Treating PTSD Patients with New Skills in Cognitive Processing Therapy

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury. The person will experience flashbacks of the event as well as other symptoms related to anxiety, such as hypervigilance. These symptoms disrupt the person’s daily life and are extremely distressing.

A wide population can experience PTSD, not just war veterans as the stereotype often depicts. So what are the treatment options for PTSD? Talk therapy and EMDR (Eye Movement Desensitization and Reprocessing) are some of the most talked about modes of treatment, but Cognitive Processing therapy has also proven to be a useful method.

According to a research article published by Science Direct, clients who participated in Cognitive Processing Therapy (CPT) for trauma saw significant decreases in PTSD related symptoms. The article also reported that, 
-Competent delivery of CTP treatment by a mental health professional with training in this modality was associated with lower next-session PTSD symptoms.
- The stronger the therapeutic alliance between client and clinician was associated with lower PTSD symptoms, as the participant was more likely to participate in CPT..
- Training in competence and alliance formation on the part of the counselor in CPT was more likely to improve outcomes
(Keef et. al, https://www.sciencedirect.com/science/article/abs/pii/S0005789421001490).

CPT is generally delivered over 12 sessions and helps patients learn how to challenge and modify unhelpful or irrational beliefs they have related to the trauma. The patient then creates a new understanding and conceptualization of the traumatic event so that it reduces its ongoing negative effects on current life. This does not erase memories of the event or even the hurt associated with those memories, but rather allows the person to process what happened to them and allow them to experience a decrease in their most intrusive symptoms. 

According to the Clinical Practice Guidelines for the Treatment of PTSD, Cognitive Processing Therapies, “[begin] with psychoeducation regarding PTSD, thoughts, and emotions. The patient becomes more aware of the relationship between thoughts and emotions and begins to identify ‘automatic thoughts’ that may be maintaining the PTSD symptoms. The patient writes an impact statement that details current understanding of why the traumatic event occurred and the impact it has had on beliefs about self, others, and the world.why the traumatic event occurred and the impact it has had on beliefs about self, others, and the world.”

Once the client has developed the skills necessary to identify unhelpful thinking and replace those thoughts, they can use those skills to continue evaluating and modifying beliefs related to their trauma. At this point, the therapist is helping the patient develop the ability to use these adaptive strategies outside of individual sessions to improve their quality of life. This can be a moving and empowering time for the client. Depending on the needs of the client, therapists may particularly focus on safety, power, esteem and intimacy as these are all areas that can be impacted by a traumatic experience.

Therapists who use CPT also frequently teach clients coping skills to help with feelings of anxiety that they may experience during treatment. Grounding and meditation practices are often used for more immediate relief for panic or anxiety attacks. If you have a loved one experiencing PTSD symptoms, it's important to get them evaluated by a mental health counselor, social worker, or psychologist. You can support them too, by being there for them, validating how hard their experience was, and giving them hope that they will get better.