Cognitive Processing Therapy (CPT) is a structured counseling approach that occurs over 12 sessions, usually lasting 50 minutes. Counselors using Cognitive Generation Therapy work with their clients to identify, change, and learn to challenge unhelpful beliefs related to the trauma they have experienced.
By learning to change and challenge unhelpful beliefs, clients can develop a new understanding of their trauma. When this shift occurs, clients notice a reduction in the distress they experience about their traumatic experience. Cognitive Generation Therapy begins by informing clients about their mental health problems, thoughts, and emotions and how they are all connected (American Psychological Association, 2017). Counselors work with their clients to identify automatic thoughts that contribute to mental health symptoms.
During CPT therapy sessions, clients are asked to complete exercises that involve describing the traumatic event they experienced and talking about details they would try to avoid. The purpose of this is to disrupt the client’s pattern of avoiding thoughts and feelings associated with the trauma (American Psychological Association, 2017).
Clients then use the skills they learn in the sessions in their daily lives and are asked to monitor their use of the skills they learn. Counselors can focus on various areas of the client’s life that have been affected by their trauma, including safety, trust, power, self-esteem, and intimacy (American Psychological Association, 2017). Read on to learn 10 Cognitive Process Therapy Exercises and Activities you can do with your clients.
Mental Health Concerns That Can Benefit from Cognitive Generation Therapy
Cognitive Generation Therapy is primarily used for people with post-traumatic stress disorder. This can include those who experienced childhood abuse and neglect, fighting, and aggression (American Psychological Association, 2017). CPT may not be well-suited for individuals struggling with non-trauma-related mental health disorders and individuals who are unable to participate in the prescribed writing exercises for 12 sessions.
Cognitive Processing Therapy Activities
Cognitive processing therapy activities can be used during individual and group therapy sessions to monitor the flow of events for CPT. The exercises used in Cognitive Generation Therapy are consistent because it is a structured therapeutic approach.
Cognitive processing therapy exercises that can be used during therapy sessions may include:
- An important aspect of Cognitive Generation Therapy is gathering necessary and relevant information about the client’s experience, distress, and general level of functioning. TherapyByPro offers Trauma History Questionnaire that can help the Counselors gather this necessary information as they begin to develop a treatment plan. This includes the client’s childhood history, current activities, target trauma, health since the traumatic experience, personality, substance use, and treatment plan. This form can then be used as a reference with clients when discussing your treatment plan, goals, and objectives. It can also help your client learn the details of their history, which can be addressed during Cognitive Processing Therapy sessions.
- Before starting with Cognitive Generation Therapy, you can talk with your client about the importance of showing kindness and compassion to themselves. When teaching PTSD psychoeducation, you can take the time to explore how they show kindness to themselves and the impact this has on our mental health, including self-esteem and symptoms of depression. Provide your client with a list of activities and behaviors they can use to show kindness and ask them to identify 3-5 they are willing to try before the next session. Encourage your client to do an activity every day and track their experience. TherapyByPro offers a Daily Self-Kindness Worksheet that clients can complete while practicing self-kindness.
- Writing an Impact Statement is a CPT exercise that clients are required to complete twice during the 12-session CPT experience. You will ask your client to write about how they were affected by their traumatic experience. Instead of explaining what caused their traumatic experience, ask your client to focus on their thoughts, feelings, beliefs, and behaviors that have been affected by their trauma.
As you approach the final stages of CPT, you will ask your client to write a new impact statement based on what they learned from their sessions. With this opportunity to reexamine affective statements, they can gain a different perspective on their trauma and how it affects their thoughts, feelings, beliefs, and behaviors.
In the final session, review the new impact statement and explore the differences that may have been observed in their first and second impact statements. Asking your client to complete two impact statements is an example of a structured CPT exercise you would use in your work.
- The CPT ABC Worksheet can be used to guide you as you psychoeducate your client or clients about how a traumatic event affects our thoughts and feelings. From here you can work with your client to break down their experience into this ABC model. You can then work with your client to address their sticking point and find healthier alternative thoughts that they can use to replace their automatic thought or belief. Encourage your client to keep the worksheet as a reminder and use it to track experiences that replace their thoughts outside of therapy.
- Counselors and Therapists can use Socratic Questioning when exploring the unhealthy automatic thoughts your client is experiencing. These questions are intended to help Counselors and Therapists understand the client’s perspective and can work gently to help them see new aspects of their existing beliefs. Socratic questions encourage reflection and problem solving, which can help facilitate some of the processes involved in Cognitive Process Therapy.
- You may find that some clients have difficulty identifying what feelings they are experiencing. This can be due to various factors such as avoidance and lack of awareness of different emotions, how they can affect us and how to cope with them when faced with difficulties. In this case, you can focus on exploring the different emotions your client is experiencing and how your client is affected by them. TherapyByPro offers Identifying Emotions Worksheet This can help your client determine what they are feeling and the overall intensity of their emotions. You can then have a discussion about which feelings your client is most likely to feel and what they are concerned about. This can help narrow down the coping skills your client will benefit from.
- Talk to your client about sticking points and how they may affect your client’s ability to move forward. Take the time to explore their sticking points and any experiences they struggle with. This CPT Stuck Point Worksheet Provides a list of common sticking points that can be used during sessions to help you find stuck points that your client is struggling with.
- People who have experienced traumatic events and experience post-traumatic stress disorder may struggle with many aspects of their lives, including intimacy. If this is a concern your client is struggling with, you can find it CPT Esteem Worksheet Available at TherapyByPro can help your client identify unhealthy beliefs that are affecting their ability to create intimacy or closeness in their relationship.
- People who struggle with self-esteem often have difficulty accepting compliments. Usage a Definitions Worksheet can provide a template that allows your customer to track the compliments they experience and how they feel when receiving a compliment. Take the time to review this worksheet and explore any stuck points your customer is having about accepting the compliments they receive.
- People who have experienced trauma often struggle with power and control in their lives. This could mean that they are trying to control things in their lives that are unrealistic or simply out of someone’s control. Exploring different aspects of clients’ lives using TherapyByPro Power and Control Worksheet It can help the client identify some areas of their life where they can work to release some of the control they hold on to. This change can have a positive effect on their mental health problems.
Final thoughts on selecting activities for CPT
Thanks for reading this resource on 10 Cognitive Process Therapy Exercises and Activities You Can Do With Your Clients. Therapists using Cognitive Generation Therapy follow a structured plan for their therapy sessions, typically consisting of 12 fifty-minute sessions. CPT can be effective in individual and group settings, allowing clinicians to use it both ways. CPT can be used in inpatient and outpatient settings, with the understanding that the client will have the support and skills necessary to cope with the distress they may encounter while completing Cognitive Generation Therapy tasks.
CPT activities and exercises should be avoided unless you have the necessary training and experience to use them. Each clinician is responsible for knowing the professional standards for their field and situation. Continuing Education Courses and other training opportunities can provide you with the necessary training to use Cognitive Process Therapy in your sessions.
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American Psychological Association. (July 31, 2017). Cognitive Processing Therapy (CPT). American Psychological Association. Retrieved March 30, 2023, from https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy.