National Center for PTSD

ptsd.va.gov | Feb 28th 2011

Trauma often causes people to struggle with their memories and thoughts about the event. You may have a hard time making sense of what happened. You may find yourself getting "stuck" in your thoughts about the trauma and how it affects your life. This feeling of being unable to make sense of the trauma can make you want to avoid thinking about or dealing with your memories.

Cognitive Processing Therapy (CPT) helps you by giving you a new way to handle these distressing thoughts and to gain an understanding of these events. By using the skills learned in this therapy, you can learn why recovery from traumatic events has been hard for you. CPT helps you learn how going through a trauma changed the way you look at the world, yourself, and others. The way we think and look at things directly affects how we feel and act.

CPT has four main parts:

Learning about your PTSD symptoms. CPT begins with education about your specific PTSD symptoms and how the treatment can help. The therapy plan will be reviewed and the reasons for each part of the therapy will be explained. You will be able to ask questions and to know exactly what you are going to be doing in this therapy. You will also learn why these skills may help.
Becoming aware of thoughts and feelings. Next, CPT focuses on helping you become more aware of your thoughts and feelings. When bad things happen, we want to make sense of why they happened. An example would be a Veteran who thinks to himself or herself, "I should have known that this would happen." Sometimes we get stuck on these thoughts. In CPT you will learn how to pay attention to your thoughts about the trauma and how they make you feel. You'll then be asked to step back and think about how your trauma is affecting you now. This will help you think about your trauma in a different way than you did before. It can be done either by writing or by talking to your therapist about it.
Learning skills. After you become more aware of your thoughts and feelings, you will learn skills to help you question or challenge your thoughts. You will do this with the help of worksheets. You will be able to use these skills to decide the way YOU want to think and feel about your trauma. These skills can also help you deal with other problems in your day-to-day life.
Understanding changes in beliefs. Finally, you will learn about the common changes in beliefs that occur after going through trauma. Many people have problems understanding how to live in the world after trauma. Your beliefs about safety, trust, control, self-esteem, other people, and relationships can change after trauma. In CPT you will get to talk about your beliefs in these different areas. You will learn to find a better balance between the beliefs you had before and after your trauma.

You and your therapist will work together to help you learn a new way of dealing with your trauma. In CPT you will work closely with your therapist to reach your goals. You will be meeting with him or her on a regular basis for 12 sessions. During your therapy you will also have the chance to practice your new skills outside of your therapy meetings. The more you practice your new skills, the sooner they will begin working for you. By choosing to approach your experiences in a new and different way, you will be able to decide how your past affects your future.

CPT for Veterans

CPT has been shown to be one of the most effective treatments for PTSD. For this reason, the VA's Office of Mental Health Services has rolled out a national therapist training program. VA therapists throughout the country will be trained in how to use CPT treatment. These therapists will also consult with CPT experts to learn how to best provide this therapy. Then they will be asked to use CPT in their routine clinical care.