Using Cognitive Processing Therapy For PTSD

Medically reviewed by Melissa Guarnaccia, LCSW
Updated May 31, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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According to the National Center for PTSD, about 50% to 60% of individuals experience trauma at some point in their lives. Some people may recover from these events, while others may continue to feel the emotional and physical impacts for a long time after the event has passed.

The US Department of Veterans Affairs reports that 11 to 20% of veterans who served in Operations Iraqi Freedom and Enduring Freedom and 12% who served in the Gulf War have experienced PTSD in a given year. It’s estimated about 30% of Vietnam veterans have had PTSD in their lifetimes.

PTSD may affect anyone who has experienced trauma. Additionally, some individuals develop the condition from witnessing or learning about an event that was traumatic in some way. Researchers aren’t sure why some people experience PTSD and others don’t. However, post-traumatic stress disorder (PTSD) can often be treated using medication and various therapy techniques, including cognitive processing therapy (CPT), a type of cognitive behavioral treatment. Learn more about cognitive processing therapy (CPT) for PTSD by reading on.

Identify the symptoms of PTSD

What is PTSD?

Post-traumatic stress disorder is a mental health condition that occurs in some individuals after a traumatic, dangerous, or life-threatening event. What qualifies as trauma may depend on how a person interprets an event. One event may be traumatic to one person and fine to another.
Commonly traumatic events may include:  
  • Childhood abuse  
  • Sexual assault
  • Physical assault
  • Emotional abuse 
  • Combat exposure
  • Accidents
  • Illness or medical procedures 
  • Natural disasters 
  • Traumatic loss 
  • Witnessing violence, abuse, or assault 

Many patients with PTSD experience flashbacks and panic attacks connected to the traumatic event they experienced, such as child abuse or other distressing incidents. Some people living with PTSD may develop anxiety that causes social difficulties. They may avoid locations, people, objects, or stimuli that remind them of their trauma. Certain sounds, movements, or occurrences may cause panic or the feeling of “reliving” a trauma, which could prompt the person to act out their fight-or-flight response by fighting or fleeing from their memory. This occurrence may happen to anyone affected by PTSD, not just war veterans. 

Signs and symptoms

According to the American Psychiatric Association, an individual must meet two or more of the following post-traumatic stress disorder symptoms for at least one month following a traumatic incident to be diagnosed with PTSD: 

  • Flashbacks about the traumatic event
  • Nightmares or night terrors
  • Avoiding specific locations, people, objects, or stimuli 
  • Negative thoughts or adverse self-beliefs 
  • Extreme fear of specific areas, people, objects, or situations 
  • Anxiety or stress 
  • Chronic fatigue
  • Trouble falling asleep or inability to stay asleep
  • Problems with self-esteem and intimacy
  • Chronic pain
  • Self-blaming thoughts
  • Angry outbursts 
  • Behaving recklessly 
  • Headaches and muscle pain
  • Heart palpitations or a fast heart rate
  • Shaking or trembling
  • Dizziness or fainting
  • Irritable bowel problems
  • Avoiding loved ones
  • Panic attacks
  • Suicidal thoughts
This list is not comprehensive. You may experience symptoms that are not mentioned above. Suppose a person meets some of the symptoms above that are not directly related to a traumatic event. In that case, the symptoms may indicate another mental health condition, like an anxiety disorder. Additionally, in order to receive a PTSD diagnosis, an individual must meet symptom requirements from several categories.

Causes of PTSD

The symptoms of PTSD may develop after a prolonged traumatic experience. Not everyone who lives through a dangerous event or develops PTSD. However, some factors may put people at higher risk of developing it after traumatic experiences, including:

  • Experiencing long-lasting or intense trauma
  • Having experienced previous childhood trauma
  • Having other mental health issues, like anxiety or depression
  • Experiencing substance use difficulties 
  • Having blood relatives with mental health conditions 

Cognitive processing therapy


Cognitive processing therapy (CPT) helps people evaluate and change their thoughts and develop a constructive outlook. CPT is a specific subtype of cognitive-behavioral therapy. Treating post-traumatic stress disorder is often done through medication and therapy, which the National Center for PTSD by the U.S. Department of Veterans Affairs lists cognitive processing therapy as a recommended therapy for PTSD.

CPT treatment for PTSD, a specific type of PTSD treatment developed by treatment authors like Patricia Resick and Kate Chard, is often completed over 12 sessions. Cognitive processing therapy for PTSD may begin with patient materials, educating and labeling symptoms and emotions. 

How cognitive processing can help

Cognitive processing therapy may also focus on the formal processing of PTSD through a written trauma account. The client may be asked to write out a detailed account of their traumatic experience (called an impact statement) and read it aloud in the next session to confront the thoughts and feelings about the trauma they’ve been avoiding. The therapist may support the client in modifying unhelpful thoughts about the experience, symptoms of PTSD, or cognitive distortions like self-blaming or labeling. 

Counseling options

Cognitive processing therapy can be an effective treatment, developed to help individuals cope with their symptoms. If you are experiencing symptoms of a mental health condition, talk to your primary care doctor for a referral or look for a therapist in your area. If you face barriers to treatment such as cost, distance, or time, you can also consider cognitive processing therapy online.  Other treatments for PTSD include Prolonged Exposure (PE), Cognitive Behavioral Conjoint Therapy (CBCT) for couples, and Eye Movement Desensitization and Reprocessing (EMDR).

Online cognitive processing therapy may provide several benefits for people with PTSD, including safety and a new perspective. You can work with a counselor from home by participating in therapy online via videoconferencing, phone, or in-app messaging (similar to email). This can be helpful when you're experiencing PTSD symptoms and need help from therapy in learning useful coping skills. 

Additionally, studies have found online therapy to be impactful. One review found that online cognitive-behavioral therapy, like cognitive processing therapy, is significantly effective at treating PTSD, anxiety, and depression. The participants in the study were equally satisfied with the effectiveness of online and in-person therapy. If you’re interested in online therapy, consider signing up with a platform like BetterHelp, which offers over 30,000 licensed specialists in mental health. 

Identify the symptoms of PTSD


Cognitive processing therapy is an evidence-based treatment that is often used to help people who are experiencing post-traumatic stress disorder (PTSD). Some therapists may use it for people who have a co-occurring traumatic brain injury or substance use disorder. During cognitive processing therapy sessions, a certified therapist may help a person process their thoughts, feelings, and behaviors in a safe environment. 

If you’re interested in trying therapy sessions but don’t feel comfortable with traditional in-office therapy, you may benefit from online therapy. With BetterHelp, you can find a therapist who has experience with cognitive processing therapy and any mental health concerns you’re facing, such as anxiety or PTSD. Take the first step toward healing and reach out to BetterHelp today.

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