CBT for Post-Traumatic Stress Disorder (PTSD)

Some mental health conditions affect multiple areas of a person’s life and can be very difficult to treat, which is true for post-traumatic stress disorder (PTSD). But that doesn’t mean they cannot be relieved or managed. Cognitive behavioral therapy (CBT) for PTSD allows individuals who have gone through traumatic experiences to regain control of their life again. Here’s everything you need to know about this treatment for PTSD.

What is CBT?

Cognitive behavioral therapy is a form of talk therapy (psychotherapy) that is based on several core principles, including how psychological problems are based partly on unhelpful ways of thinking and learned patterns of unhelpful behavior [*]. CBT is also based on Dr. Aaron T. Becks’ cognitive model, which theorizes that how individuals perceive something is more closely tied to their reaction than the actual situation [*].

In CBT, trained psychotherapists help their clients identify distressing thoughts and assess how realistic these thoughts are. As individuals become more aware of their thoughts and can evaluate them, they tend to feel better. CBT also focuses on helping clients with solving problems, learning new skills, and setting and achieving meaningful goals. While therapists and clients work together closely during sessions, therapists also empower their clients to practice their skills independently, outside of therapy.

How Does CBT Work for PTSD?

CBT works for PTSD by helping individuals change how they think and feel about their trauma. This type of therapy allows people to address their trauma in therapeutic settings, thereby promoting safe confrontations via exposure.

CBT also helps people explore their reactions to trauma reminders, which increases understanding of their own emotions. The goal is to modify dysfunctional thoughts underlying PTSD as well as the distress associated with these thoughts and reminders.

This treatment works for various age groups, including CBT for adults, CBT for teens, and CBT for kids.

CBT Techniques for PTSD

Generally, cognitive behavioral treatment for PTSD can be divided into three large categories: exposure procedures, anxiety management, and cognitive therapy. Here, we will look at some techniques that fall into each category.

Psychoeducation

Psychoeducation is the practice of teaching individuals about the mental health conditions they are living with. The reasoning behind this is that having a comprehensive understanding of one’s condition can make it easier to manage and provide them with better coping skills.

Psychoeducation in terms of PTSD refers to the provision of information about post-traumatic stress, its symptoms, and what to do about it. Psychoeducation can occur before or after possible exposure to stressful situations [*].

By increasing understanding of the trauma response, psychoeducation can make it easier for people to cope. They may feel relieved to know that they are experiencing a common response to trauma. Individuals who receive psychoeducation may also feel more motivated to adhere to their treatment plan because they understand how the treatment is intended to help.

A small study found that even a single session of trauma psychoeducation can be beneficial [*]. However, there is not enough evidence to support its role as a standalone treatment [*], so it works best in combination with other techniques.

Cognitive Restructuring

Cognitive restructuring is a skill that helps people learn how to identify upsetting thoughts and beliefs about their situations and the world. Therapists then teach individuals to find new ways of thinking to help them better cope with their unique situations. This can help with reducing PTSD symptoms and improve functioning in people with severe mental illness [*]. It also helps with general anxiety, worry, and even depression.

Exposure Therapy

Exposure therapy is another technique that can effectively address the symptoms of post-traumatic stress disorder.

Exposure therapy is a behavioral treatment that targets learned behaviors that people with PTSD engage in (for example, avoidance) in response to anxiety-provoking situations, thoughts, or memories. For instance, a rape survivor may avoid relationships or dates for fear that she will be attacked again. However, as avoidance behavior becomes more extreme, quality of life may diminish [*]. The goal of exposure therapy is to reduce a person’s anxiety and fear enough to eliminate avoidance behavior. By confronting feared situations, emotions, and thoughts, an individual can learn that anxiety and fear will lessen on their own.

Grounding Techniques

Grounding is a coping strategy designed to connect you with the present moment immediately. This technique is often used to cope with flashbacks or dissociation associated with PTSD and can be useful for other types of anxiety as well [*].

Grounding techniques often involve the five senses to immediately connect an individual to the present moment. The goal is to distract you from what’s going on in your mind.

Cognitive Processing Therapy (CPT)

Cognitive processing therapy (CPT) focuses on how the traumatic event has altered an individual’s view of themselves, the world, and others within five domains: safety, trust, control, esteem, and intimacy [*]. It then teaches individuals to take a look at their thoughts and helps them progress toward recovery. CPT is effective in treating PTSD in many populations, including veterans, refugees, and sexual assault victims.

Stress Inoculation Training (SIT)

Stress inoculation training (SIT) is another type of cognitive behavioral therapy for PTSD. This technique teaches individuals coping skills and new ways to manage PTSD symptoms, which are worsened by stress. SIT teaches people with PTSD to react differently to stressful situations so they can be more confident in how they cope with and manage PTSD symptoms [*].

Is CBT Effective for Treating PTSD?

CBT is effective for treating PTSD. It can lessen the negative effects of panic in daily life and make reactions to trauma less severe. CBT also helps reduce avoidance behaviors and improves quality of life [*].

How Long Does CBT Treatment for PTSD Last?

Although more research is required, findings suggest that CBT interventions for PTSD can be effective up to years following initial treatment [*].

Are There Risks and Side Effects Associated with CBT for PTSD?

There is no evidence that trauma-focused treatments like CBT are associated with adverse side effects on individuals [*]. However, more research is needed on possible adverse effects for further understanding of CBT treatment for PTSD.

The Bottom Line

Whether you’re dealing with PTSD yourself, PTSD in a loved one, PTSD in children, or PTSD in teens, it is helpful to understand how treatments like CBT can help. CBT has been considered the gold standard of treatment for many mental health conditions, and PTSD is one of them. It is always helpful to consult a mental health professional who specializes in CBT and PTSD for any concerns you have related to the condition.

If you are a trauma therapist utilizing CBT with clients feel free to incorporate our CBT worksheets or trauma worksheets into your sessions.

References:

1. American Psychological Association. What is Cognitive Behavioral Therapy? 2017.
2. Beck Institute for Cognitive Behavior Therapy. Understanding CBT. 2024.
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5. Brooks S, Weston D, Wessely S, et al. Effectiveness and acceptability of brief psychoeducational interventions after potentially traumatic events: A systematic review. 31 May 2021.
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