Angela Hathaway, M. Ed., LCMHCA, LPCA, NCC

Trauma & Perinatal Specialist

What is Cognitive Processing Therapy (CPT)?

About Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) focuses on the faulty interpretations the brain has made about a traumatic event. Those distortions trigger emotional responses that result in dysfunctional behaviors. Cognitive Processing Therapy guides the client in recognizing and challenging the "thinking errors" about the event, and then uses tools and exercises to help identify new, healthier, more accurate ways to view the traumatic event. As a result of this re-conceptualization about the event, the old dysfunctional behavior responses and coping mechanisms are no longer necessary and healthier behavior pattern take over, thus improving the client's overall mental health.

How is CPT different from other therapies?
Cognitive Processing Therapy (CPT) is a variation of Cognitive Behavioral Therapy (CBT), which is what most people think of when they thing about "talk therapy." There are two primary differences between Cognitive Processing Therapy and Cognitive Behavioral Therapy. First, CPT is strictly trauma-focused. Think of it as regular "talk therapy," but with tunnel vision on one specific trauma. And second, CPT is very structured. Whereas traditional CBT is usually free-flowing and the conversation takes you wherever it goes, CPT has an actual manual with specific steps and homework assignments. While CPT is single-trauma focused, the tools and skills learned with CPT generalize to other traumas or concerns. Many people with a complex history of multiple traumas find that after doing a series (usually 8-12 sessions) of CPT on one trauma, they have automatically applied their new way of thinking to other traumas without even realizing it!


What types of trauma does CPT help with?
CPT can be applied to almost any kind of trauma, including (but not limited to):

  • Childhood Physical, Emotional, or Sexual Abuse
  • Sexual Assault
  • Domestic Violence
  • Natural Disasters
  • Military Combat
  • Grief and Loss
  • Serious Accidents or Injuries

  • Miscarriage or Stillbirth
  • Traumatic Childbirth Experience
  • Relationship Trauma—Infidelity, abandonment, etc.
  • Medical Trauma
  • Serious Medical Diagnosis
  • Any other even that is perceived as traumatic or created PTSD responses.

How effective is CPT?
Cognitive Processing Therapy (CPT) has been around since the 1980’s and has been rigorously tested and been shown to be very effective in the treatment of Post-Traumatic Stress Disorder (PTSD). It's long-term presence has allowed for extensive research and further development of type-specific adaptations for certain types of traumas, such as sexual assault, military combat, etc. Most clients experience a noticeable reduction in symptoms within the first 4-5 sessions, with continued improvement over the remaining course of treatment. While it may be tempting to stop treatment early because you are "feeling better," it is important to complete the entire process in order to achieve complete results that not only reduce the likelihood of your symptoms returning, but can also withstand future potentially traumatic events. Also, like any type of therapy, the successful treatment largely relies on your commitment to doing the work. This is especially true for CPT, which requires weekly outside homework assignments. The bottom line is, the more you put into it, the more you will get out of it.

What does a CPT session look like?
Cognitive Processing Therapy (CPT) consists of three phases. First, we must assess the appropriateness of CPT, which involves confirming a PTSD diagnosis, ruling out contraindications, and identifying a specific traumatic event to work with. Next, we will do a little psychoeducation about how the brain gets “stuck” when trauma occurs and an overview of how we will work together to help you get "un-stuck." These two phases take 2-3 sessions.

Next comes the "working phase" of CPT. You will receive your own workbook, which will consist of many worksheets for us to use together as we take a close look at what happened, why it happened, how it has affected your current functioning, and what "thinking errors" need to be addressed. We will do some specific exercises (which you will also practice outside of session) to objectively re-evaluate your core beliefs about safety, trust, power and control, self-esteem, and intimacy. The use of weekly homework assignments is to help you becoming your own therapist, able to apply these new tools and skill throughout every aspect of your life.

Is CPT right for me?
Just like people have different "learning styles" (visual, verbal, tactile, etc.), everyone processes information and events differently. For some people, cognitive (thinking and logic-based) approaches produce the best results, while others may find cognitive approaches frustrating, overwhelming, or simply ineffective. Every person and situation is unique and must be assessed accordingly. If you are interested in CPT, make sure to mention it when we meet, so I can gather the necessary information to determine if CPT would be an appropriate fit for you. At the same time, I will provide information about any other therapies that I think are worth considering so you can make an informed decision about how you would like us to proceed.