Cognitive Processing Therapy in Addiction: Meaning, Benefits and How it Works

In addiction treatment, Cognitive Processing Therapy can help confront traumatic thoughts and feelings, as well as address co-occurring PTSD and addiction. Apart from treating addiction and PTSD, CPT can help you restructure your cognitive patterns, improve your overall well-being, and enhance your coping mechanisms.

What is Cognitive Processing Therapy (CPT)? 

Cognitive Processing Therapy (CPT) is an evidence-based addiction treatment that focuses on changing the problematic thoughts and beliefs related to a traumatic event. CPT helps individuals understand how their thoughts and feelings are connected. The main goal of Cognitive Processing Therapy is to help individuals process their traumatic experiences in a more balanced way. 

This involves challenging and modifying unhelpful beliefs and perspectives that have developed as a result of the trauma. Cognitive Processing Therapy typically involves weekly sessions with a trained therapist and can also include homework assignments to practice new skills between sessions. This therapy is effective in reducing symptoms of post-traumatic stress disorder (PTSD) and improving the overall quality of life for those who have experienced trauma.

Where is Cognitive processing therapy used?

CPT has demonstrated its effectiveness in treating PTSD across various populations, including:

  • Combat veterans: Cognitive Processing Therapy (CPT) is utilized to address trauma related to combat experiences among veterans. Many combat veterans suffer from PTSD, and CPT has demonstrated effectiveness in helping them process and manage trauma, improving overall mental well-being.
  • Sexual assault victims: CPT is employed to assist individuals who have survived sexual assault in processing and coping with the psychological impact. Sexual assault survivors often experience PTSD, and CPT is beneficial in reducing symptoms and improving quality of life.
  • Trauma: CPT is applied broadly in the treatment of trauma-related disorders beyond specific events, addressing the impact of various traumatic experiences. It is recognized for its versatility in treating trauma, encompassing different sources such as accidents, disasters, or witnessing violence.
  • Refugees: Refugees who have experienced traumatic events in their home countries may undergo CPT to help them process and cope with the psychological effects. CPT can be adapted to address the unique needs of refugees, providing a structured approach to dealing with the consequences of displacement and trauma.
  • Child abuse: CPT is utilized to treat individuals, including children, who have experienced abuse, helping them process and overcome the psychological impact. Children exposed to abuse can increase the chance of developing PTSD, and CPT is applied to alleviate symptoms, enhance coping mechanisms, and support overall recovery.

How Can (CPT) Cognitive Processing Therapy help with addiction treatment?

Cognitive Processing Therapy (CPT) plays a crucial role in addressing addiction when it co-occurs with Post-Traumatic Stress Disorder (PTSD). If you or someone you know is dealing with both PTSD and substance use disorders, here’s how CPT can be a valuable part of the treatment journey:

  • Cognitive Processing Therapy assists in confronting thoughts and feelings related to traumatic experiences, focusing on their causes and impact on beliefs.
  • It teaches individuals to evaluate the validity of negative thoughts and replace them with realistic and positive ones, contributing to overall mental health.

While Cognitive Processing Therapy is not a standard addiction treatment, its effectiveness in addressing trauma-related issues can significantly contribute to a comprehensive approach to treating substance use disorders and mental health. 

How Does Cognitive Processing Therapy Work?

Cognitive Processing Therapy (CPT) is a targeted and evidence-based approach designed to address post-traumatic stress disorder (PTSD) through a series of 12 treatment sessions. During these sessions, individuals work with therapists to challenge and modify unhelpful beliefs stemming from trauma. The focus is on empowering individuals to evaluate and change upsetting thoughts linked to their traumatic experiences.

The treatment session dynamic involves a cognitive-behavioral framework, where therapists guide patients in assessing thoughts surrounding significant trauma. This process aims to foster a new understanding of the traumatic event, ultimately helping patients overcome negative thought patterns. These patterns often lead to feelings of worthlessness and uncertainty, reinforcing the need to address cognitive distortions through therapy techniques.

Cognitive Processing Therapy operates on the principle that our thoughts profoundly influence our feelings. After a traumatic event, individuals tend to experience a shift in thought patterns, contributing to the manifestation of PTSD symptoms. Therapy techniques involve challenging assumptions about traumatic events, a demanding yet necessary task for achieving emotional progress and mitigating the effects of trauma.

The therapist can recommend specific exercises to be performed between sessions, enhancing the effectiveness of the cognitive restructuring process.

This therapy doesn’t only aim at cognitive restructuring but also focuses on helping individuals understand and process their traumatic experiences, effectively reducing painful symptoms associated with trauma. Emphasizing research-supported treatment, Cognitive Processing Therapy acknowledges the profound impact of negative or traumatic experiences on an individual’s mental well-being.

What are the procedures during Cognitive Processing Therapy?

Cognitive Processing Therapy (CPT) is a structured and effective approach to post-traumatic stress disorder (PTSD) treatment. Let’s dive into the essential procedures during CPT:

1. Assessment:

The initial phase involves a thorough assessment to determine the suitability of the individual for CPT. This includes diagnosing PTSD and identifying treatment priorities.

2. Psychoeducation:

The second phase focuses on providing the individual with comprehensive psychoeducation about PTSD and the workings of Cognitive Processing Therapy. This step ensures a clear understanding of the treatment process.

3. Cognitive Therapy Techniques:

CPT employs cognitive therapy techniques to address and challenge faulty thoughts associated with traumatic events. This crucial step helps individuals recognize and modify unhelpful beliefs.

4. Challenging Thoughts About Trauma:

Therapists actively engage patients in challenging their thoughts about the traumatic event. Techniques such as Socratic questioning are used to explore and reshape these thoughts.

5. Trauma Account:

In this step, individuals write a detailed account of their worst traumatic experience. This trauma account is then processed collaboratively with the therapist, promoting a deeper understanding and emotional processing.

6. Cognitive Restructuring:

CPT guides individuals through cognitive restructuring, teaching them to evaluate the validity of their thoughts. This involves replacing negative and distressing thoughts with more realistic, adaptive, and positive ones.

7. Delivery:

Cognitive Processing Therapy is typically delivered over 12 sessions, each lasting approximately 60–90 minutes. The sessions are held once or twice a week to maintain continuity and support the therapeutic process.

8. Adaptability:

CPT is adaptable to various settings, allowing for both individual and group sessions. It has also been successfully delivered through telebehavioral health, ensuring accessibility and flexibility in treatment options.

Who performs Cognitive Processing Therapy?

Licensed therapists who have undergone specialized training are the professionals responsible for performing Cognitive Processing Therapy (CPT). These therapists receive certification to use CPT in treating PTSD and related conditions. To maintain their status, CPT providers must submit therapy session recordings for review and meet specific criteria every three years. Quality-rated CPT providers, with licenses also lasting three years, adhere to additional criteria, ensuring a high standard of therapy. 

The importance of choosing a trained therapist for CPT is essential, emphasizing that not every therapist is eligible to provide this specialized therapy. Healthcare providers can recommend eligible CPT providers, highlighting the significance of seeking trained individuals for optimal care. In summary, licensed therapists, specifically trained in Cognitive Processing Therapy, play a pivotal role in delivering effective and evidence-based treatment for individuals dealing with PTSD and related conditions.

What are the Benefits of Cognitive Processing therapy?

Cognitive Processing Therapy (CPT) offers significant benefits for individuals dealing with trauma and PTSD-related symptoms. The therapy, designed to reduce anxiety and anger, helps people recognize and address negative thoughts that hinder recovery from PTSD.

Here are the top benefits of CPT:

  • Addresses self-defeating thoughts and beliefs related to trauma.
  • Effective treatment for individuals with PTSD.
  • Helps in overcoming the psychological impact of trauma.
  • Focuses on restructuring maladaptive cognitive patterns.
  • Provides a structured approach to processing traumatic experiences.
  • Contributes to improving overall mental well-being.
  • Offers a valuable tool for addressing substance use disorders.
  • Assists in reducing symptoms associated with PTSD.
  • Can be crucial in managing co-occurring conditions like alcohol addiction.
  • Enhances self-awareness and coping mechanisms.

Moreover, a 2014 study published in the Journal of Traumatic Stress by K Mullen and team explored CPT's effectiveness in reducing self-reported symptoms of PTSD and depressive symptoms for male veterans with military sexual trauma (MST)-related PTSD.

CPT stands out for its holistic approach, incorporating evidence-based strategies, addressing unique challenges, and providing individuals with coping skills to improve their overall well-being.

What are the phases of Cognitive Processing Therapy?

The process of Cognitive Processing Therapy (CPT) is structured into distinct phases, each designed to address specific aspects of trauma-related symptoms:

Psychoeducation (First Phase):

  • Involves learning about thoughts, feelings, and PTSD.
  • Provides an overview of the treatment process and rationale.
  • Addresses symptoms of PTSD.
  • Aim to raise awareness of the impact of beliefs about trauma on feelings.
  • Includes writing an impact statement about how the traumatic event has influenced beliefs.

Processing of Trauma (Second Phase):

  • Focuses on processing the traumatic event and identifying negative thoughts.
  • Requires individuals to write a detailed account of their traumatic experience.
  • Involves reading the written assignment in the following session.
  • Discusses the meaning of the traumatic experience to identify stuck points or self-blame issues.
  • Utilizes a Socratic style of questioning to modify negative thinking patterns.

Consolidation (Third Phase):

  • Involves consolidating gains made in previous phases.
  • Develop a plan for maintaining progress.
  • Focuses initially on changing negative thoughts involving self-blame.
  • Shifts the focus to other beliefs affected by the traumatic event, including trust, power, intimacy, and self-esteem.

These phases illustrate the systematic and progressive nature of CPT, providing a comprehensive approach to addressing diverse aspects of trauma-related symptoms throughout the treatment process.

What techniques are used in Cognitive Processing Therapy

Here are the most common techniques used in Cognitive Processing Therapy.

Cognitive Restructuring:

  • Helps individuals evaluate the validity of their thoughts.
  • Aims to replace negative thoughts with more realistic, adaptive, and positive thoughts.

Challenging Thoughts About Trauma:

  • Involves challenging faulty interpretations and thoughts about the traumatic event.
  • Utilizes techniques such as Socratic questioning to address negative thinking patterns.

Trauma Account:

  • Involves writing a detailed account of the traumatic experience.
  • This written account is processed with the therapist.

Safety, Trust, Power, Control, Esteem, and Intimacy (STPCE):

  • Therapists focus on these areas affected by traumatic experiences.
  • Aims to help individuals address related beliefs.


  • CPT is generally delivered over 12 sessions.
  • Each session lasts approximately 60–90 minutes.
  • Sessions are usually held once or twice a week.

Socratic Questioning:

  • Therapists use a questioning technique to help patients examine the evidence for and against negative thoughts and beliefs.
  • Encourages critical thinking and challenges assumptions.

Thought Records:

  • Patients keep a record of negative thoughts and triggering situations.
  • Helps identify patterns and gain insight into thought processes.

Imaginal Exposure:

  • Involves vividly imagining and describing the traumatic event in a safe environment.
  • Helps confront and process emotions related to the trauma.

Challenging Core Beliefs:

  • Therapists guide patients in challenging and modifying negative core beliefs associated with the traumatic event.
  • Involves examining evidence for and against these beliefs.

How does CPT differ from the traditional Cognitive-Behavioral Treatment?

Cognitive Processing Therapy (CPT) differs from traditional Cognitive-Behavioral Therapy (CBT) in several key aspects:

AspectCognitive Processing Therapy (CPT)Traditional Cognitive Behavioral Therapy (CBT)
FocusSpecifically focuses on addressing negative thoughts related to traumatic events, helping individuals who are “stuck” in their thoughts about trauma by identifying and addressing conflicts known as “stuck points”1.Addresses a broader range of negative thoughts and behaviors without a specific focus on errors in thinking related to trauma2.
Trauma AccountInvolves writing a detailed account of the traumatic event, which is then processed with the therapist1.Typically does not include a detailed account of traumatic events as a part of the therapy process.
DeliveryGenerally delivered over 12 sessions, each lasting approximately 60–90 minutes, usually held once or twice a week1.May be delivered over a longer or shorter period, depending on the individual’s needs.
Structured ApproachHighly structured with a manual that outlines specific steps and homework assignments1.Generally free-flowing, allowing the conversation to go wherever it needs to without a strict manualized approach.
Positive ImpactsFound to be effective in reducing symptoms associated with PTSD and may have positive impacts in areas not specifically targeted during therapy1.Effectiveness varies, and its impact on areas outside the targeted symptoms is not as explicitly mentioned.
TechniquesUtilizes techniques such as cognitive restructuring, challenging thoughts about trauma, thought records, and imaginal exposure.Incorporates various techniques like cognitive restructuring, behavioral activation, and exposure therapy, addressing a wide range of issues.
Use CasesPrimarily used for individuals with PTSD or trauma-related disorders.Applied to a broad spectrum of mental health issues, including anxiety, depression, and substance use disorders.
Role of TherapistTherapists guide patients in challenging and modifying negative core beliefs associated with the traumatic event1.Therapists work collaboratively with patients, offering support and insights to address various cognitive and behavioral patterns

How does Cognitive Processing Therapy Tie into Cognitive Behavioral Therapy (CBT)?

Cognitive Processing Therapy (CPT) is a specialized form of cognitive-behavioral therapy (CBT) with distinct features aimed at modifying and challenging unhelpful beliefs related to traumatic experiences. While both fall under the broader umbrella of CBT, CPT specifically targets negative thoughts associated with trauma. It is structured, manualized, and typically spans 12 sessions, incorporating psychoeducation, cognitive restructuring, and techniques for challenging thoughts about trauma. The therapy process follows a manual with three phases: psychoeducation, trauma processing, and consolidation.

The main difference lies in focus—CBT addresses a wide range of mental health issues, while CPT concentrates on trauma and PTSD. Both therapies share the goal of identifying and challenging negative thoughts and beliefs to enhance mental well-being. CBT encompasses various therapeutic approaches, and CPT stands out as a specific intervention for PTSD.

CPT’s structured approach, emphasis on trauma-focused sessions, and its effectiveness in reducing PTSD symptoms contribute to its distinction within the CBT framework. The therapies emphasize the processing of traumatic events and their impact on thoughts and emotions, sharing a foundation in cognitive-behavioral principles.

Get Help at The Grove

At The Grove, CPT is a key component of our treatment offerings, specially designed to aid individuals in overcoming the psychological challenges associated with addiction. This therapy focuses on helping you understand and reframe negative thoughts and beliefs stemming from past experiences, which often contribute to addictive behaviors.

Our process involves structured sessions where you are gently guided to confront and process their thoughts and emotions, leading to significant improvements in your overall mental health. Contact us today to begin your journey to recovery.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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If you or a loved one is grappling with addiction, don’t face it alone. The Grove Estate is here to guide you on the path to recovery. With a compassionate team and a proven approach, we’re dedicated to helping you reclaim your life. Reach out to The Grove Estate today and take the first step towards a brighter, addiction-free future. Your journey to healing begins with a single call. Please reach out to us today at 765-327-4111 to book your appointment! And start your healing journey at our convenient facility.

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