Cognitive Processing (CPT) Therapists in British Columbia

What is Cognitive Processing Therapy (CPT)?

Cognitive Processing Therapy (CPT) is an evidence-based, structured psychotherapy for PTSD developed by Patricia Resick in the 1980s, originally for survivors of sexual assault and later validated across diverse trauma populations. CPT is based on the understanding that trauma can disrupt how we make sense of the world — altering beliefs about safety, trust, power and control, esteem, and intimacy in ways that maintain PTSD symptoms. The therapy focuses on identifying and challenging these trauma-related cognitions ("stuck points") to allow natural recovery to proceed.

What does CPT treat?

CPT is primarily used for PTSD resulting from a wide range of traumatic events — sexual assault, combat trauma, natural disasters, motor vehicle accidents, physical abuse, and complex developmental trauma. It is also effective for depression and other conditions that co-occur with PTSD. CPT has been widely implemented in military and veteran populations and has been adapted for diverse cultural contexts. It is recommended by major clinical guidelines including the VA/DoD and NICE as a first-line PTSD treatment.

How does CPT differ from EMDR and Prolonged Exposure?

All three are first-line evidence-based treatments for PTSD. EMDR uses bilateral stimulation to process traumatic memories directly. Prolonged Exposure works through detailed imaginal and in-vivo re-engagement with traumatic memories and situations, using habituation and extinction. CPT focuses primarily on challenging the unhelpful beliefs that have developed as a result of the trauma, with less emphasis on detailed narrative processing of the traumatic event itself. CPT may be preferable for people who are resistant to memory-focused approaches or who have multiple traumas.

What does CPT involve?

CPT is typically delivered over 12 sessions following a structured protocol. After psychoeducation about PTSD and the CPT model, clients write an impact statement describing their beliefs about why the trauma occurred and its effects on their life. Subsequent sessions involve identifying "stuck points" — problematic cognitions maintaining the PTSD — and using structured worksheets (Challenging Questions Worksheet, Patterns of Problematic Thinking) to examine and modify these beliefs. The five themes of safety, trust, power/control, esteem, and intimacy are systematically addressed.

How effective is CPT?

CPT is one of the most extensively researched PTSD treatments available. Dozens of randomized controlled trials across diverse populations and trauma types demonstrate its efficacy — approximately 50–70% of people who complete CPT no longer meet diagnostic criteria for PTSD at follow-up. Effect sizes are large and gains are durable. CPT is effective delivered individually or in group format, and in some studies a written-only version (CPT without the trauma account) has shown similar effectiveness to the full protocol.