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PTSD: National Center for PTSD

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Cognitive Processing Therapy for PTSD

 

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This section is for Veterans, General Public, Family, and Friends

Cognitive Processing Therapy for PTSD

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Practice guidelines have identified that trauma-focused psychotherapies have the most evidence for treating PTSD. Cognitive Processing Therapy (CPT) is one type of trauma-focused psychotherapy.

CPT teaches you how to evaluate and change the upsetting thoughts you have had since your trauma. By changing your thoughts, you can change how you feel.

How Does It Work?

Trauma can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy.

CPT teaches you a new way to handle these upsetting thoughts. In CPT, you will learn skills that can help you decide whether there are more helpful ways to think about your trauma. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide whether or not it makes sense to take a new perspective.

What Can I Expect?

Your provider will start off by giving you an overview of the treatment. Together, you will review some information about PTSD to help you better understand your symptoms. Your provider will ask about the type of trauma you experienced, but you will not need to go into great detail right away. Your provider will also ask you to do some writing about how your trauma has affected you.

Over the next several sessions, you will talk about any negative or unhelpful thoughts you have been having about the trauma, and you will work together to consider other ways of thinking about the situation. You will use worksheets in session and at home that help you learn this strategy. CPT can also include writing about the details of your trauma, if you and your provider decide this is right for you.

This may sound difficult at first, but writing about the trauma may help you cope with emotions like anger, sadness and guilt. Towards the end of therapy, you and your provider will focus on some specific areas of your life that may have been affected by the trauma, including your sense of safety, trust, control, self-esteem, and intimacy.

How Long Does Treatment Last?

CPT usually involves 12 weekly sessions (so treatment lasts about 3 months), but this can vary. Sessions are 60 to 90 minutes each. You may start to feel better after a few sessions. And the benefits of CPT often last long after your final session with your provider.

What Are the Risks?

It may be difficult to talk or write about trauma-related memories or beliefs, especially at first. These feelings are usually brief and people tend to feel better as they keep doing CPT. Most people who complete CPT find that the benefits outweigh any initial discomfort.

Group or Individual?

CPT can be done individually, where you meet one-to-one with a provider. CPT can also be done in a group with one or two providers and about 6-10 other people who also have PTSD. However, there is more research evidence supporting individual CPT than group CPT.

Will I Talk in Detail about My Trauma?

You will not need to talk about the specific details of your trauma, but you will be asked to talk about your beliefs and feelings related to the trauma. You can choose to do a type of CPT that involves writing about the details of the trauma, but this is optional.

If you and your provider decide that writing about the trauma is right for you, this writing assignment will be done at home after your third session. You will read this written trauma account out loud in your next session. If you are in group CPT, you will read through your written trauma account with a provider -- but not in front of the whole group. There is also another type of CPT that does not ask you to write about the details of your trauma.

Will I Have Homework?

You will do some writing and complete worksheets between sessions. Take-home worksheets help you practice in real life the skills you learn during your therapy visits. Most people find that the more effort and energy they put into these assignments, the more they get out of CPT.

Does VA Have an App for That?

Yes, CPT Coach is a mobile app that you can use while you are doing CPT with a provider. CPT Coach can help you to learn more about CPT and PTSD symptoms, and the app helps you stay organized with worksheets as you complete treatment. CPT Coach is free and can be downloaded on most mobile devices.

Choosing the Best Treatment for You

Trying to figure out which PTSD treatment is best for you? For more videos about Cognitive Processing Therapy and other treatments that work, get started with the PTSD Treatment Decision Aid.

Date this content was last updated is at the bottom of the page.

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The National Center for PTSD does not provide direct clinical care, individual referrals or benefits information.

PTSD Information Voice Mail:
(802) 296-6300
Contact Us: ncptsd@va.gov
Also see: VA Mental Health

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