How Does One Recover from Trauma Using CPT?

May 6, 2021 by

One purpose of research is to determine what helps most people, most of the time, better than other ways, and better than nothing.

One of the most effective therapies found by research to help people regain freedom from trauma symptoms is Cognitive Processing Therapy (CPT). CPT offers a sequence of 12 sessions, the first 6 of which are considered fundamental. If trauma symptoms abate, use of the protocol can be ended at any point in the sequence.

Inner wisdom

Addressing trauma can feel like too much. At the same, time, the sequencing of the CPT sessions can feel like too little, too slowly, especially if sessions are scheduled once per week. The founders of CPT suggest twice per week sessions as optimal and posit that all 12 sessions might be held in an intensive session, perhaps two days over a weekend. The intensively scheduled sessions might feel like too much, and they would also be enough, and all at once.

Some of the indirect learning and support that in-person CPT counseling sessions offer is missing from telehealth sessions, especially during the stress of a pandemic. With clients’ input, we have discovered that a) assistance with emotion regulation, b) a sense of progress outside of assessment scores, and c) an overview of the process, all in straightforward language, are needed.

Since I define terms and provide links to the content in this post elsewhere, I have provided few links here but have included a list of related resources at the end of the post.

“Inner wisdom” is our in-house term and adaption of “Wise Mind,” a component of the “States of Mind” concept from Dialectical Behavior Therapy (DBT) invented by Marsha Linnehan, Ph.D. In sum, the guidance of one’s “inner wisdom” would result from awareness of one’s thoughts and feelings – the content of one’s mind and heart – and from accessing emotion and cognitive structures and functions in the brain.

The content below is expressed in first person. The second person “you” can be perceived as directive and unhelpful.

What do I get from therapy for trauma?

I gain freedom and power.

If something troubling happens today, I am able to kindly – and without judgment – help myself with it.

When a troubling feeling or thought occurs, I can say, “Well, of course you would be feeling that feeling or thinking that thought, given what happened.” In doing so, I perform a profound act of compassion for myself.

What is the process by which one engages in therapy for trauma?

At essence, my intention is to be able to help myself with whatever is happening, whether it be an interior state or an external circumstance.

What is meant by “help myself”?

Help would begin with, kindly and respectfully, becoming aware of my feelings and thoughts and, thus, become able to access my inner wisdom wherein my knowledge, life experience, and skills reside.

Then I would use any or all of these meticulously acquired skills, in potentially most useful order:

  1. Adjust the volume on my inner intensity through self-soothing and attention-shifting so I can regulate the emotion centers of my brain and thus free my prefrontal cortex to think things through.
  2. When I become aware I am replaying the trauma in my mind or dwelling on intrusive thoughts, I very gently shift my attention, often to something that engages my senses and/or accesses my inner knowing. I’m aware that rethinking is like using flashcards to train myself to memorize what alarms and distresses me.
  3. If I am thinking some form of, “Who am I, who I am not, and what did I do or not do to cause this?”, remind myself that reality is complex and dynamic and very little can be definitively identified as causal.
  4. Remind myself that the “just-world hypothesis,”* however unsupportable, is based on my very human longing for things to make sense.
  5. Remind myself that it’s usually my humanity that wishes things were different AND that to increase my chances of effectively helping myself with a current reality, I’ll need to use a reality-based approach.
  6. Ask myself, “Do I have any self-care deficits going on? What can I do to buttress my ability to engage in the awareness process? Do I need food, water, to move a bit? What can I do to help myself feel more steady and strong?”
  7. Identify feelings and differentiate between natural, primary feelings, and thought-generated, secondary feelings.
  8. Ask, “What thoughts am I thinking that might be causing my feelings?”
  9. Among my thoughts, identify and differentiate between facts, beliefs, and hypotheses. (“Hypotheses” are posited to be reality-based vs. belief-based statements generated by one’s inner wisdom that may be truthful, if not verifiably factual.)
  10. Identify problematic patterns of thinking, particularly the “just-world hypothesis.”*
  11. Ask useful questions about my thinking (from an individualized set of questions derived from CPT’s Challenging Questions Worksheet).
  12. Among these questions, ask, “Is there any feeling here that I’m trying not to feel? What is it? Is there any reality here that I’m trying to not think about? What is it? Am I doing something to try to not feel or think? What realities do I need to approach rather than try to protect myself from?”
  13. Accept that humans are not given predictive powers. One’s own actions might have made things better…and they might have made things worse. There is no way to know.
  14. Ask, “Am I thinking in ‘if-thens’? Am I thinking, ‘If only I __________ or if only they __________’?” If so, I recognize I’m thinking I can know the complexity of reality and predict which factors would change which outcomes. I realize I’m just trying to think my way out of feeling sad. I give myself a hug for wishing things could be different.
  15. Then I do activate my prefrontal cortex. It helps me regulate emotions now. I’m also working it like a muscle to increase its power to help me in the future.
  16. Assess probabilities. Start by asking, “What are the odds? 50-50?”
  17. Ask, “What opposites are both true?”
  18. Do a cost-benefit analysis with rank ordering.
  19. Acknowledge family-of-origin issues (FOOI) that may be playing a role in my thinking process, give them a nod but little time, and shift my attention to my hard-won, individually identified values and priorities.
  20. Ask myself, “Let’s say I’m given 100 years on this planet. How would I want to spend them? How about the next 100 minutes? Is this to what I want to give my time? Might I have given this due time?”
  21. Ask myself, “Given these cards I’ve been dealt, how do I want to play them?”
  22. Devise strategies based on my values, priorities, and skills-informed, inner wisdom’s guidance.
  23. Ask, “I’ve consulted my inner wisdom. Is there anyone I might consult who is likely to honor the nuances of withholding judgment, fostering my independence, all the while offering commentary?!”
  24. Make a judgment call and execute the strategies.
  25. Accept outcomes as the best I could do at the time given the data and resources I had.
  26. Return to the opposites-are-both true dialectic of consolidating gains to foster stability AND opening myself to possible instability as I gain new insights and grow.
  27. Continue to monitor beliefs that oppress from without and from within. Become aware of familial, cultural, and societal beliefs that may be so deeply held that they are nearly invisible. Differentiate between those in which I willingly participate to organize society and those that limit me. Jettison the unhelpful beliefs that I can and shift my attention to my values, priorities, and inner knowing.

*”The just-world belief holds that good things happen to good people, that bad things happen to bad people, and that the world should be a fair and just place. This belief emanates from the desire to find an orderly, cause-effect association between an individual’s behavior and the consequences of that behavior…this is a hard-wired, evolutionary need of humans to predict and control events in order to survive.” (CPT manual, page 65)  Further, the just-world hypothesis holds that hard work will be rewarded, bad deeds will be punished, “things happen for a reason,” “what goes around comes around,” and that self, others, and the world should be controllable, orderly, and predictable. In contrast, reality is complex and dynamic. Some occurrences are unforeseeable and have no discernible origin, causality, meaning, or explanation. Ultimately, it is compassion for humans and their aching hearts that is merited.

Last updated 5/21/21

The views expressed are my own. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: CPT, Trauma

Learning Mandarin Chinese Efficiently with Mandarin Blueprint

April 20, 2021 by

Life can be shorter than any of us may wish. I want to learn Mandarin Chinese in the most accelerated, efficient way possible.  I wish to reach as high of a level of proficiency in Mandarin Chinese as possible, as quickly as possible, with the least amount of effort, time, and dollars.

Further, that method has to work in lockdown in a small town. No opportunities for interactive practice or real life exposure exist outside of scheduled, online tutoring sessions with italki and private instructors.  Sequestered in my house, the rest is silence.

Luke Neale and Phil Crimmins, founders of Mandarin Blueprint

I have spent countless hours and dollars reviewing textbooks, courses, and apps, trying to find a means of learning Mandarin Chinese that meets these criteria.

I learned of Mandarin Blueprint on episode #55 of Jared Turner’s and John Pasden’s podcast, You Can Learn Chinese. I signed up for the free trial on Saturday, February 13, 2021, and was wowed.

To adults wishing to learn Mandarin Chinese efficiently, I recommend Blueprint wholeheartedly.

I had done literature reviews of the research on second language acquisition by adults. Of all the courses and materials I’ve reviewed, Mandarin Blueprint’s systematic approach most closely matches my findings.

In addition to offering a research-informed protocol, Mandarin Blueprint’s online course includes:

100% responsiveness to my schedule. I treasure speaking with online teachers so much that I have changed my sleep-wake schedule to more closely match Beijing time so I can meet with native speakers. However, I want and need to study when teachers are not available as well.

Accuracy. I have tried multiple online courses and apps. Even as a beginner, I could find errors in the content. I was learning the wrong stuff! Luke Neale and Phil Crimmins, the co-founders of Mandarin Blueprint, create impeccably accurate content.

Brief, succinct videos. I was a history major and am fascinated by China’s 5,000 year history. (Was there a Xia Dynasty?!) I appreciate context. At this point, however, please just tell me what I need to know.

Comprehensiveness. My scattered knowledge of bits of vocabulary and grammar is being consolidated. Systematically, Mandarin Blueprint takes students sound by sound, then character by character.

Fascinating content, often charmingly conveyed, by congenial, master teachers with strong speaking styles. I find myself engaged in the content and do not have to force myself to focus or continue. During this pandemic, on any given day, I frequently spend more time with Luke and Phil than I do with any other human beings. They are excellent company.

Use of strengths and interests I already have. Luke and Phil have devised an awe-inspiring process by which learners use memories from the richness of their personal lives, plus their imaginations, to create meaningful, memorable narratives associated with the pronunciation, components and meanings of Chinese characters, While my mind understands the power of the forgetting curve and the countering powers of the method of loci and spaced repetition, while learning with Mandarin Blueprint, I find my heart feeling at play as if I were a child again.

Uncertainties addressed by either the help desk or the Mandarin Blueprint community.  Anki is spaced repetition software (SRS) that buttresses learning with the Mandarin Blueprint method. I was able to set it up and use it for the Pronunciation Mastery course, but was stumped when I moved to the next level. Immediately, I got message board, email, and video responses to my questions. In one video, Phil has a cat in his lap! Phil even offered to Zoom and personally walk me through this step. I may have maxed out what I can do with Anki on my end, but “customer service” seems a mundane term for the direct, personal, serious help I received.

An innovation and a masterwork. I respect the co-founders for applying for a patent. I do think their formulation is a unique synthesis of research and best practices on second language acquisition. For me, engaging with such fine, thoughtful, original, humane work is a genuine emotional and intellectual pleasure.

Heroism. Luke Neale and Phil Crimmins launched Mandarin Blueprint in Chengdu, China on January 1, 2019. Native English-speakers, they were learning Mandarin Chinese as adults, joined forces, and devised the Mandarin Blueprint method to teach themselves efficiently and effectively. They then started sharing the method with others.

As of this writing, in about 28 months, they have created over 4,000 lessons and over 1,000 videos, ranging from 1 minute to 1 hour. They continue to create lessons, videos, blog posts, and podcast episodes. Through the videos, I have watched their lives unfold. I have seen Phil’s facial hair come and go and heard a baby chortle in one of Luke’s recordings. I can only imagine being non-native speakers founding a company in a non-native land, attempting to keep that company and their lives and loves afloat during a pandemic. and continuing to uphold the mission, create the course, and take care of their customers. I find their efforts quite moving and exemplary.

Outcomes. I need what I do to work. My life span is probably two-thirds complete. The pandemic has created new deprivations and urgencies. I need for the time, dollars and effort I put into anything to yield results. Before I tried this method, I struggled to read characters. With the support of my italki and private instructors, I have been able to read sentences aloud in the characters-only Mandarin Companion Breakthrough Level graded readers. Although a subjective measure, this is extraordinary, motivating progress.

Bravo to Luke and Phil! 谢谢! I truly cannot thank the founders of Mandarin Blueprint enough for their vision, leadership, and invention.

. . . . .

The image is a screenshot of Luke Neale and Phil Crimmins from a Mandarin Blueprint YouTube video explaining the Pronunciation Mastery course.

As of this writing, I completed the 6-hour Pronunciation Mastery Course during the trial period, purchased the full bundle of courses, and have completed through level 15, part of the Phase 3 Sentence Building portion of 36 levels in the Introductory Course. My plan is to complete the Introductory Course, then proceed to the Intermediate Course to complete levels 37-57. I feel confident I can do this, partly due to the inspiration of William Beeman, Professor Emeritus and past Chair of the Department of Anthropology at University of Minnesota, who also recommends Mandarin Blueprint.

An Advanced Course is in the works and I plan to take it as well when it is released. When test centers open again, I intend to proceed through the HSK exams.

For this post, I excerpted some of the content from the review I posted on my public Facebook page on March 9, 2021.

Updates as of 7/16/21

  • I was delighted to contribute at the access level to Mandarin Blueprint’s crowdfunding campaign to jumpstart development of the Advanced Course.
  • I and others are writing brief dialogues in simplified Chinese characters, pinyin, and English using words that help foster empathy and understanding. The posts also identify characters in Mandarin Blueprint’s numbering system. We call it the “Meaningful Words” series and it is here.
  • I developed a paper-and-pen alternative to Anki and describe it here.

Disclaimers

The views expressed are my own and may not represent Mandarin Blueprint’s positions, strategies or opinions. I receive no compensation from any businesses or organizations mentioned in this post.

I am a student of Mandarin Chinese and also a mental health counselor, able to provide counseling services only to residents of the Commonwealth of Virginia, U.S.A. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: Chinese

Questions to Ask and Answer to Reduce Substance Use

February 10, 2021 by

Humans have used substances for over 12,000 years in ways that are meaningful to them. Between 70-80% of people who use drugs do so without issue. When people find themselves engaging in unintended use or overuse, particularly if use results in harm, their brains may have developed what’s termed “brain automaticity,” i.e. action without thought. Brain structures and functions involved with bonding, attaching, relating and loving are also involved. When this occurs, the terms “substance use disorder” and “addiction” are applied.

In the U.S., an estimated 1 in 10 who use drugs develops a substance use disorder, usually preceded by trauma and/or mental illness. Although chronic cases exist, most people with substance use concerns recover on their own without treatment. If substance use concerns do not resolve on their own, research suggests a three-pronged approach: 1) medical care, 2) skills-focused, cognitive theory-based counseling, and 3) connection and support.

However, if people are required to, or choose to, reduce substance use or abstain from substance use, what does research suggest is helpful on a practical level?

When people lose something or someone important to them, they have to both endure the loss and find adequate replacements. They have to accept that a one-to-one correspondence will likely never exist between what’s lost and what approximately fills the space. People who have lost loving mothers, fathers, grandparents, first loves, and dear pets know this. They are loved and will be loved again. However, it will never again be in that way.

So it is with mandated or chosen reduction in use or absence of use of substances. Substances take the human brain where it normally can’t go on its own. That’s why humans have used substances for 12,000 years. Their absence can be a one-of-a-kind loss.

As Maia Szalavitz, author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction, puts it here, “If addiction resides in the parts of the brain involved in love, then recovery is more like getting over a breakup than it is like facing a lifelong illness. Healing a broken heart is difficult and often involves relapses into obsessive behavior, but it’s not brain damage.”

After substance use, our own brains and our own lives are, essentially, cornered into a no-win scenario. Life is expected to make a better offer than substance use. Life can’t? Well, why stop then?

How does one create a life to which substance use would add insignificant value? How might one evolve from ambivalence to indifference about substance use?

At essence, to taper from, reduce, or eliminate use, a person would need to regain autonomy over automaticity. After first seeking medical care, a person would painstakingly discover and identify specifically what substances do for them and use their own hearts, minds, and actions to provide, as best they can, what substances did.

A very tall order.

Below are questions a group of people experienced with using research-backed methods to address substance use concerns concluded might be helpful. Beneath each question is related, simply-stated guidance.

Begin, however, with self-kindness. Although current social norms may judge substance use, human history does not. Embrace yourself and begin to help yourself with this challenge.

What do substances do for you?

People use substances for reasons that are complex and dynamic. Discover these reasons and find legal alternatives that provide similar, adequate effects.

When the longing for a substance arises, what feelings do you wish were different?

Identify the feelings and attempt to help yourself reduce the volume on their intensity. Rather than attempt to unsuccessfully suppress the unsupressible, counteract automaticity. Consciously use your attention as a muscle and shift your attention to your interests, preferences, and priorities.

What are the problems that arise which create a longing for substances?

Identify those problems and seek solutions, including identifying health conditions and seeking medical care and medications for them.

What are the rituals associated with using?

Find alternatives that provide similar, adequate effects.

With whom are you mostly likely to use substances?

Negotiate with those individuals a no-use policy when you’re together. At the same time, find others to be with who do not use.

What beliefs do you hold about using? Examples: “I can’t take what’s happening without using!” or “It might help if I have more” or “If I don’t use, I won’t belong.”

Consider this fill-in-the-blank: “If I use substances, I have/receive __________. If I don’t have/receive this, that means __________.”

Are the answers facts or beliefs?

Challenge beliefs with facts and questions. Examples: “I have made it through challenges before.” “It might help if I have more but it also might hurt.” “Does the group I want to belong to hold my values and priorities?” “Might I want to look at the ways I am thinking about things?”

What do you not know about substance use, the substance(s) you use, and evidence-based treatment for substance use disorders?

Find out. Educate yourself. Find or get recommendations for research-backed, self-guided therapy workbooks and complete them.

What have you found that substances do and do not give you? Did you get what you thought you would? Does the inner narrative of anticipated results match real results?

Consider this fill-in-the-blank: “On the one hand, substances and/or substance use do give me __________. On the other hand, I had hoped substance use would give me __________ but it has let me down.”

Another possibility: “I just did it to __________. I didn’t mean to end up here.”

Practice self-kindness, self-empathy, and self-compassion. Embrace yourself, your disappointment, and your sorrow. Acknowledge that you did – and continue to – wish the best for yourself.

What outside support do you need?

Practice self-kindness and self-care. Reach out for medical care, agency support, and professional care. Seek the support from safe, non-judgmental people that you need.

. . . . .

To gain insight into answers to these questions, completing these exercises may be helpful.

  1. Self-Care Checklist
  2. Awareness Skills Self-Assessment
  3. Checklists to Assess Needs, Wants, Strengths and Preferences
  4. Values and Priorities Exercises
  5. Other posts in the Guide category.

Other guides on this site may be helpful:

Research-Backed Ways to Reduce or Eliminate Substance Use is a free, online course I have posted on Udemy for people with substance use concerns. Here’s an introduction to the course and here’s the direct link.

With any questions at all, please do contact me.

Image: IStock

Last updated 4/17/21

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: Guide

Now Might Be a Good Time to Learn Mandarin Chinese

December 8, 2020 by

Why might now be a good time to learn Mandarin Chinese?

  1. We may be able to directly and indirectly contribute to world peace.
    Peace in any relationship – whether personal or international – depends upon being able to talk. Given current tensions between the U.S. and China, we, literally, need to speak each other’s language to gain deep, mutual understanding of each other’s needs and wants, feelings and thoughts.
  2. We can share the responsibility for communicating.
    According to research company Ethnologue, languages with the most native speakers in the world, in order, are Mandarin Chinese, Spanish, then English. Of languages with the most speakers, English is first, followed closely by Mandarin Chinese, then by Hindi. According to Wikipedia, 10 million people in China have acquired English as a second language. In contrast, an estimated 30,000 to 50,000 people in the U.S. are studying Mandarin Chinese.
  3. Logic suggests that, to solve the globe’s main problems, we need to speak the globe’s main languages.

I turn 62 at the end of this month. I have become aware that now might be a particularly good time for older adults to learn Mandarin Chinese. Why?

  1. We join the team.
    Perhaps, in human history, now is not the time for older adults to retire. Among the acquisition difficulty rankings of languages by the U.S. Department of State, Mandarin Chinese is ranked as a Category IV language, among the very hardest to learn. Although human bodies normally and naturally lose functioning with age, our brains gain complex cognitive abilities, unless afflicted with neurocognitive diseases. Might our mature brains now be optimally wired for efficient and effective learning? Might our mature brains be untapped resources to assist scholars, scientists, policy-makers, and members of our communities? Might now be the time for us to take this challenging task on – in service to all of us, for the sake of all of us?
  2. We may be putting our mature human brains to optimal use.
    The findings of neuroscience contradict the myth that second language learning is ineffectual in adulthood. In fact, with assistance with intermittent, short-term memory challenges, the intricately and deeply networked mature adult human brain may be particularly primed for second language acquisition.
  3. Learning Mandarin Chinese may be a way to covertly protest and change aging in the U.S.
    The process of aging and dying in the U.S. has become so lonely and bleak that guides like this one and this one have to be written about how to deal with it all. The primary challenges? Loss of purpose and meaning, cognitive decline, and social isolation. Triumphantly, learning Mandarin Chinese has no less than world peace as its mission, neuroscience backs it as a potentially enhancing, improving, even restorative cognitive endeavor, and connection with instructors and people with whom to practice are available online, 24-7.

Want to experiment with seeing if learning Mandarin Chinese might be a fit for you?

Through 5 months of literature reviews of research on second language acquisition, extensive testing of apps and materials, and difficult trial-and-error learning, these are the steps and resources I suggest:

  1. Download and use the Hello Chinese app. Early learning features are free; premium subscriptions start at $8.99 per month. Hello Chinese is beautiful and beautifully coded, offers enough explanation to keep moving but not too much to get discouraged, and blends learning with gamification in engaging and appealing ways.
  2. Download and use the Skritter app to become familiar with Chinese characters.
  3. Watch some episodes of Happy Chinese on YouTube.
  4. Listen to some episodes of the You Can Learn Chinese podcast.
  5. Once you know what “Nǐ hǎo” is, and way before you feel ready, do this anyway: Listen to their video introductions, make a selection, and book a session with one of the nearly 800 online teachers of Mandarin Chinese on italki.

(To select teachers on italki, I begin by filtering the search results through “Availability.” I am an early riser and take a break around 1:00 PM. So I look for teachers available for 5:00 AM and 1:00 PM sessions. italki makes this easy by displaying results filtered through the user’s time zone. Before your session on italki, you’ll have the opportunity to message your teacher that you’re a beginner.)

5. Savor the heart-pounding, nerve-wracking awe and excitement of waiting to attempt to speak another language with a complete stranger in another part of the world. When your instructor’s face appears on the screen, say, “Nǐ hǎo” and see what happens after that.

If you have an experience similar to mine, the first teacher wasn’t exactly a fit but the longing to learn Mandarin Chinese began. And, the belief that it was doable began as well.

Here’s a video of my progress after 4 months of independent effort supported, all online, by my italki teachers, my local teacher, members of our Mandarin Chinese Conversation Club, and fellow learners on My Language Exchange. I’m very excited to begin to supplement my work through formal instruction with AllSet Learning, founded by John Pasden, co-host of the You Can Learn Chinese podcast, and co-author, with Jared Turner, of the Mandarin Companion graded reader series.



If you find the video somewhat excruciating to listen to and watch, that’s okay, ’cause I do, too. I don’t speak very well yet! I laugh near the start because I realize the teacher has asked me about the weather and I replied with a date. Mostly I feel joy, however. I, too, started with “Nǐ hǎo.”

Please do contact me if you have any ideas, suggestions or feedback on learning Mandarin Chinese.

Updated 12/13/20

I am a beginning student of Mandarin Chinese and also a counselor, able to provide services only to residents of Virginia, U.S.A. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: Chinese

Is Online Cognitive Processing Therapy for Trauma a Fit for Me?

November 10, 2020 by

At essence, Cognitive Processing Therapy, CPT, is a way to use one’s own heart and mind to help reduce the impact on one’s brain of having experienced trauma. Designed to be a brief protocol, CPT has over 25 years of research to back it and is recommended by the Veterans Administration and the American Psychological Association (APA).

Cognitive Processing Therapy for PTSD ManualI experienced such significant trauma symptom reduction myself from being taken through the protocol by clinical psychologist Stephanie Fearer, Ph.D., that I trained in providing the CPT protocol so I could pass this relief forward to others. I provided individual and group sessions in CPT in my private practice’s counseling office until March, 2020. Since then, we have been conducting individual and group CPT sessions online.

Numerous research studies report the effectiveness of online vs. in-person counseling, including for CPT.

The CPT protocol includes 12 sessions. These can be scheduled weekly, twice weekly, or at other intervals. In this case study, a person received 10 sessions of Cognitive Processing Therapy delivered twice per day over a single, five-day work week.

The first 7 sessions are fundamental and the last 5 offer deeper insights. Some people experience noteworthy symptom reduction in a few sessions – “early responders” – and complete the protocol in fewer than 12 sessions.

Participants complete assessments prior to each session and plot them on a graph to track their progress. They complete daily homework between sessions.

Some people want to take their time and experience the comprehensive experience of the full protocol. Others, because of time and cost limitations, want to be early responders. In my professional experience, all who engage in CPT for any length of time are brave. Early responders tend to be those who 1) do the homework daily (not intermittently or all at once), and 2) do it thoroughly. In addition, women who identify as female and for whom attendance of our online CPT group is a fit may also respond quickly to the protocol.

The primary logistics challenge for conducting and participating in online CPT is distributing and using the handouts. When I had an office, I created a folder for each client and arranged a sequence of handouts in folders as if in a buffet line. Clients arrived, completed assessments, acquired the session’s handouts, and we were ready to begin in about 3 minutes.

Online, I have used a website page as a virtual table and made an ordered list of the materials participants need and the actions to take prior to each session. The give-and-take of quick questions that happens while seated in-person, side-by-side at a table doesn’t really happen in online sessions when one is, virtually, inches away from the other person’s face. There’s a focus and seriousness to it that, again in my opinion, might actually improve outcomes. That is hypothesis, not data. I’ve made a CPT glossary that covers the questions I was most often asked about terms and concepts.

Although a self-guided workbook is being developed, I encourage people to buy a copy of the CPT manual. I kept an in-house copy of the manual in my office so clients could follow along during each session. This was more efficient than attempting to page through copies of handouts in a folder or notebook.

If you’ve read this far, then you’ve answered the first question.

Is online Cognitive Processing Therapy (CPT) a fit for me?

1. Am I open to reading short passages of explanatory text at about the reading level of the text in this post?

2. Am I open to reading and following lists of directions primarily on my own and asking clarifying questions if I’m having trouble?

3. Am I open to doing daily homework? After the first homework assignment, which takes an hour, am I open to doing homework each day, maybe 20-30 minutes per day?

4. Am I aware that the primary symptom of trauma disorders is clinically – and somewhat uncharitably – termed “avoidance” but is my attempt to protect myself from emotional pain?

5. Am I aware that, paradoxically, the primary symptom of trauma disorders – avoidance – is the one that may get in the way of me getting help for it? If I do get help, am I aware I will, understandably, lean toward canceling sessions and not doing homework and lean away from attending appointments and doing homework? That I may find myself wanting to quit attending sessions at all?

6. Am I aware that a secret, fearful belief I have is that, if I engage in counseling for trauma, all my defenses and adaptations will shatter and I will be so raw and vulnerable that I will be unable to function?

7. Given all this, am I open to taking a chance on the protocol for about 20-30 minutes per day for up to 12 sessions, knowing I, truly, can stop at any time and use the manual on my own?

The start of any counseling process for any condition begins with self-kindness. Having questions and concerns like these makes complete sense. People who have trauma symptoms suffer. People who have been diagnosed with post-traumatic stress disorder (PTSD) have a condition considered a severe mental illness (SMI) for which they qualify to apply for disability benefits. This is serious business and deserves our attention and care.

If you are a Virginia resident and would like to consider Cognitive Processing Therapy facilitated by a counselor, please fill out this contact form. (If you are not a resident of Virginia, here is a roster of other CPT providers.)

I will use your email address to send you the CPT contract and the .pdf of CPT worksheets for your review. If you decide you would like to engage in the protocol, I’ll send you further enrollment information and we’ll schedule a meeting to answer any questions you may have.  When we meet, we’ll schedule a set of 12 appointments together. Then we’ll begin.

If you would like to consider engaging in CPT on your own, Self-Help Guide to Reducing Trauma Symptoms may be of assistance.

With any questions at all, please do contact me.

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: CPT, Trauma
« Previous Page
Next Page »