Cognitive Processing Therapy (CPT) is an evidence-based form of cognitive behavioral therapy used to treat symptoms of Post-Traumatic Stress Disorder (PTSD) resulting from various types of trauma, such as, combat, adverse childhood experiences (ACEs), natural disasters, and rape. Recognized by the United States Department of Veterans Affairs (VA) as a best practice for PTSD treatment, CPT was developed in the late 1980s by Dr. Patricia Resick, whose original intent was to treat PTSD symptoms for victims of sexual assault.
Cognitive Processing Therapy has been proven to improve treatment outcomes among veterans who have a trauma history. Among veterans with substance use disorders (SUDs) and depression, prior research suggests that those who did not have Post-Traumatic Stress Disorder fared better with integrated cognitive-behavioral therapy (ICBT) than those who did have PTSD symptoms. In a study published in The Journal of Substance Abuse Treatment, the objective was to see if the implementation of trauma-focused therapy would improve treatment outcomes for veterans with PTSD. The participants received group sessions for 12 weeks (Phase 1) and then received 12 individualized follow-up sessions after the group sessions (Phase 2). In Phase 2, participants were randomly assigned to receive either integrated cognitive-behavioral therapy or cognitive processing therapy. Results of the study showed that incorporating cognitive processing therapy with addiction treatment effectively reduced symptoms of PTSD, substance use disorders and depression for veterans with trauma histories.
Brief descriptions of various types of Cognitive-Behavioral Therapy are as follows:
Differs from other variations of Cognitive-Behavioral Therapy in that clients are asked to identify a traumatic event in writing, which they would share in subsequent sessions with their therapist either in individual or group sessions. Generally delivered over 12 sessions, CPT for PTSD focuses on addressing “stuck points,” which are negative thoughts and patterns that prevent a client from making strides in his or her recovery. Clients have homework assignments whereby they are required to describe and share details of their trauma in writing as part of the healing process.
Is adapted according to the culture where clinicians are providing services. Implementation of this adaptation process is described in a case study in which CPT was tailored to meet the needs of the client population living in Iraq where rates of illiteracy were high. Therapists with limited prior training in CBT received additional training and became more culturally competent in understanding the Kurdish beliefs and structures.
Whereas other forms of cognitive-behavioral therapy address the impact of negative thoughts on feelings, Dialectical Behavioral Therapy (DBT) emphasizes emotional regulation and is especially helpful in minimizing self-harm and other destructive behaviors. With DBT, clients learn self-acceptance, mindfulness and acceptance of things they can’t change.
The overwhelming negative emotions that trauma survivors experience can be a roadblock to one’s recovery. Cognitive processing therapy (CPT) helps individuals adjust their beliefs about the consequences of traumatic events they’ve had to endure. For example, if one believes that a traumatic event, or a series of traumatic events, is the reason for the subsequent bad stroke of luck in life, then the individual’s beliefs about the past event(s) will continue to exacerbate one’s outlook on life. Ongoing negative beliefs about oneself and the effects of the trauma will block his or her progress from moving forward if one does not learn to change maladaptive thinking patterns. Individuals suffering from PTSD symptoms often feel unsafe, helpless and powerless, which adversely affects intimacy in their relationships.
Since most people do not have the healthy coping mechanisms they need to move forward, they turn to unhealthy behaviors such as avoiding traumatic triggers in order to function on a daily basis. By avoiding traumatic triggers, individuals also limit themselves from processing their traumatic experience, so they remain “stuck” and experience roadblocks in their personal growth.
In CPT, you will develop the skills to identify and address certain types of “automated” false beliefs associated with PTSD. False beliefs may be related to how you feel about yourself or the event itself. It’s easy to compare your story to others’ stories and feel that others have had it “much worse” than you have. Perhaps loved ones have told you to “stop complaining” about the events that happened because it was so long ago, and you feel ashamed for “not getting over it” sooner. With the assistance of a skilled CPT therapist, you will gain the tools to break free from the thoughts that hold you captive.