Cognitive Processing Therapy (CPT)

CPT is a specific type of cognitive behavioral therapy (CBT) that helps patients learn how to modify and challenge unhelpful beliefs related to trauma.

Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy (CBT) that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape, and natural disasters.

CPT is generally delivered over 12 sessions and helps patients learn how to challenge and modify unhelpful beliefs related to the trauma. In so doing, the patient creates a new understanding and conceptualization of the traumatic event so that it reduces its ongoing negative effects on current life. 

This treatment is strongly recommended for the treatment of PTSD.

Using CPT to Treat PTSD

Treatment begins with psychoeducation regarding PTSD, thoughts, and emotions. The patient becomes more aware of the relationship between thoughts and emotions and begins to identify “automatic thoughts” that may be maintaining the PTSD symptoms. The patient writes an impact statement that details current understandings of why the traumatic event occurred and the impact it has had on beliefs about self, others, and the world.

Next, the patient begins more formal processing of the trauma(s). The patient writes a detailed account of the worst traumatic experience, which the patient reads in the next session to try and break the pattern of avoiding thoughts and feelings associated with the trauma. The therapist uses Socratic questioning and other strategies to help the patient question his or her unhelpful thoughts about the trauma (e.g., self-blaming thoughts) in order to modify any maladaptive thinking.

Finally, once the patient has developed skills to identify and address unhelpful thinking, she or he uses those skills to continue evaluating and modifying beliefs related to traumatic events. At this point, the therapist is helping the patient develop the ability to use these adaptive strategies outside of treatment to improve overall functioning and quality of life. Therapists may particularly focus on safety, trust, power, control, esteem, and intimacy as these are all areas that can be affected by traumatic experiences.

CPT can be delivered both individually and in structured group sessions. Regardless of modality, patients will have out-of-session practice assignments. CPT was originally developed with the written trauma account as one component of treatment, but sometimes it is delivered without this and more emphasis is placed on cognitive techniques.

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