Randomized Control Trials
Sexual Assault
Reference – Resick, P.A., Galovski, T.A., Uhlmansiek, M. O., Scher, C.D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243-258.
[PubMed-Free Full Text]
Summary – A dismantling study that examined the various components of CPT, including the written account (WA) and cognitive only (CPT-C) elements, in sexual assault survivors. Results revealed improved PTSD and depression symptoms across WA, CPT-C, and the full CPT protocol. CPT-C demonstrated the quickest reduction in PTSD symptoms and greater overall improvements than WA alone.
Reference – Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive processing therapy, prolonged exposure and a waiting condition for the treatment of posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.
[PubMed- Free Full Text]
Summary – Sexual assault victims reported improved PTSD and trauma-related symptoms following either CPT or Prolonged Exposure (PE) as compared to a minimal attention (MA) control group. These results were maintained across a 9 month follow-up. Similar levels of symptom improvement emerged in CPT and PE, but CPT demonstrated greater improvements in guilt and shame.
Active Duty Military Personnel
Reference – Resick, P. A., Wachen, J. S., Mintz, J., Young-McCaughan, S., Roache, J. D., Borah, A. M., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Peterson, A. L., & On behalf of the STRONG STAR Consortium (2015). A Randomized Clinical Trial of Group Cognitive Processing Therapy Compared With Group Present-Centered Therapy for PTSD Among Active Duty Military Personnel. Journal of Consulting and Clinical Psychology, 83, 1058-1068. doi: 10.1037/ccp0000016
[Paid Full Text] [PubMed-Abstract]
Summary – Group CPT-C (CPT – cognitive therapy only version) in active duty military personnel showed significant and meaningful reductions in PTSD and depression severity. These gains were maintained at 12-month follow-up, and improvements were larger for the CPT-C group compared with an active control condition.
Veterans
Reference – Forbes, D., Lloyd, D., Nixon, R., Elliott, P., Varker, T., Perry, D., Bryant, R.A. & Creamer, M. (2012). A Multisite Randomized Controlled Trial of Cognitive Processing Therapy for posttraumatic stress disorder in a naturalistic setting. Journal of Anxiety Disorders, 26, 442– 452.
[Paid Full Text] [PubMed-Abstract]
Summary – Veterans with chronic military-related PTSD showed significant improvement in PTSD and other related concerns (depression, general anxiety) following individual CPT compared with active treatment as usual. Gains were maintained at 3-month follow-up. All treatment was administered in community-based veteran mental health services by clinicians in the service.
Reference – Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898–907. doi: 10.1037/0022-006X.74.5.898
[Paid Full Text] [PubMed-Abstract]
Summary – Veterans with chronic military-related PTSD demonstrated significant improvements in PTSD and trauma-related symptoms, even when compared to a waitlist control.
Child Sexual Abuse
Reference – Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 965–971. doi: 10.1037/0022-006X.73.5.965
[Paid Full Text] [PubMed-Abstract]
Summary – Victims of Childhood Sexual Abuse demonstrated short- and long- term (1 year) improvements in PTSD and other trauma-related symptoms following CPT as compared to a Minimal Attention wait-list control.
Mixed Traumas
Reference – Falsetti, S. A., Resnick, H. S., Davis, J., & Gallagher, N. G. (2001). Treatment of posttraumatic stress disorder with comorbid panic attacks: Combining cognitive processing therapy with panic control treatment techniques. Group Dynamics, 5(4), 252–260.
[PubMed-Abstract] [Paid Full Text]
Summary – PTSD patients experiencing panic attacks demonstrated improvements on trauma symptoms following Multichannel Exposure Therapy (M-CET), a group treatment combining elements of both CPT and panic control treatment.
Processes of CPT
Reference – Gutner, C. A., Suvak, M. K., Sloan, D. M., & Resick, P. A. (2016). Does Timing Matter? Examining the Impact of Session Timing on Outcome. Journal of Consulting and Clinical Psychology, advanced online publication. doi: 10.1037/ccp0000120
[Paid Full Text] [PubMed-Abstract]
Summary – This study showed that less days between sessions was associated with larger reductions in PTSD severity, suggesting more frequent CPT sessions will be associated with better outcomes.
Reference – Liverant, G. I., Suvak, M. K., Pineles, S. L., & Resick, P. A. (2012). Changes in Posttraumatic Stress Disorder and Depressive Symptoms During Cognitive Processing Therapy: Evidence for Concurrent Change. Journal of Consulting and Clinical Psychology, 80, 957-967. doi: 10.1037/a0030485
[PubMed-Abstract] [Paid Full Text]
Summary – Both PTSD and depression symptoms appeared to change at the same time during CPT, CPT-C (CPT with cognitive therapy only) and Written Account therapy (WA) components CPT (rather than one disorder type driving change in the other).
Reference – Nishith, P., Nixon, R. D. V., & Resick, P. A. (2005). Resolution of trauma-related guilt following treatment of PTSD in female rape victims: A result of cognitive therapy targeting comorbid depression? Journal of Affective Disorders, 86, 259–265.
[Free Full Text]
Summary – CPT and PE both demonstrated similar levels of PTSD symptom improvement in sexual assault victims, but CPT was more effective than PE in decreasing specific trauma-related guilt cognitions.
Reference – Nishith, P., Resick, P. A., & Griffin, M. G. (2002). Pattern of change in prolonged exposure and cognitive processing therapy for female rape victims with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 70, 880–886.
[Free Full Text]
Summary – In the course of conducting both Prolonged Exposure (PE) and CPT with sexual assault victims, patient PTSD symptoms typically increase slightly during the beginning phases of therapy before significantly decreasing in mid- and late-therapy.
Reference – Owens, G. P., Pike, J. L., & Chard, K. M. (2001). Treatment effects of cognitive processing therapy on cognitive distortions of female child sexual abuse survivors. Behavior Therapy, 32(3), 413–424.
[Paid Full Text]
Summary – Child sexual assault (CSA) survivors showed significant decreases in cognitive distortions from pre- to post- treatment with a CPT protocol adapted for CSA (CPT-SA).
Open Trials / CPT in Special Populations
Veterans
Reference – Lloyd, D., Couineau, A., Hawkins, K., Kartal, D., Nixon, R., Perry, D., & Forbes, D. (2015). Preliminary Outcomes of Implementing Cognitive Processing Therapy for Posttraumatic Stress Disorder Across a National Veterans’ Treatment Service. Journal of Clinical Psychiatry, 76, e1405-e1409. doi: 10.4088/JCP.14m09139
[Paid Full Text] [PubMed-Abstract]
Summary – Following implementation of CPT training across multiple community veterans’ mental health service sites, this study shows that significant and clinically relevant reductions in PTSD were observed for routine clients of the service who received CPT.
Reference – Zappert, L.N., & Westrup, D. (2008). Cognitive processing therapy for posttraumatic stress disorder in a residential treatment setting. Psychotherapy Theory, Research, Practice, & Training, 45(3), 361-376.
[Paid Full Text] [PubMed-Abstract]
Summary – An adaptation of group CPT implemented in a VA residential program demonstrated improvements in PTSD symptoms for inpatient women veterans.
Reference – Monson, C. M., Price, J. L., & Ranslow, E. (2005, October). Treating combat PTSD through cognitive processing therapy. Federal Practitioner, 75–83.
[FedPrac-Abstract]
Summary – Male and female veterans treated with CPT in an outpatient setting reported significant improvements in PTSD symptoms.
• (also see the Randomized Control Trials section above for additional articles about this population)
Adolescents
Reference – Ahrens, J., & Rexford, L. (2002). Cognitive processing therapy for incarcerated adolescents with PTSD. Journal of Aggression, Maltreatment and Trauma, 6, 201– 216.
[Paid Full Text] [NCJRS-Abstract]
Summary – CPT was associated with decreased self-reported trauma symptoms in adolescent, incarcerated males as compared to a wait-list control.
Childhood Sexual Assault Survivors
Reference – Chard, K. M., Weaver, T. L., & Resick, P. A. (1997). Adapting cognitive processing therapy for child sexual abuse survivors. Cognitive and Behavioral Practice, 4, 31–52.
[Paid Full Text]
Summary – A preliminary look at data regarding the effectiveness of a 26-session (17 week) CPT protocol for child sexual abuse survivors.
Reference – House, A. S. (2006). Increasing the usability of cognitive processing therapy for survivors of child sexual abuse. Journal of Child Sexual Abuse, 15, 87–103.
[Paid Full Text]
Summary – Pilot data suggests that a version of cognitive processing therapy modified for child sexual abuse (CSA), including fewer sessions and additional dialectical behavior therapy skills training, effectively reduces PTSD and depression symptoms in CSA survivors.
• (also see the Randomized Control Trials and Processes of CPT sections above for additional articles about this population)
Sexual Assault Victims
Reference – Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748–756.
[Paid Full Text] [PubMed-Abstract]
Summary – Group format CPT showed significant improvements in PTSD and depression for sexual assault victims as compared to a wait-list control, which did not show any changes in symptoms from pre- to post- treatment. These results were maintained at 6 month follow-up.
• (also see the Randomized Control Trials and Processes of CPT sections above for additional articles about this population)
Recent Trauma and Acute Stress Disorder
Reference – Nixon, R.D.V. (2012). Cognitive Processing Therapy versus Supportive Counselling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial. Behavior Therapy, 43, 825-836.
[Paid Full Text] [EuropePMC-Abstract]
Summary – Showed that CPT was efficacious in recent victims of interpersonal assault when delivered in 6 x 90min weekly sessions. Individuals in both CPT and SC improved in PTSD, depression and unhelpful trauma-related beliefs, however changes were larger in CPT. Gains were maintained at 6-month follow-up.
Refugees and non-Western Clients
Reference – Bass, J.K., Annan, J., Murray, S.M., Kaysen, D., Griffiths, S., Cetinoglu, T., Wachter, K., Murray, L.K., & Bolton, P.A. (2013). Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence. New England Journal of Medicine, 368, 2182-2191. doi: 10.1056/NEJMoa1211853
[Free Full Text]
Summary – Group CPT for female survivors of sexual violence delivered by non-expert counsellors resulted in significant reductions of anxiety and depression compared with individually delivered general support. At 6-month follow-up only 9% of the CPT group had probable depression or anxiety versus 42% of the individual-support group.
Reference – Schulz, P. M., Resick, P. A., Huber, L. C., & Griffin, M. G. (2006). The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting. Cognitive and Behavioral Practice, 13, 322-321.
[Paid Full Text]
Summary – Foreign-born refugees reported decreased PTSD symptoms after completing a CPT protocol delivered by a therapist speaking their native language or through use of an interpreter.
Comorbid Psychological Symptoms
Reference – Lloyd, D., Nixon, R., Varker, T., Elliott, P., Perry, D., Bryant, R.A., Creamer, M. & Forbes, D. (2014). Comorbidity in the prediction of Cognitive Processing Therapy treatment outcomes for combat-related posttraumatic stress disorder. Journal of Anxiety Disorders, 28, 237-240. doi: 10.1016/j.janxdis.2013.12.002
[Paid Full Text] [PubMed-Abstract]
Summary – Examined impact of comorbidity on CPT outcomes. Baseline severity of anxiety, depression or alcohol abuse did not influence outcomes. Higher levels of anger at baseline did predict an attenuated treatment response.
Reference – Kaysen, D., Schumm, J., Pedersen, E.R., Seim, R.W., Bedard-Gilligan, M. & Chard, K. (2013). Cognitive Processing Therapy for Veterans with Comorbid PTSD and Alcohol Use Disorders. Addictive Behaviors, 39, 420-427. doi: 10.1016/j.addbeh.2013.08.016
[Free Full Text]
Summary – Examined effectiveness of CPT for clients with PTSD and alcohol use disorder (AUD) or PTSD alone. Both groups reported significant reductions in PTSD and depression and that veterans with comorbid AUD tolerated CPT for their PTSD in this outpatient setting.
Reference – Clarke, S.B., Rizvi, S.L., & Resick, P.A. (2008). Borderline personality characteristics and treatment outcome in cognitive-behavioral treatments for PTSD in female rape victims. Behavior Therapy, 39, 72-78.
[Free Full Text]
Summary – Despite higher levels of pre-treatment trauma symptoms, PTSD patients with high levels of Borderline Personality Characteristics (BPC) showed significant improvements in PTSD and trauma-related symptoms following either CPT or Prolonged Exposure (PE). These patients were also just as likely to complete therapy as those without high levels of BPC. Results did not differ across treatment type.
Reference – Falsetti, S.A., Erwin, B.A., Resnick, H.S., Davis, J., & Combs-Lane, A.M. (2003). Multiple channel exposure therapy of PTSD: Impact of treatment on functioning and resources.
[Research Gate-Abstract-Article request]
Summary – Women PTSD patients with comorbid PTSD and panic attacks reported improved work, marital, economic, and overall functioning, as well as decreased PTSD and panic symptoms, after completing Multichannel Exposure Therapy (M-CET). These results were maintained across 3 and 6 month follow-up.
Reference – Falsetti, S.A., Resnick, H.S., & Davis, J.L. (2008). Multiple channel exposure therapy for women with PTSD and comorbid panic attacks. Cognitive Behaviour Therapy, 37(2) 117-130.
[Paid Full Text] [PubMed-Abstract]
Summary – Crime victims with comorbid PTSD and panic attacks reported significant decreases in both PTSD and panic symptoms after completing Multichannel Exposure Therapy (MCET). These results were maintained at 6 month follow up.
Reference – Resick, P. A., Nishith, P., & Griffin, M. G. (2003). How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child sexual abuse survivors within a clinical trial. CNS Spectrums, 8, 340–355.
[Free Full Text]
Summary – CPT and Prolonged Exposure (PE) were equally effective in reducing a wide range of trauma-related symptoms, including PTSD and depression, in sexual assault survivors. These results were maintained through a 9 month follow-up, suggesting that CPT and PE are effective in treating patients with complex trauma histories and severe symptom patterns.
Case Studies
Reference – Difede, J., & Eskra, D. (2002). Cognitive processing therapy for PTSD in a survivor of the World Trade Center bombing: A case study. Journal of Trauma Practice, 1, 155–165.
[Paid Full Text]
Summary – CPT revealed successful treatment and long-term outcome in a patient reporting PTSD from the World Trade Center bombing.
Reference – Kaysen, D., Lostutter, T. W., & Goines, M. A. (2005). Cognitive processing therapy for acute stress disorder resulting from an anti-gay assault. Cognitive and Behavioral Practice, 12, 278–289.
[PubMed-Free Full Text]
Summary – A victim suffering from Acute Stress Disorder following a homophobic assault reported decreases in PTSD and depression symptoms after completing CPT. These results were maintained at 3 month follow-up.
Reference – Messman-Moore, T. L., & Resick, P. A. (2002). Brief treatment of complicated PTSD and peritraumatic responses in a client with repeated sexual victimization. Cognitive and Behavioral Practice, 9, 89–99.
[Paid Full Text]
Summary – Improvements in PTSD and depression were seen in a client with presenting with severe symptoms and a complex history of repeated sexual victimization beginning in childhood. This study suggests that CPT treatment strategies are effective with multiple trauma histories and severe symptomatology.
Reference – Galovski, T.E. & Resick, P.A. (2008). Cognitive processing therapy for posttraumatic stress disorder secondary to a motor vehicle accident: A single-subject report. Cognitive and Behavioral Practice, 15, 287-295.
[Paid Full Text]
Summary – A long-haul truck driver with motor vehicle accident (MVA) related PTSD demonstrated improvements in trauma-related symptoms after completing CPT, suggesting that CPT is generalizable to MVA trauma populations.
Reference – Hall, C. A., & Henderson, C. M. (1996). Cognitive processing therapy for chronic PTSD from childhood sexual abuse: A case study. Counseling Psychology Quarterly, 9(4), 359–371.
[Paid Full Text] [ResearchGate-Abstract-Article Request]
Summary – A woman with a complex trauma history, including childhood sexual abuse and multiple sexual victimizations in adulthood, reported reduced symptoms after undergoing a 17- week adaption of CPT which incorporated both individual and group modalities.
Reference – Davis, J.L., Davies, S., Wright, D.C., Falsetti, S., & Roitzsch, J.C. (2005). Simultaneous treatment of substance abuse and post-traumatic stress disorder: A case study. Clinical Case Studies, 4, 347 362. doi: 0.1177/1534650103259745
[Paid Full Text]
Summary – Simultaneously providing both substance abuse treatment and Multi Channel Exposure Therapy (M-CET), which contains elements of CPT, revealed decreased substance use and PTSD symptoms in a female patient with comorbid diagnoses.
Other CPT Articles
Reference – Chard, K.M., Schumm, J.A., Owens, G.P., & Cottingham, S.M. (2010). A comparison of OEF and OIF veterans and Vietnam veterans receiving cognitive processing therapy. Journal of Traumatic Stress, 23(1), 25-32.
[Paid Full Text] [PubMed-Abstract]
Reference – Galovski, T.E., Monson, C., Bruce, S.E., & Resick, P.A. (2009). Does cognitive behavioral therapy for PTSD improve perceived health and sleep impairment? Journal of Traumatic Stress, 22, 197–204.
[Free Full Text]
Reference – Sobel, A.A., Resick, P.A., & Rabalais, A.E. (2009). The effect of cognitive processing therapy on cognitions: Impact statement coding. Journal of Traumatic Stress. 22, 205–211.
[Free Full Text]
Reference – Rizvi, S.L., Vogt, D., & Resick, P.A. (2009). Cognitive and affective predictors of treatment outcome in cognitive processing therapy and prolonged exposure for posttraumatic stress disorder. Behaviour Research and Therapy, 47, 737-743.
[Free Full Text]
Reference – Kelly, K.A., Rizvi, S.L., Monson, C.M., & Resick, P.A. (2009). The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder. Journal of Traumatic Stress, 22, 287-293.
[Paid Full Text]
Reference – Galovski, T. E. & Resick, P. A. (2005). Cognitive processing therapy and the treatment of posttraumatic stress disorder. In A. Freeman (Ed.) International Encyclopedia of Cognitive Behavior Therapy. Kluwer Academic/ Plenum Publishers.