Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is an evidence-based psychotherapy designed to help individuals recover from post-traumatic stress disorder (PTSD) and other trauma-related symptoms, though I have found its structured approach useful in addressing depression, anxiety, and substance abuse/addiction as well.

Developed in the 1980s by Patricia Resick, CPT focuses on addressing and modifying the maladaptive beliefs and thought patterns that sustain emotional distress following trauma. It is a structured, annualized, time-limited treatment typically conducted over 12 sessions, though it can be adapted for individual or group formats.

CPT is based on the premise that trauma disrupts an individual’s ability to process information, leading to unhelpful or inaccurate thoughts about the traumatic event, oneself, and the world. These cognitive distortions, such as blaming oneself for the trauma or believing the world is entirely unsafe, can exacerbate PTSD symptoms, including hypervigilance, avoidance, and emotional numbness. These types of black and white, negative beliefs are also typical of many clients with depression, anxiety, and substance use/addiction challenges, and those clients also respond well to the CPT protocol.

The therapy begins with psychoeducation, where clients learn about PTSD and the connection between thoughts, feelings, and behaviors. This helps them understand how their interpretations of the trauma can perpetuate distress. Clients are then guided to write a detailed account of the traumatic event, which serves as a foundation for identifying problematic beliefs.

A key component of CPT is cognitive restructuring, where clients learn to challenge and modify maladaptive thoughts, such as guilt, shame, or self-blame, through structured exercises. They examine evidence for and against these beliefs, identify cognitive distortions like overgeneralization or catastrophizing, and replace them with more balanced, accurate perspectives. This process fosters a shift from rigid, trauma-related thinking to more flexible, adaptive thought patterns. I find this structured process valuable for changing rigid, maladaptive thinking in a wide variety of clients.

As treatment progresses, clients work on five core themes often affected by trauma: safety, trust, power, esteem, and intimacy. They explore how the trauma has impacted these areas and develop healthier beliefs to support recovery.

CPT has been extensively studied and is recognized as one of the most effective treatments for PTSD by organizations like the Department of Veterans Affairs (VA) and the American Psychological Association (APA). Its structured approach and emphasis on empowering clients to change their thought processes make it a highly effective tool for reducing trauma-related distress and improving overall functioning. I have used CPT to help clients from Oakland, around the Bay Area, and beyond. Please reach out if you would like to know more.