This type of therapy can be effective for helping people who have post-traumatic stress disorder (PTSD) after experiencing a traumatic event.
Post-traumatic stress disorder (PTSD) is a mental health condition that can affect anyone who has witnessed or survived a traumatic event, such as:
- natural disasters
- sexual or physical abuse
PTSD can cause you to have an elevated fight, flight, or freeze response, and it’s also common to experience:
- anger and rage
Some people might find themselves avoiding places or situations that trigger PTSD symptoms. Others may find it difficult to connect with people or stay focused on jobs or schoolwork.
While it can be difficult to prevent PTSD, there are research-backed treatments — including cognitive behavioral therapy (CBT) — to help you manage your symptoms.
Created by Dr. Aaron Beck, cognitive behavioral therapy (CBT) is a form of psychotherapy that looks at the connection between your thoughts and your behaviors, moods, and attitudes.
“The premise behind CBT is that our thoughts, feelings, and behaviors are interconnected, and thus when we make changes in one area, we inherently shift the others,” explains Elena Welsh, a licensed clinical psychologist in Los Angeles, California.
How it works
CBT primarily focuses on changing unhelpful thought and behavior patterns to help relieve PTSD symptoms.
For example, a therapist usually begins by asking you about your past, your experiences, and your beliefs to figure out what motivates you, how you handle disappointment and anger, and how you cope with things. Then, they’ll work with you to try to shift some of your thought patterns.
CBT can be used for treating trauma because it can help you identify how traumatic experiences may have affected your thoughts and behaviors.
If you have PTSD, your therapist might start by trying to understand your thought patterns and how they might have been impacted by the trauma you experience. This is called the development of your trauma narrative.
“Whether in written or spoken form, the client needs to identify, describe, and discuss their traumatic experiences,” explains Luis Ramirez, licensed marriage and family therapist, psychologist, and clinical director for The Children’s Center of the Antelope Valley. “[And] from there, we can evaluate the impact of those traumatic events on current thoughts, feelings, and behaviors.”
For example, has the traumatic event caused you to be more afraid of people or places? Has it caused you to avoid certain things?
Then, “We embark on a process of desensitization, through which the client can develop resilience to future traumatic triggers and events,” Ramirez explains. “We call this process ‘cognitive restructuring’ and it’s designed to change the way one thinks about a particular experience or trigger.”
Your therapist might work with you to reevaluate your thinking patterns and the assumptions you make about your trauma, such as overgeneralizing the likeliness that something bad could happen to you.
Welsh explains that your therapist might also conduct exposure therapy with you.
However, therapists are often careful to avoid situations that might cause you to confront fears or relive traumatic memories. According to Welsh, it’s important to first develop “sufficient coping resources to manage psychological distress“ before starting intense exposure therapy.
Ultimately, the goal is to help you process traumatic events and remove the power they have over your actions and thought processes. In turn, this could help reduce symptoms, like:
CBT is an evidence-based and widely used form of therapy that is considered effective for treating PTSD in children, teens, adults, and older adults.
In fact, the Department of Veterans Affairs (VA) states that CBT is the most effective treatment for PTSD, due to the number of studies that support its use:
- A 2021 systematic review found that CBT worked well at reducing symptoms of PTSD.
- A 2013 study found CBT to be effective at reducing feelings of depression and anxiety in people with PTSD.
2011 literature reviewalso found CBT to be just as effective as several other therapy types in treating people with PTSD.
Solution-focused brief therapy (SFBT)
Not all therapists use CBT for treating PTSD, though. Kelly Vick, a registered psychotherapist in Ontario, Canada, prefers using solution-focused brief therapy (SFBT).
With SFBT, a therapist may ask questions designed to elicit details of your strengths and resources, instead of asking for details of the traumatic event.
“Through their questions, an SFBT therapist shines a light on a person’s strengths and resources, not on their past and their problems,” Vick says.
She explains that focusing on your strengths can generate helpful emotions — such as increased feelings of hope and optimism — that can help improve your confidence and overall mood.
SFBT can help you become more receptive to making small, meaningful changes that may help reduce PTSD symptoms and improve quality of life.
Effectiveness can vary
There are different types of PTSD, and not everyone develops the same symptoms. As a result, the effectiveness of CBT for treating PTSD can vary.
For example, someone with dissociative PTSD might benefit from:
- prolonged exposure (PE)
- Eye Movement Desensitization and Reprocessing (EMDR)
- narrative exposure therapy (NET)
This suggests that there may be a need for more specialized types of CBT for PTSD.
There are several more specialized types of CBT. Some of these include:
- Mindfulness-based cognitive therapy (MBCT). This form combines CBT with meditation to help people develop a nonjudgmental, present-oriented attitude, or mindfulness.
- Dialectical behavior therapy (DBT). This form of CBT uses problem-solving and acceptance-finding to help patients see things in less absolute terms. It has been found to be effective for treating PTSD.
- Cognitive processing therapy (CPT). This is a specialized form of CBT that was developed for treating PTSD, specifically over 12 sessions.
- Cognitive therapy (CT). This type of therapy is commonly used for the treatment of PTSD and involves modifying pessimistic views and memories of the trauma.
Trauma-focused CBT (TF-CBT) is a cognitive behavioral treatment recommended by the American Psychological Association (APA) for PTSD in kids.
This method was developed for children and teenagers who have experienced trauma, though it can also involve non-offending caregivers as well.
How it works
TF-CBT uses interventions like the ones used for adults, but they’re tailored to be more appropriate for younger ages.
There are three phases involved:
- trauma narration and processing
- integration and consolidation
Goals of TF-CBT
Goals of TF-CBT for PTSD include:
- helping kids understand the effects that a traumatic event may have had on their lives
- recognizing unhelpful and inaccurate beliefs, like who is to blame for what happened
- correcting unhealthy behavior patterns
- developing coping skills
- helping find practical solutions
- supporting them
If you live with PTSD, CBT can be an effective type of therapy to help reduce the frequency of symptoms and help you develop coping skills.
Since this is such a well-researched and popular therapy type, there are many therapists who use it with their clients. To find a therapist, check out Psych Central’s resource page on how to find mental health support.