Key Takeaways
Cognitive processing therapy (CPT) is a structured, time-limited therapy shown to be highly effective for managing post-traumatic stress disorder (PTSD) and related conditions.
The therapy focuses on identifying and challenging “stuck points,” or unhelpful beliefs that keep you tied to the trauma.
CPT can help you understand how trauma has changed your thoughts and beliefs about yourself and the world and work toward healing.
Trauma is more common than you might think.
Up to 70% of people worldwide [1] will experience at least one potentially traumatic event in their lifetimes. Trauma can have a big impact on the way you feel about yourself and the world around you. But there’s hope for healing. Cognitive processing therapy (CPT) is one of the most effective treatments for trauma.
This type of therapy supports you in moving past “stuck points” that keep you linked to the trauma. Over time, CPT can help you feel grounded and safe again.
The core principles of cognitive processing therapy
CPT is based on the core principle that trauma changes the way you think about yourself and the world. Its main goal is to help you process the trauma and challenge the negative beliefs — especially self-beliefs — that you’ve developed as a result.
These beliefs are called “stuck points.” They’re thinking patterns that prevent you from processing and getting past the trauma. You’ve developed stuck points as a way to make sense of the traumatic event, but they’re not always accurate. They can either be thoughts about why you believe the traumatic event happened or thoughts about yourself or the world that have changed dramatically as a result of the trauma.
Stuck points might sound like:
“It was my fault that this happened. If I had behaved differently, I could have prevented it.”
“I’m a bad person and deserve bad things.”
“The world is an unsafe place.”
“I should have known this would happen.”
“If I let people get close to me, I’ll get hurt again.”
“If I let myself think about what happened, I’ll lose my mind.”
“I’m dirty.”
“I’m worthless and unlovable.”
“Nobody will ever be able to understand me.”
What to expect from cognitive processing therapy
CPT is a structured treatment program [2] that’s usually delivered over about 12 sessions. You can participate in CPT both individually as well in a group. Individual sessions typically last 60 minutes, while group sessions may last up to 90 minutes.
You’ll work through four main phrases of CPT together with your therapist. These include:
Stage 1: Psychoeducation
In this phase, you’ll learn about trauma and how it affects your brain and worldview. You’ll explore how trauma can lead to avoidance, emotional numbing, and distorted thoughts about safety, trust, and control. You’ll also discuss why these reactions are normal responses to abnormal experiences.
This stage mostly focuses on learning more about CPT treatment and what to expect. It’s a great time to ask any questions you may have about the therapy.
Stage 2: Trauma processing
In this stage, your therapist will help you remember and process the traumatic memories. They’ll do this in a safe way that doesn’t retrigger you.
Some specific techniques that your therapist might use to help you do this include:
Asking you to talk about the event
Inviting you to write down the story of what happened
Helping you identify thoughts and emotions that come up when you revisit the memory
This second phase is also when your therapist will help you identify the “stuck points” that are linked to trauma for you.
This can be an uncomfortable phase of treatment. Thinking about the trauma can be painful. You may have spent a long time trying to avoid memories about what happened. But it’s important to keep working through these memories so you can get to the other side and move forward.
Stage 3
The third stage is about challenging these stuck points or the unhelpful thoughts that have come from the trauma. This is done both during sessions as well as between sessions using worksheets.
The worksheets used in CPT help you identify the connections between events, thoughts, and emotions, and practice reframing distorted beliefs into more balanced ones. Over time, you’ll learn to question automatic negative thoughts, test them against evidence, and replace them with beliefs that feel truer and less self-blaming.
Stage 4
In the final few sessions of CPT, you and your therapist will work on five themes: safety, trust, power and control, esteem, and intimacy.
These are areas that trauma often affects.Your therapist will help you identify challenges and stuck points that you face in any of these areas. You’ll also complete worksheets during and in between sessions.
You may have to create new beliefs to challenge your stuck points, because the beliefs that you held before the trauma are no longer accurate.
For example, let’s take the theme of safety. Before experiencing assault, you may have believed, “I’ll be able to keep myself safe no matter what happens.” But the trauma happened, which disproved this point. Now you have a conflict, and you’ve developed the stuck point, “I can never keep myself safe. The world is an unsafe place.” In this situation, CPT will help you develop more realistic thoughts. You might replace your stuck point with, “This is very unlikely to happen again, and I can take steps to protect myself.”
Who benefits from cognitive processing therapy?
If you’ve experienced any traumatic event in your life that you feel “stuck” on, CPT can help.
Examples of traumatic events include:
CPT has been found to be very effective [3] for reducing symptoms of post-traumatic stress disorder (PTSD). It can also help reduce co-occurring depression. In fact, CPT is often used with veterans because it’s so effective for PTSD.
Regardless of if you’ve developed symptoms of PTSD after the event, it has probably affected the way you see yourself and the world. CPT can help you challenge these beliefs, find meaning after trauma, and move toward a sense of safety and connection.
How to get started with cognitive processing therapy
If you’ve been through trauma, CPT could help you move past it.
Look for a therapist who has experience using CPT to help people recover from trauma. It may help to ask questions about the type of trauma they specialize in, if any. For example, a therapist who works with combat veterans may not be appropriate for someone who’s experienced a natural disaster.
Another decision to make is whether you want to receive treatment individually or in a group setting. Both have benefits and drawbacks, but CPT has been found to be effective both ways. It’s just about what makes you feel the most comfortable and supported in your healing process.
Clinician's take
Many people think trauma therapy means reliving painful memories. In reality, approaches like CPT focus on understanding and reshaping the thoughts that keep you stuck — not re-experiencing the trauma itself.
Find care with Rula
Cognitive processing therapy helps you recognize how trauma has shaped your thoughts, emotions, and sense of self — and gives you tools to reclaim control over your life. With time and practice, many people find that CPT helps them feel lighter, more hopeful, and more grounded in the present.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 21,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
