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Understanding Cognitive Processing Therapy (CPT)

CPT was developed in the late 1980s as a method to address PTSD symptoms in individuals who have experienced various forms of trauma, including violence, abuse, and natural disasters. It is a structured, short-term therapy, generally spanning 12 sessions. Each session focuses on helping individuals reassess and understand their thoughts about the trauma and develop new ways to live with their memories.


When CPT Is Used

CPT is generally recommended for adults and older adolescents diagnosed with PTSD. It is particularly beneficial for individuals likely to face ongoing traumatic situations, such as emergency responders or those in high-risk professions. CPT fundamentally alters how individuals process and interpret traumatic events, providing resilience against future trauma.

However, CPT might not be suitable for individuals without a PTSD diagnosis, those with literacy challenges, active substance abuse issues, or severe psychiatric conditions like bipolar disorder. In such cases, other therapies might be more appropriate.

What to Expect in CPT


  • Initial Sessions: The therapy usually begins with psychoeducation, where patients learn about PTSD and the specific ways CPT can help them. This sets the groundwork for more intensive work in later sessions.

  • Middle Sessions: Patients engage in identifying "stuck points" — unhelpful beliefs related to the trauma that may contribute to ongoing PTSD symptoms. These might include thoughts related to safety, trust, control, esteem, and intimacy.

  • Writing Assignments: Patients are often asked to write detailed accounts of their traumatic experiences or their feelings and beliefs about the trauma. These writings are then used in therapy sessions to help identify maladaptive thoughts and develop healthier perspectives.

Example Scenario

Alice, a survivor of a severe car accident, entered CPT to address her PTSD, which manifested in intense fear of driving and irrational guilt over surviving the crash that injured her friend. During therapy, she wrote about her trauma and her subsequent avoidance of cars. This exercise helped her articulate her feelings of guilt and fear. In therapy, she read her account aloud, which allowed her and her therapist to explore these emotions and challenge her belief that "driving is always dangerous" and her guilt by examining the real circumstances of the accident. Through this process, Alice learned to accept that the accident was a random event, not a reflection of her competence or worth, helping her reduce her anxiety about driving.

The Core Processes of CPT


  • Safety: Patients learn to redefine their perceptions of safety, distinguishing between rational precautions and over-generalized fear.

  • Trust: Therapy helps rebuild trust in others by examining past experiences and current relationships objectively.

  • Control: Patients explore areas of their lives where they do have control, thereby reducing feelings of helplessness.

  • Esteem: CPT addresses feelings of self-worth and helps patients separate their self-identity from their traumatic experiences.

  • Intimacy: The therapy encourages open discussions about fears surrounding closeness and vulnerability, facilitating healthier relationships.

Long-term Benefits of CPT

By the end of the therapy, patients like Alice not only achieve a better understanding of their PTSD symptoms but also develop skills that empower them to handle future challenges more effectively. Many find that CPT not only alleviates symptoms but also significantly improves their quality of life.



Cognitive Processing Therapy offers a clear, structured path to recovery for those suffering from PTSD, equipping them with the necessary tools to understand and modify harmful beliefs related to past trauma. By focusing on thought processes and factual reassessment, CPT helps individuals break free from the debilitating cycles of PTSD and reclaim control over their emotional lives. For anyone struggling with the aftermath of traumatic events, CPT represents a beacon of hope, providing a methodical approach to healing and resilience.

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