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Cognitive Processing Therapy for PTSD: How It Works?

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Cognitive processing therapy (CPT) is a form of trauma-focused psychotherapy specifically designed to treat Post-Traumatic Stress Disorder (PTSD).

Developed by Patricia Resick, the therapy aims to alleviate the negative effects of trauma by helping individuals change their thought patterns and process trauma-related memories and emotions.

Through a combination of cognitive and exposure therapies, patients learn to identify and challenge unhelpful beliefs, allowing them to develop a more adaptive understanding of the traumatic event.

Cognitive Processing Therapy Basics

Cognitive Processing Therapy for PTSD

Cognitive Processing Therapy (CPT) is a type of cognitive therapy specifically designed for treating Post-Traumatic Stress Disorder (PTSD).

CPT is based on the understanding that traumatic experiences can disrupt healthy thought patterns and can lead to lasting symptoms of PTSD.

Cognitive Processing Therapy focuses on helping individuals with PTSD understandprocess, and modify their thought patterns related to their trauma.


CPT is conducted over 12-20 sessions, usually on a weekly basis. Each session typically lasts 60-90 minutes and involves both individual and group activities.

Patients work with their therapist to identify dysfunctional thoughts or “stuck points,” which are then carefully examined and challenged using cognitive techniques.

The American Psychological Association (APA) recognizes CPT as an evidence-based treatment for PTSD.

Numerous studies have demonstrated the effectiveness of CPT in reducing PTSD symptoms as well as improving overall functioning, especially when compared to other therapy methods, such as prolonged exposure.

Techniques Used

Cognitive Processing Therapy integrates elements of cognitive-behavioral therapy (CBT) with cognitive therapy techniques to help individuals challenge and change unhelpful beliefs and thought patterns related to their traumatic experiences.

Some of the techniques used include:


CPT typically begins with psychoeducation about PTSD, its symptoms, and its impact on thoughts, feelings, and behaviors.

Individuals learn about the cognitive model of PTSD, which emphasizes the role of trauma-related beliefs and interpretations in maintaining symptoms.

Writing Exercises & Thought Monitoring

Writing Exercises & Thought Monitoring

Writing assignments are a central component of CPT. Individuals are typically asked to write detailed accounts of their traumatic experiences (e.g., trauma narratives) and to reflect on the impact of the trauma on their beliefs, emotions, and behaviors.

Through thought monitoring, individuals learn to identify and challenge trauma-related thoughts and beliefs, such as negative beliefs about oneself, others, or the world. These beliefs often involve themes of safety, trust, power/control, esteem, and intimacy.

Cognitive Restructuring

Cognitive restructuring involves helping individuals identify and replace unhelpful or distorted thoughts with more adaptive and balanced ones.

Individuals learn to challenge cognitive distortions (e.g., black-and-white thinking, catastrophizing) and develop alternative, more realistic perspectives.

Emotion Regulation Skills

CPT may include teaching individuals skills for managing difficult emotions related to their trauma, such as relaxation techniques, mindfulness practices, and emotion regulation strategies.

Relapse Prevention

Towards the end of therapy, individuals learn relapse prevention strategies to maintain gains and cope with potential setbacks.

This may involve identifying triggers for symptom recurrence and developing strategies to cope with stressors effectively.

CPT in Practice

Cognitive Processing Therapy for PTSD

Individual and group CPT formats have shown positive results in treating PTSD, with varying degrees of success depending on the specific needs and preferences of clients.

The choice between individual and group CPT should be guided by the client’s comfort, therapeutic needs, and the availability of trained clinicians and resources.

Individual Format

Cognitive Processing Therapy (CPT) in an individual format is a structured, time-limited approach for treating Post-Traumatic Stress Disorder (PTSD).

This format usually includes 12 sessions, where the therapist works one-on-one with the client to identify and address specific traumatic events.

The main focus of CPT is to help the client understand and change how they think about their traumatic event. During individual CPT sessions, clients are usually asked to write a detailed account of their trauma to identify unhelpful thoughts and emotions.

The therapist then guides the clients through cognitive techniques, such as challenging these unhelpful thoughts, identifying logical errors, and understanding the connection between thoughts and emotions. These techniques help clients develop healthy coping strategies and reduce PTSD symptoms.

Group Format

CPT can also be conducted in a group format, where multiple individuals with PTSD participate simultaneously in therapy sessions.

Group CPT generally follows the same structure and principles as individual CPT, with some adaptations to accommodate the unique dynamics of a group setting.

In group CPT, participants still work on their individual traumas, but they also have the opportunity to share their experiences, thoughts, and emotions with others who have experienced similar traumas. This can foster a sense of camaraderie and support among group members, helping them feel less isolated in their struggles.

The therapist’s role in group CPT is to facilitate discussion and ensure that all group members have the opportunity to both share and process their experiences.

Group CPT sessions may also include psychoeducation, skill-building exercises, and homework assignments for participants to practice applying the techniques they’ve learned in therapy.

CPT and Emotions

Cognitive Processing Therapy for PTSD

Cognitive Processing Therapy (CPT) for PTSD is an evidence-based treatment that focuses on identifying and modifying maladaptive thought patterns related to traumatic experiences. Individuals with PTSD often experience emotions such as anger, guilt, and shame.

In this section, we will discuss how CPT addresses these emotions.

Understanding Anger

Anger is a common emotion associated with PTSD. In CPT, therapists help clients to recognize and challenge the thoughts that contribute to their anger.

This includes identifying and disputing irrational beliefs, such as overgeneralizations and catastrophizing.

Clients are also taught to distinguish between adaptive and maladaptive anger expressions and develop coping strategies such as relaxation and assertiveness techniques.

The goal is to replace unhelpful thought patterns with more accurate and balanced cognitions, leading to a reduction in anger and associated distress.

Dealing with Guilt

Guilt is another emotion frequently experienced by those with PTSD, often stemming from beliefs about responsibility for the traumatic event.

In CPT, clients are guided to examine these guilt-related thoughts and beliefs, exploring the accuracy and helpfulness of such cognitions.

Through this process, clients learn to challenge and modify distorted beliefs about their role in the traumatic event, ultimately reducing feelings of guilt and promoting emotional healing.

Handling Shame

Shame is closely related to guilt, but it involves disapproval and self-condemnation.

Individuals with PTSD may experience shame due to perceived inadequacies or perceived judgment from others.

In CPT, therapists focus on assisting clients in identifying and changing self-blaming and shame-inducing thoughts.

By fostering self-compassion and encouraging adaptive thinking, CPT helps individuals to let go of shame and work towards a healthier self-image and emotional well-being.

CPT for Veterans and Refugees

Cognitive Processing Therapy for PTSD

Cognitive Processing Therapy (CPT) has been proven to be an effective treatment for Post-Traumatic Stress Disorder (PTSD) in both veterans and refugees.

The therapy focuses on the cognitive aspects of trauma, helping individuals to process their experiences and develop adaptive coping skills.

CPT is also beneficial for refugees who have experienced traumatic events, such as war or forced migration.

A comprehensive manual on CPT for PTSD highlights its effectiveness in treating PTSD among female veterans with military sexual trauma and survivors of war-related experiences.

In conclusion, CPT has been shown to be an essential therapeutic approach for addressing PTSD in veterans and refugees.

With its focus on cognitive strategies, CPT enables individuals to cope with their traumatic experiences and ultimately improve their mental health and well-being.


Cognitive Processing Therapy (CPT) offers several benefits for individuals experiencing post-traumatic stress disorder (PTSD) and related symptoms.

One of these benefits is it specifically targets the core symptoms of PTSD, including intrusive thoughts, avoidance behaviors, negative beliefs about oneself, others, and the world, and alterations in mood and cognition. By addressing these core symptoms, CPT aims to alleviate distress and improve functioning.

Additionally, CPT focuses on identifying and challenging unhelpful or distorted beliefs and thought patterns related to the traumatic event. By addressing underlying cognitive processes, CPT helps individuals make sense of their experiences, reduce self-blame and guilt, and develop more adaptive ways of thinking.

Research suggests that the benefits of CPT are often sustained over the long term. By addressing underlying cognitive processes and providing individuals with coping skills and strategies, CPT can lead to lasting improvements in PTSD symptoms and overall well-being.

Therapists Specializing in Stress

Frequently Asked Questions

Frequently Asked Questions

What are the main components of Cognitive Processing Therapy for PTSD?

Cognitive Processing Therapy (CPT) is an evidence-based treatment for Post-Traumatic Stress Disorder (PTSD) that focuses on helping individuals identify and modify dysfunctional beliefs related to their traumatic experiences.

The main components of CPT include psychoeducationcognitive restructuring, and exposure to trauma-related thoughts.

Through these techniques, patients learn to challenge and modify unhelpful beliefs, ultimately leading to a reduction in PTSD symptoms.

How does prolonged exposure therapy differ from CPT?

While both CPT and Prolonged Exposure (PE) therapy are effective treatments for Post-Traumatic Stress Disorder (PTSD), they differ in their approaches.

PE therapy primarily focuses on in vivo and imaginal exposure exercises to reduce emotional distress and avoidance behaviors associated with traumatic memories.

On the other hand, CPT emphasizes cognitive restructuring to challenge and modify dysfunctional beliefs related to traumatic events.

Which therapeutic strategies are common to both CPT and CBT for treating PTSD?

Both Cognitive Processing Therapy (CPT) and Cognitive Behavioral Therapy (CBT) for PTSD share some common therapeutic strategies.

Some of these strategies include psychoeducation, exposure to trauma-related thoughts and memories, and cognitive restructuring.

Both approaches aim to help individuals understand and modify their emotional experiences related to traumatic events by changing maladaptive thoughts and beliefs.

What is the role of the five themes in shaping the CPT approach?

The five themes in CPT provide a framework for understanding and addressing the dysfunctional beliefs often found in individuals with PTSD.

These themes include:

  1. Safety
  2. Trust
  3. Power/control
  4. Esteem
  5. Intimacy

By addressing these themes, therapists can help patients identify and modify unhelpful beliefs related to their trauma, ultimately promoting recovery and growth.

How can I find a therapist that offers Cognitive Processing Therapy?

To find therapists that offer Cognitive Processing Therapy you can use online therapist directories that allow you to search for therapists by location, specialty, and treatment approach like

There you can filter your search according to your preferences to find providers like Emergent Mental Health ServicesNew Foundation Counseling, or Sarah Carpenter, Ph.D. who offer cognitive processing therapy to address PTSD symptoms.


Chard, K. M., Ricksecker, E. G., Healy, E. T., Karlin, B. E., & Resick, P. A. (2012). Dissemination and experience with cognitive processing therapy. Journal of Rehabilitation Research & Development49(5). Link.

Tran, K., Moulton, K., Santesso, N., & Rabb, D. (2016). Cognitive processing therapy for post-traumatic stress disorder: a systematic review and meta-analysis. Link.

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About the author

Eliana Galindo
Eliana is a dedicated psychologist from Colombia who has gained extensive experience and made significant contributions in child development, clinical psychology, and rehabilitation psychology. Her work as a rehabilitation psychologist with disabled children has been transformative and compassionate. In the child development field, she creates nurturing environments through assessments, interventions, and collaboration with families. In clinical psychology, she supports individuals overcoming mental health challenges with empathy and evidence-based approaches. Inspired by her experiences, Eliana is motivated to write about mental health, aiming to raise awareness and advocate for a compassionate and inclusive approach to well-being.

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