Cognitive Processing Therapy is a structured form of cognitive behavioral therapy that can be used when working with clients who are living with post-traumatic stress disorder. PTSD can develop after exposure to child abuse, combat experiences, rape, and natural disasters. The American Psychiatric Association has reported that PTSD affects approximately 3.5% of U.S. adults each year. Keep reading to learn 50 Cognitive Processing therapy questions to ask your clients in therapy sessions.

As a structured treatment approach, CPT typically includes 12 therapy sessions. CPT can occur in individual therapy or in group sessions.  Counselors may find themselves focusing on different themes of their client’s life that were impacted by their trauma including safety, trust, power, control, esteem, and intimacy.

View all of our Cognitive Processing Therapy Worksheets

Clients are asked to write an impact statement that explains their understanding of why their traumatic event occurred, and the impact that it has had on their beliefs of themselves, others, and the world around them. This is done before your client is given psychoeducation about their mental health symptoms, and the way that their thoughts and emotions interact with each other.

Psychoeducation is a vital component of cognitive processing therapy. You will spend time providing education about your client’s mental health symptoms, and the connection between their thoughts and emotions. They will then learn to identify the automatic thoughts that influence their current PTSD symptoms and new adaptive ways to respond when these thoughts are present.

Once these steps are completed, your focus then moves to process the trauma that your client has experienced. An assignment often included in CPT asks clients to write down their traumatic experience and read it aloud in the next session. The purpose of this exercise is to stop engaging in avoidance behaviors that pull away from the feelings and thoughts associated with their trauma.

CPT can be effective in addressing any “stuck points” that clients are experiencing, and allow them to use healthier coping strategies in their day-to-day life. Some clients are surprised when they see that other areas of their lives, aside from their PTSD symptoms, are positively impacted by cognitive processing therapy. 

Getting Ready for Your First Cognitive Processing Therapy Session with a New Client

When you are meeting with a new client, there are some things that may look a little different when you use CPT compared to other therapeutic approaches. The first step is to make sure that your client is appropriate for cognitive processing therapy. As noted above, this therapeutic approach is ideal for individuals who are living with PTSD symptoms, however, there are other mental health concerns that can benefit from this approach as well.

If you have received referral paperwork, self-assessments, or screeners, reviewing them before your session can help you gain an understanding of your client’s experience before sitting with them for your session. This can also help you formulate a plan for your session and the areas of your life that you would like to focus on.

Once you have determined that your client could benefit from CPT, the next step would be to explain the benefits and limitations of CPT. This would be the time to discuss the structured approach to CPT and details including the use of assignments that need to be completed outside of the session. It is important that your client is aware that these assignments are needed to proceed with their treatment. If your client has concerns about their ability to complete these assignments outside of their sessions, CPT may not be a good fit for them.

If your client would like to engage in CPT sessions, you may find yourself asking them to write their impact statement before their second session. TherapyByPro offers a variety of CPT worksheets that can be used, including a CPT Impact Statement Worksheet.  

An important topic for counselors, especially those working with clients struggling with PTSD and other trauma-related concerns, is the importance of self-care. As counselors and therapists, we listen to, support, and provide empathy to clients who have experienced a range of traumas and difficulties in their lives. As humans, it is understandable that you could be impacted by your client’s experiences in one way or another.

In order for us to support our clients, we need to make sure that we are taking care of ourselves. This can include taking care of personal needs at the moment, such as making sure we are hydrated and eating properly, as well as addressing any mental health concerns that we may be living with ourselves. Self-care practices can be incorporated into our day-to-day routine to promote our own mental health and wellness. 

Common CPT Questions to Ask Clients in Therapy Sessions

Cognitive processing therapy questions often include Socratic questions and other approaches to help clients see where their automatic thoughts about their trauma may be unhelpful. CPT questions can also be used to facilitate structured sessions and check in with your client’s interpretation and understanding of the material discussed. 

Examples of cognitive processing therapy questions you can use include:

1.   What makes you say it was your fault?
2.   Why do you feel that way? 
3.   What evidence is there to support this thought?
4.   Is there other information you need to know before deciding if you were at fault? 
5.   How do your feelings impact the fault you are placing on yourself? 
6.   How does the evidence you have impact your thoughts regarding your responsibility in that situation? 
7.   Is there another way we can look at this situation?
8.   What do you feel you should have done differently? 
9.   What were you feeling and thinking at that moment? 
10.   What did you think would happen?
11.   What did you want to occur in that moment? 
12.   Have you experienced a similar trauma before?
13.   Has the behavior you engaged in led to similar outcomes before?
14.   What do you believe the main concern or difficulty is for you?
15.   Why do you think I asked you about that? 
16.   How does this impact your day-to-day life? 
17.   Can you tell me more about that thought?
18.   Can we revisit that thought, but with more detail? 
19.   That’s a powerful statement, how does it make you feel to say that?
20.   Can you describe the concerns you have regarding your mental health?
21.   What changes will you see when you are making progress? 
22.   Do you have any concerns about writing your impact statement at home? 
23.   What emotions were you experiencing when writing your impact statement? 
24.   What thoughts came up for you while you were writing your impact statement? 
25.   How do you feel after reading your impact statement aloud? 
26.   What emotions are you experiencing after sharing your impact statement with me? 
27.   Can you share with me the thoughts you are having, after sharing your experience with me?
28.   Were you able to cope with those thoughts and emotions? 
29.   What coping skills do you feel work the best for you? 
30.   What coping skills would you like to practice more? 
31.   Do you have any hesitations or concerns about the coping skills we have discussed? 
32.   What questions can I answer about the information I shared with you today?
33.   I know that we covered a lot of material today, is there anything we can circle back to for clarification?
34.   Can you share with me something you have done in the past day or two to show yourself kindness? 
35.   How do you feel after showing yourself kindness? 
36.   Would you like to explore ways that you could show yourself kindness?
37.   Tell me about your experience trying to show yourself compassion. 
38.   Can you share with me your “stuck point”? 
39.   Have you been able to move past a “stuck point” in the past? 
40.   Can you describe what safety means to you? 
41.   Do you have a safe place that you could describe to me? 
42.   Can you describe your experience with trust? 
43.   Whom in your life do you trust? What is it about them that made this so? 
44.   How would you describe your self-esteem?
45.   How would you describe yourself?
46.   Can you share with me your experiences with intimacy?
47.   How important is intimacy to you? 
48.   How do you feel in situations that you cannot control?
49.   Do you feel in control of your thoughts and behaviors? 
50.   How do you feel that your thoughts and emotions are connected to each other?

Final Thoughts On Asking the Right Questions in CPT Therapy

Thank you for reading this resource on 50 Cognitive Processing therapy questions to ask your clients in therapy sessions. Cognitive processing therapy is a great therapeutic approach for clients who are living with PTSD symptoms and some other mental health concerns.  It is important to note that individuals who are living with PTSD in addition to other mental health concerns may not be a good fit for this form of therapy. This includes individuals who experience dissociation, psychosis, depression, and substance use disorders whose symptoms may prevent them from fully participating in the different aspects of CPT.

If you work with clients who are living with PTSD and other mental health concerns that can benefit from cognitive processing therapy, we encourage you to explore the different Continuing Education

and training opportunities available to you. It is important to ensure that you meet the professional requirements associated with your credentialing entity before utilizing new skills and approaches with your clients.

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:

• American Psychological Association. (n.d.). Cognitive processing therapy (CPT). American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy  
• What is posttraumatic stress disorder (PTSD)?. Psychiatry.org – What is Posttraumatic Stress Disorder (PTSD)? (n.d.). https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd#:~:text=PTSD%20affects%20approximately%203.5%20percent,as%20men%20to%20have%20PTSD

The post 50 Cognitive Processing Therapy (CPT) Questions to Ask Clients in Sessions appeared first on TherapyByPro.