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What Is Cognitive Processing Therapy?

Andrew MartinAndrew L. Martin, PsyD

Cognitive Processing Therapy (CPT) is a structured psychotherapy designed to cure post-traumatic stress disorder (PTSD). CPT cures PTSD at a rate of about 70%, which means at the end of treatment, 70% of patients report their symptoms are either gone, or are reduced to the point that they no longer cause distress or interfere with life.

What should patients expect from cognitive processing therapy (CPT)? CPT begins with an in-depth explanation of PTSD symptoms, their cause, and how CPT cures those symptoms. In the first CPT session, I demonstrate to patients that their symptoms are normal and not their fault, and why they should invest their valuable time and effort in this treatment. This is important, because anxiety about therapy for trauma is natural. Once people see how help is possible, their desire to feel better overwhelms their anxiety about treatment.

Subsequent sessions follow a structured format – you learn a new skill and receive homework. At the next session, we review the homework, learn a new skill, and repeat. You can learn all the CPT skills in about 12 to 16 meetings, by which time most people’s symptoms are gone or significantly reduced.

Cognitive processing therapy carries no risks, although some people say they dislike homework. This is understandable. It is normal to avoid troubling memories and the feelings that come with those memories. But only by approaching, versus avoiding trauma, can we develop the skills needed to feel better.  Indeed, when my patients complete therapy homework, their success rate is closer to 95% versus the 70% found in treatment studies. In rare cases, someone may put forth tremendous effort, but not meet all their goals after learning all the CPT skills. In those cases, we extend treatment, continuing to apply CPT skills until the patient meets their treatment goals.

CPT is designed specifically to address trauma, and includes long-proven elements of cognitive, behavioral, and psychodynamic therapy. Cognitive processing therapy is more successful than other forms of therapy because it involves changing the way the brain thinks about traumatic memories. Cognitive therapy is based on the idea that emotional pain comes not from a memory itself, but from the memory and how our minds think about the memory. That’s good news, because while we can’t get rid of memories, we CAN change the way our minds think about those memories, and therefore change our symptoms and quality of life.

 

Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Publications.

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