Cognitive Processing Therapy
Cognitive processing therapy, cognitive-behavioral therapy, and PTSD
Those experiencing post-traumatic 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.
What is the relationship between cognitive processing therapy and PTSD symptoms?
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.
Cognitive processing therapy methodology for trauma treatment
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.
Final sessions with cognitive processing therapy (CPT) therapists
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.
Types of cognitive processes
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
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 interested in cognitive processing therapy
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.
Counseling options
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.
How does CPT work for trauma?
CPT (cognitive processing therapy) works for trauma by helping individuals become aware of negative thoughts and beliefs associated with the traumatic event (referred to as stuck points) and reframing them to develop a more beneficial view of the trauma. This may require them to dismantle the components of the trauma. They may also be asked to write about the sensory details of a traumatic event as part of the formal processing stage of treatment.
Is cognitive processing therapy part of cognitive-behavioral therapy?
Yes. Cognitive processing therapy is one of many other forms of cognitive behavioral therapy. It can be used to treat PTSD and other types of trauma. Some research indicates it is effective in treating female victims of sexual assault, for example.
What is exposure therapy?
Exposure therapy is a type of cognitive behavioral therapy that consists of exposing clients to their fears to help them overcome these fears. Exposure therapy can be used to treat phobias, PTSD, panic disorder, and obsessive compulsive disorder.
How long does treatment from cognitive processing therapy (CPT) therapists take to work?
It can vary. Some people begin to see benefits in just three to four sessions with a CPT therapist, while it could take longer for others. The average length of CPT treatment is approximately three months.
What causes desensitization?
Repeated or chronic exposure to traumatic events like interpersonal violence, for example, can cause desensitization to these events over time.
What are the three steps involved in systematic desensitization?
Systematic desensitization is a technique used to decrease fear and anxiety around an object or situation. It can be implemented in three steps:
Implementing relaxation techniques
Identifying the hierarchy of fears
Exposure to the source of fear
What is the difference between CBT and CPT therapy?
Cognitive processing therapy (CPT) is a type of cognitive behavioral therapy (CBT). CPT focuses on post-traumatic stress disorder in particular.
Who should not do cognitive processing therapy?
Cognitive processing therapy is a safe form of treatment for most populations. Still, some experts in clinical psychology believe people who experienced childhood trauma such as childhood sexual abuse should avoid this form of therapy.
How effective is CPT therapy for post-traumatic stress disorder (PTSD)?
A recent randomized clinical trial found cognitive processing to be highly effective for treating posttraumatic stress disorder related symptoms.
Is CPT better than EMDR?
Possibly. CPT is typically conducted as a first-choice treatment for PTSD while EMDR is considered an alternative. More research is needed to determine the effectiveness of EMDR for post-traumatic stress disorder.
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