Cognitive Processing Therapy in Oakland and the East Bay
Cognitive Processing Therapy, or CPT, is one of the most rigorously studied treatments for PTSD in existence, and is recognized by the VA, the Department of Defense, and the American Psychological Association as a gold-standard approach. But I've found it useful well beyond trauma work, and I'd encourage you not to dismiss it if PTSD doesn't feel like the right label for what you're dealing with.
CPT is fundamentally about this: traumatic or very difficult experiences often leave behind not just emotional pain, but a set of beliefs about yourself, other people, or the world that harden into something that's hard to see past. Those beliefs tend to keep people stuck, and they tend to do their damage quietly, because they feel like just "the way things are" rather than ideas that can be examined and changed. CPT is a structured process for examining those beliefs and changing them.
Who CPT Is For
CPT was developed primarily for PTSD, and it remains one of the most effective treatments for it. But the cognitive patterns CPT addresses, such as self-blame, shame, black-and-white thinking about safety or trust, the belief that the world is fundamentally dangerous or that one is fundamentally deficient, show up across a wide range of presentations, including depression, anxiety, and substance use.
I've found CPT particularly useful for:
People dealing with PTSD from a specific traumatic event or series of events
People carrying significant shame or self-blame that hasn't shifted with other approaches
People with highly entrenched negative beliefs about themselves that feel factual rather than distorted
High-achieving people whose thinking is a genuine strength in most areas of their lives, but whose rigidity or perfectionism is creating problems
People who prefer a structured, skills-based approach with clear goals and measurable progress
How CPT Works
CPT is a structured, time-limited treatment: typically around 12 sessions, though I adapt it based on individual need. It has two main components: processing the trauma itself, and systematically examining the beliefs that have formed around it.
The first part involves writing about the traumatic experience and what it has meant to you: not just what happened, but what conclusions you've drawn from it. This is often difficult and occasionally uncomfortable, but it creates material we can work with directly rather than circling around.
The second part, which is the majority of the work, involves cognitive restructuring: learning to notice problematic patterns of thought (overgeneralization, catastrophizing, taking on responsibility for things that weren't yours to carry), examine the actual evidence for and against them, and arrive at more accurate and livable beliefs. This is not positive thinking. It's more like rigorous fact-checking applied to your own internal narrative.
CPT typically focuses on five areas that trauma commonly disrupts: safety, trust, power and control, self-esteem, and intimacy. Most people find that the disruption extends well beyond the specific traumatic event and touches how they relate to themselves and other people across the board.
CPT Alongside Other Approaches
I sometimes use CPT as a standalone treatment and sometimes in combination with EMDR or IFS, depending on what a particular client needs. For some people, the cognitive restructuring component of CPT helps consolidate or make sense of shifts that have happened through EMDR. For others, CPT is the primary framework and other approaches support it.
Working With Me
I see clients in person in Oakland and via telehealth throughout California. I work outside of insurance, which keeps sessions fully confidential and our treatment free from third-party oversight. I offer a free 20-minute consultation to discuss whether CPT or another approach might be the right fit for what you're working on.