Cognitive processing therapy (CPT) for PTSD was initially developed in the early 1990s for victims of sexual assault. Patricia Resick and her colleagues noticed how these individuals developed strong beliefs of fault about the traumatic event(s) they experienced. They also noticed how much the event(s) influenced belief systems. In turn, those beliefs influenced how the individual copes with symptoms. This led to creation of CPT and widespread cognitive processing therapy training for therapists.
Cognitive processing therapy focuses on helping individuals modify negative beliefs (aka “stuck points”) that can form as a result of a traumatic event(s). These beliefs contribute to continuing distress and influence how the memory recall of the event(s). For example, a belief that “I invited the assault because I smiled at them” will lead individuals to experience continued guilt about the event and to increasingly avoid reminders. This combination of beliefs and memories can influence how individuals cope with distressing memories in ways that can actually prolong PTSD.
CPT uses specific journaling assignments about the traumatic event and subsequent beliefs that develop. These assignments help clients build skills to challenge these beliefs to develop more neutral or realistic views of the event and what it means about themselves in the world. For example, inherent fairness or unfairness of the event, whether others and the world are trustworthy, and power dynamics.
Pros: Results show CPT to be extremely effective for a range of traumatic events. This includes combat survivors, motor vehicle accident survivors, natural disasters, physical assault). This approach has found to be one of the two most effective PTSD treatments, along with prolonged exposure therapy (PE). Effects of CPT also benefits memory dynamics of PTSD and leads to more accurate recall of traumatic events. The highly-structured nature of the treatment still allows for plenty of empathy and alignment with client needs. This approach is doable in a brief period of time (10-12 sessions). Additionally, skills from CPT can are applicable to other aspects of life.
Limits: Clinicians require specified live training in CPT for the client to attain effective outcomes (like many structured therapies). This treatment can be more difficult when there appear to be few or no maladaptive beliefs developed as a result of the event. In such cases, prolonged exposure might be more beneficial.
CPT has been shown to be extremely effective. Especially when there are maladaptive beliefs about a client’s role in a traumatic event(s) and accompanying guilt or shame. There is an extremely excellent example of this treatment from an episode of This American Life. There is also a good cognitive processing therapy training by a co-creator of CPT if you want to learn how to conduct this therapy. Lastly, there are therapist resources and workbooks for CPT that can be provided for clients.
PTSD is extremely difficult for clients, but CPT provides a great and well-supported method for helping them approach such difficulties.
