What is Cognitive Processing Therapy?

Mary-Lauren O’Crowley, NCC, LPC 

Trauma can influence thoughts, emotions, and daily choices long after an event has passed. Cognitive Processing Therapy offers a structured and evidence-based approach to addressing trauma. It also focuses on the beliefs that often develop in response to those experiences.

As a multi-state counseling and psychotherapy practice, Symmetry Counseling works with adolescents and adults who want practical tools for trauma recovery. Our clinicians employ evidence-based methods that meet individuals where they are and support meaningful progress over time.

Cognitive Processing Therapy for Trauma Survivors

Cognitive processing therapy focuses on individuals who have experienced trauma and now struggle with lingering emotional and psychological effects. These experiences may involve childhood abuse, domestic violence, sexual assault, combat exposure, natural disasters, or serious accidents. Trauma can occur once or over a long period, and both situations can affect how people interpret themselves, others, and the world.

This form of therapy centers on how trauma influences thought patterns. Many trauma survivors develop beliefs such as “I caused this” or “I cannot trust anyone.” These beliefs often feel convincing and automatic, yet they can limit healing and personal growth. Cognitive processing therapy works to identify and challenge these thoughts so healthier perspectives can take their place.

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

Cognitive processing therapy typically follows a structured format spanning approximately 12 sessions, though the pace may be adjusted based on progress and personal needs. Sessions focus on understanding the trauma, examining beliefs tied to the experience, and practicing new ways of thinking that support recovery.

This approach often helps people living with post-traumatic stress disorder, also known as PTSD. Research continues to support its effectiveness, particularly when therapy adapts to the individual rather than adhering to a rigid formula. Progress guides the process, and therapy moves forward at a pace that supports growth without overwhelming the client.

Understanding Trauma and Its Effects

Trauma often develops under unexpected or distressing circumstances such as abuse, violence, or sudden loss. These events can affect the brain and nervous system, thereby influencing emotional responses and behavior. Many people notice heightened alertness, difficulty relaxing, distrust of others, social withdrawal, or negative self-image.

Cognitive changes may also appear. Concentration problems, memory concerns, reduced motivation, appetite changes, and emotional exhaustion commonly accompany trauma-related symptoms. Some individuals cope by avoiding reminders or suppressing emotions, which can lead to ongoing distress. Trauma represents a health condition that benefits from professional care rather than something to handle alone.

The Theoretical Model Behind Cognitive Processing Therapy

Cognitive theory in clinical psychology posits that people store information about the world and others in 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 initially developed as a 12-session process in which clients provide a written account of their experience; however, this has since been modified, and the number of sessions now varies, and patients may choose not to provide a written account.

A 2012 study found that administering therapy according to the patient’s progress yields more satisfactory results than adhering 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 is broken down to:

• 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 seeks to identify the root cause of the patient’s problem in detail. The patient may be asked to write an impact statement that accounts for their 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

Cognitive coping skills form the core of cognitive processing therapy. These skills help challenge distorted thinking and replace it with balanced perspectives.

Therapists guide clients through exercises that examine evidence for and against trauma-related beliefs. Over time, individuals learn to approach memories and triggers with greater flexibility and confidence.

• 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 the quality of life.

How We Support Cognitive Processing Therapy at Symmetry Counseling

At Symmetry Counseling, our licensed clinicians provide cognitive processing therapy as part of our trauma-informed care. Services remain available for ages 10 through adulthood, with options for in-person sessions and telehealth across multiple states. Insurance-friendly care allows more people to access support without added financial stress.

Individual counseling sessions last 53 minutes and focus on personalized goals. Clients seeking broader emotional support may also explore our individual counseling services or specialized trauma and abuse counseling based on their needs.

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. 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