Module 1: Foundational Skills of CPT

Question 1

Briefly describe cognitive processing therapy

Answer 1

CPT requires patients to talk about the traumatic event and how it has affected them. Traumatic events, by definition, are distressing and disturbing, and they are often nearly as difficult for therapists to listen to as they are for patients to talk about. Avoiding things that make us uncomfortable is a common coping mechanism that we all use, and in PTSD extreme avoidance is a core element of the disorder. Learning how to manage our patients’ - and our own - tendencies to avoid dealing with traumatic material, or “avoiding avoidance,” is critical in CPT.

Question 2

What do therapists delivering CPT need to recognize in their clients?

Answer 2

Therapists who deliver CPT have to recognize patient avoidance and encourage their patients to overcome it.

Question 3

How may patients avoid talking about their trauma?

Answer 3

Patients can attempt to avoid talking about their traumatic event in numerous ways, including changing the subject, minimizing aspects of what happened, “forgetting” to do a practice assignment, or even not showing up for scheduled sessions.

Question 4

What are therapists encouraged to do when avoidance comes up?

Answer 4

In CPT, therapists are encouraged to educate patients about avoidance and to label it when it happens.

Question 5

How may therapists acknowledge avoidance to their clients?

Answer 5

Sometimes this requires being quite direct with patients and reminding them that their avoidance is helping to maintain their PTSD symptoms.

Question 6

What do therapists delivering CPT need to recognize within themselves?

Answer 6

Therapist avoidance

Question 7

Why may a therapist avoid to discuss a trauma?

Answer 7

1) Reading and hearing graphic material can be overwhelming.
2) Therapists, because of their desire to “protect” the patient from becoming distressed during sessions, may allow patients to avoid talking about upsetting material (e.g., overlooking a patient’s failure to complete a practice assignment).

Question 8

Why is therapist avoidance discouraged in CPT?

Answer 8

Because it does not facilitate recovery

Question 9

What are stuck points?

Answer 9

Stuck points are defined as conflicting beliefs or strong negative beliefs that create unpleasant emotions and problematic or unhealthy behaviors

Question 10

What is a fundamental principle in CPT?

Answer 10

A fundamental assumption of CPT is that these dysfunctional beliefs get clients “stuck” in the natural recovery process that usually occurs after a traumatic experience.

Question 11

Do most people who experience a traumatic event obtain PTSD?

Answer 11

Research shows that many people have PTSD symptoms or other related problems immediately after a traumatic experience, but most recover in the first few weeks or months afterwards.

Question 12

If people who are exposed to a trauma don’t recover within 6-months of exposure, what does CPT assert?

Answer 12

If they don’t recover, it is because some stuck point in their belief system has interfered with normal recovery.

Question 13

What is a central tenant of cognitive therapy?

Answer 13

Everyone develops a set of core beliefs about the world and other people. Sometimes these core beliefs are positive (e.g., the world is safe), and sometimes they are negative (e.g., people can’t be trusted)

Question 14

What’s an example of a positive core belief?

Answer 14

The world is safe

Question 15

What’s an example of a negative core belief?

Answer 15

People can’t be trusted

Question 16

If a traumatic event occurs how is it interpreted in which context?

Answer 16

When a traumatic experience happens, it is interpreted in the context of a person’s pre-existing core beliefs.

Question 17

What are the three ways to resolve the conflict?

Answer 17

1) Alter the view of themselves or the event to fit prior beliefs
2) Change their prior beliefs in an exaggerated fashion
3) Modify their prior beliefs to incorporate the traumatic event without abandoning a positive world view

Question 18

Give an example of “alter the view of themselves of the event to fit prior beliefs”

Answer 18

I must have done something wrong because bad things don’t happen to good people

Question 19

Give an example of “change their prior beliefs in an exaggerated fashion”

Answer 19

I can never trust any man again because all men are potential rapists and might attack me

Question 20

Give an example of “modify their prior beliefs to incorporate the traumatic event without abandoning a positive world view”

Answer 20

Some people and places are dangerous, but the risk of danger in most situations is tolerable

Question 21

Which resolution is good?

Answer 21

Modify their prior beliefs to incorporate the traumatic event without abandoning a positive world view.

Question 22

What is the job of therapists in CPT?

Answer 22

it is the therapist’s job to begin to identify possible stuck points, and help the patient recognize and then challenge them using the cognitive therapy technique