What is CPT Therapy and How Does It Help PTSD?

Published on: 17 Oct 2020
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Updated on 8/10/2021

For those who have been through a traumatic situation, the memories from that incident may lead to feelings of fear, and in trying to deal with that fear they may develop escape and avoidance behaviors — often unconsciously. Although traumatic events are often beyond one’s control, emotions like guilt or shame tend to arise in the aftermath of trauma.

These difficult emotions may be a sign that you’re experiencing post-traumatic stress disorder (PTSD), a mental health condition resulting from the experience of a traumatic event. Many who have been traumatized find it difficult to readjust, but treatment options like cognitive processing therapy can manage that adjustment in a healthy way.

What Is CPT Therapy?

Cognitive processing therapy (CPT) is an evidence-based therapy defined by its effectiveness at treating PTSD and other symptoms that follow traumatic events such as rape, abuse, natural disaster, accidents, or military combat. CPT therapy focuses on how a person reacts to or copes with trauma while trying to regain control of their life.

CPT therapy was designed to help people deal with trauma and its long-term implications. A traumatic event can change brain functioning and the way you think of yourself and of the world – these thoughts keep you from the happiness you experienced previously. CPT helps you find a new way to deal with these thoughts and emotions and equips you with the skills to both manage the effects of PTSD and confront trauma in a healthier manner.

Cognitive processing therapy was originally designed to treat PTSD in survivors of sexual assault, but it has also proven helpful in the treatment of military-related and other forms of trauma.

How Does CPT Therapy Work?

CPT typically takes place over a course of 12 sessions, which usually begin with your CPT therapist detailing the treatment process. In the first therapy session, you’ll be provided with more information on PTSD and its symptoms and cognitive behavioral therapy, and you will likely be asked to briefly discuss the type of trauma you experienced. You’ll also be allowed to ask questions and write about how the trauma has affected you, as well as how it has impacted other areas of your life like relationships and work.

As treatment progresses, your CPT coach will help you better understand the thoughts and feelings you have related to your trauma, and you’ll work together to find alternative ways of understanding your experience. To achieve this, you may be required to discuss the traumatic event in detail over the course of treatment, and your provider will teach you to challenge negative emotions, such as guilt and self-blame, that may have left you feeling stuck with your PTSD.

As CPT sessions allow you to delve deeper, you’ll be given homework in the form of worksheets and other written assignments by your CPT coach. This work will help you gradually recognize beliefs that should be challenged, and you’ll also learn how to question and reframe your thoughts.

In the later stages of cognitive processing therapy, your provider will help you identify and understand how your thought process can change after experiencing a traumatic situation, with a specific focus on your sense of safety, trust, power, control, self-esteem, and intimacy. At this point, you’ll likely be taking the lead in your exposure therapy sessions, with your CPT therapist acting as your guide and consultant.

Finally, a review of your treatment process and future plans marks the conclusion of cognitive processing therapy. Your provider is also expected to guide you on how to prevent relapse episodes in the future.

Cognitive processing therapy can be done either individually or in a group setting, usually with one or two providers and about 6-10 people who are dealing with PTSD. In some cases, your provider may recommend a combination of the two treatment environments.

Living with PTSD is challenging, so it’s possible that you may have some difficulty easing into the therapy process, especially when it comes to describing or writing about your trauma. Talking about any discomfort with the process with your provider can help create a trusting and open atmosphere for you to openly address your trauma. For instance, if you’re in group CPT exposure therapy, you may choose to describe your trauma privately to your provider as opposed to sharing it with the entire group.

How Long Does CPT Therapy Last?

The 12 sessions generally involved in CPT therapy typically last about three months. Each therapy session — which may take place once a week — is 60-90 minutes each, and you may start to notice progress after only a few sessions.

The benefits of CPT therapy typically last long after the last CPT session with your provider. Studies have shown that clients who attend at least 10 sessions experience the most favorable outcomes when dealing with a traumatic experience. However, new evidence suggests that varying the number of sessions in the CPT therapy protocol according to patient response to treatment can improve outcomes.

How Effective is CPT Therapy?

Research shows that cognitive processing therapy therapy is one of the most effective treatments for going through a traumatic experience. It has been proven to be more successful than trauma-focused psychotherapy, even when carried out by experienced professionals. CPT therapy is also a brief form of therapy, which means it’s more cost-effective and convenient than some other forms of therapy.

A 2019 study conducted by a team of researchers from several U.S. universities showed that cognitive processing therapy was more effective in individuals who attended more sessions than in the individuals who discontinued PTSD treatment after 2 to 5 sessions. The research concluded that identifying patients who may be at risk for discontinuing treatment, and making a concerted effort toward retaining them, is imperative to maintaining effectiveness of CPT therapy.

Are There Risks Involved In CPT Therapy?

Cognitive processing therapy has proven to be useful in PTSD treatment, but some may be at risk of facing a level of discomfort when writing or talking about their trauma in each CPT session. These feelings, however, are often brief and most tend to acclimate to treatment as CPT therapy progresses.

Although more research is still needed on cognitive processing therapy to understand its effectiveness in different demographics, there’s no doubt that most who complete the treatment find that the benefits outweigh any discomforts or associated risks.

Sources: 

American Psychological Association. Cognitive Processing Therapy (CPT). https://www.apa.org. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy. Published May 2017.

Holmes SC, Johnson CM, Suvak MK, Sijercic I, Monson CM, Wiltsey Stirman S. Examining patterns of dose response for clients who do and do not complete cognitive processing therapy. Journal of Anxiety Disorders. 2019;68:102120. doi:10.1016/j.janxdis.2019.102120

Wachen JS, Dondanville KA, Young-McCaughan S, et al. Testing a variable-length Cognitive Processing Therapy intervention for posttraumatic stress disorder in active duty military: Design and methodology of a clinical trial. Contemporary Clinical Trials Communications. 2019;15:100381. doi:10.1016/j.conctc.2019.100381

Watkins LE, Sprang KR, Rothbaum BO. Treating PTSD: a Review of Evidence-Based Psychotherapy Interventions. Frontiers in Behavioral Neuroscience. 2018;12(258). doi:10.3389/fnbeh.2018.00258
Holmes SC, Johnson CM, Suvak MK, Sijercic I, Monson CM, Wiltsey Stirman S. Examining patterns of dose response for clients who do and do not complete cognitive processing therapy. Journal of Anxiety Disorders. 2019;68:102120. doi:10.1016/j.janxdis.2019.102120

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.

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