Cognitive Processing Therapy, better known as CPT, is a cognitive therapy that is commonly used to treat PTSD resulting from child abuse, sexual assault, natural disasters, and combat. This is a structured therapeutic approach that typically spans 12 therapy sessions. During this time, clients learn to challenge and modify unhealthy beliefs stemming from their traumatic experiences. Keep reading to explore 8+ Cognitive Processing Therapy techniques and interventions to use with clients.
CPT can be incorporated into residential and outpatient treatment sessions, enabling diverse applications. Residential programs may include multiple CPT-based sessions each week in addition to psychotherapy, skills training, and psychiatric care. Outpatient programs may include weekly or more frequent sessions, depending on the level of care provided. Outpatient treatment allows clients to use the skills they learn in real time, which can be effective when their symptoms are stabilized.
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5 Cognitive Processing Therapy Techniques
CPT techniques are cognitive tools that are incorporated into trauma sessions to help clients evaluate and challenge unhealthy beliefs that formed after a traumatic experience. These techniques address the underlying changes that trauma has made to a client’s perception of safety, trust, control, self-worth, and interpersonal relationships. After introducing your client to CPT techniques in session, you can encourage them to use them in real-life situations.
1) Identifying Stuck Points
A foundational part of CPT is helping clients notice where their thinking became rigid after trauma. These beliefs often develop as attempts to make sense of what happened, but over time they can keep clients emotionally and behaviorally stuck.
What It Is: Stuck points are rigid, trauma-based beliefs about oneself, others, or the world that interfere with recovery. Common examples include “It was my fault,” “I can’t trust anyone,” or “The world is completely unsafe.”
How It Helps Clients: Gaining awareness of stuck points helps them recognize beliefs that contribute to difficulties they experience, like guilt, shame, fear, and avoidance. This can provide a clear path to making changes in daily life.
How To Do It: You can help your client identify stuck points during the session and spend time on the ones that resonate with them. You can revisit these points as they come up in later sessions during cognitive work.
2) Impact Statement
Impact statements give clients an opportunity to reflect on how trauma has shaped their core beliefs about themselves, others, and the world, creating a foundation for identifying stuck points and tracking belief changes over the course of treatment.
What It Is: Impact statements are narratives your client will write that describe how their trauma affected their beliefs about safety, trust, power, self-esteem, and intimacy. This does not focus on recounting the details of their trauma.
How It Helps Clients: Impact statements bring hidden assumptions to the surface, allowing your client to see how they contribute to emotional symptoms or difficulties. Repeating this technique allows clients to see the outcomes of treatment firsthand.
How To Do It: You will ask your client to write an impact statement early in their treatment and encourage them to revise it later, once their beliefs and assumptions are balanced
3) Cognitive Restructuring
Cognitive restructuring teaches clients how to systematically evaluate trauma-related thoughts, helping them distinguish facts from interpretations and reduce rigid or extreme thinking patterns that contribute to ongoing symptoms.
What It Is: Cognitive restructuring is a classic cognitive technique that focuses on evaluating the evidence for and against thoughts and beliefs.
How It Helps Clients: This CPT technique can increase awareness of unhealthy thoughts or beliefs, and give clients an opportunity to challenge them. This can reduce extreme thinking patterns, emotional reactivity, and other trauma-related symptoms.
How To Do It: You will help your clients learn to evaluate their thoughts and beliefs by focusing on facts, rather than emotions or feelings. They can then replace unhelpful thoughts or beliefs with realistic alternatives. Worksheets can be used to bring attention to common unhealthy thoughts or beliefs.
4) ABC Worksheets
ABC worksheets provide a concrete way to show clients how thoughts mediate emotional and behavioral responses by breaking experiences into triggers, beliefs, and consequences, making cognitive patterns more visible and changeable.
What It Is: ABC worksheets break experiences into Activating events, Beliefs, and Consequences (emotions and behaviors). This structure highlights how beliefs — not events alone — drive distress.
How It Helps Clients: Clients gain insight into where change is possible and learn that emotional reactions are understandable responses to beliefs, not personal failures.
How To Do It: Have clients complete ABC worksheets using recent triggers. Review them collaboratively, helping clients identify stuck points and consider alternative beliefs.
5) Skills Practice
Skills practice reinforces CPT learning by helping clients apply cognitive and emotional processing tools in real-life situations, strengthening their ability to respond differently to trauma-related triggers outside of sessions.
What It Is: Skills practice involves the intentional use of CPT tools outside therapy.
How It Helps Clients: This CPT technique helps promote the use of skills that strengthen long-term recovery.
How To Do It: You can invite your clients to practice CPT skills outside the session and review their process in their next sessions. Review what worked and if they felt anything could be improved.
6) Challenging Questions
Challenging questions help clients examine stuck points more deeply by prompting them to evaluate evidence, responsibility, and alternative explanations, reducing self-blame and overgeneralized conclusions.
What It Is: This technique uses structured Socratic questions to examine stuck points, such as questions about evidence, responsibility, hindsight bias, and overgeneralization.
How It Helps Clients: Challenging questions help clients move away from self-blame and absolute thinking, increasing cognitive flexibility and emotional relief.
How To Do It: Use CPT challenging question worksheets or ask questions verbally in session. Encourage clients to apply the same questions independently over time.
7) Patterns of Problematic Thinking
Reviewing patterns of problematic thinking helps clients identify common cognitive distortions that arise after trauma, increasing awareness of how these thinking styles influence emotional reactions and behavior.
What It Is: Patterns of problematic thinking include all-or-nothing thinking, emotional reasoning, mind reading, catastrophizing, and minimization.
How It Helps Clients: Recognizing patterns helps clients depersonalize their thoughts and see them as learned responses rather than facts.
How To Do It: Review examples of problematic thinking styles and help clients identify which ones show up in their own trauma-related beliefs. Link these patterns to stuck points.
8) Trauma Account (Written Trauma Narrative)
The trauma account helps clients engage with avoided memories in a structured way that allows distorted interpretations and emotional responses to be identified and addressed using CPT cognitive tools.
What It Is: The trauma account is a written description of the traumatic event used to identify distorted interpretations and emotional responses connected to the memory.
How It Helps Clients: Clients often experience reduced avoidance and decreased emotional intensity over time. The narrative provides rich material for identifying stuck points and separating facts from interpretations.
How To Do It: Support clients as they write and review their trauma account. Read it aloud together when appropriate and identify associated thoughts, emotions, and beliefs.
3 Cognitive Processing Therapy Interventions to Use in Sessions
CPT interventions are therapeutic strategies used to facilitate the use of related techniques. You can use CPT interventions to support session progression and pacing, enabling you to use techniques safely and effectively. CBT interventions can be applied across a range of treatment programs, from residential to outpatient care.
1) Trauma Meaning and Belief Processing
CPT interventions can focus on how your clients’ beliefs about themselves, others, and the world were impacted by their trauma.
What It Is: This intervention is a guided exploration of what safety, trust, esteem, intimacy, power, and control mean to them.
How It Helps Clients: Clients can begin reducing overgeneralization and fear-based worldviews. They can also begin finding their identity after trauma.
How To Do It: Encourage your clients to explore how their beliefs changed after they experienced trauma. Explore the purpose of these beliefs and whether they are helpful. You can use CPT interventions, such as impact statement reviews, theme-based worksheets, and theme mapping.
2) Trauma Narrative Engagement
Trauma narrative engagement can help clients process their memories when they have been avoiding them.
What It Is: This can be a written or verbal account of their trauma that is used to pinpoint and examine distorted interpretations and emotional responses tied to the memory of their trauma.
How It Helps Clients: Clients reduce their use of avoidance behaviors and often find that the intensity of intrusive thoughts diminishes. This can also help them differentiate facts from unhelpful trauma-based interpretations.
How To Do It: You can support your client as they write or talk in detail about their traumatic experience. Spend time finding suck points and their related emotional responses. You can use CPT techniques like emotion labeling, re-reading their narrative aloud, or writing about their trauma.
3) Emotional Awareness and Tolerance Development
Emotional awareness and tolerance development can help address avoidance tendencies and avoidance behaviors that often follow traumatic experiences.
What It Is: This CPT intervention is a process used to help clients recognize, cope with, and regulate trauma-related emotions. This can decrease the use of avoidance, suppression, and dissociation.
How It Helps Clients: This CPT intervention can help reduce dissociation and strengthen their emotion regulation skills, thereby increasing their ability to cope with distress.
How To Do It: You can help your client identify their emotional responses in session and name them. Encourage them as they stay with the emotions, noticing as they come and go without judgment. This can be done with in-session emotion tracking, emotion identification exercises, and the incorporation of grounding skills.
Other Helpful Cognitive Processing Therapy Resources
TherapyByPro is a reliable resource for mental health professionals seeking evidence-based, customizable tools. Here, you’ll have access to unique worksheets, session note templates, treatment plans, and more. Resources are organized by mental health disorders or therapeutic approach, making it easy to find the right tools for your work. Examples of available CPT resources include:
Final Thoughts on Using Cognitive Processing Therapy in Sessions
CPT is a structured evidence-based therapy that uses interventions as the framework for clinical direction. Techniques can be used in session to reinforce the different processes in CPT, helping your clients meet their goals. When used together, interventions and techniques can help keep treatment on track and measurable.
Because CPT focuses on addressing the underlying causes of trauma-related symptoms, it can have a lasting impact on your clients’ emotional and psychological well-being. If you would like to learn more about CPT, we encourage you to explore training and continuing education opportunities in your field. Because CPT is a structured therapy, it is essential that you have the training and experience to apply it successfully
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