50 CPT Therapy Questions to Ask Clients in Therapy Sessions

Cognitive processing therapy is a structured form of cognitive behavioral therapy that can be used when working with clients who are living with post-traumatic stress disorder. PTSD can develop after exposure to child abuse, combat experiences, rape, and natural disasters. The American Psychiatric Association has reported that PTSD affects approximately 3.5% of U.S. adults each year. Keep reading to learn 50 CPT therapy questions to ask your clients in therapy sessions.

As a structured treatment approach, CPT typically includes 12 therapy sessions. CPT can occur in individual therapy or in group sessions.  Counselors may find themselves focusing on different themes of their client’s life that were impacted by their trauma including safety, trust, power, control, esteem, and intimacy.

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Clients are asked to write an impact statement that explains their understanding of why their traumatic event occurred, and the impact that it has had on their beliefs of themselves, others, and the world around them. This is done before your client is given psychoeducation about their mental health symptoms, and the way that their thoughts and emotions interact with each other.

Psychoeducation is a vital component of cognitive processing therapy. You will spend time providing education about your client’s mental health symptoms, and the connection between their thoughts and emotions. They will then learn to identify the automatic thoughts that influence their current PTSD symptoms and new adaptive ways to respond when these thoughts are present.

Once these steps are completed, your focus then moves to process the trauma that your client has experienced. An assignment often included in CPT asks clients to write down their traumatic experience and read it aloud in the next session. The purpose of this exercise is to stop engaging in avoidance behaviors that pull away from the feelings and thoughts associated with their trauma.

CPT can be effective in addressing any “stuck points” that clients are experiencing, and allow them to use healthier coping strategies in their day-to-day life. Some clients are surprised when they see that other areas of their lives, aside from their PTSD symptoms, are positively impacted by cognitive processing therapy. 

Why CPT Therapy?

Cognitive Processing Therapy (CPT) is chosen for several compelling reasons:

  1. Evidence-Based: CPT is a well-established and evidence-based treatment for post-traumatic stress disorder (PTSD) and related trauma-related concerns. Extensive research supports its effectiveness.
  2. Structured Approach: It offers a structured and systematic approach to processing and addressing trauma, making it accessible for both clients and therapists.
  3. Cognitive Restructuring: CPT helps individuals identify and challenge unhelpful or distorted thought patterns related to their traumatic experiences, leading to cognitive restructuring and a more balanced perspective.
  4. Emotional Processing: CPT assists individuals in emotionally processing their trauma, reducing the emotional distress associated with traumatic memories.
  5. Exposure Techniques: It incorporates gradual exposure to trauma-related thoughts and feelings, allowing individuals to confront their fears and anxieties in a controlled and supportive environment.
  6. Empowerment: CPT empowers individuals by teaching them skills to manage their emotional reactions and regain a sense of control over their lives.
  7. Reduction in Avoidance: It helps reduce avoidance behaviors and encourages individuals to confront their traumatic memories and their associated emotions.
  8. Customized Treatment: CPT can be tailored to the unique needs and experiences of each individual, ensuring that therapy is personalized and relevant.
  9. Positive Therapeutic Relationship: CPT emphasizes building a strong therapeutic relationship characterized by empathy, support, and collaboration.
  10. Long-Term Benefits: Many individuals who complete CPT report sustained improvements in their mental health and quality of life, with reduced risk of relapse.
  11. Trauma-Informed Approach: It is designed with a deep understanding of trauma and its impact on individuals, making it sensitive to the unique needs of trauma survivors.
  12. Enhanced Coping Skills: CPT equips individuals with effective coping skills for managing trauma-related symptoms and emotional reactions.
  13. Complementary to Other Therapies: CPT can be used alongside other therapeutic approaches, enhancing the effectiveness of treatment for various mental health concerns.

Cognitive Processing Therapy is particularly well-suited for individuals who have experienced trauma, especially those with PTSD, and are seeking to process their traumatic experiences, reduce distressing symptoms, and regain a sense of control and well-being in their lives. It offers a structured and evidence-based approach to healing from trauma and is highly regarded in the field of mental health. Keep reading to learn 50 CPT therapy questions you can ask clients in session.

Getting Ready for Your First Cognitive Processing Therapy Session with a New Client

When you are meeting with a new client, there are some things that may look a little different when you use CPT compared to other therapeutic approaches. The first step is to make sure that your client is appropriate for cognitive processing therapy. As noted above, this therapeutic approach is ideal for individuals who are living with PTSD symptoms, however, there are other mental health concerns that can benefit from this approach as well.

If you have received referral paperwork, self-assessments, or screeners, reviewing them before your session can help you gain an understanding of your client’s experience before sitting with them for your session. This can also help you formulate a plan for your session and the areas of your life that you would like to focus on.

Once you have determined that your client could benefit from CPT, the next step would be to explain the benefits and limitations of CPT. This would be the time to discuss the structured approach to CPT and details including the use of assignments that need to be completed outside of the session. It is important that your client is aware that these assignments are needed to proceed with their treatment. If your client has concerns about their ability to complete these assignments outside of their sessions, CPT may not be a good fit for them.

If your client would like to engage in CPT sessions, you may find yourself asking them to write their impact statement before their second session. TherapyByPro offers a variety of CPT worksheets that can be used, including a CPT Impact Statement Worksheet.  

An important topic for counselors, especially those working with clients struggling with PTSD and other trauma-related concerns, is the importance of self-care. As counselors and therapists, we listen to, support, and provide empathy to clients who have experienced a range of traumas and difficulties in their lives. As humans, it is understandable that you could be impacted by your client’s experiences in one way or another.

In order for us to support our clients, we need to make sure that we are taking care of ourselves. This can include taking care of personal needs at the moment, such as making sure we are hydrated and eating properly, as well as addressing any mental health concerns that we may be living with ourselves. Self-care practices can be incorporated into our day-to-day routine to promote our own mental health and wellness. 

Common CPT Questions to Ask Clients in Therapy Sessions

Cognitive processing therapy questions often include Socratic questions and other approaches to help clients see where their automatic thoughts about their trauma may be unhelpful. CPT questions can also be used to facilitate structured sessions and check in with your client’s interpretation and understanding of the material discussed. 

Examples of cognitive processing therapy questions you can use include:

  1. Can we revisit that thought, but with more detail?
  2. Can you describe the concerns you have regarding your mental health?
  3. Can you describe what safety means to you?
  4. Can you describe your experience with trust?
  5. Can you share with me something you have done in the past day or two to show yourself kindness?
  6. Can you share with me the thoughts you are having, after sharing your experience with me?
  7. Can you share with me your experiences with intimacy?
  8. Can you share with me your “stuck point”?
  9. Can you tell me more about that thought?
  10. Do you feel in control of your thoughts and behaviors?
  11. Do you have a safe place that you could describe to me?
  12. Do you have any concerns about writing your impact statement at home?
  13. Do you have any hesitations or concerns about the coping skills we have discussed?
  14. Has the behavior you engaged in led to similar outcomes before?
  15. Have you been able to move past a “stuck point” in the past?
  16. Have you experienced a similar trauma before?
  17. How do you feel after reading your impact statement aloud?
  18. How do you feel after showing yourself kindness?
  19. How do you feel in situations that you cannot control?
  20. How do you feel that your thoughts and emotions are connected to each other?
  21. How do your feelings impact the fault you are placing on yourself?
  22. How does the evidence you have impact your thoughts regarding your responsibility in that situation?
  23. How does this impact your day-to-day life?
  24. How important is intimacy to you?
  25. How would you describe your self-esteem?
  26. How would you describe yourself?
  27. I know that we covered a lot of material today, is there anything we can circle back to for clarification?
  28. Is there another way we can look at this situation?
  29. Is there other information you need to know before deciding if you were at fault?
  30. Tell me about your experience trying to show yourself compassion.
  31. That’s a powerful statement, how does it make you feel to say that?
  32. Were you able to cope with those thoughts and emotions?
  33. What changes will you see when you are making progress?
  34. What coping skills do you feel work the best for you?
  35. What coping skills would you like to practice more?
  36. What did you think would happen?
  37. What did you want to occur in that moment?
  38. What do you believe the main concern or difficulty is for you?
  39. What do you feel you should have done differently?
  40. What emotions are you experiencing after sharing your impact statement with me?
  41. What emotions were you experiencing when writing your impact statement?
  42. What evidence is there to support this thought?
  43. What makes you say it was your fault?
  44. What questions can I answer about the information I shared with you today?
  45. What thoughts came up for you while you were writing your impact statement?
  46. What were you feeling and thinking at that moment?
  47. Whom in your life do you trust? What is it about them that made this so?
  48. Why do you feel that way?
  49. Why do you think I asked you about that?
  50. Would you like to explore ways that you could show yourself kindness?

Final Thoughts On Asking the Right Questions in CPT Therapy

Thank you for reading this resource on 50 CPT therapy questions to ask your clients in therapy sessions. Cognitive processing therapy is a great therapeutic approach for clients who are living with PTSD symptoms and some other mental health concerns.  It is important to note that individuals who are living with PTSD in addition to other mental health concerns may not be a good fit for this form of therapy. This includes individuals who experience dissociation, psychosis, depression, and substance use disorders whose symptoms may prevent them from fully participating in the different aspects of CPT.

If you work with clients who are living with PTSD and other mental health concerns that can benefit from cognitive processing therapy, we encourage you to explore the different Continuing Education

and training opportunities available to you. It is important to ensure that you meet the professional requirements associated with your credentialing entity before utilizing new skills and approaches with your clients.

TherapyPatron.com helps mental health professionals better serve their clients. Our (editable, fillable, printable PDF) therapy worksheets can help you streamline your practice, effectively deliver different types of therapy, and support your clients be the best version of themselves.

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Resources:

Kayla VanGuilder, MA, LCMHC
Author: Kayla VanGuilder, MA, LCMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.

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