Cognitive Processing Therapy

What is cognitive processing therapy?

Cognitive processing therapy (CPT) is a type of cognitive behavioral therapy (CBT) that helps people who have experienced trauma. It has a strong base of evidence supporting its efficacy and is recommended by the American Psychological Association for the treatment of post-traumatic stress disorder (PTSD).

In CPT, the therapist helps people challenge their trauma-related thoughts and beliefs. This enables them to reconceptualize their trauma experience and reduces PTSD symptoms.

Read on for more information about CPT, what therapy is like, and tips for finding a therapist.

What can cognitive processing therapy help with?

CPT helps people with trauma-related symptoms, including post-traumatic stress disorder (PTSD). PTSD symptoms may arise when a person experiences a traumatic event, such as:

  • Accidents
  • Sexual trauma or abuse
  • Physical abuse
  • Domestic violence
  • Neglect
  • Community violence
  • War (from a veteran or civilian perspective)
  • Natural disasters
  • Other forms of child maltreatment or traumatic loss
  • Witnessing violence or death

Does cognitive processing therapy work?

Yes, the research suggests that CPT can effectively reduce trauma symptoms. It is endorsed by the American Psychological Association, U.S. Department of Veterans Affairs and Defense, and the International Society of Traumatic Stress Studies for the treatment of PTSD.

How does cognitive processing therapy work?

CPT is a type of cognitive behavior therapy (CBT) that involves identifying and re-examining unhelpful thoughts, feelings, and beliefs about traumatic events.

In the CPT framework, PTSD symptoms are a normal response to traumatic events that resolve with time. Those who have ongoing challenges with symptoms are thought to have become ‘stuck’, or had an interrupted recovery. One reason for becoming stuck is that people often try to avoid thinking about traumatic events or push away the associated emotions. This limits the opportunity to process the experience and associated emotions, and recover.

CPT helps people identify, examine, and challenge these ‘stuck points’ in order to move towards recovery. Unlike some other therapies for trauma, CPT does not necessarily involve writing about details of the traumatic event itself. Instead, the focus is primarily on thoughts and interpretations of the events.

Length and frequency of cognitive processing therapy sessions

CPT is a structured, time-limited therapy protocol, delivered over 8 to 15 sessions.

The frequency of sessions depends on individual circumstances. Typically, CPT is delivered weekly or twice weekly in individual sessions, although it can also be delivered by combined individual and group sessions.

Structure of cognitive processing therapy sessions

CPT is a structured, short-term type of therapy, where sessions typically last for 50 minutes.

Typically, the focus of the initial session is clarifying and understanding the problem. In later sessions, you’ll work through the elements of therapy, as described below.

  • Psychoeducation: The therapist will help you to understand PTSD and the relationship between thoughts, feelings, behaviors, and sensations.
  • Identifying your stuck points: You might write about why you think the trauma occurred and how it has affected how you think about yourself and the world. The therapist will help you to identify your ‘stuck points’, which you’ll use throughout therapy.
  • Processing trauma: The therapist helps examine and question thoughts and beliefs related to the trauma. You’ll look for unhelpful thinking patterns and beliefs about yourself, the trauma, and the world. The goal is to learn skills to evaluate your thinking and develop alternative viewpoints, and reduce avoidance and distress related to memories of the trauma. Therapy often focuses on safety, trust, power or control, esteem, and intimacy as these areas are commonly affected by the experience of a traumatic event.

What happens in a typical cognitive processing therapy session?

The content of a CPT session changes from session to session as you progress through the therapy protocol.

Typically, however, at the start of a session, you’ll complete a questionnaire rating your PTSD symptoms. This enables you and your therapist to track changes in your symptoms over the course of therapy. You’ll then review the homework tasks set in the previous session.

The therapist will then work on an element of CPT, as described above. This is likely to involve:

  • Psychoeducation
  • Learning cognitive skills (for example, how to challenge unhelpful thoughts and beliefs)
  • Worksheets and activities requiring your active participation

At the end of the session, homework tasks or ‘practice assignments’ are set. This usually involves tasks to be completed outside of the session and then brought back for review at your next appointment. This might include keeping a log of your thoughts and connected emotions, or completing worksheets where you evaluate your thinking patterns.

What to look for in a therapist for cognitive processing therapy

There are several factors to keep in mind when selecting a CPT therapist, including:

Specialization: Look for a therapist who has experience treating people with PTSD and has completed the CPT Training Program. Therapists often include this information in their biography on their website or online profile. Look for the provider status of “CPT provider” or “Quality-Rated CPT Provider”.

Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. This ensures that your therapist has completed the appropriate level of education to practice. All therapists on Zencare have already been vetted.

Personal fit: The trusting relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. People who have experienced trauma may feel unsafe and see the world as a more dangerous place, so it’s important to work with someone you trust and feel understood by.

The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also allows you to ask about their CPT training, experience, and what therapy will be like. Try to speak to a few different therapists before deciding.

Find therapists specializing in cognitive processing therapy

Find therapists who specialize in cognitive processing therapy on Zencare. Search by insurance, fees, and location; watch therapist introductory videos; and book free initial calls to find the right therapist for you!