What Is Cognitive Processing Therapy (CPT)?

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 post-traumatic stress disorder 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 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 post-traumatic stress disorder by reading on.

What is post-traumatic stress disorder?

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 post-traumatic stress disorder 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

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

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 post-traumatic stress disorder diagnosis, an individual must meet symptom requirements from several categories.

Causes of PTSD

The symptoms of post-traumatic stress disorder 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 the condition 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 CPT as a recommended therapy for post-traumatic stress disorder.

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

How cognitive processing can help

CPT therapy may also focus on the formal processing of trauma 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 or cognitive distortions like self-blaming or labeling. 

Counseling options

CPT 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 CPT online.  Other treatments for PTSD include Prolonged Exposure (PE), Cognitive Behavioral Conjoint Therapy (CBCT) for couples, and Eye Movement Desensitization and Reprocessing (EMDR).

Online CPT treatment may provide several benefits, including safety and a new perspective. You can work with a qualified 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 post-traumatic stress disorder symptoms and need help from your therapist in learning useful coping skills. 

Additionally, studies have found online counseling to be impactful. One review found that online cognitive-behavioral therapy, like CPT, is significantly effective at treating post-traumatic stress disorder, 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 counseling, consider signing up with a platform like BetterHelp, which offers over 30,000 licensed specialists in mental health.