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Cognitive Processing Therapy
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Cognitive processing therapy (CPT) is a specific type of cognitive-behavioral therapy found
to be effective for treating Post-Traumatic Stress Disorder (PTSD) in people who have
experienced, violence, abuse, natural disasters, or other traumatic events including reoccurring trauma.
CPT is based on the social cognitive theory of PTSD, which posits that incorporating a traumatic event into one’s worldview is often counterproductive and may lead to maladaptive beliefs. CPT, therefore, focuses on repairing
the damage done by a traumatic event to someone’s beliefs about themselves and the world. By offering specific cognitive restructuring skills, CPT allows an individual to challenge these negative thoughts and interpretations (known as stuck points), gain a healthier perspective about the trauma (for example, “While I can’t trust my abuser, I can still trust other people”), cope better with any future trauma, and move forward with their lives.
CPT is short-term, typically conducted over the course of 12 sessions.
Cognitive Processing Therapy (CPT) helps individuals identify and reconsider
trauma-related beliefs that may contribute to ongoing PTSD symptoms.
Learn more about our approach to trauma and PTSD therapy in Boca Raton at Waves Therapy Group.
When CPT Is Used
CPT is a viable treatment option for most adults who have received a diagnosis of PTSD; it may also be used to treat older adolescents. Some researchers and clinicians believe that CPT might be particularly beneficial
for those who anticipate encountering additional traumatic events say, in
the military or as an emergency worker, such as a firefighter, police officer,
or EMT as it aims to alter the way patients interpret and
process trauma on an ongoing basis.
CPT is not recommended for those who have not received a diagnosis of PTSD or those with literacy difficulties, as it involves written homework. It may also not be an ideal treatment for individuals struggling with substance abuse or suicidal ideation, or individuals with comorbid Bipolar Disorder. In these instances, another research-supported trauma treatment, such as Prolonged Exposure Therapy (PET), is often recommended over CPT.
What To Expect
CPT is based on the social cognitive theory of PTSD, which posits that incorporating a traumatic event into one’s worldview is often counterproductive and may lead to maladaptive beliefs. CPT, therefore, focuses on repairing the damage done by a traumatic event to someone’s beliefs about themselves and the world. By offering specific cognitive restructuring skills, CPT allows an individual to challenge these negative thoughts and interpretations (known as stuck points), gain a healthier perspective about the trauma (for example, “While I can’t trust my abuser, I can still trust other people”), cope better with any future trauma,
and move forward with their lives.
CPT can be conducted in individual or group therapy sessions, or a combination of the two. A full course of CPT typically involves 12 weekly sessions, each about 60 to 90 minutes long, though this can vary slightly depending on the client’s specific needs.
Initial sessions are typically focused on psychoeducation that helps the client learn about PTSD and what they can expect from treatment. In subsequent sessions, the client will work with their therapist to identify and explore the ways that trauma may have altered the client’s thoughts and beliefs, affecting both the way they feel and how they act. Specifically, the therapist will help the client pick out thoughts that create barriers to recovery. The client will learn a set of strategies to challenge and modify thoughts that are inaccurate and/or unhelpful and will practice these strategies with the therapist and on their own with worksheets and exercises.
Clients may be asked to write about the specific events of their traumatic experience, including any sensory details that they remember, or they may be asked to write more broadly about how their experience makes them feel and how they tend to think about what occurred. The client may read these statements aloud during a session.
CPT can be cognitively or emotionally intense, especially when the patient is writing or talking about the experience itself. Feeling discomfort during CPT is normal.
How Cognitive Processing Therapy Works
Someone who has experienced significant trauma and has developed PTSD as a result may notice that they think very differently about themselves or their environment than they did prior to the trauma. This is often particularly noticeable in the following five areas:
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Safety: They may doubt their ability to protect themselves and others.
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Trust: They may question their judgment and/or the judgment and intentions of others.
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Power & Control: They may feel unable to control their own life or influence the lives of those they care about
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Self Esteem: They may view themselves and/or others differently, perhaps seeing themselves as “broken” or others as “evil.
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Intimacy: They may feel incapable of connecting with or being understood by and accepted by others.
These thoughts tend to lead to negative emotions such as fear, anxiety, guilt, and anger and can halt the person's recovery from PTSD. CPT focuses on teaching a set of skills that will help the person challenge these negative thoughts.
Using CPT, therapists at Waves Therapy Group will help a client who has undergone significant trauma to evaluate his or her thoughts surrounding the trauma, particularly maladaptive or self-blaming thoughts that may be exacerbating PTSD symptoms, and conditions including anxiety and depression that set on in the wake of the experience. The
client will then learn to challenge those thoughts and take a new perspective when appropriate.
References
Asmundson, G., Thorisdottir, A. S., Roden-Foreman, J. W., Baird, S. O., Witcraft, S. M., Stein, A. T., Smits, J., & Powers, M. B. (2019). A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder. Cognitive behaviour therapy, 48(1), 1–14. https://doi.org/10.1080/16506073.2018.1522371
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., ...& Weil, A. (2016). Psychological treatments for adults with posttraumatic stress disorder: a systematic review and meta-analysis. Clinical Psychology Review, 43, 128–141.
Gallagher, M. W., Thompson-Hollands, J., Bourgeois, M. L., & Bentley, K. H. (2015). Cognitive behavioral treatments for adult posttraumatic stress disorder: Current status and future directions. Journal of Contemporary Psychotherapy, 45(4), 235–243.
Resick, P.A., Galovski, T.A., Uhlmansiek, M. O., Scher, C.D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258.
Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898–907.
Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 965–971.