Cue Centered Therapy

Training and Implementation

Our Trainers welcome you to register for the Cue-Centered Therapy online training course.

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SPANISH VERSION (Newly Launched!!)

CCT Essential Treatment Manual

English and Spanish versions

What is CCT

  • Cue-Centered Therapy, or CCT, is intended for pediatric mental health professionals who have experience with evidence-based interventions and treatment of trauma. CCT was developed by Dr. Victor Carrion, Dr. Hilit Kletter, and Dr. Ryan Matlow.
  • CCT is an evidence-based intervention for youth with chronic traumatic experiences. Rather than focus on traumatic events in isolation, the CCT framework emphasizes the impact of accumulating traumas and other stressors throughout a lifespan, otherwise known as allostatic load.
  • This intervention anchors in the fact that exposure to multiple forms of trauma and adversity in childhood leads to different psychological and developmental outcomes. CCT aims to address the diverse outcomes by promoting self-empowerment through increased knowledge and insight.
  • CCT is a hybrid approach that combines elements from cognitive behavioral, psychodynamic, interpersonal, expressive, and family therapies. The intervention is framed around the neurobiology of trauma beginning by teaching children the meaning of traumatic cues, natural reactions to stress, and how classical conditioning plays a role in our responses. In addition, CCT teaches how cues affect current emotions, cognitions, physiological reactions, and, ultimately, behaviors.
  • A central component of CCT is to help youth place their traumatic events in the greater context of their lives. Rather than “unlearn” conditioned maladaptive responses to cues, CCT focuses on building new responses, utilizing the strengths and adaptive coping mechanisms already present in the child. This principle empowers youth to be their own agents of change.

What to Expect: CCT is generally 15 sessions long with the flexibility of adding additional sessions to help the child understand the treatment concepts. Each weekly session is 45 - 60 minutes. During the first few sessions we will assess the child’s symptoms and determine if this treatment is appropriate to address the child’s needs. Caregivers and the child will also be asked to complete some self-report questionnaires to assist with the assessment.

Practicing the skills learned is an important part of treatment. Take-home assignments are provided, and caregivers are enlisted as coaches to help the child practice these skills outside the therapy setting.

CCT primarily focuses on individual treatment of the child with 3-4 joint sessions with the child and caregiver together.

CCT Training

This online course was designed by the creators of CCT, Dr. Victor Carrion, Dr. Ryan Matlow, and Dr. Hilit Kletter of the Early Life Stress and Resilience Program at Stanford University.

The Cue-Centered Therapy online training course is a self-paced course consisting of 10 modules that cover the fundamentals of CCT and is the first required step to be certified in the intervention (the other two steps are a 1.5 day in person training and consultation on at least 2 cases).

The course provides the theoretical rationale, goals, therapeutic techniques, and resources for each session of the intervention. Four vignettes that the created from the developers' own clinical experience are used throughout to demonstrate session goals.

The course is unique in that it incorporates different learning modalities including introduction of the vignettes in a graphic novel style, use of audio book format for the clinical scripts, illustrations/animations to teach key didactic concepts, and quizzes and interactive exercises to enhance learner knowledge. 

The course is approved for 6.00 continuing education AMA PRA category 1 credits: is why in this course we'll meet four different children across a series of short audiobook chapters. Join us as we observe their therapy sessions, and follow their journeys of self-knowledge and empowerment.

CCT Publications

Cue-Centered Therapy for Youth Experiencing Posttraumatic Symptoms

Recent findings Studies demonstrate promising outcomes indicating CCT effectiveness in reducing child and caregiver posttraumatic stress, and in improving child functioning. Further research, however, is needed to identify which clients are best-suited for CCT (versus other available child trauma treatments) and to identify which components of CCT are most critical for addressing complex developmental trauma.

Carrion, VG, Kletter, H, Weems, CF, Rialon Berry, R, & Rettger JP (2013). Cue-centered treatment protocol for children exposed to interpersonal violence: a school-based randomized controlled trial. Journal of Traumatic Stress, 26, 654-662.

Kletter, H (2019). Cue-Centered Therapy. In Victor G. Carrion (ed). Assessing and Treating Youth Exposed to Traumatic Stress (pp. 207-221). American Psychiatric Association Publishing.

Friedman, MA, & Kletter, H (2019). Parent-child informant discrepancy and treatment response among youth exposed to chronic adversity: Implications for childhood PTSD assessment and intervention. Poster presented at the 35th annual conference of the International Society for Traumatic Stress Studies: Boston, MA

International Cue Centered Therapy Training

Teaching at Hebrew University in Jerusalem, Israel by Hilit Kletter, PhD

This past summer, I was invited to teach at the Paul Baerwald School of Social Work and Social Welfare at Hebrew University in Jerusalem, Israel. This was an exciting opportunity for me to get to teach in my native homeland. It also allowed me to continue collaborating with Israeli colleagues whom I first met when our lab hosted a workshop on youth exposed to war and terror. 

The course was based on the Cue-Centered Therapy training which I extended into a full academic course: “Assessment and Treatment of Trauma and Cue-Centered Therapy (CCT) in Youth Exposed to Chronic Trauma." Therapy training which I extended into a full academic course: “Assessment and Treatment of Trauma and Cue-Centered Therapy (CCT) in Youth Exposed to Chronic Trauma." It covered many topics including the history of, theories, neuroscience, assessment and diagnosis of PTSD and related conditions, as well as an in-depth overview and hands-on practice of CCT.

The course was offered as a Master’s level elective, delivered in four full intensive days. The thirty three participants included students within the clinical social work track at Hebrew University and several psychologists from the Haruv Institute for the training and research of child abuse and neglect, which is affiliated with the university. The number was way more than is usual especially considering that it was in English and not in the native language. The group was very heterogeneous, younger and older age, secular and religious Orthodox, representing many different groups within Israeli society. They were eager to participate, some even commuted several hours each day from remote areas. The students all had experience working with various traumatized populations including maltreated youth, victims of domestic violence, elderly, veterans, sexually assaulted women, religious circles, and communities in conflict zones.

I was impressed by their desire to learn, enthusiasm, and high level of engagement and participation.

They were especially interested in learning about CCT, searching for practical skills that they could incorporate into their work. I was touched that a few of them shared with me their personal trauma stories and told me how the course better helped them understand their reactions. It was a real pleasure to teach such a group. I found the discussion on culture to be the most fascinating. I discovered that while there are many similarities between Israel and the US in trauma causes, conceptualization and treatment, there are also things unique to Israeli society and culture. For example, trauma of living in continuously threatened conflict zones, “shared fate” resilience, handling of trauma in closed religious circles, and more. Teaching the course was a very enriching experience for me and I received very positive feedback from both students and university staff that I was invited to teach it again next year.     

To learn more about Dr. Kletter, please visit her CAP profile


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CCT Training in San Juan, Puerto Rico 

by Dr. Victor Carrion

Dr. Carrion was invited by the Government of Puerto Rico to train all school counselors in the Department of Education. These events were made possible by Pure Edge, Inc.

CCT Training in Panama City for the Heads of the Latin American Team of the International Committee of the Red Cross (Geneva)

by Susana de Cruylles, MFT

International Colloborator, Ms. Cruylles conducted a CCT Training in Panama City for the Heads of the Latin American Team of the International Committee of the Red Cross (Geneva). Some of the countries represented: Mexico, Guatemala, El Salvador, Colombia, Perú, Honduras, Brasil. TO find out more about ICRC please visit

CCT Book Reading Presentation and training in Madrid, Spain

by Dr. Victor Carrion and Susana de Cruylles, MFT

Dr. Carrion and international collaborator, Ms. Cruylles facilitated a day long CCT educational program for mental health providers from the Consejería de Sanidad de la Comunidad de Madrid.The morning training was for psychologist and psychiatrist of the spanish public mental health system The afternoon book presentation was in the Ruber Internacional Hospital.