Comparing Trauma Therapies: Cognitive Processing Therapy and Prolonged Exposure

When it comes to therapy and mental health treatment, there is not a one-size-fits-all approach. There is a wide variety of effective therapy options out there, and we have a good idea of which ones tend to work best with different mental illnesses. Trauma/PTSD can affect people of all demographics, and we know that cognitive processing therapy (CPT) as well as prolonged exposure therapy (PE), have proven to be successful in treating these conditions. In this article, we’re going to go over what these two trauma therapies each bring to the table along with the primary distinctions that make them unique from one another.

What is Cognitive Processing Therapy?

Cognitive processing therapy is a form of cognitive behavioral therapy that can help people who suffer from PTSD and other types of trauma. It can help them manage their symptoms and prevent them from developing new ones, and it has been shown to be highly effective. It was initially developed to help those that have suffered specific kinds of traumatic events, but we now know that it can be beneficial for many types of trauma.

When someone embarks on a treatment course with CPT, sessions are conducted to help the patient develop a deeper understanding of how thoughts and emotions can affect their behavior. It’s typical for the client to start their journey with CPT by writing out how they believe the traumatic event they experienced affects them and their beliefs about themselves and the world around them, but this is not always the case, and some therapists choose to focus more on cognitive approaches.

The next phase in CPT involves approaching their trauma more directly and begin processing it in a helpful way. The client will write out a thorough breakdown of their experience and eventually read it during a session in an attempt to discontinue the habit of evading thought patterns and feelings that are related to the trauma. After the patient can recognize and correct negative thinking patterns, they can apply those abilities continuously to review and change their attitudes about any traumatic occurrences. It is also possible to offer CPT in both individual and group sessions. Clients will be assigned practice exposures to do outside of their sessions.

What is Prolonged Exposure Therapy?

When it comes to prolonged exposure therapy, this type uses a technique known as prolonged exposure to help people overcome their fears. It involves steadily working on their memories of past experiences and the feelings associated with them. Most people avoid things that remind them of negative past experiences, but doing so can intensify their fear. Through prolonged exposure therapy, they are able to learn that the memories and cues are not dangerous, leading to a decrease in their PTSD symptoms.

Therapists typically start the treatment process by providing a general summary of what the treatment will be comprised of and learning about the patient’s previous experiences. It’s common for therapists to teach the client breathing techniques to help with anxiety before diving deeper into the course of the treatment. The exposure factor usually begins after the assessment and introductory session. Your therapist should ensure that you feel safe in the environment because this can activate anxiety in a lot of patients. The rate at which the treatment proceeds is set by the client for each form of exposure. In vivo and imaginal exposure are both used in prolonged exposure therapy.

  • Imaginal exposure for trauma

With imaginal exposure, it takes place during and in between sessions. The client narrates their experience with as much detail as possible for their trauma therapist and with their help. After this, the patient and the therapist can explore and analyze the emotions brought forth through this exposure.

  • In vivo exposure for trauma

In vivo exposure is assigned as a kind of “homework” for the client to go and encounter the feared stimuli outside of treatment. During sessions, the therapist and patient work to pinpoint a variety of probable triggers associated with their anxiety, like certain environments or individuals. They decide on which triggers to address through in vivo exposure and create a course of action of confronting them in between sessions. The goal is for the patient to do this in a slow and steady manner so that there is a higher chance of success when it comes to coping with their emotional response to the stimuli.

Vivo Exposure for Trauma Therapy

Main Differences Between These Trauma Therapies

Now that we have a better understanding of what each of these therapies is comprised of, we are able to see the respective benefits that each of these therapies brings to the table more clearly. Both are highly recommended for both PTSD and trauma treatment. One of the most common elements of these two treatments is psychoeducation. This process helps survivors understand their individual experiences and how to respond to them, and it also helps them feel like they are not alone.

The biggest difference between these two forms of therapy is the direction that is taken with PE with the in vivo and imaginal exposures, while CPT often primarily focuses on written accounts by the patient. There are other slight differences, as well, such as the duration of each individual session and the number of sessions that occur over the course of treatment.

While there are differences between these trauma therapies, they both have impressive success rates in helping patients overcome their trauma. The route taken for addressing trauma all depends on the individual’s circumstances and the direction that their therapist sees fit. Issues like PTSD are huge burdens and can be tricky to navigate, but it’s important to know that trauma and the effects it can have on a person are very possible to work through with the right therapeutic approach.

At our practice in Louisville, Kentucky, our trauma therapists specialize in both CPT and PE and will ensure that the right method for your individual needs is offered. We understand just how much trauma/PTSD can affect a person, and we want to help you learn the right coping strategies so that you can regain a sense of freedom and improve your quality of life exponentially. To learn more about how we treat trauma and PTSD, click here.  To learn about our therapists, click here.