Cognitive Processing Therapy (CPT)
for
Post-Traumatic Stress Disorder (PTSD)
Many people with PTSD know the traumatic event is over, yet still feel as though their mind or body hasn’t caught up. CPT is designed to help reduce the ways trauma continues to shape beliefs, emotions, and daily life.
PTSD is characterized by having been exposed to actual or threatened death, serious injury, or sexual violence. One may have directly experienced an event, witnessed it, heard about it happening, or been exposed to aversive details.
In response to the event, four types of symptoms typically emerge:
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Intrusive (i.e., flashbacks, nightmares)
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Avoidance of related stimuli or memories
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Negative effects to mood
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Hypervigilance, impulsivity, or outbursts
These symptoms typically result in a significant detriment to one's work or school performance, self-care, relationships, and general quality of life.
Cognitive Processing Therapy
(CPT)
CPT is one of the three gold-standard evidence-based treatments for PTSD (the other two are Prolonged Exposure and EMDR). The benefit of CPT is that it is a short-term treatment that lasts between 12-18 sessions at most. CPT does not rely on prolonged or detailed retelling of the traumatic event. Instead, it focuses on how the trauma has affected beliefs and meaning.
CPT is especially helpful for individuals who notice that trauma has changed how they see themselves, others, or the world. It focuses on identifying and modifying beliefs that keep PTSD symptoms active, rather than requiring repeated retelling of the traumatic event. CPT works by changing the way we think about the trauma we experienced, which ultimately reduces and eliminates the unhelpful symptoms that PTSD produces.
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The treatment of PTSD with CPT consists of six phases:
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Assessment
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Education
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Processing the Trauma
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Learning to Challenge
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Discussing Trauma Themes
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Facing the Future
1. Assessment
During your first appointment your therapist will conduct a clinical interview and use a gold-standard assessment tool for PTSD: the PTSD Checklist for DSM-5 (PCL-5).
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​This allows us to specify symptom intensity and frequency, and correctly diagnose whether PTSD is present.
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We use the PCL-5 throughout treatment to continuously monitor PTSD symptoms and inform how your treatment is progressing.
2. education
After assessment, we spend the first session making you an expert on PTSD treatment. We provide you with the crucial CPT tools to effectively recover from PTSD.
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We also discuss the neurobiological function of PTSD and the theory behind CPT so that you have the confidence that CPT will work for you.
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You wouldn't allow a doctor to operate on you without knowing what they were going to do or how it was supposed to help - you deserve the same informed treatment for PTSD.
3. Processing
CPT involves identifying unhelpful and/or unrealistic beliefs and developing new beliefs. The goal is that these new beliefs will no longer trigger the symptoms of PTSD.
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A substantial amount of our work together involves collaboratively identifying the beliefs that maintain PTSD symptoms - we call these beliefs "stuck points".
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4. Challenging
We then begin processing the maladaptive beliefs that were created by the traumatic incident you experienced and work together to help you develop more accurate and adaptive beliefs.
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We will give you the tangible skills to challenge these beliefs. We use both in-session modeling of cognitive challenges, as well as homework that we assign for you to practice on your own between sessions.
5. Themes
The latter part of treatment involves the discussion of 5 key themes that are often at the core of maladaptive PTSD beliefs:
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Safety
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Trust
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Power/Control
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Esteem
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Intimacy
6. Face the Future
Once you have completed your course of CPT and PTSD is no longer controlling your life, you are ready to face the future!
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This phase usually consists of a final few sessions where we discuss the beliefs you overcame and replaced, review the skills you have learned, and solidify the progress you have made. We also ensure that we address any remaining therapeutic goals.
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Now it is time to celebrate that you are back in control of your life!