Creating a Cognitive Processing Therapy Treatment Plan: What to Include + Example

Cognitive Processing Therapy, commonly called CPT, was developed by Dr. Patrica A. Resick in 1988. CPT is a structured therapeutic approach that is used to help those who are struggling with Post Traumatic Stress Disorder (PTSD). This approach includes 12 therapy sessions, lasting from 60 to 90 minutes.

CPT can be an effective approach in individual therapy sessions, as well as in a group setting with 6 to 10 group members, each of which is living with PTSD.  CPT can also be offered as a form of dual diagnosis treatment for those struggling with PTSD and other conditions, including substance use disorders.

With this approach, you’ll help your clients learn to evaluate and modify upsetting thoughts that are tied to their trauma. CPT is grounded in the belief that changing the way you think can affect the way you feel. Examples of commonly targeted thoughts are tied to feeling blame for the trauma, and believing that the world is unsafe.

CPT begins with psychoeducation to help clients gain a more in-depth understanding of PTSD and the symptoms they’re experiencing. Socratic questions are commonly used during the initial stages of CPT treatment. You may ask questions about the type of trauma your client experienced, without going into details of their trauma. 

As a structured approach, your 12 sessions will follow a set format. One of these steps includes asking your client to write a first impact statement. This exercise asks them to focus on how their trauma has affected them, compared to the event itself. You’ll later help your client determine if the facts of their trauma align with your thoughts. As an example, someone who is carrying the blame for their trauma may be asked to evaluate the responsibility they had in the situation to determine their role in the event. This allows your clients to determine for themselves if it would be appropriate to try and gain a new perspective.

View all of our Cognitive Processing Therapy Worksheets

Setting Goals and Objectives With Clients in a Cognitive Processing Therapy Treatment Plan

The effectiveness of CPT ranges in studies, with the National Center for PTSD noting that 40% of Veterans who engage in CPT no longer meet clinical criteria for PTSD when they completed treatment. Examples of overall improvements noted in research include PTSD symptoms, depression, anxiety, guilt, and adjustment challenges.

Worksheets are commonly incorporated into CPT sessions and used as homework assignments to be completed at home. TherapyByPro is a leading resource for mental health professionals, offering an assortment of mental health worksheets, including CPT worksheets. Examples of documents you could use to enhance your therapy sessions include:

• CPT Worksheet Bundle
• CPT Trauma History Questionnaire
• CPT Stuck Point Log
• CPT Impact Statement Worksheet
• CPT Patterns of Problematic Thinking Worksheet

When you are setting your treatment goals for CPT, it is important to ensure that your goals align with CPT and the initial stages of treatment. You’ll want your goals to be realistic for your client, given their current support and resources.     

What to Include in a Treatment Plan for Cognitive Processing Therapy

For the remainder of this article, we will focus on developing a cognitive processing therapy treatment plan, based on the TherapyByPro Treatment Plan Template. This is an editable document. Continue reading for Jane’s Story:

Jane’s Story:

Jane is a 24-year-old woman who was in a serious motor vehicle accident about 3 months ago, which has led to continued mental health distress. She was hit by a drunk driver, which caused serious physical injuries that required hospitalization and long-term physical rehabilitation. Jane indicated that she struggles with nightmares, flashbacks, hypervigilance, irritability, poor concentration, sleep disturbances, and limits her traveling to places she can walk or ride her bike. She noted that she has a hard time feeling happiness and joy and that she feels anxious and worried if she needs to travel by car.

Jane’s symptoms have had limited effect on her work, as she works remotely as a customer service representative. She did indicate that they have impacted her social life because she has not been engaging in as many girl nights with her friends as she previously did. After all, some occur in farther locations. Jane lives with her partner, who was described as patient and supportive. Jane indicated that when she does need to drive to an appointment, he will drive her to and from her appointment, providing support and encouragement throughout the trip. 

Jane spoke about her continued mental health difficulties with her physical therapist who referred her to the outpatient clinic you work in. After her initial assessment, it was determined that she does meet the clinical criteria for PTSD. She is not taking medications at this time, and was receptive to meeting with the on-staff psychiatrist. 

Agencies Involved and Plans for Care Coordination

The referring agency for this case is Jane’s Physical Therapist. It would be appropriate to touch base with this care provider to ensure comprehensive care.

Example for Jane:

Care Coordination:Physical Therapist John Doe, (123)456-7890

Clinical Diagnoses

Based on the information provided, Jane meets the clinical criteria for PTSD. Specific symptoms that align with this diagnosis include hypervigilance, nightmares, flashbacks, irritability, poor concentration, sleep disturbances, and difficulties experiencing positive emotions.

Example for Jane:

Clinical Diagnosis: Post Traumatic Stress Disorder 309.81 (F43.10)

Current Medications and Responses

Jane denied current medication use and was agreeable to meeting with the psychiatrist working within your outpatient clinic. Should she begin taking medications to improve her symptoms, you can modify her treatment plan to accurately reflect her treatment. 

Example for (name):

Current Medications: Post Traumatic Stress Disorder 309.81 (F43.10)

Presenting Problem and Related Symptoms

This section of your treatment plan allows you to include a case conceptualization in your treatment plan. The information included should align with your diagnosis, treatment goals, and specified interventions. 

Example for Jane:

Jane, a 24-year-old woman, presents with mental health distress following a serious motor vehicle accident three months ago. Jane indicated that she was hit by a drunk driver and that she sustained severe physical injuries requiring hospitalization and ongoing physical rehabilitation. Jane endorsed PTSD symptoms including nightmares, flashbacks, hypervigilance, irritability, difficulty concentrating, and disrupted sleep. Jane explained that she avoids car travel, opting for walking or biking instead. She discussed a diminished ability to experience happiness or joy. She often feels anxious and worried when car travel is unavoidable.

Jane noted that her psychological distress has caused minimal impact on her work as a remote customer service representative. She has experienced notable social withdrawal, including declining social outings requiring significant travel.

Jane reported that she currently lives with a supportive partner who assists with driving to appointments and provides encouragement. She was referred to the clinic by her physical therapist after discussing her ongoing mental health concerns. Her initial assessment confirms her PTSD diagnosis. Jane is not on medication but remains open to consultation with the clinic’s psychiatrist. Coordination with a referring physical therapist for integrated care is recommended.

Goals and Objectives

The goals and objectives of your CPT treatment plan should be specific to your client, and align with your chosen therapeutic approach. Since CPT is a structured therapy, your goals and objectives for this case will align with the initial stages of treatment.

Example for Jane:

Goal 1: Provide Psychoeducation About PTSD and CPT

• Objective 1: Identify her stuck points that are related to her trauma with the use of discussion and writing assignments.
• Objective 2: Explore the connection between her thoughts, emotions, and behaviors to increase her awareness of trauma-related patterns
• Objective 3: Introduce and utilize relaxation techniques to improve the management of PTSD symptoms

Goal 2: Increase Emotional Engagement and Reframe Negative Beliefs

• Objective 1: Explore emotions that are tied to her trauma through the use of worksheets
• Objective 2: Reframe maladaptive beliefs related to safety and trust with the use of Socratic questioning
• Objective 3: Identify and label emotions to improve her emotion regulation

Goal 3: Introduce and Implement New Coping Strategies

• Objective 1: Explore and begin using self-soothing exercises to use during triggering moments
• Objective 2: Begin engaging in meaningful activities that rebuild social connections
• Objective 3: Gradually reintroduce car travel with the use of exposure exercises

Specific Interventions to Be Used

In the next section, you can specifically outline interventions that can be used to help you work towards your client’s goals. This can be used as a reference before future sessions, offering reminders of interventions that can be used. 

Example for Jane:

Intervention 1:

Trauma Narrative Writing

Responsible person: Jane

Intervention 2:

Complete Stuck Points Worksheet

Responsible person: Jane

Intervention 3:

Psychoeducation Focused on CPT and PTSD

Responsible person: Counselor A

Intervention 4:

Socratic Questioning

Responsible person: Counselor A 

Intervention 5:

Behavioral Activation

Responsible person: Counselor A and Jane 

Family Involvement

Based on the information provided, it does not appear necessary to include family in her treatment.

Example for Jane:

Family Involvement: None at this time

Additional Services and Interventions

 Additional services and interventions that may be used to enhance her progress include a support group for trauma survivors, case management services, medication management services, and continued individual therapy after completing CPT. You can review these service options with Jane, and allow her to choose which services she would like to engage in. 

Example for Jane:

Additional Services: Review available services and allow her to choose which services she would like to engage in.

Estimation for Completion 

As a structured therapy, CPT takes place throughout 12 sessions typically occurring once per week.

Example for Jane:

Estimated Time for Completion:  12 weeks of individual therapy sessions

Aftercare Plans

Aftercare plans should be written as if Jane were to be discharged from treatment today. This section can be used as a referral resource in the event of an unexpected termination. 

Example for Jane:

Aftercare Plans: Meet with a primary care physician to ask for a mental health treatment referral and psychiatric care. 

Final Thoughts On Creating a Treatment Plan for Cognitive Processing Therapy

Cognitive processing therapy can be an effective treatment option for those who are struggling with post traumatic stress disorder. Research has shown that this approach can effectively decrease trauma-related symptoms including flashbacks and hypervigilance. Many find that their emotion regulation and stress management skills greatly improve as well.

CPT can help clients strengthen their relationships by decreasing irritability and improving their understanding of how their PTSD symptoms are affecting them. If you would like to learn more about cognitive processing therapy and how you can implement it into your work, we encourage you to look for local continued education and training opportunities. 

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here. We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health worksheets here.

View all of our Cognitive Processing Therapy Worksheets

Resources:

• Va.gov: Veterans Affairs. Cognitive Processing Therapy (CPT) for PTSD. (2018, August 10). https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp
• Va.gov: Veterans Affairs. Cognitive Processing Therapy for PTSD. (2019, March 20). https://www.ptsd.va.gov/professional/treat/txessentials/cpt_for_ptsd_pro.asp#:~:text=Forty%20percent%20of%20Veterans%20who,by%20the%20end%20of%20treatment.   

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