Traditional Cognitive Therapies
Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.Cognitive therapies, and cognitive-behavioral therapies are based upon the premise that our thoughts affect our feelings and behaviors and visa versa. To the extent those feelings and behaviors are problematic, the thoughts that preceded them are also problematic. Cognitive therapies focus on modifying those dysfunctional thoughts so that feelings and behaviors improve. A simple example will illustrate this concept. Suppose a man walks by and steps on my foot. If my thoughts are founded on the belief that the world is a dangerous place, I may become very angry at that foot-stepper who just intentionally assaulted me. Since I'm angry at this unprovoked attack, I'm going to yell at this jerk. Conversely, if my thoughts are founded upon the belief that people are inherently good, then I may interpret the foot-stepper's action quite differently. I may just think he was clumsy. I might even feel sorry for him that he is so uncoordinated. As you can see, my thoughts about the foot-stepper's intention subsequently determined both my feelings and behavior. Because of the circular relationship between thoughts and behavior, some therapies will focus on changing thoughts, while other therapies begin by trying to change behavior first.
Most therapists practicing in this day and age received some basic training in cognitive strategies since cognitive-related models rose to prominence in the last decades of the twentieth century. Many people consider cognitive therapy a form of "talk therapy" and therefore of limited use for trauma. As we explained in the discussion of the brain, this is because "talk" accesses a part of the brain where trauma is not stored. It is important to note that most cognitive therapists do not consider "talk" as central to healing. The "talk" occurs in the therapist's office for the purpose of setting up new experiences inside and outside the therapy session. The healing occurs as a result of these new experiences via specific actions taken by therapy participants during and between sessions (often called homework). These new experiences update the brain's model of the world to be more functional and realistic. It bears mentioning that these strategies have helped many individuals recover from PTSD over the years as supported by the research evidence.
Traditional cognitive-behavioral therapy (CBT), and a newer variant called cognitive processing therapy (CPT), help survivors reorient their thinking around the trauma. These are on the SAMHSA registry. They are also among the favored approaches of the Veterans Administration for PTSD, based upon their understanding of the research.
Another cognitive model is called trauma focused, cognitive behavioral therapy (TF-CBT). It is on the SAMHSA registry of evidence-based practices specifically indicated for PTSD in children and adolescents. It has also been used for adult treatment. As described on the SAMHSA registry:
TF-CBT is a psychosocial treatment model designed to treat posttraumatic stress and related emotional and behavioral problems in children and adolescents. Initially developed to address the psychological trauma associated with child sexual abuse, the model has been adapted for use with children who have a wide array of traumatic experiences, including domestic violence, traumatic loss, and the often multiple psychological traumas experienced by children prior to foster care placement. The acronym PRACTICE reflects the components of the treatment model: Psycho-education and parenting skills, Relaxation skills, Affect expression and regulation skills, Cognitive coping skills and processing, Trauma narrative, In vivo exposure (when needed), Conjoint parent-child sessions, and Enhancing safety and future development. Although TF-CBT is generally delivered in 12-16 sessions of individual and parent-child therapy, it also may be provided in the context of a longer-term treatment process or in a group therapy format.
Evidence-Based Practices: How Do I Know If a Trauma Treatment Is Effective?
Resources
-
Articles
-
Introduction to Trauma and Stressor-Related Disorders
- Introduction to PTSD, Trauma, Abuse and Other Stress-Related Disorders
- What Are Trauma and Stressor-Related Disorders?
- Physical and Emotional Trauma
- How is Trauma Different from Stress?
- What are Adverse Life Experiences?
- Can Grief and Loss Be Traumatic?
- Are Abuse and Neglect Types of Trauma?
- What is Complex Trauma?
-
Signs and Symptoms of Trauma and Stressor-Related Disorders
- What are the Signs and Symptoms of Trauma and Stressor-Related Disorders?
- Intrusive Symptoms
- Distressing Images, Thoughts, Memories
- Flashbacks, Dissociative Reactions
- Distressing Dreams and Nightmares
- Intense or Prolonged Psychological Distress
- Physiological Distress or Body Memory
- Intrusive Symptoms: Children's Re-Enactment As Re-Experiencing
- Avoidance Symptoms
- Negative Thoughts and Feelings: The Cognitions and Mood Symptoms
- Arousal and Reactivity Symptoms
-
Diagnostic Descriptions of Trauma and Stressor-Related Disorders
- The Trauma and Stressor-Related Disorders: Diagnostic Descriptions
- Post-Traumatic Stress Disorder (PTSD) Criteria
- Acute Stress Disorder Criteria
- Adjustment Disorders Criteria
- Reactive Attachment Disorder & Disinhibited Social Engagement Disorder Criteria
-
What Causes the Symptoms of Trauma-Related Disorders?
- What Causes the Symptoms of Trauma-Related Disorders?
- Trauma and the Triune Brain
- Reptilian Brain of Survival and Mammalian Brain
- Trauma and the Neomammalian Brain (Cerebral Cortex)
- Trauma's Physical and Emotional Toll on the Body
-
Treatment of Trauma, PTSD, Abuse and Other Stressor-Related Disorders
- The Treatment of Trauma, PTSD, Abuse, and Other Stressor-related Disorders
- Revolutionary New Treatments For PTSD, Trauma, Abuse, and Other Stress-Related Disorders
- The Basic Framework of Trauma Treatment and Recovery
- Finding and Choosing a Trauma Therapist
- Evidence-Based Practices: How Do I Know If a Trauma Treatment Is Effective?
- Traditional Cognitive Therapies
- Hybrid Cognitive Therapies: Mindfulness and Cognitive Therapy
- Exposure and Visualization Therapies
- Eye Movement Desensitization and Reprocessing (EMDR) and Related Approaches
- Body, Movement & Expressive Arts Therapies
- Energy Therapies & Other Innovative Approaches
- Feedback-Informed Treatment
- Medication for Trauma and Stressor-Related Disorders
- Combination Models on the SAMHSA Registry
- A Final Note on Treatment Options
-
Conclusion, Resources and References
- Resilience, Resolution, Reconciliation, and Recovery: Some Closing Remarks
- Helpful Websites
- References
-
Dealing with the Effects of Trauma - A Self-Help Guide
- Dealing with the Effects of Trauma Introduction
- Help From Health Care Providers, Counselors and Groups
- Things You Can Do Every Day to Help Yourself Feel Better
- The Healing Journey
- Moving Forward on Your Healing Journey
- Further Resources
-
Introduction to Trauma and Stressor-Related Disorders
-
News
- Study Probes Causes of Anger in Returning U.S. Soldiers
-
Questions and Answers
- Multiple Sex Abuse as a Child
- Feel Like Something's Wrong
- Self Hate
- Is This a Flashback?
- Does My Boyfriend Have a Personality Disorder?
- I Am Wondering What Could be Wrong With Me?
- Past Following me For the Worse
- Am I Depressed?
- Depressed, Anxious and Dead Inside...Please Help!
- Broken
-
46 more
- My Husbands Roller Coaster of Proper Hygiene: Is it Depression?
- I Can't function Normally Anymore, Can More Diagnoses issues Risk Survival?
- PTSD vs. DID
- Abused As A Child and Now It's Ruining My Life
- Just Want to Die
- Anxiety
- Hearing Things?
- Please Help Me!
- Boyfriend
- Why Am I Thinking Like This?
- PTSD
- Post Brain Surgery Mental Problems
- PTSD
- Help
- Dissociation events
- How do you turn your back on your 19 year old daughter?
- What is going on?
- Please help.
- Why
- How do I help my husband with anger issues since he has been back from Iraq.
- I have PTSD and I feel nothing
- Tolerating emotion
- PTSD since childhood, with no memory of trauma?
- I get paralysed and cant do anything
- Repressed Memory
- My Husband\'s confusion and inability to make correct lifestyle decisions
- Death of both parents
- Healthy sexuality not instinctual for me after abusive situations
- What would this be
- visions of what could have been
- about depersonalization
- Amnesia
- My friend needs help that I can\'t give,can you help me?
- Relationship Between Dissociation, DID and PTSD
- Bi-polar with PTSD
- Is there a difference between abuse and trauma?
- Fear Of Remembering Things
- Living With PTSD
- Emotional Orphan
- PTSD Getting Worse
- Will I Have To Deal With PTSD For The Rest Of My Life?
- Is It Really Panic? And How Do We Get Help
- I Don't Recall Any Trauma
- PTSD and Night Terrors
- I Can't Tell a Lie
- Abuse and Trauma
-
Book & Media Reviews
- A War of Nerves
- Afterwar
- Bereft
- Children Changed by Trauma
- Conquering Post-Traumatic Stress Disorder
- EMDR Therapy and Somatic Psychology
- Faking Normal
- Helping Children Cope With Disasters and Terrorism
- In an Unspoken Voice
- Lovely Green Eyes
-
18 more
- New York September 11
- Posttraumatic Stress Disorder
- Posttraumatic Stress Disorder
- Raising Kids in an Age of Terror
- Remaking a World
- Remembering Trauma
- Roadmap to Resilience
- Spectral Evidence
- The Heart of Trauma
- The Limits of Autobiography
- The Little Friend
- The Only Girl in the World
- The September 11 Photo Project
- Trauma in the Lives of Children
- Traumatic Pasts
- Traumatic Relationships and Serious Mental Disorders
- What Have We Done
- With Their Eyes
-
Links
- [1] Articles
- [2] Associations
- [1] Community
- [8] Information
- [2] Journals
- [1] Research
- [16] Videos
- [3] Apps
-
Videos
- PTSD Warning Signs
- Therapies for PTSD
- Art can heal PTSD's invisible wounds
- PTSD Strikes on the Home Front
- Suffering Soldiers: A Look at PTSD
- Anxiety, Trauma and How Prolonged Exposure Therapy Works For PTSD
- PTSD: Stress and Resilience
- Bessel van der Kolk on Understanding Trauma
- How to Overcome PTSD
- Cognitive Processing Therapy for PTSD
-
6 more
- Prolonged Exposure for PTSD
- PTSD Treatment: Know Your Options
- What is PTSD?
- Disaster Anniversaries
- Psychological Effects of Disasters: Identifying the Problem and Helping Individuals Cope
- How to Manage PTSD
-
More Information
- An Interview with Pat Bracken, MD, Ph.D. on Post-Modern Psychiatry and the Social Context of Trauma
- Wise Counsel Interview Transcript: An Interview with Edna Foa, Ph.D. on the Nature and Treatment of PTSD
- Wise Counsel Interview Transcript: An Interview with Frank Ochberg, MD on Post-Traumatic Stress Disorder (PTSD)
- Wise Counsel Interview Transcript: An Interview with Victoria Lemle Beckner, Ph.D. on Treatments for Post-Traumatic Stress Disorder (PTSD)
Topics
-
Related Topic Centers
-
Addictions
-
Aging & Elder Care
-
Assessments & Interventions
-
Career & Workplace
-
Emotional Well-Being
-
Life Issues
-
Parenting & Child Care
-
Abuse
-
ADHD: Attention Deficit Hyperactivity Disorder
-
Adoption
-
Autism
-
Child & Adolescent Development: Overview
-
Child & Adolescent Development: Puberty
-
Child Development & Parenting: Early (3-7)
-
Child Development & Parenting: Infants (0-2)
-
Child Development & Parenting: Middle (8-11)
-
Child Development & Parenting:Adolescence (12-24)
-
Child Development Theory: Adolescence (12-24)
-
Child Development Theory: Middle Childhood (8-11)
-
Childhood Mental Disorders and Illnesses
-
Childhood Special Education
-
Divorce
-
Family & Relationship Issues
-
Intellectual Disabilities
-
Learning Disorders
-
Oppositional Defiant Disorder
-
Parenting
-
Self Esteem
-
-
Psychological Disorders
-
Anxiety Disorders
-
Bipolar Disorder
-
Conversion Disorders
-
Depression: Depression & Related Conditions
-
Dissociative Disorders
-
Domestic Violence and Rape
-
Eating Disorders
-
Impulse Control Disorders
-
Intellectual Disabilities
-
Mental Disorders
-
Obsessive-Compulsive Spectrum Disorders
-
Personality Disorders
-
Post-Traumatic Stress Disorder
-
Schizophrenia
-
Sexual Disorders
-
Somatic Symptom and Related Disorders
-
Suicide
-
Tourettes and other Tic Disorders
-