If you’re exploring therapy options, you may have come across cognitive processing therapy. This is an evidence-informed approach designed to help people understand their experiences and work through the thoughts that can keep distress going afterwards.
Here, we explore what cognitive processing therapy (CPT) is, what challenges it can help with, and whether it may suit your needs.
What is cognitive processing therapy (CPT)?
Cognitive processing therapy (CPT) is a structured form of talking therapy that focuses on how your thoughts can influence your emotions, especially after a distressing or traumatic experience.
A key idea behind CPT is that when something difficult happens, we naturally try to make sense of it. Sometimes this can lead to beliefs that feel convincing but may also keep us feeling stuck. These are sometimes referred to as ‘stuck points’, which may sound like:
- "It was my fault"
- "I can’t trust anyone"
- "The world isn’t a safe place."
The aim of CPT is to support people in working through trauma by exploring these thoughts and beliefs, understanding where they come from, and considering whether there may be other ways of looking at the situation.
How does cognitive processing therapy work?
CPT works by helping you notice the link between your thoughts, emotions, and reactions. This means that rather than trying to push thoughts away, the focus is on becoming more aware of them and exploring how they may be influencing your feelings.
In CPT, you’ll work with your therapist to:
- notice thoughts linked to distressing or traumatic experiences;
- understand how these thoughts affect your emotions and behaviour;
- explore whether these thoughts are helpful, accurate, or perhaps incomplete;
- consider alternative, more balanced perspectives.
CPT usually follows a structured approach, often over around 12 sessions, with your therapist supporting you to understand your experiences through practical exercises and reflective questions. However, sessions are paced to allow you to move through the process in a way that feels manageable.
Through CPT, many people find they develop skills to respond to distressing thoughts and feel more in control.
In practice, this may look like:
- thoughts feel less overwhelming;
- emotions are becoming easier to manage;
- distressing memories have less of an impact on daily life.
What can cognitive processing therapy help with?
Cognitive processing therapy is often used to support people who are experiencing persistent distress after difficult or traumatic events. For this reason, CPT is recommended by NICE for the treatment of trauma-related difficulties.
It may help with:
- distressing or intrusive memories;
- feelings of guilt, shame, or self-blame;
- anxiety or low mood linked to past experiences;
- relationship difficulties connected to trust or safety.
Additionally, CPT can be a particularly useful approach if you notice thoughts that feel repetitive, rigid, or difficult to question on your own.
What happens in a cognitive processing therapy session?
CPT sessions are usually structured, but still feel like a collaborative conversation in which you and your therapist explore how your thoughts are connected to your emotions.
There are often three stages to CPT:
1. Building awareness
The initial sessions of CPT often revolve around becoming more aware of the connection between your thoughts and emotions, especially identifying automatic thoughts that may be keeping you distressed.
This may involve talking about how experiences have affected you, identifying ‘stuck points’, and exploring beliefs you hold about yourself, others, or the world.
2. Processing trauma
Next, you move on to processing traumatic experiences from your past. This may involve writing about the event and then reading it aloud in the next session. This can help break the pattern of avoiding thoughts and feelings associated with the trauma.
In this stage, your therapist may support you in exploring and gently questioning unhelpful thoughts and beliefs related to the trauma. Some ways they may do this include asking open, reflective questions, guiding you through structured worksheets or exercises, and helping you examine the evidence for and against certain thoughts.
3. Strengthening new perspectives
Finally, you continue using the skills you’ve learned to keep evaluating and changing beliefs related to the traumatic events.
Over time, this can support a new understanding of the event, a more balanced view of yourself, others, and the world, and a reduction in its ongoing impact on your life. Your therapist can support you in exploring these alternative perspectives.
While CPT involves talking about difficult experiences, it isn’t about making you relive them. It focuses on understanding how you’ve made sense of what happened to you, and how those interpretations may be affecting you in the present.
Who might benefit from cognitive processing therapy?
You might consider cognitive processing therapy if:
- you feel ‘stuck’ after a difficult or traumatic experience;
- you notice persistent negative thoughts about yourself or others;
- certain memories feel hard to process or move past;
- you regularly experience guilt, shame, or self-blame;
- You prefer a structured and practical approach to therapy.
Is cognitive processing therapy right for me?
The following may be useful if you are considering cognitive processing therapy.
- Your thoughts around distressing events are often explored in CPT therapy, meaning it may bring up uncomfortable emotions at times.
- The process involves making connections among your thoughts and past events, and understanding how they are connected.
- You may be asked to complete exercises during or in between sessions, similar to homework.
- CPT is often limited to 12 sessions; however, this may be adjusted depending on your needs.
Many people find having a clear structure can feel reassuring, especially when working through complex or distressing thoughts and emotions.
How to find a cognitive processing therapist
If you are seeking support for distressing thoughts or memories affecting your life following traumatic events, CPT offers a structured way to understand your experiences and begin to move forward in a way that feels more manageable.
Working with a therapist trained in CPT can offer:
- support in understanding patterns that may feel ‘stuck’;
- guidance in exploring your thoughts safely;
- a structured framework to help you move forward.
Counselling Directory can support you as you explore your options by helping you find a therapist who matches your needs and preferences.
Content attribution
This article was written by Hayley Snelling, a qualified counsellor and well-being and body confidence coach, as well as a professional writer at PsychWrite.
The content was commissioned by Counselling Directory.
