In the field of trauma therapy, Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are two highly effective treatments for Post-Traumatic Stress Disorder (PTSD). Below, I’ll share two case examples to explain how these approaches help individuals process and recover from trauma, such as domestic abuse and car accidents. Both CPT and PE are specialized forms of Cognitive Behavioural Therapy (CBT) designed to help clients overcome traumatic experiences. Other therapeutic approaches can also provide significant healing and recovery, depending on the individual’s needs.
Note: These cases are fictional and meant for educational purposes only.
Case 1: Cognitive Processing Therapy (CPT)
Meet Sarah:
Sarah, a 38-year-old woman, had been trapped in an abusive marriage for several years. Her partner not only physically abused her but also manipulated her emotionally, leaving her with deep feelings of helplessness and shame. Although she has since left the relationship, the emotional scars remain. Sarah constantly battles guilt, believing that if she had been stronger, she could have stopped the abuse. This sense of guilt has made it difficult for her to trust others, especially in romantic relationships.
How CPT Can Help:
CPT is a structured therapy that focuses on helping individuals like Sarah challenge the distorted beliefs and thoughts they’ve developed around their trauma. During our one-hour sessions, I guide Sarah through exercises that help her identify and reframe these negative thoughts.
One key part of the process is reflective writing. I often assign clients the following task:
Assignment: Write a one-page statement exploring why you think the most distressing incident of abuse occurred. You don’t need to describe the event in detail, but focus on what you believe caused it. Additionally, reflect on how this experience has affected your beliefs about safety, trust, control, self-esteem, and intimacy. Bring this to our next session.
If it’s difficult to complete this on your own, we can discuss it during our next session instead.
In our follow-up sessions, we review Sarah’s thoughts to identify “Stuck Points”—negative, often deeply held beliefs about herself and the world that are getting in the way of her healing. By gradually challenging these beliefs, Sarah begins to understand that she isn’t responsible for her partner’s actions, and through this work, she can slowly start to rebuild trust in future relationships.
Case 2: Prolonged Exposure Therapy (PE)
Meet David:
David is a 25-year-old man who was involved in a serious car accident two years ago. Since then, he’s been struggling with PTSD symptoms. He experiences intense anxiety whenever he drives or even thinks about being in a car. He avoids driving altogether and finds it difficult to watch anything related to cars. Nightmares about the accident keep him up at night, leading to sleep issues and constant stress.
How PE Can Help:
Prolonged Exposure Therapy helps individuals confront and process their trauma in a safe and structured environment. In David’s case, our sessions sometimes extend to 90 minutes due to the intensity of his emotional responses. PE has two main components: in vivo exposure and imaginal exposure.
In vivo exposure: We create a plan that gradually reintroduces David to the situations he’s been avoiding. This might begin with something as simple as looking at pictures of cars and eventually progress to sitting in a car and, finally, driving again. Throughout the process, I guide him through relaxation techniques, helping him manage his anxiety until he feels more comfortable in these settings.
Imaginal exposure: Here, David recalls and retells the story of his accident in detail. By revisiting this memory several times, he begins to desensitize himself to the emotional impact, making the memory less overwhelming over time.
Given the intensity of David’s emotions surrounding the accident, some sessions are extended to give us the necessary time to process his feelings thoroughly. As he continues with therapy, David gradually reduces his avoidance behaviours and begins to regain confidence in driving, helping him take back control of his daily life.
Finding the Right Path for Healing
Both CPT and PE offer powerful tools for trauma recovery, helping individuals like Sarah and David reclaim their lives from the weight of their past experiences. However, it's important to note that there are many other therapeutic approaches that can also support trauma recovery. The key is finding the right fit for each individual’s unique journey.
If you’re navigating the aftermath of trauma, know that there is help available, and the right approach is the one that feels supportive and effective for you.
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