Cognitive-Processing Therapy (CPT) Flashcards
Learn the basic premise of CPT
Who are the main people?
Patricia A. Resick
Schnicke
What is the root of CPT?
CPT, specifically designed for the treatment of PTSD resulting from sexual assault, consists of two integrated components: cognitive therapy and exposure in the form of writing and reading about the traumatic event.
What is the main premise of CPT?
The theory behind CPT conceptualizes PTSD as a disorder of non-recovery, in which a sufferer’s beliefs about the causes and consequences oftraumatic eventsproduce strong negative emotions, which prevent accurate processing of the traumatic memory and the emotions resulting from the events. Because the emotions are often overwhelmingly negative and difficult to cope with, PTSD sufferers can block the natural recovery process by usingavoidanceoftraumatic triggersas a strategy to function in day-to-day living. Unfortunately, this limits their opportunities to process the traumatic experience and gain a more adaptive understanding of it. CPT incorporates trauma-specific cognitive techniques to help individuals with PTSD more accurately appraise these “stuck points” and progress toward recovery.
The primary focus of the treatment is to help the client understand and reconceptualize their traumatic event in a way that reduces its ongoing negative effects on their current life. Decreasing avoidance of the trauma is crucial to this, since it is necessary for the client to examine and evaluate theirmeta-emotionsand beliefs generated by the trauma.
The first phase consists ofeducationregarding PTSD, thoughts, and emotions.The therapist seeks to developrapportwith, and gain the co-operation of, the client by establishing a common understanding of the client’s problems and outlining the cognitive theory of PTSD development and maintenance. The therapist asks the client to write an impact statement to establish a current baseline of the client’s understanding of why the event occurred and the impact that it has had on their beliefs about themselves, others, and the world. This phase focuses on identifying automatic thoughts and increasing awareness of the relationship between a person’s thoughts and feelings. A specific focus is on teaching the client to identifymaladaptive beliefs(“stuck points”) that interfere with recovery from traumatic experiences.
The next phase involves formal processing of the trauma. The therapist asks the client to write a detailed account of their worst traumatic experience, which the client then reads to the therapist in session. This is intended to break the pattern of avoidance and enable emotional processing to take place, with the ultimate goal being for the client to clarify and modify their cognitive distortions. Clinicians often useSocratic questioningto gently prompt the client, based on the idea that the client’s own arrival at new cognitions about their trauma, as opposed to unquestioning acceptance of the clinician’s interpretations, is critical to recovery. Alternatively, CPT can be conducted without the use of written accounts (in a variant known as CPT-Cognitive, or CPT-C), which some clinicians have found to be equally effective and perhaps more efficient. This alternative method relies almost entirely on Socratic dialogue between the therapist and client.
The final phase of treatment focuses on helping the client reinforce the skills they learned in the previous phase, with the intent that they can use those skills to further identify, evaluate, and modify their beliefs concerning their traumatic events.The intent is to allow the clients to exit treatment with the confidence and ability to use adaptive coping strategies in their post-treatment lives. This phase focuses on five conceptual areas that traumatic experiences most frequently cause damage to:[12]safety,trust,power/control,esteem, andintimacy. Clients practice recognizing how their traumatic experiences resulted in over-generalized beliefs, as well as the impact of these beliefs on current functioning andquality of life.
Four essential part
Educating the patient about the specific post-traumatic stress disorder (PTSD) symptoms and the way the treatment will help him/her.Informing the patient about his/her thoughts and feelings.
Imparting lessons to the patient to help him/her develop skills to challenge or question his/her own thoughts.
Helping the patient to recognise changes in his/her beliefs that happened after going through the traumatic event.
Structure of CPT individual sessionsEditTwelve 50-minute structured sessionsSessions typically conducted once or twice weekly. Patients complete out-of-session practice assignments
2 Formats:CPT includes a brief written trauma account component, along with ongoing practice of cognitive techniquesCPT-C omits the written trauma account, and includes more practice of cognitive techniques
Structure of CPT group sessionsEditTwelve 90-120 minute structuredgroup sessions
Typically conducted by two clinicians
8-10 patients per group
Patients complete out-of-session practice assignments
3 Formats:CPT includes a brief written trauma account component, along with ongoing practice of cognitive techniques. The details of the written accounts are not shared during sessions, but the emotional and cognitive reactions identified while writing the account are processed by the group.
CPT-C omits the written trauma account, and includes more practice of cognitive techniques.Individual and Group Combined includes practice assignments and the written trauma account, which are processed in additional individual therapy sessions.
How does CPT differ from AEDP?
The case of Grace…
Cognitive Processing Therapy (CPT)—an empirically- supported, trauma-focused therapy developed by Resick and colleagues (e.g., Resick, Monson & Chard, 2008)—also utilizes writing and sharing of these entries with the therapist; however, the timing, content, and structure of the writing components in CPT and AEDP-Writing differ appreciably. In CPT, writing assignments begin in the very first session and are utilized in every session thereafter, all assignments are directly trauma- and cognition-based [with a focus on the index trauma and its consequent impact on the individual in the areas of trust, safety, power/control, esteem, and intimacy], and specific cognitive restructuring sheets are also utilized throughout the course of therapy [typically 12 sessAEDP?ions]. In AEDP-Writing, assignments did not begin until the therapist determined that an emotional bond and adequate trust was established (session 14); only half of the writing assignments were trauma-based while the remainder were chosen at Pass’ discretion [they included childhood memory, letter to a friend, good memory of brother, comparative list of stress and soothing resources, free write, and disappointment as if it were a person]; and the structure of therapy was open, flexible, and emotion- and relationship-focused [ultimately lasting 40 sessions].
The Case of “Grace”. Pragmatic Case Studies in Psychotherapy, Volume 8, Module 2,
