Cognitive processing therapy

Cognitive processing therapy (CPT) is a manualized therapy used by clinicians to help people recover from posttraumatic stress disorder (PTSD) and related conditions. It includes elements of cognitive behavioral therapy (CBT) treatments. A typical 12-session run of CPT has proven effective in treating PTSD across a variety of populations, including combat veterans,sexual assault victims, and refugees. CPT can be provided in individual and group treatment formats.

The theory behind CPT conceptualizes PTSD as a disorder of non-recovery, in which a sufferer's beliefs about the causes and consequences of traumatic events produce strong negative emotions, which prevent accurate processing of the traumatic memory and the emotions resulting from the events. Because the emotions are often overwhelmingly negative and difficult to cope with, PTSD sufferers can block the natural recovery process by using avoidance of traumatic triggers as a strategy to function in day-to-day living. Unfortunately, this limits their opportunities to process the traumatic experience and gain a more adaptive understanding of it. CPT incorporates trauma-specific cognitive techniques to help individuals with PTSD more accurately appraise these "stuck points" and progress toward recovery.

The primary focus of the treatment is to help the client understand and reconceptualize their traumatic event in a way that reduces its ongoing negative effects on their current life. Decreasing avoidance of the trauma is crucial to this, since it is necessary for the client to examine and evaluate their meta-emotions and beliefs generated by the trauma.

The first phase consists of education regarding PTSD, thoughts, and emotions. The therapist seeks to develop rapport with, and gain the co-operation of, the client by establishing a common understanding of the client's problems and outlining the cognitive theory of PTSD development and maintenance. The therapist asks the client to write an impact statement to establish a current baseline of the client's understanding of why the event occurred and the impact that it has had on their beliefs about themselves, others, and the world. This phase focuses on identifying automatic thoughts and increasing awareness of the relationship between a person's thoughts and feelings. A specific focus is on teaching the client to identify maladaptive beliefs ("stuck points") that interfere with recovery from traumatic experiences.

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