CBT+ Initiative was created specifically to meet the needs of public mental health based on feedback from community mental health organizations. The goal is to provide the training and support providers need to treat their clients; reducing stress, burnout, and ideally, turnover. Community mental health organizations consider CBT+ to be “foundational” to their provider training, support, and retention.

CBT+ uses generic versions of evidence-based models that address over 80% of the behavioral health conditions for which youth seek care in Washington State. These conditions include anxiety, depression, trauma-focused anxiety (or posttraumatic stress) and behavioral problems. It is a novel approach that avoids the limited coverage, extra costs, and restrictions of using brand-name programs. Each year, we train 250+ clinicians (MA and BA) and supervisors statewide. Youth in WA who receive CBT from CBT+ trained clinicians experience clinical improvement. Training includes on-line recorded and live interactive training, and 6 months of small group, case consultation. Clinicians who participate in these activities receive a certificate of completion. All of our CBT+ provider training  is co-led by experienced supervisors from community mental health organizations. Trainings fill up every year; more slots are always requested. Interventions from CBT+ are consistently the most frequently-reported SERI codes. We also offer advanced yearly trainings for providers, bringing in speakers on topics such as CBT for trauma with Black youth, CBT for LGBTQIA+ youth. We maintain two active listservs, one for providers and one for supervisors.

In addition to the supervisor listserv, the CBT+ Initiative provides supervisor-specific supports for sustainment, including a yearly supervisor training, a monthly supervisor meeting, and a BIPOC supervisor group to support centering DEI. These additional activities are intended to develop and support clinical leadership for effective, sustained behavioral health care in public mental health.

The Chadwick Center for Children Services conducted the Kauffman Best Practices Project Final Report and found TF-CBT to be a best practice (an evidence based practice) in the field of child abuse treatment. Also of interest is the 2004 Child Physical and Sexual Abuse: Guidelines for Treatment.

For more information on TF-CBT and other evidence-based practices for treating child trauma, please visit The National Child Traumatic Stress Network. If you are a masters-level mental health clinician or provider and are interested in obtaining training in TF-CBT, there are two free online training resources. They have basic training and, once basic is completed, training on using TF-CBT with childhood traumatic grief.


  1. Berliner, L., Dorsey, S., Merchant, L., Jungbluth, N., Sedlar, G. (2013). Practical Guide for EBP Implementation in Public Health. Washington State Division of Behavior Health and Recovery, Harborview Center for Sexual Assault and Traumatic Stress & University of Washington, School of Medicine, Public Behavior Health and Justice Policy.
  2. Berliner, L., Dorsey, S., Sedlar, G., Jungbluth, N., & Merchant, L. (2013). Everyday Competence and Fidelity for EBP Organizations: Practical Guide. Washington State Division of Behavior Health and Recovery, Harborview Center for Sexual Assault and Traumatic Stress & University of Washington, School of Medicine, Public Behavior Health and Justice Policy.
  3. Lyon, A. R., Dorsey, S., Pullman, M. Silbaugh-Cowdin, J., Berliner, L. (2014). Clinician use of standardized assessments following a common elements psychotherapy training and consultation program. Administration and Policy in Mental Health. Advance online publication.
  4. Dorsey, S., Berliner, L., Lyon, A. R., Pullmann, M., & Murray, L. K. (2014). A statewide common elements initiative for children’s mental health. Journal of Behavioral Health Services and Research. Advance online publication.