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Cognitive Processing Therapy (CPT)

What is Cognitive Processing Therapy (CPT)?

CPT is an evidence-based and one of the most widely used streams of psychotherapy for treating Post-Traumatic Stress Disorder (PTSD) around the world. It is based on Cognitive Behavioural Therapy (CBT) but has slight modifications to address common areas of difficulties in patients who have PTSD. It is a 12-step structured program involving worksheets and educational resources that focuses on identifying your thinking in situations where you get stuck, choked up or in a rut, and evaluating from where they come; these thoughts are called Stuck Points. Then on the touchstone of reason/logic/values/utility/rhetoric, these stuck points are tested to see if they are valid and/or useful.

Then the same process is applied to five “modules”. These modules represent hierarchical and interdependent human needs that are commonly adversely affect in PTSD:



Sense of power/control



The aim of the treatment is to change the way our brains behave, neurophysiologically-speaking. There are a multitude of trauma reminders – many of which you are not consciously aware – that are encoded with the traumatic event. These reminders can be certain emotions, physical sensations, sensory perceptions, memories, thoughts that were encoded in our psyche. Our reactions to these can spiral out of control and cause significant clinical symptoms and interpersonal dysfunction. CPT, through language and Socratic Dialogue, is designed to turn the frontal lobe back on to put the brakes on our fear. It promotes intentional action rather than habitual reaction. Like this, we can create new and meaningful experiences rather than reliving the past events that dwell in the recesses of our memory and associated networks.

Our YouTube Channel has videos introducing you to CPT:

PTSD is not a condition that is experienced by soldiers who saw combat. It can happen in many contexts including car accidents. In fact, it is said that 12% of PTSD is accounted for by life-threatening traumatic events like car accidents; 30% are due interpersonal-network traumatic experiences like the unexpected death or traumatic event of a loved one and life-threatening illness of a child (Kessler et al., 2014). The chance of getting PTSD in one’s lifetime is estimated to be from 6.2-9.1% (Kessler et al., 2005; Van Ameringen et al., 2008; Koenen et al., 2017; Goldstein et al., 2016). While the majority of those who go on to develop PTSD onset within the first few months after a traumatic event, 25 percent experience a delayed onset after six months or more (Smid et al., 2009).

  • Goldstein, Risë & Smith, Sharon & Chou, S. & Saha, Tulshi & Jung, Jeesun & Zhang, Haitao & Pickering, Roger & Ruan, Wenjing & Huang, Boji & Grant, Bridget. (2016). The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Social Psychiatry and Psychiatric Epidemiology. 51. 10.1007/s00127-016-1208-5.
  • Kessler, Ronald & Rose, Sherri & Koenen, Karestan & Karam, Elie & Stang, Paul & Stein, Dan & Heeringa, Steven & Hill, Eric & Liberzon, Israel & Mclaughlin, Katie & SA, McLean & Pennell, Beth & Petukhova, Maria & Rosellini, Anthony & Ruscio, Ayelet & Shahly,
  • Victoria & Shalev, Arieh & Silove, Derrick & Zaslavsky, Alan & Viana, Maria. (2014). How well can post‐traumatic stress disorder be predicted from pre‐trauma risk factors? An exploratory study in the WHO World Mental Health Surveys. World Psychiatry 13: 265-274. World Psychiatry. 13. 265-274. 10.1002/wps.20150.
  • Kessler, Ronald & Chiu, Wai & Demler, Olga & Merikangas, Kathleen & Walters, Ellen. (2005). Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 62. 590-592. 10.1001/archpsyc.62.7.709.
  • Kessler, Ronald & Berglund, Patricia & Demler, Olga & Jin, Robert & Merikangas, Kathleen & Walters, Ellen. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of general psychiatry. 62. 593-602. 10.1001/archpsyc.62.6.593.
  • Kessler, Ronald & Sonnega, Shelby & Bromet, EJ & Hughes, Michael & Nelson, Christopher. (1996). Posttraumatic Stress Disorder in the National Comorbidity Survey. Archives of general psychiatry. 52. 1048-60. 10.1002/1099-1298(200011/12)10:6<475::AID-CASP578>3.0.CO;2-F.
  • Koenen, K. C., Ratanatharathorn, A., Ng, L., McLaughlin, K. A., Bromet, E. J., Stein, D. J., & Karam, E. G. (2017). Posttraumatic stress disorder in the world mental health surveys. Psychological Medicine , 47 (13), 2260-2274.
  • Smid, Geert & Mooren, Trudy & Mast, Roos & Gersons, Berthold & Kleber, Rolf. (2009). Delayed Posttraumatic Stress Disorder: Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Prospective Studies. The Journal of clinical psychiatry. 70. 1572-82. 10.4088/JCP.08r04484.
  • Van Ameringen, Michael & Mancini, Catherine & Patterson, Beth & Boyle, Michael. (2008). Post-Traumatic Stress Disorder in Canada. CNS neuroscience & therapeutics. 14. 171-81. 10.1111/j.1755-5949.2008.00049.x.

CPT offered in...

psychotherapy, IBFM Institute for Behavioural & Functional Medicine Ontario, Canada


Getting your mind in line with what you want