Cognitive Behavioral Therapy for PTSD Treatment

Published on: 22 Sep 2021
Clinically Reviewed by Liz Kelly, LCSW
woman in a blue jean jacket sitting with her arms folded having a conversation with her therapist

Cognitive behavioral therapy (CBT) is a popular form of psychotherapy that starts with a basic premise: if we can change how we think, we can change our behavior patterns. 

CBT has proven to be an effective treatment for a number of mental health conditions, and it’s thought to be one of the most effective options for treating post-traumatic stress disorder (PTSD). Considering the fact that almost 9 million adults in America have PTSD, it’s critical to look at effective treatment options like cognitive behavioral therapy to see how they can help. CBT for PTSD encourages those struggling to adopt skills that help treat, and in some cases even eliminate, PTSD symptoms.

Does Cognitive Behavioral Therapy Help With PTSD?

There are several CBT techniques that are effective in treating individuals with chronic PTSD. CBT for PTSD can make it possible for a person to benefit from:

  • Association shifts: The memories of traumatic events can be triggered by any number of situations, including news headlines, conversations, and physical locations. CBT helps people change how they process these associations so they can protect their core emotions.
  • Improved social cognition: CBT challenges an individual’s own harmful beliefs. For instance, if someone thinks their trauma occurred because they somehow deserved it, a therapist can use cognitive behavior therapy to help them work through those thoughts so they can better understand the reality of what happened to them.
  • Education: Educating someone about common PTSD reactions helps them to begin to learn how to manage stressful situations and work on having a plan of action for any known triggers.

Many of our belief patterns are based on shortcuts that help us make sense of our world. When someone feels like they need to find a reason for their trauma, doing it alone (without the guidance of a therapist) can result in solutions that aren’t always helpful in terms of mental health. Cognitive therapy for PTSD makes it possible to accurately view trauma in the context of the bigger picture.

“Trauma can change how we view ourselves, other people, and the world. CBT techniques can support clients in developing a realistic and beneficial perspective.

Talkspace therapist Liz Kelly, LICSW

Core Components of CBT

While there are a number of CBT techniques widely used, there are two core components of CBT for PTSD that are known for their efficacy in reducing PTSD symptoms. In general, all subsequent techniques will fall into one of these two overarching categories. 

Cognitive restructuring

Cognitive restructuring is a technique that helps someone make sense of a traumatic experience or memory. It’s normal (and actually very common) to recall a trauma slightly to significantly different than how it actually happened. For example, some people will remember a traumatic experience in a disjointed way. Or they may completely block out certain parts of what happened to them. They also may have feelings of shame or a sense of guilt associated with their trauma, despite it not being their fault.  

Exposure therapy

Exposure therapy is an intervention geared towards helping people face and then conquer their fears. It works by reliving a traumatic memory in a safe space. This type of therapy often uses writing, mental imagery, or even visits back to places where a traumatic event occurred. It can also include discussions and visits with actual people who were involved as well.

CBT incorporates a number of specific beliefs that work together, including:

  • Psychological disorders are based on faulty thought patterns, which can then lead to faulty behavior patterns.
  • If a person can learn how to recognize these thought patterns, they can reevaluate whether there’s any truth to them.
  • Once someone gains a better grasp of their own thoughts, they can begin to understand their own behavior and the behaviors of others.
  • Specific problem-solving skills can be taught and implemented for better coping both in times of crises, as well as in everyday situations.
  • A person can grow in confidence if they confront their worst fears and work towards conquering them.

Types of CBT Techniques for PTSD

CBT for PTSD is typically approached with one or more of the following types of CBT:

  • Cognitive Processing Therapy (CPT): CPT asks individuals to confront both a traumatic event, as well as the effects they feel as a result of it. This can be effective for those who feel stuck in one way of thinking, and thus are unable to recover from their chronic PTSD. CPT is a trauma focused therapy that helps break these patterns and helps people to move on.
  • Prolonged Exposure Therapy (PE): PE relies more on behavioral therapy techniques to help people approach  specific memories, situations, and emotions that bring out the worst of their symptom severity. Exposure can be done through imagination, virtual reality, or real-life scenarios.
  • Stress Inoculation Training (SIT): Stress inoculation training focuses on teaching those with PTSD specific coping skills. Some of these skills can include breathing techniques, muscle relaxation, and cognitive restructuring. This can help someone react differently to scenarios that increased their stress and anxiety at one time due to their PTSD.

“Trauma symptoms can often be physical as well as mental and emotional.  CBT for PTSD incorporates education, coping strategies, as well as challenging and reframing unhelpful thoughts and beliefs.”

Talkspace therapist Liz Kelly, LICSW

CBT for PTSD: Different strategies for different people

CBT is not just one strategy or treatment plan. Therapists must work with individual clients to develop a system that works for effective treatment. The goal of cognitive-behavioral therapy for PTSD is for the treatment to be a collaboration between therapist and client. In general, prolonged exposure therapy has been found to be incredibly successful when dealing with post-traumatic stress. Because of that, prolonged exposure therapy is often used in a number of situations when it comes to trauma treatment with positive results.

Regardless of the tactics used though, CBT for PTSD is not always done solely in-session. Those who are suffering from trauma may be asked to do homework as a part of their recovery, too. Reinforcing and strengthening skills between each session can help speed up the therapy process and result in a more effective treatment plan.

Getting Help for PTSD

No matter what the trauma was, or how significant symptom severity is, it’s important that to understand there is help available for those recovering from PTSD. CBT and PTSD go hand-in-hand with one another because ultimately it’s often thoughts and fears resulting from a traumatic experience that lead to the worst symptoms.

By adjusting those thoughts on an incremental basis, many people find they can leave a large portion of a traumatic event in the past without ignoring its significance. Cognitive therapy for PTSD doesn’t seek to discount your lived experiences. Nor does it attempt to minimize the impact or severity of what’s happened to you. Recognizing your experience is an essential part of your healing, so it’s worth noting this aspect upfront. This way you can set healthy expectations about what your therapy will entail.  

At its core, cognitive behavioral therapy was founded on the basis of respect for an individual’s feelings. It centers around meeting you where you are mentally. By challenging negative thoughts (for example, the fact that bad things happen to bad people) and offering exposure to situations that were once believed impossible to handle, people with PTSD can start to see their lives from a very different perspective.

Is CBT the right PTSD treatment for you? 

There are several treatment options for those looking for help with their PTSD. For example, one such technique, eye-movement desensitization and reprocessing (EMDR therapy), is considered an effective form of treatment.

Other options include problem-solving therapy, supportive psychotherapy, psychodynamic therapy, and present-centered therapy, to name just a few. When looking at all of the therapies out there, CBT for PTSD seems to be associated with better remission rates in comparison overall.

If you have PTSD and are looking for help, traditional therapy settings, where you meet with a therapist face to face is one option. But there are other opportunities for you to seek treatment, too. Online CBT sessions with a trusted, licensed Talkspace therapist can be a first step toward improving your life and reducing your PTSD symptoms.

Cited Sources:

  1. Cognitive Behavioral Therapy (CBT) for Treatment of PTSD. https://www.apa.org. https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy. Published 2017. Accessed August 18, 2021.
  2. PTSD Facts & Treatment | Anxiety and Depression Association of America, ADAA. Adaa.org. https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment-facts. Published 2021. Accessed August 20, 2021.
  3. CBT for PTSD: Basics and Rationale – Psychotherapy Academy. Psychotherapy Academy. https://psychotherapyacademy.org/pe-trauma-training-ptsd/cbt-for-ptsd-basics-and-rationale/. Published 2020. Accessed August 19, 2021.
  4. What is Cognitive Behavioral Therapy?. https://www.apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral. Published 2017. Accessed August 20, 2021.
  5. Ioannis Syros. Cognitive behavioral therapy for the treatment of PTSD. https://doi.org/10.1080/20008198.2017.1351219 Published 2017. Accessed August 20, 2021.
  6. Posttraumatic Stress Disorder | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder. Published 2017. Accessed August 18, 2021.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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