Cognitive Processing Therapy for PTSD

I have years of experience and success in utilizing Cognitive Processing Therapy for treating clients with Post-Traumatic Stress Disorder. I attended an intensive two-day training in Cincinnati, OH in October 2018, facilitated by Dr. Kathleen Chard, one of the three originators of the model, along with Drs. Patricia Resick and Candice Monson. Cognitive Processing Therapy, or CPT, is rooted in Cognitive Behavioral Therapy (CBT). It is highly successful, as demonstrated by the rich research data compiled over its roughly 25 years in existence. (Resick, Monson, Chard, 2016). https://books.google.com/books?hl=en&lr=&id=8Z5jDAAAQBAJ&oi=fnd&pg=PP1&dq=cognitive+processing+therapy+for+ptsd&ots=voOqeMFlt2&sig=HYJubGnoxRN-33d_VBTsN-VdMiI#v=onepage&q=cognitive%20processing%20therapy%20for%20ptsd&f=false

Anecdotally, I have seen remarkable transformations in my clients as their fear reduces, their confidence increases, and they find themselves doing things they didn’t even consider prior to entering CPT—such as full-time employment in stressful settings. Perhaps best of all, the treatment is only 12-15 sessions, representing a significant improvement over prolonged exposure therapy, which can take years to be effective. (Resick, Monson, Chard, 2016). Thus, with CPT, people typically see rapid relief, often after a few sessions.

CPT is a highly structured protocol that involves identifying and changing people’s cognitions, known in the treatment model as stuck points. Socratic dialogue, guided discovery, and carefully designed practice assignments target the client’s avoidance, which is one of the primary factors influencing non-recovery from trauma. A skilled and experienced CPT therapist is necessary to help the client formulate more adaptive thought responses and allow the natural recovery process to unfold, or to help the client get unstuck from recovery-interfering beliefs (Resick, Monson, Chard, 2016).

The treatment targets the trauma survivor’s fight-flight-freeze response by activating the frontal cortex and deactivating the amygdala or alarm center of the brain. There is a reciprocal relationship between the amygdala and the frontal lobes—when one region is active the other is relatively dormant. Thus, looking accurately and objectively at the recovery stuck points activates the reason center of the brain and quiets the fight-flight-freeze response, allowing the client to more accurately assess environmental stimuli and participate more fully in their lives without crippling anxiety. (Resick, Monson, Chard, 2016).

https://medicalxpress.com/news/2016-11-active-duty-military-ptsd-relief-individual.html

PTSD survivors often develop rigid and exaggerated views of themselves and the world through the process of trying to make meaning of traumatic event(s). CPT targets these beliefs in the areas of safety, self-esteem, power/control, trust, and intimacy, allowing the person to engage in more meaningful relationships and to formulate more balanced views of their ability to keep themselves safe in the world (Resick, Monson, Chard, 2016).

CPT is one of the most rewarding treatment modalities I work with due to the relief experienced by clients. There is often a genuine “aha” phenomemon that occurs when people are able to make more accurate meaning of the traumatic experience and to stop blaming themselves for events that they did not cause. I welcome the opportunity to treat trauma survivors who are willing to commit to this remarkably effective treatment.

- Aaron George