Working the mind
The trauma-focused therapies with the strongest evidence, plus two frameworks many people find useful. For each: what a session looks like, and what you can practice now.
Trauma leaves behind conclusions: "It was my fault." "I can't trust anyone." "The world is dangerous." CPT calls these stuck points. It teaches you to examine them like evidence and replace the ones that don't hold up.
One of the best-studied PTSD treatments in existence, with dozens of trials including many with service members and veterans. Recommended first-line in the VA/DoD guideline and offered across the VA.
| Phase | What happens |
|---|---|
| Sessions 1–2 | Learn how PTSD works. Write an Impact Statement: why you think it happened and how it changed your beliefs. |
| Sessions 3–5 | Identify stuck points. Learn to separate events, thoughts and feelings. |
| Sessions 6–7 | Challenge stuck points with structured questions. Look at blame and "could have / should have." |
| Sessions 8–12 | Work through five themes: safety, trust, power and control, esteem, intimacy. Rewrite the Impact Statement. |
Typically 12 weekly sessions of about an hour, individually or in a group, with short practice sheets between sessions. Talking through the full trauma story is optional.
| 01 | Catch one stuck pointWrite a belief you carry since the trauma, as a sentence. Absolutes ("always," "never," "I should have") are clues. | 5 min |
| 02 | Check the evidenceWhat facts support it? What facts don't? What would you tell a buddy who said it? | 10 min |
| 03 | Hindsight checkDid you know then what you know now? Judge the decision with the information you had at the time. | 5 min |
| 04 | Write a balanced versionNot a positive spin, an accurate one. | 5 min |
Self-practice is a warm-up, not a substitute. Stuck points about blame and guilt are hard to shift alone; a CPT-trained therapist makes the difference.
| ✕ | Fault: Treating it as positive thinkingCorrection: CPT is about accuracy. The goal is a true sentence, not a happy one. |
| ✕ | Fault: Skipping the practice sheetsCorrection: The work between sessions is where most of the change happens. |
Ask for a therapist certified or trained in CPT; the VA trains its clinicians in it. A free CPT Coach app supports a course with a therapist.