What Is Cognitive Processing Therapy (CPT)?

Cognitive Processing Therapy (CPT) is a type of talk therapy designed to help people who feel mentally “stuck” after something traumatic happened. It’s part of the cognitive behavioral therapy (CBT) family and is especially well-known for treating post-traumatic stress disorder (PTSD).

In simple terms, CPT helps you notice the story your mind tells about the trauma—what it means about you, other people, and the world—and then gently question the parts of that story that are painful, unfair, or just not true. Over time, that can lessen PTSD symptoms and help you feel more grounded, safe, and in control again.

At Evolve Counseling Services in Fort Collins, our therapists Ben Smith, LPC, and Lindsey Phillips, LPC, use CPT with clients who are healing from events like assault, abuse, accidents, medical trauma, military or first responder work, and other experiences that were way too much, too fast, or too soon.

Before we get into the step-by-step process, let’s talk about why CPT can be so helpful.

Benefits of Cognitive Processing Therapy

CPT is more than just “talking about the past.” It’s a structured way of changing how you relate to what happened and to yourself. Research has found that CPT can:

• Reduce PTSD symptoms and help them stay lower over time
• Shift harsh, negative beliefs about yourself (like “It was all my fault,” “I’m broken,” or “I’m weak”)
• Help you feel safer, more in control, and more connected in relationships

The benefits often spill over into other parts of life:

• Some people notice improvements in mood and anxiety.
• Others see changes in things like anger, shame, or emotional numbing.
• When trauma and substance use show up together, CPT can sometimes help reduce heavy or risky drinking as people start treating themselves with more compassion.

In everyday language: when you stop treating yourself like the villain of your own story, your choices, habits, and relationships often start to shift in healthier directions.

CPT doesn’t erase what happened, but it can change how much power it has over your daily life.

How Does CPT Actually Work?

CPT is a structured, time-limited therapy. The classic version is about 12 sessions, usually once a week for around an hour. It can be:

• One-on-one with a therapist
• Done in a group
• Or a mix of both

Evolve Counseling Services offers in-person or via secure online sessions.

Underneath the structure, CPT is based on one simple idea:

Trauma can shake the beliefs you used to have about yourself and the world.

Before the trauma, you might have thought things like:

• “The world is mostly safe.”
• “I can trust my judgment.”
• “Bad things happen, but not to me or the people I love.”

After the trauma, all of that can feel shattered. Suddenly, your brain might be saying:

• “Nowhere is safe.”
• “It was my fault.”
• “I can’t trust anyone.”
• “I’m permanently damaged.”

When your old beliefs and your new experiences collide, you can get “stuck” in painful thoughts that keep PTSD symptoms going. In CPT, those are called stuck points—short, powerful beliefs that feel true but are actually getting in the way of healing.

CPT helps you:

• Notice those stuck points
• Look at the evidence for and against them
• Replace them with more balanced, realistic thoughts

Your therapist doesn’t force you to think positively or pretend the trauma wasn’t serious. Instead, they help you see the trauma more clearly and more fairly, especially toward yourself.

What Happens During CPT? (The Main Phases)

Phase 1: Learning About PTSD and How CPT Helps (Psychoeducation)

There are common things that happen in the first few therapy sessions.

• Explain what PTSD is and how trauma affects the brain, body, and emotions
• Talk about how thoughts, feelings, and behaviors are all connected
• Ask about your symptoms and what you’d like to change
• Introduce the idea of stuck points. Those beliefs that feel true but keep you in pain

This part is more than just “education.” It’s about helping you understand that your reactions make sense in the context of what you went through, and that there are tools to help you shift them.

Phase 2: Understanding Thoughts and Feelings About the Trauma

Next, you and your therapist start looking more closely at what you tell yourself about the trauma and what it means.

You might:

• Notice patterns in your thoughts: blame, shame, “I should have…”, “I’m a bad person,” “I’m weak,” etc.
• Connect the dots between what you think, how you feel, and what you do
• Start identifying your personal list of stuck points

Many CPT therapists also use something called an impact statement. That’s a written reflection where you answer questions like:

• Why do I think this trauma happened?
• What does it say about me?
• What does it say about other people and the world?
• How has it changed my life and my beliefs?

You don’t have to be a great writer, and you don’t have to share every detail with a group if you’re in group therapy. Sometimes you only go over it privately with your therapist, or even just use it on your own as you move through treatment. An impact statement is about addressing why you think the incident happened more so than what happened to you. 

Some therapists will also ask you to write a more detailed account of the trauma itself—what happened, what you saw, heard, felt, and thought in the moment. This isn’t to torture you; it’s a careful, guided way of helping your brain process something it’s been trying to push away or make sense of.

Phase 3: Learning New Skills to Challenge Unhelpful Thoughts

Once you’ve identified some stuck points, your therapist teaches you practical tools to work with them.

In this phase, you learn how to:

• Spot automatic thoughts that pop up in response to triggers
• Notice patterns like black-and-white thinking, over-generalizing, or self-blame
• Ask questions like:
  • “What’s the evidence this is true?”
  • “Is there another way to look at this?”
  • “Would I say this to someone I care about?”

You’ll likely use worksheets or written exercises in session and as homework. For example, you might:

• Write down a stuck point, like “It was all my fault.”
• List the evidence that supports that thought.
• List the evidence that doesn’t.
• Work with your therapist to find a more accurate, less punishing version.

Over time, this doesn’t just change how you think about the trauma—it can shift how you think about yourself in general.

Phase 4: Shifting Core Beliefs and Moving Forward

In the last phase of CPT, the focus zooms out from the traumatic event itself and looks at how it affected big-picture beliefs in your life.

CPT often looks at five key areas where trauma tends to hit hardest:

• Safety – “I’m never safe anywhere.”
• Trust – “No one can be trusted, including me.”
• Power and control – “I’m completely helpless; bad things will always happen.”
• Esteem – “I’m worthless,” “I’m broken,” “I’m a bad person.”
• Intimacy – “I can’t get close to anyone,” “If people really knew me, they’d leave.”

You and your therapist work through stuck points in each of these areas and practice new ways of thinking and relating to yourself and others.

Near the end of treatment, you might:

• Rewrite your original impact statement from this new perspective
• Compare the “before” and “after” versions with your therapist
• Talk about situations in the future that might be challenging and come up with a plan for handling them

The goal isn’t to erase what happened—it’s to help you carry it in a way that doesn’t control your whole life.

How CPT and CBT Work Together

You might be wondering, “So is CPT just CBT (Cognitive Behavioral Therapy) with a different name?”

In a way, yes—CPT is actually built on CBT. They’re closely connected, and in real-life therapy, they’re almost impossible to separate.

Cognitive Behavioral Therapy (CBT) is the big umbrella. It’s a therapy and scientific approach that looks at how your thoughts, feelings, and behaviors all interact. CBT is used for a wide range of concerns—like anxiety, depression, panic, OCD, and more—by helping you:

• Notice unhelpful thought patterns
• See how those thoughts affect emotions and behavior
• Practice more balanced, realistic ways of thinking and responding

Cognitive Processing Therapy (CPT) grew directly out of CBT. It’s a specialized form of CBT created specifically for trauma and PTSD. Instead of trying to treat everything at once, CPT zooms in on one central question:

How did this trauma change the way I see myself, other people, and the world?

That’s why CPT and CBT are so intertwined:

• CPT uses core CBT tools like identifying automatic thoughts, challenging beliefs, and testing out new ways of thinking.
• It just points those tools directly at trauma—especially at stuck points like “It was all my fault,” “I’m broken,” or “No one is safe.”

At Evolve Counseling Services, we don’t put CBT in one box and CPT in another and make you choose. We often blend them together based on what you’re going through:

• If you’re dealing with anxiety, depression, or panic along with trauma, we might start with broader CBT skills:
  • Grounding and calming techniques
  • Coping tools for big emotions
  • Challenging everyday negative thoughts
• As you feel a bit more stable and supported, we can shift more deeply into CPT:
  • Exploring why you think the trauma happened
  • Looking at what you believe it means about you and your worth
  • Working through stuck beliefs that keep PTSD symptoms going

So it’s not really “CPT vs. CBT.” It’s more like:

• CBT gives the foundation—the basic tools and structure.
• CPT is a trauma-focused pathway built on top of that foundation.

Both approaches are evidence-based, and at Evolve, we use them hand in hand to support you as a whole person—not just a diagnosis or a list of symptoms.

CPT vs. Exposure Therapy

Another common question: “Is CPT the same thing as exposure therapy?”

Not quite, but they do overlap.

Exposure therapy for PTSD often focuses on:

• Gradually and safely facing memories, situations, or triggers you’ve been avoiding
• Staying with the distress long enough that your brain learns, “This is uncomfortable, but I can handle it,” or “I’m safe now.”

CPT also asks you to face the trauma—through writing, talking, and reflecting—but it goes a step further:

• In CPT, you don’t just re-tell the story.
• You actively look for thinking errors and stuck points inside that story.
• Your therapist helps you shift beliefs that are unrealistic, overly harsh, or based on incomplete information.

So:

• Exposure therapy focuses more on reducing avoidance and fear.
• CPT focuses more on changing the beliefs that grew out of the trauma.

Both can be powerful. Sometimes a therapist will even integrate ideas from both approaches, depending on your needs and goals.

Who Can CPT Help?

CPT was originally developed for PTSD, but it’s been used with many different kinds of trauma, including:

• Combat or military trauma
• Sexual assault or harassment
• Childhood abuse or neglect
• Intimate partner violence
• Serious accidents, natural disasters, or medical trauma
• First responder or frontline work

If you’re dealing with things like:

• Intense anger or irritability
• Feeling constantly on edge
• Fear or panic in certain situations
• Feeling numb, disconnected, or shut down
• A lot of shame or self-blame
• Feeling overwhelmed by emotions—or unable to feel much at all
• Trouble trusting yourself or others

CPT may be one option your therapist brings up as part of your treatment plan.

How Effective Is CPT?

CPT is considered one of the leading, evidence-based treatments for PTSD. Studies have shown that:

• Many people experience meaningful drops in PTSD symptoms during and after CPT
• Those gains often last well beyond the end of treatment
• It can also reduce trauma-related depression and other emotional difficulties

When therapists look at impact statements before and after CPT, they often see big changes. People move from statements full of hopelessness, self-blame, and fear to statements that sound more:

• Self-compassionate
• Realistic and balanced
• Hopeful about the future

They report improvements in things like:

• Trusting themselves and others
• Feeling safer in the world
• Enjoying relationships and intimacy
• Self-esteem and self-respect
• Feeling more capable and in control of their lives
• Tolerating difficult emotions without shutting down or exploding

None of this means CPT is magic or easy—but it does mean it’s a well-studied option with a solid track record.

Things to Think About Before Starting CPT

A few honest things to know:

• It can feel harder before it feels better.
• Talking and writing about trauma, examining long-held beliefs, and facing triggers is emotional work. It’s normal for symptoms to spike a bit at the beginning.
• You’re allowed to go at your pace.
• You and your therapist can talk about how quickly to move, how much writing to do at once, and what kind of support you might need between sessions.
• It’s not the only trauma therapy out there.
• Some people do better with other approaches, or a combination of therapies. A good therapist won’t push CPT if it’s not a fit or if you’re not ready.
• You don’t have to have everything “figured out” before you start.
• You don’t need the perfect words or a fully clear memory. Your therapist is there to help you sort through the confusion.

If you’re curious about CPT but also nervous (which is very normal), bring that up directly with your therapist. You can ask questions like:

• “What would CPT look like for me?”
• “How do we handle it if I start feeling worse?”
• “Can we adjust the pace if I get overwhelmed?”

Getting Started with CPT at Evolve Counseling Services

If you’re in Colorado or around Fort Collins and wondering whether CPT might help you move forward from trauma, you don’t have to figure it out alone.

At Evolve Counseling Services, our therapists Ben Smith, LPC, and Lindsey Philips, LPC:

• Use trauma-informed approaches like CPT and CBT together
• Move at a pace that feels safe and respectful to you
• Help you build coping tools while you work through the hard stuff
• Focus on seeing you as a whole person, not just a diagnosis or a traumatic event
• Can provide online and in-person therapy to best help you where it’s most comfortable

This article is for information only and isn’t a substitute for professional care, but if what you’ve read here resonates with your experience, that’s a good sign it might be worth exploring CPT with a trained therapist, and we can help you with the process and getting started.