Cognitive Processing Therapy Vs Prolonged Exposure
Prolonged exposure (PE) and cognitive processing therapy (CPT) are two of the most frequently prescribed treatments for posttraumatic stress disorder, or PTSD. Both have been scientifically proven effective in relieving symptoms related to PTSD and have been strongly supported by both American Psychological Association and Veterans Health Administration/Department of Defense guidelines in 2017.
PE (Progressive Exposure) is a type of cognitive behavioral therapy that involves slowly confronting memories, feelings or situations that have previously caused you to feel fear or distress. Through this process, one learns that these trauma-related thoughts and memories are not dangerous and can approach them without causing additional anxiety or distress.
CPT, on the other hand, involves altering negative thoughts and beliefs that may be causing your symptoms. Additionally, it provides you with coping skills and strategies for handling difficult emotions and situations.
In a typical CPT session, you and your therapist will explore how trauma has affected you. Then, they may assign a series of exercises to help you comprehend these thoughts and beliefs more clearly.
Some therapists may suggest practicing eye movement desensitization and reprocessing (EMDR), a type of therapy which uses back-and-forth finger waves, light, or tone to trigger memories of trauma. This is believed to defragment and organize this stored memory, potentially alleviating symptoms associated with PTSD.
Your therapist will guide you through the initial sessions in order to help you recognize and correct faulty thought patterns that are negatively affecting your life. These thoughts often accompany feelings of anger, fear or sadness.
You will be provided with tasks to help you reframe your thoughts and beliefs about trauma, such as writing about it in different ways or envisioning a positive outcome from it. Next, you’ll collaborate with your therapist to practice these skills in real life scenarios.
Your sessions with your therapist typically last around 12 weeks, though this may vary depending on individual needs. It is best to ask them how many sessions are necessary before beginning treatment.
Your therapist can help you decide if prolonged exposure or cognitive processing therapy is suitable for you. You can search for a therapist near you through Penn Psychiatry, or contact us and we’ll do our best to connect you with one.
If you decide to try prolonged exposure or cognitive processing therapy, be aware that it is an intense form of therapy. About 30% of those who attempt this type of treatment won’t make it through the entire course.
At the start of treatment for PTSD, symptoms usually worsen. But after several sessions with a therapist, those who remain motivated to continue working together tend to achieve greater success in overcoming PTSD.
A study of over 900 Veterans conducted by the VA revealed that prolonged exposure was statistically more effective than cognitive processing therapy in relieving PTSD symptoms, though the difference wasn’t clinically significant. As a result, researchers recommended shared decision-making between clinicians and patients to help them select their preferred treatment.