Cognitive Processing Therapy

What Is Cognitive Processing Therapy?

Cognitive Processing Therapy (CPT) is a type of cognitive-behavioral therapy found to be effective for treating post-traumatic stress disorder (PTSD). With PTSD, you may find yourself thinking very differently about yourself and your environment, particularly in the following five areas: Safety: You may doubt your ability to protect yourself and others. Trust. You may question your judgment and, or, the judgment and intentions of others. Control: You feel unable to control your own life and, or, to influence the lives of those you care about. Esteem: You view yourself and, or, others differently, perhaps seeing yourself as broken or others as evil. Intimacy: You may feel incapable of connecting with or being understood and accepted by others. These thoughts lead to negative emotions, such as fear, anxiety, guilt, and anger, and can halt your recovery. CPT focuses on teaching a set of skills that will help you challenge these negative thoughts and gain control over the impact they have on your life.

When It's Used

CPT is considered to be effective for anyone who has received a diagnosis of PTSD. Some researchers and clinicians believe that CPT might be particularly beneficial if you 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 you interpret and process trauma. CPT is not recommended if you have not received a diagnosis of PTSD or if you have literacy difficulties, as it involves written homework. In this instance, another research-supported trauma treatment, such as Prolonged Exposure Therapy (PET), is often recommended over CPT.

What to Expect

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, though this can vary depending on your needs. In CPT, you will work with your therapist to identify and explore the ways that the trauma may have altered your thoughts and beliefs, affecting both the way you feel and how you act. Your therapist will specifically help you pick out thoughts that keep you fixed in the trauma and create barriers to recovery. You will learn a set of strategies to challenge and modify thoughts that are inaccurate and, or, unhelpful and will practice these strategies with your therapist and on your own with worksheets and exercises. You may find it helpful, though it is not required, to write about the specific events of your trauma.

How It Works

CPT, based on the social cognitive theory of PTSD, focuses on repairing the damage done by a traumatic event to your beliefs about yourself and the world. By offering specific cognitive restructuring skills, CPT allows you to challenge these negative thoughts and interpretations (stuck points), gain a healthier perspective about the trauma (While I can’t trust my abuser, I can trust other people), cope better with any future trauma, and move forward with your life.

What to Look for in a CPT Therapist

Mental health providers can receive training and certification for CPT. Some institutions, such as university clinics, provide training seminars and workshops in CPT. Additionally, several CPT treatment manuals have been developed to assist clinicians in delivering the therapy.

Sources

  • 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.

  • 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.

  • Falsetti, S. A., Resnick, H. S., Davis, J., & Gallagher, N. G. (2001). Treatment of posttraumatic stress disorder with comorbid panic attacks: Combining cognitive processing therapy with panic control treatment techniques. Group Dynamics, 5(4), 252–260.

  • 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.

  • 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.

  • 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.