Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is a cognitive behavioural treatment designed as a manualized 12-session protocol for treating post-traumatic stress disorder (PTSD) and related conditions, including anxiety and depression. The treatment protocol was developed in the last 1980s by Dr. Patricia Resick and her colleagues for victims of sexual assault and veterans. CBT is another evidence-based treatment for trauma [and related conditions] in non-military populations, such as refugees, victims of childhood abuse, and torture.
The primary aim of CPT is to help individuals develop a healthier conceptualization of a traumatic event(s). A more realistic perspective of the trauma can help individuals move forward in healthier, more meaningful ways with reduced negative effects of the trauma.
CPT therapists use a style of questioning known as Socratic dialogue, which helps process the cognitive and emotional elements surrounding the traumatized individual's beliefs.
Components of Cognitive Processing Therapy
- Treatment begins with informed consent on the CPT protocol, reviewing a trauma timeline, and identifying a target trauma. If traumas occurred repeatedly over a period of time, then the most distressing event is chosen as the target trauma.
- The CPT therapist provides psycho-education on normal symptoms of post-traumatic stress, different types of emotions, stuck points, and an explanation for how PTSD develops. At the beginning of treatment, the client writes an impact statement about the ways in which they believe they were impacted by the trauma in the five themes commonly associated with it: (1) safety, (2) trust, (3) power and control, (4) esteem, and (5) intimacy. A written account of the trauma itself is not required for treatment efficacy.
- The CPT therapist and client collaboratively review the impact statement and begin identifying 'stuck points', or deeply ingrained beliefs that are triggered in relation to the trauma. Typically, stuck points are associated with strong emotion.
- The CPT therapist gradually introduces three different sets of cognitive behavioural worksheets that will set the stage for the remaining sessions. Targeting stuck points related to specific themes (i.e., safety, trust, power and control, esteem, and intimacy) tends to happen in the last five treatment sessions. While not every single stuck point may be addressed in treatment, the research shows that people tend to generalize their skills as they become psychologically flexible.
"Trauma creates change you don't choose; healing creates change you do choose." - Michele Rosenthal
References
- American Psychological Association. (2017). Cognitive processing therapy (CPT). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy
- Cognitive Processing Therapy for PTSD. (n.d.). About us. https://cptforptsd.com/about-us/
- John Hopkins Bloomberg School of Public Health. (n.d.). Cognitive processing therapy (CPT). https://www.jhsph.edu/research/centers-and-institutes/global-mental-health/talk-therapies/cognitive-processing-therapy/
- Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Publications.
Benefits:
- Effectiveness. Research shows that online therapy can be just as effective as in-person therapy for issues related to mental health.
- Accessible. Accommodates those living in rural or remote areas, people living with disabilities that prevent them from leaving the home, and eliminates transportation barriers.
- Convenience. No need to schedule time for a commute.
- Cost Effective. Eliminates cost of parking and transportation.
Considerations:
- Coverage. Some insurance companies may not cover it. We encourage you to check with yours.
- Confidentiality and Privacy. Although we use encrypted, HIPAA-compliant software and abide by telehealth guidelines, communicating over the Internet entails a greater risk for security breach compared to in-person. It also means possible Internet connectivity issues.
- Distractions. Possibilities for disruption depending on your living circumstances and others in the home.
Benefits:
- Trust and Body Language. Some people may prefer viewing the entire body language of their therapist for more effective communication.
- Severe mental health or psychiatric concerns. A more appropriate and accommodating option for people that may need crisis intervention that is better supported with in-person care.
- Participation. It is an opportunity to engage in an activity outside of your home.
Considerations:
- Time consuming. Ensuring commute time may be challenging for busy schedules.
- Expenses. Possible parking and transportation fees.
All virtual sessions are conducted using secure, HIPAA-compliant software. Research has shown that psychotherapy offered through telehealth is an effective solution for mental health treatment. The efficacy of either option depends on individual preference and comfort level.