Cognitive processing therapy

Cognitive Processing Therapy (CPT) is a type of cognitive-behavioral therapy that has been extensively researched and utilized in the treatment of post-traumatic stress disorder (PTSD) and related conditions. Developed by Patricia A. Resick in the 1980s, CPT is designed to help individuals understand and change how they think about their trauma and its aftermath. The goal of CPT is to help individuals with PTSD learn to challenge and modify unhelpful beliefs related to the trauma, thereby reducing their symptoms of PTSD, including intrusive thoughts, emotional numbness, and hyperarousal.

Overview

CPT is typically delivered over 12 sessions, with each session lasting about 50 minutes. The therapy can be conducted on an individual basis or in group settings. The core of CPT involves helping individuals to identify and challenge "stuck points," which are rigid, unhelpful thoughts related to the trauma that prevent recovery. These stuck points often revolve around themes of safety, trust, power/control, esteem, and intimacy.

Phases of CPT

CPT is divided into several phases, each with specific goals and techniques:

Introduction and Education

The first phase involves educating the individual about PTSD and CPT, establishing the therapeutic relationship, and discussing the impact of trauma on beliefs and emotions.

Identification of Stuck Points

Patients are taught to identify their stuck points related to the trauma. This involves recognizing thoughts and beliefs that are overly negative and not fully accurate.

Challenging Beliefs

Using Socratic questioning and worksheets, therapists help individuals challenge their stuck points. This phase encourages the examination of evidence for and against these beliefs, leading to the development of more balanced and realistic perspectives.

Understanding Changes in Beliefs

Patients learn how their thoughts about the trauma have affected their feelings and behaviors. This understanding helps them to further modify their beliefs and reduce symptoms of PTSD.

Skills Consolidation

The final phase focuses on consolidating the skills learned throughout therapy, preventing relapse, and discussing future goals.

Techniques Used in CPT

- **Cognitive Restructuring:** A key technique in CPT, cognitive restructuring involves identifying, challenging, and modifying unhelpful thoughts and beliefs. - **Writing Assignments:** Patients may be asked to write about their trauma or about the impact of the trauma on their beliefs and lives. - **Socratic Dialogue:** Therapists use guided questions to help patients examine and challenge their thoughts and beliefs.

Effectiveness

Research has shown that CPT is effective in reducing symptoms of PTSD, depression, and anxiety in various populations, including military veterans, sexual assault survivors, and individuals experiencing trauma from accidents or natural disasters. CPT has been compared favorably to other treatments for PTSD, such as prolonged exposure therapy and eye movement desensitization and reprocessing (EMDR).

Training and Certification

Mental health professionals who wish to provide CPT must undergo specialized training and certification. This typically involves attending a CPT workshop, completing consultation calls with a CPT trainer, and demonstrating competency in delivering the therapy.

Conclusion

Cognitive Processing Therapy is a valuable and evidence-based approach for treating PTSD and related conditions. By focusing on the modification of unhelpful beliefs and thoughts related to trauma, CPT helps individuals recover from the impact of traumatic events and improve their quality of life.