Cognitive Processing Therapy

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Liberty University *

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607

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Psychology

Date

May 9, 2024

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docx

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2

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Cognitive Processing Therapy (CPT) is a psychotherapy intervention developed over two decades ago by Dr. Patricia Resick and her colleagues. It has since emerged as a foundational component of cognitive-behavioral approaches to the treatment of Posttraumatic Stress Disorder (PTSD). The structured and manualized nature of CPT allows for its widespread dissemination and replication across diverse settings and populations, contributing to its substantial empirical support. One of the primary mechanisms of action of CPT is the identification and challenge of maladaptive cognitions and beliefs that have developed as a consequence of the traumatic event. These may include distorted beliefs about personal responsibility, safety, trust, and control over one's life. Through a systematic examination of the evidence supporting and contradicting these beliefs, CPT aims to promote more adaptive cognitive schemas and reduce the debilitating symptoms of PTSD. The efficacy of CPT for the treatment of PTSD has been extensively documented. A meta-analysis by Hembree et al. (2009) synthesized the results of 21 randomized controlled trials and concluded that CPT resulted in significant reductions in PTSD symptoms compared to control conditions and other psychological interventions. The Department of Veterans Affairs and Department of Defense (VA/DoD) also endorse CPT as a first-line treatment for PTSD based on its robust empirical evidence. This endorsement reflects the recognition of CPT's effectiveness in addressing the high prevalence of PTSD within veteran populations. However, the effectiveness of CPT may be influenced by various client factors. Those with a strong introspective capacity and positive social support may demonstrate greater engagement with and benefit from CPT. In contrast, clients with traits such as avoidance or difficulty with introspection may find the focus on confronting and processing traumatic memories challenging. Additionally, those with severe comorbid conditions may require adaptations to the standard CPT protocol to ensure feasibility and therapeutic benefit. Clients with a history of successful outcomes with cognitive-behavioral therapy (CBT) may respond particularly well to CPT due to the overlap in therapeutic techniques. This familiarity can enhance client engagement and outcome expectations, contributing to the positive effects of CPT. As CPT continues to be refined and disseminated, further research is warranted to explore its long-term outcomes, the mechanisms of change, and ways to enhance its effectiveness across diverse populations. The strong empirical support for CPT provides a solid foundation for these future investigations. CPT works well for soldiers dealing with guilt over things they wish they had done differently or feel responsible for because of a bad outcome they couldn't change. It is not clear how CPT helps soldiers deal with the deeper guilt and pain from losing someone or feeling they did something wrong.
There are no specific exercises or conversations to show how this guilt should be processed. This makes it hard for therapists to know what to do when facing these tough issues. Without clear steps, it's hard to say if their approach will work the same way every time. References Hembree, E., et al. (2009). Cognitive processing therapy for PTSD: a review of the empirical support. Clinical Psychology Review, 29(1), 103-112. Laifer, A., Amidon, A., Lang, A., Litz, B. (2015). Treating War-Related Moral Injury and Loss with   Adaptive Disclosure : A Case Study. In: Ritchie, E. (eds) Posttraumatic Stress Disorder and Related Diseases in Combat Veterans. Springer, Cham. https://doi.org/10.1007/978-3-319-22985-0_23 VA/DoD (2017). Clinical Practice Guideline: Management of posttraumatic stress disorder and acute stress reaction in adults. Washington, DC: Department of Veterans Affairs
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