Most people in addiction recovery are still trying to process some kind of traumatic experience. Cognitive processing therapy (CPT) is a cognitive-behavioral therapy that can help people get unstuck from their thoughts and ideas about their trauma. A comprehensive addiction treatment program will incorporate CPT alongside other therapies to promote healing. As trauma and addiction remain tightly connected, addressing both simultaneously is critical for long-lasting recovery.
What is Cognitive Processing Therapy?
Developed by Dr. Patricia Resick, cognitive processing therapy helps treat posttraumatic stress disorder (PTSD), particularly among sexual assault victims. However, today CPT remains a widely used approach to treat PTSD.
This type of therapy is based on the idea that PTSD symptoms come from a conflict between pre-trauma beliefs and post-trauma information. These conflicts cause people to be stuck. The notion of cognitive processing therapy is to teach people healthy ways to evaluate and change the disturbing thoughts they have since the traumatic episode.
In CPT, patients write about their traumatic event in detail. Then, they’re instructed to read the story aloud, both in and outside of sessions. Therapists then help clients recognize stuck points and errors in thinking. The idea is to help patients see beyond their trauma.
How CPT Works for Trauma Recovery
Unlike other forms of therapy, cognitive processing therapy ends after 12 sessions. In each session, patients work on learning skills to recognize and acknowledge more helpful ways to think about their trauma. Ultimately, this form of therapy teaches patients the ability to decide whether it makes more sense to take a new perspective.
CPT addresses four different sections:
- PTSD Symptoms: Learning how to identify and address specific PTSD symptoms.
- Thoughts and Feelings: Learning how to become more aware of thoughts and feelings related to the traumatic event. Recognizing that someone might be stuck in specific beliefs and memories that are causing more harm than good.
- New Skills: Learning how to challenge these thoughts and feelings. Exploring how to recognize these triggers and think about these triggers differently.
- Changes in Beliefs: Recognizing how people’s feelings and beliefs change after a traumatic experience. Then, how to balance the way someone sees the world before and after the traumatic experience.
Most CPT sessions are private ones. However, group therapy can also be helpful. Most CPT sessions are about 60 minutes long, and the treatment structure involves 12 sessions in three months.
What to Expect from Treatment
While it was initially to treat people who had survived violent crimes like rape and assault, CPT has evolved to treat many styles of PTSD. Recent research considers CPT to be more effective than other trauma-focused psychotherapies, even when that other therapy was provided by clinicians. CPT is one of the most effective treatments for PTSD, and it’s now used to treat military trauma, grief, and other traumatic experiences.
It’s important to point out that patients do have to talk in detail about their trauma. Usually, by the 3rd session, therapists ask patients to write down their trauma, so they can read it out loud in the next session. However, in group settings, patients will read their trauma with their providers, but not in front of the entire group.
Of course, CPT isn’t the only PTSD treatment out there. A substantial number of veterans have continued to experience symptoms after completing treatment. Individuals with trauma are also likely to struggle with substance abuse and depression. Using CPT alone without addressing co-occurring mental health disorders might not be the best course of treatment.
Also, part of cognitive processing therapy weighs heavily because patients must complete their assigned homework to see noticeable progress. Patients who fail to do this might not show improvement as those who follow instructions.
Many therapists are specialists in cognitive processing therapy. For veterans, CPT services are now available through the VA. Also, in most rehab facilities that treat the connection between trauma and addiction, CPT services are likely to be part of the program.
– Abou, E., & Goldwaser, G. (2010). Effective psychological treatments for PTSD: Cognitive processing therapy. Retrieved from http://www.med.navy.mil/sites/nmcsd/nccosc/healthProfessionalsV2/reports/Documents/cptAPRFinalVersion.pdf
– Wachen JS, Dondanville KA, Young-McCaughan S, et al. Testing a variable-length Cognitive Processing Therapy intervention for posttraumatic stress disorder in the active-duty military: Design and methodology of a clinical trial. Contemp Clin Trials Commun. 2019;15:100381. doi:10.1016/j.conctc.2019.100381
– US Department of Veteran Affairs. Cognitive processing therapy: helping during treatment.