How Cognitive Processing Therapy (CPT) treats Post-Traumatic Stress Disorder

If you’ve been struggling with long-lasting effects of trauma — flashbacks, anxiety, recurring nightmares, a negative view of yourself/others/the world, self-blame, or feeling stuck in the past — you’re not alone. Post-Traumatic Stress Disorder (PTSD) can make everyday life feel overwhelming. At Well Bee Counseling with Alexandra Holt, we offer a specialized approach called Cognitive Processing Therapy (CPT). It is a proven, evidence-based treatment designed to help you understand and change how trauma has impacted your thoughts, emotions, and daily life.

A Brief History of CPT

CPT was developed in the late 1980s by psychologist Dr. Patricia Resick. It was originally designed to support survivors of sexual assault. It has since been expanded and validated for a wide range of trauma survivors, including military veterans and individuals who have experienced interpersonal violence, accidents, or loss. Today, CPT is considered one of the most effective treatments for PTSD and is endorsed by leading mental health organizations, including the U.S. Department of Veterans Affairs (VA) and the American Psychological Association (APA).

The Purpose of CPT: Changing the Way Trauma Lives in the Mind

Trauma can fundamentally shift how we view ourselves, other people, and the world. CPT helps you recognize and revise those trauma-related beliefs that may be keeping you stuck.

The goal of CPT is to help you:

• Understand how your trauma has shaped your thinking
  
  
• Identify and shift “stuck points,” such as beliefs like “It was my fault” or “I’m permanently damaged”
  
  
• Regain a sense of clarity, safety, trust, and self-worth
  
  
• Feel less controlled by the trauma and more present in your life
  
  

At Well Bee Counseling, we guide you through these changes gently while using evidence-based therapeutic techniques.

Who Can Benefit Most from CPT?

CPT is especially helpful for individuals who have experienced what’s known as a "Criterion A" trauma. This is a term used in diagnosing PTSD. According to the DSM-5 (the manual clinicians use to define mental health conditions), Criterion A trauma refers to direct or indirect exposure to:

• Actual or threatened death
  
  
• Serious injury
  
  
• Sexual violence
  
  

Notice that the criteria is direct or indirect exposure. This means that you might have experienced the event first hand, or you may have witnessed or heard about it. So many clients have come to therapy and said they didn’t believe they had been through a trauma because it didn’t happen directly to them. Events can be traumatic just from hearing about them! 

Traumatic events might include surviving an assault, witnessing violence, a car accident, military combat, a natural disaster, or learning that a loved one experienced such trauma.

You don’t have to fit into a textbook definition of “criterion A trauma” to benefit from CPT. If a traumatic experience has left you feeling overwhelmed, changed, or “not like yourself,” this therapy may be a powerful and healing option.

How CPT Understands PTSD

CPT views PTSD not just as a response to trauma but as a problem in how the brain processes that trauma.

When something traumatic happens, our brains naturally try to make sense of it. But sometimes, the event is so overwhelming or unexpected that the mind struggles to fully process what occurred. Instead of integrating the experience into our memory in a healthy way, the brain gets “stuck” and tries to protect us by avoiding reminders or feelings associated with the trauma.

This avoidance can look like:

• Staying busy all the time
  
  
• Avoiding certain places, people, or conversations
  
  
• Pushing away emotions
  
  
• Trying not to think about what happened
  
  

While this kind of avoidance can feel protective in the short term, it can actually prevent the brain from completing its natural healing process. Over time, avoidance keeps the trauma frozen in the nervous system, leading to ongoing distress such as nightmares, emotional numbness, or hypervigilance. This is what ultimately contributes to Post-Traumatic Stress Disorder (PTSD).

CPT gently helps you return to the thoughts and beliefs surrounding the trauma. The goal is not to re-traumatize, rather, to reduce fear around traumatic memories and to support healing where the processing got interrupted.

Importantly, CPT does not require you to go into vivid detail about what happened. Instead, it focuses on what you tell yourself about the trauma — such as why it happened, or what it says about you. These meanings can deeply affect how you feel about yourself and the world. CPT offers a compassionate way to challenge and reshape them.

What Is the PCL-5?

Before and during CPT, we often use a tool called the PCL-5 (PTSD Checklist for DSM-5) to track symptoms. This is a short self-report questionnaire that helps us understand how PTSD may be affecting your life and how your symptoms are changing over time. It’s a helpful, research-backed way to measure progress and adjust therapy to meet your needs.

What to Expect in CPT at Well Bee Counseling

Here’s how the course of CPT typically unfolds at Well Bee Counseling:

1. Structured and Time-Limited

CPT is usually delivered over 12 sessions on average, but length of treatment is customizable to meet each client’s needs. CPT is delivered in weekly sessions. This focused approach ensures that you build momentum and develop specific tools to work through trauma.

2. Reflection and Writing Exercises

One key component of CPT involves writing about why you believe your traumatic event(s) happened and the beliefs surrounding it. This is not to relive it, in fact, discussing “why” it happened instead of “what” happened can help avoid re-experiencing the traumatic memory. Writing exercises help externalize and reframe distressing thoughts in a safe, supportive environment.

3. Identifying “Stuck Points”

Your therapist, Alexandra Holt, will help you identify and work through unhelpful beliefs that developed after the trauma. We’ll gently explore questions like:

• “Do I blame myself for what happened?”
  
  
• “What do I believe about trust, safety, or control now?”
  
  
• “Am I holding on to beliefs that no longer serve me?”
  
  

4. A Safe, Non-Judgmental Space

At Well Bee Counseling, therapy is always trauma-informed and non-pathologizing. That means we don’t view your symptoms as flaws or disorders. Instead, we see them as understandable reactions to overwhelming experiences. You are not broken; you are adapting. CPT honors this while helping you heal.

Let’s Begin

If you're ready to explore a therapy that is supportive, structured, and research-backed, Cognitive Processing Therapy may be a life-changing path forward. Healing doesn’t require reliving the past. It starts with understanding how that past lives inside you and gently changing the story.

Reach out to Well Bee Counseling with Alexandra Holt to schedule a consultation. You deserve to heal, and we’re here to help.