What is Cognitive Processing Therapy?

Mary-Lauren O’Crowley, NCC, LPC 

CPT or Cognitive Processing Therapy is a type of behavioral therapy that focuses specifically on patients who are survivors of trauma. This may include child abuse, domestic abuse, rape, natural disasters, major accidents, combat, among others.

What is Cognitive Processing Therapy and How Does it Help in The Treatment of Trauma? 

This particular therapeutic process is conducted for an average of 12 sessions and gradually helps the patients to address the root of their trauma and the negative and often irrational beliefs they may have because of it (e.g., “I could have prevented it,” “I asked for it”). By doing so, patients are encouraged to form new insight about the event or events that traumatized them. CPT is most commonly utilized for patients with post-traumatic stress disorder or PTSD. 

Understanding Trauma

Trauma and post-traumatic symptoms often occur under abnormal, unexpected, or shocking circumstances including abuse, violence, and death. The traumatic experience that the individual undergoes, whether it occurred once or over a period of time, causes physical changes to both the brain and the nervous system which can then alter the way we think, feel, and act. The individual may become more hypervigilant or on edge, less trusting of the world and those around them, socially isolated, self-conscious, among others. Apart from behavior changes, there may be noticeable decline in cognitive ability, attention, memory, motivation, appetite, and general well-being. Many individuals go without a proper diagnosis and develop less adaptive or effective coping mechanisms to deal with their symptoms It is, however, a disease and should not go untreated. 

Theoretical Model on Which CPT Operates

The cognitive theory in clinical psychology says that people store different information about the world and people into different categories called schemas. Schemas help us to make sense of the world around us. Experiences of trauma can disrupt this schema system, especially with regards to safety, trust, power, self-esteem, and intimacy. We may have trouble trusting our partners, feeling a sense of peace and safety, or seeing ourselves in a positive light. CPT helps to remedy this. 

How Does It Work? 

CPT was originally developed as a 12-session process during which clients provide a written account of their experience; However, this has since been modified, and now the number of sessions varies, and patients may choose not to do a written account. A study in 2012 found that administering therapy according to the progress of the patient yields more satisfactory results than sticking to a fixed number of sessions or techniques. By the time this study ended, 92% of the subjects no longer had any symptoms of PTSD. 

The process broken down 

• Psychoeducation/Rapport building 

The initial sessions are often spent building the therapeutic relationship and providing education about the therapeutic process. The therapist, in essence, “chats” with the victim about their reason for therapy, their presenting symptoms, and their goals and what they would like to achieve. An introduction to trauma, its impact on the body, its presenting symptoms, and the process of Cognitive processing therapy is also typically provided to the patient. 

• Addressing ”Stuck Points,” or negative, irrational thoughts 

Next, the therapist attempts to find out the root of the patient’s problem in detail. The patient may be asked to pen down an impact statement accounting for their own beliefs about the event and how it has changed the way they see the world. The goal of this step is to help the patient recognize that their beliefs, such as “this was my fault,” “I am unlovable,” etc. are not necessarily logical, realistic, or factual. 

• Learning Cognitive Coping Skills

This step of the therapeutic process is most vital as it teaches the individual to combat their irrational thoughts. The therapist will list common thought patterns that happen as a response to traumatic experiences and alternative thought patterns that the patient is encouraged to think about. Here, they will be encouraged to perceive in a different light. This will be done by the therapist providing evidence against the traumatized thought patterns and for the normal one. 

• Recovery

The five areas that trauma survivors most frequently struggle with are safety, intimacy, power/control, and self-esteem. CPT aims to heal and recover these areas to improve quality of life. 

If you or someone you know is struggling with post-traumatic stress disorder and would like to learn more about CPT, please reach out to the intake specialists at Symmetry Counseling today! 

Referenced articles: 

1. https://cptforptsd.com/
2. https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp
3. https://www.goodtherapy.org/learn-about-therapy/types/cognitive-processing-therapy