Introduction

The Basics

What is Cognitive Processing Therapy (CPT)?

Cognitive Processing Therapy (CPT) is a 12-session, evidence-based treatment for PTSD that helps people process traumatic experiences by challenging unhelpful thoughts and beliefs that developed after the trauma.

The therapy combines cognitive restructuring techniques with written trauma accounts to help individuals overcome “stuck points” in their thinking and reduce PTSD symptoms.

Goal

What is the goal of Cognitive Processing Therapy (CPT)?

The fundamental goal of Cognitive Processing Therapy (CPT) is to help individuals process traumatic experiences by identifying and modifying unhelpful beliefs that developed following trauma. These beliefs often relate to:

• Safety
• Trust
• Power/Control
• Esteem
• Intimacy

This type of therapy aims to help people develop more balanced, realistic perspectives about their trauma, themselves, others, and the world, ultimately reducing the impact of trauma on their daily lives. CPT is typically delivered in about 12 sessions and teaches clients to identify and challenge trauma-related “stuck points.”

Uses

Who could benefit from Cognitive Processing Therapy (CPT)?

While Cognitive Processing Therapy (CPT) was originally developed for PTSD, it has shown effectiveness for treating a variety of types of trauma, including:

• Complex trauma
• Sexual assault trauma
• Childhood abuse
• Trauma-related guilt and shame

CPT is a first-line, guideline-recommended treatment for PTSD with evidence across diverse trauma populations, including survivors of sexual assault and childhood abuse.

Subtypes

Are there any subtypes of Cognitive Processing Therapy (CPT)?

While there are no specific subtypes of Cognitive Processing Therapy (CPT), several adaptations of CPT have been developed to meet specific needs:

• Group CPT: Provides the same structured tools in a group setting, offering peer support and shared healing, commonly used with veterans and trauma survivors.
• Culturally Responsive CPT: Adjusts language, examples, and treatment themes to align with a client’s cultural context, values, and lived experience.
• CPT for Specific Traumas/Populations: Tailors materials and examples for needs such as sexual assault survivors, childhood abuse, combat trauma, or first responders.

Effectiveness

Origins

Who developed Cognitive Processing Therapy (CPT) and when?

Cognitive Processing Therapy was developed by Dr. Patricia Resick and colleagues in the late 1980s, initially designed to treat the psychological aftermath of sexual assault.

The therapy emerged from their work, during which they observed that traditional exposure therapy alone wasn’t adequately addressing the complex thought patterns that maintained post-traumatic stress symptoms.

Evidence Base

Is Cognitive Processing Therapy (CPT) evidence-based?

The evidence base for Cognitive Processing Therapy (CPT) is particularly strong, especially for treating PTSD. The Department of Veterans Affairs has designated it as a first-line treatment for PTSD, and numerous studies have shown it maintains its effectiveness across diverse populations and trauma types.

Research consistently shows that CPT leads to significant reductions in PTSD symptoms, depression, and anxiety, with improvements often maintaining or even continuing to improve at follow-up assessments.

How It Works

Techniques Used

How does Cognitive Processing Therapy (CPT) work?

Cognitive Processing Therapy (CPT) works through a structured process of examining and challenging “stuck points,” beliefs that keep people trapped in their trauma response.

CPT can help individuals understand how traumatic experiences may have altered their beliefs and teach them to evaluate and modify these beliefs through systematic examination of evidence and alternative perspectives. This process involves:

• Distinguishing between facts and interpretations
• Identifying patterns in thinking (“stuck points”)
• Evaluating beliefs against evidence and alternative perspectives
• Developing more adaptive ways of understanding experiences

What to Expect in a Session

What can I expect from a Cognitive Processing Therapy (CPT) session?

In a typical Cognitive Processing Therapy (CPT) session, you can expect the following might occur:

1. Review of practice assignments from the previous session
2. Introduction of new concepts or skills
3. Guided practice in identifying and challenging stuck points
4. Written exercises to deepen understanding
5. Assignment of practice work for the coming week

When doing CPT, it’s crucial to understand that the therapy involves active engagement both during and between sessions. Clients can expect to complete regular worksheets and writing assignments that help track and challenge their thoughts.

CPT requires commitment but offers structured, concrete tools for processing trauma and developing healthier ways of thinking about traumatic experiences.

The treatment progresses systematically through:

• Impact statements
• Identifying beliefs that have changed due to trauma
• Learning to question and modify these beliefs
• Addressing specific areas of life that trauma often affects

This systematic approach helps ensure thorough processing of trauma-related thoughts and beliefs.

Treatment Length & Structure

How long does Cognitive Processing Therapy (CPT) take?

The standard Cognitive Processing Therapy (CPT) protocol consists of 12 sessions, typically delivered once or twice weekly. Each session lasts about 50–60 minutes.

CPT follows a precise structure with the following breakdown of sessions:

• Sessions 1–2: Understanding how thoughts and emotions connect
• Sessions 3–4: Working with the impact statement and identifying stuck points
• Sessions 5–7: Learning to challenge thoughts using Socratic questioning
• Sessions 8–12: Focusing on specific themes (safety, trust, power/control, esteem, intimacy)

Getting Care

Finding a Therapist

How do I find a therapist trained in Cognitive Processing Therapy (CPT)?

Alma’s directory has many therapists who are trained in Cognitive Processing Therapy (CPT), including: