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The Role of Cognitive Processing Therapy in Addiction Recovery

Addiction, also known as substance use disorder (SUD), is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic brain disorder. It is characterized by compulsively engaging in rewarding stimuli without regard for consequence. Data from 2022 presented by the National Center for Drug Abuse Statistics, indicate that addiction affects over 20 million Americans aged 12 and older. The development of substance use disorder does not occur immediately, nor will recovering from addiction be achieved instantaneously. Further, there is no universal treatment method that proves most effective when it comes to the recovery process from substance use disorder. Rather, a customized treatment plan that considers an individual’s unique circumstances and is tailored to address his or her nuanced and distinct needs is essential to the efficacy of treatment. Depending on one’s needs, including Cognitive Processing Therapy into one’s treatment plan may be advantageous. 

Cognitive Processing Therapy (CPT) is an is an evidence-based treatment that was originally developed in the 1980s to treat post-traumatic stress disorder (PTSD). Post-traumatic stress disorder, as defined by the Mayo Clinic, “is a mental health condition that’s triggered by a terrifying event—either experiencing it or witnessing it.” PTSD is recognized in the DSM-5 as a diagnosable mental health condition and is listed under the new category called Trauma- and Stressor- Related Disorders. CPT focuses on “restructuring trauma-related maladaptive thoughts about the meaning of the traumatic event and about self, others, or the world that serve to maintain trauma symptoms (i.e., “stuck points”), and helping facilitate emotional processing of the event.” CPT, which is generally delivered over 12 sessions, follow a process that includes three phases:

  • First Phase – Psychoeducation: This stage involves learning about and exploring the link between trauma-related thoughts and feelings and how they may manifest as PTSD symptoms. This phase also allows clients to identify unhelpful thoughts that might contribute to and/ or exacerbate PTSD symptoms.
  • Second Phase – Processing of Trauma: This stage involves helping the client process the traumatic event. BetterHelp explains that a clinician “may ask the individual to write an impact statement about the trauma and read it back. By confronting the event in a safe environment rather than avoiding it, the client may feel better able to process their emotional responses.”
  • Third Phase – Modify Beliefs Related to Traumatic Events: Through Socratic questioning or other techniques, the therapist encourages the client to question their maladaptive thoughts to help them modify potentially unhelpful ways of thinking about their trauma. During this phase, the therapist and client work together to shift beliefs surrounding common areas of struggle (e.g., safety, trust, power and control, esteem, and intimacy) that are often impacted by trauma. 

PTSD is a common co-occurring diagnosis people with substance use disorders often experience. Statistics from The National Child Traumatic Stress Network indicate that nearly 76% of individuals who are addicted to alcohol or drugs have been exposed to some type of trauma. Although CPT was not specifically designed for addiction recovery, it can play a valuable role in the overall treatment process for trauma survivors struggling with substance use disorder. 

For Information and Support Substance abuse and addiction can be incredibly dangerous and can result in severe short and long-term consequences. If you or someone you know is suffering from substance abuse or addiction, please get help as soon as possible. The earlier you seek support, the sooner you and your loved ones can return to leading happy, healthy, and fulfilling lives. There is no reason to go through this alone, and we are here to help. Please feel free to reach out to us for further information or with any questions regarding substance abuse or addiction. We are available anytime via telephone at: 213-389-9964, or you can always email us at:

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