Cognitive Processing Therapy
Cognitive processing therapy and PTSD
Those experiencing posttraumatic stress disorder (PTSD) may struggle to find a treatment for their symptoms. Because ranges of PTSD symptoms and triggers can be varied, PTSD treatment may also vary. Many individuals with PTSD find cognitive-behavioral therapy (CBT), also called cognitive processing therapy (CPT), to be helpful.
Cognitive processing therapy was originally developed by psychology professor Dr. Patricia Resick and was further refined through her collaborations with Dr. Candice Monson and Dr. Kate Chard. The authors have continued to conduct research on cognitive processing therapy specifically for PTSD, with collaborations with the International Society for Traumatic Stress Studies and the Association for Behavioral and Cognitive Therapies.
CPT methodology after a traumatic event
Cognitive processing therapy is a type of cognitive behavioral treatment that often aims to help clients address past adverse events and unhelpful thoughts or behavioral patterns attached to them. The focus is often to create a deeper understanding of an individual's reaction to trauma triggers through an examination of how past traumatic events may have changed their world view.
Phase one
The first phase of cognitive processing therapy can involve cooperation between therapist and client to establish an understanding of events or traumatic experiences that occurred and connections between them and the client's thoughts, behaviors, and emotions. Clients may find that their responses to trauma are automatic responses that they struggle to control. Therapists will use these insights to draft a treatment plan and help clients identify initial factors potentially prompting a behavioral loop, such as self blaming thoughts.
Phase two
The second phase of cognitive processing therapy may start as soon as the next session, or may take more time, depending on the client. In the treatment manual, Phase Two involves helping clients process traumatic events, their ongoing negative effects, and the potential symptoms of PTSD. Therapist may ask individuals to write an impact statement about trauma and read it back. By confronting events in a safe environment rather than avoiding it, clients may feel better able to process their emotional responses.
Future phases
After the individual has begun questioning their experience and how they have processed trauma, therapists may ask them to write another account of the events, often many sessions after the first account. The client can compare their first account with their second to see how their perception of the event has changed with treatment. Some therapists may complete this step without a written record, using only Socratic questioning. This method is referred to as the CPT-C method.
What to expect
Individual cognitive processing therapy sessions are often conducted once or twice a week for 12 sessions that last approximately 50 minutes each. In addition to these factors, individuals may be given homework assignments. The main written piece, where they write a detailed account about their traumatic experience, might be completed after the third session as a homework assignment or with the therapist and added to their patient materials. Counseling may include a written trauma account or may be verbal, depending on the therapist's technique.
Understanding the techniques could prove helpful if you're looking for a therapist. If you're interested in cognitive processing therapy work, you can reach out to a therapist in your area or online. In addition to individual sessions, an individual might participate in support groups for PTSD.
There are six recognized cognitive processes often used during cognitive processing therapy to identify a client's reactions. They can each play a role in individuals' understanding of experiences before reacting to them.
Attention
Perception
Perception is used to understand your environment using sensory organs. For clients with PTSD, perception may be harder during a flashback or distressing memory. Cognitive processing therapy can teach mindfulness and grounding skills to help individuals feel "in their body."
Memory
Language
Language is communication. By communicating, the client and therapist can foster a better understanding of the trauma or why the individual is attending treatment.
Learning
Higher reasoning
The higher reasoning process connects other cognitive processes using reasoning and decision-making. It can help an individual cultivate more effective problem-solving skills when facing a reaction to certain stimuli or automatic thoughts. The therapist can help clients identify this inner voice or force and how to use it.
Risks
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
However, many people report feeling relief in their current life after sessions. The US Department of Veterans Affairs’ (VA) National Center for PTSD states that over 40% of veterans utilizing this treatment had no symptoms of PTSD when it was completed. The National Center for PTSD recommends cognitive processing therapy treatment as a course of treatment for PTSD.
Receiving cognitive processing therapy from a trained, licensed clinician may make this treatment effective for you. If it is not helpful, other treatments are available for PTSD.
Clinicians who want to study cognitive processing therapy can take an accredited course from a professional organization like the American Psychological Association (APA) or the National Board for Certified Counselors (NBCC). Cognitive processing therapy training may be an extended course module in addition to a graduate-level education in the mental health field.
If you are experiencing challenges related to trauma, you might benefit from talking to a therapist about cognitive processing therapy. There are many options for using this therapeutic modality, and you do not necessarily need to do it in person. Many clients who struggle to leave home or set appointments may benefit from online cognitive processing therapy.
Research has shown that online counseling is as effective as in-person care, and you can try it from the comfort of your home. With a platform like BetterHelp, you can be matched with a therapist experienced in cognitive processing therapy and contact your therapist via in-app messaging in between sessions. You can also choose between phone, video, or live chat session formats.
Takeaway
Cognitive processing therapy (CPT) is sometimes used to treat posttraumatic stress disorder (PTSD). While it may be used with veterans, a therapist may use cognitive processing therapy to treat anyone who has experienced trauma. If you are experiencing symptoms of PTSD, such as low self-esteem, you're not alone. You may benefit from speaking with a licensed therapist who practices cognitive processing therapy, whether in your community or online. With BetterHelp, you can choose a therapist who has experience using CPT for PTSD or other challenges you may be facing. Take the first step toward getting support, and reach out to BetterHelp today.
Frequently asked questions (FAQs)
Below are several frequently asked questions on the topic of cognitive processing therapy.
Cognitive processing therapy is a specific cognitive-behavioral therapy technique often used to treat PTSD or other mental health conditions. Cognitive processing therapy for PTSD involves addressing the unconscious and conscious thoughts that may lead to distressing symptoms. The therapist may aim to help clients break unwanted patterns.
Prolonged exposure therapy is another cognitive-behavioral therapy technique that might be used for PTSD. In this modality, a trained psychologist creates an environment of safety, trust, and calm to expose individuals to what they fear or avoid. The fears could be surrounding objects, activities, situations, or ideas. Exposing clients to these fears in a safe environment may build tolerance and acceptance to face them at home.
Often, clients may not begin by being exposed to the worst fear they could imagine. Instead, they may start slowly and begin to build a tolerance for their fears.
Desensitization may be caused by an abundant exposure to a stimulus that, over time, causes a lesser fear reaction when a person is exposed to it. Desensitization may fall under the category of exposure therapy or cognitive processing therapy.
First, a client may be taught a specific type of breathing and deep muscle relaxation technique to utilize during desensitization. Next, they may be asked to create a fear hierarchy, starting with the stimuli that cause the slightest fear and building up to the most provoking causes.
Finally, they may work their way up the personal fear hierarchy to be exposed to each stimulus. However, if they struggle with one, they might return to a previous hierarchy stage and discuss their concerns with their therapist. Systematic desensitization can benefit those who experience significant phobias or obsessive-compulsive disorder (OCD) as well.
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