What Is Cognitive Processing Therapy and Why Is It Helpful?

What Is Cognitive Processing Therapy?

Cognitive Processing Therapy (CPT) is a type of cognitive behavioral therapy (CBT) that focuses on the treatment of an individual living with Post-Traumatic Stress Disorder (PTSD) as well as individuals living with similar conditions. CPT is designed to help individuals who may be “stuck” in their thoughts about a trauma they have undergone. This therapy is based on the ideology that PTSD symptoms likely stem from a conflict between an individual’s pre-trauma beliefs and post-trauma facts. 

An example suggested by Matthew Tull (2019) is that a possible pre-trauma belief might be that ‘the world is a safe place,’ and a post-trauma fact might suggest that the world is dangerous. CPT aims to work with the ‘stuck’ individual to identify dysfunctional thinking patterns and challenge those beliefs. There are three main goals of CPT:

Reflect 

Reflection will provide the client with psychoeducation to help them improve their understanding of PTSD and how it may impact their ability to move forward after a traumatic event. The more educated an individual is on their disorder, the more likely they are to understand their cognitions and move towards change.

Redefine 

Here, the therapist allows the client to challenge their negative cognitions (“stuck points”) to develop a more realistic and helpful belief about themselves and the world around them.

Recover 

Throughout the treatment sessions, the overall goal is to see a significant decrease in PTSD symptoms. In this sense, recovery does not necessarily mean a return to pre-trauma thinking. Recovery may be better understood by the individual returning to daily activities with new knowledge about emotional regulation, dysfunctional cognitions, and therapeutic coping skills.

CPT sessions are typically 45 – 90 minutes in duration and are seen to be completed for 12 to 15 weeks. CPT is offered as an individual therapy option as well as a group therapy option. However, individual homework assignments will likely arise during sessions regardless of how the individual engages in CPT.

How Is Cognitive Processing Therapy Helpful?

Developing Coping Skills

CPT can be helpful for individuals who need to address their coping skills. Often, those living with PTSD symptoms have maladaptive coping skills that don’t allow them to cope in healthy ways. CPT can help individuals notice how their maladaptive cognitions impact their daily lives. Suppose the individual can recognize they may be in a position of vulnerability. In that case, they can use new coping skills developed in their therapy sessions to overcome that distress.

Emotional Regulation

As above, CPT can help the patient focus on the emotion they are experiencing and use coping skills to get through it. CPT sessions can help individuals recognize those emotions and give them the necessary knowledge to reduce those PTSD symptoms. 

Empowerment

CPT can help clients in their journey of taking back their life after a traumatic event. Those who experience a traumatic event may feel that their life now revolves around that incident. CPT helps the client to recognize that they have experienced something life-changing and that going through something like this is OK.

Cognitive Restructuring

The individual will learn how common it is for a thought and belief system to be changed after a serious traumatic event. As with CBT, CPT also links to cognitive restructuring as its main approach. Cognitive restructuring allows the individual to reframe how they think about their trauma. Asking the client to look for evidence about their beliefs and thoughts can challenge the dysfunctional cognitions an individual is having, CPT can reduce the extreme distress symptoms that arise with PTSD. 

Cognitive Processing Therapy Techniques and Exercises:

Psychoeducation 

Therapists can use psychoeducation to educate the client on PTSD symptoms as well as explain how it hinders recovery and how it is likely impacting their ability to recover from the event. 

Impact Statements 

These are usually done by getting the client to write down how their traumatic experience impacted them. These statements focus on the thoughts, feelings, beliefs, and behaviors, not recounting what the event physically entailed. Impact statements can be made at any point in the therapy course. However, conducting one at the beginning of the sessions and a new one at the end may be most beneficial to see the client's progress.

Socratic Questioning

Socratic questioning is a technique used by therapists to encourage reflection. This is especially important in CPT. This questioning technique can facilitate some of the reflection needed within sessions to progress. 

Identifying Stuck Points

Thoughts that halt individuals from recovering are called “stuck points”. This is typically done by working with the client to identify the possible stuck points they may be experiencing. An example of a stuck point might be: “Because I did not tell anyone, I am to blame for the abuse”. Once these stuck points have been identified, the individual can work through changing these thoughts. 

Exploring Power and Control

It makes sense that anyone who has experienced a traumatic event might find themselves struggling with trying to control things. Often, people with PTSD might unrealistically try to control things in their lives that are out of anyone’s control, and this can often leave them more distressed or engaging in avoidance behaviors. Exploring any issues with power and control that the individual might be experiencing can help them recognize areas where they might be able to let go. 

Cognitive Processing Therapy Worksheets:

Various worksheets can aid in the implementation of CPT during sessions with clients. Here are a few:

ABCDE Journal PTSD Worksheet

This ABCDE Journal Worksheet created by Carepatron allows individuals to explore their cognitions about an event. This worksheet can be used in therapy sessions to safely explore the client’s emotional reactions to their traumatic event. Clients can also use it as self-help for when they are struggling outside of the therapy session.

Grounding Techniques Log PTSD Worksheet

This grounding techniques worksheet can be used by licensed healthcare professionals who are working with clients living with PTSD. Individuals can use this worksheet to highlight the grounding techniques they discussed in session and want to practice daily.

Trauma History Questionnaire

This worksheet can help the therapist to gather the necessary information about the client’s overall level of functioning. This may also be a good time to consider whether CPT is the right therapy option for the individual. 

Impact Statement 

This is often completed twice during the client’s session course with the CPT therapist. The individual may be asked to write about how they feel the traumatic event impacted them. The individual should focus on thoughts, feelings, and beliefs to complete the impact statement.

Socratic Questioning

Socratic Questioning can be used in CPT to further the progress in therapy with a client. This Socratic Questioning Guide can help therapists enhance their sessions and deepen their client’s understanding of their issues. 

When Is It Best to Take Cognitive Processing Therapy? 

As always, the timing of therapy is extremely important. Individuals who are not ready to undergo any therapy form may not retain useful benefits from the sessions, and it could ultimately be a waste of time for the client. 

After Stabilization 

It is recommended that the client takes some time to stabilize after their traumatic experience. This is due to the heightened emotions and psychological state that typically occurs in those initial days – weeks after an event. Around the third session of CPT, the client may be asked to talk about their experience of their traumatic event, and this can be difficult for those who haven’t had time to stabilize.

Time Requirements 

Taking CPT after carefully considering the commitment required for sessions is also best. CPT is usually run over 12 to 15 sessions (about three months). This means that to get the most benefit from CPT. The client must carefully consider whether this therapy option is something they can commit to with full confidence in completing the course.

It is important to remember that CPT may not be recommended for several reasons. A healthcare professional should assess individuals who are experiencing the following before beginning this type of therapy:

• Mania caused by bipolar disorder
• Suicidal ideation/intent
• Symptoms of an active psychosis
• Cognitive processing, such as dementia
• Going through a detox treatment for substance abuse disorder

How Can Carepatron Help With Cognitive Processing Therapy-Related Work?

Carepatron is all about making life for therapists that little bit easier! As a cognitive processing therapy software, we know how much you value your time spent in session with your clients and ensure you provide the utmost support. 

As a therapy practice management software, Carepatron can help you manage client records, schedule sessions,, and organize billing in one easy-to-use platform. As a therapy scheduling software, Carepatron takes care of chasing clients up to remind them of your upcoming session and helps you to schedule more time for yourself!

Therapy EHR is essential for modern practitioners who value their time with clients. Implementing Carepatron’s system can help you be more present with your valuable clients when you don’t need to worry about pesky administrative tasks that hold you down before and after therapy sessions. 

When you upgrade to Carepatron for your mainstream cognitive processing therapy app, you can successfully upgrade your skills, knowledge, and practice management to align with your core values as a therapist!