How PTSD Therapy Works: A Complete Guide

Post-traumatic stress disorder (PTSD) can be debilitating, affecting a person’s thoughts, emotions, relationships, and daily life. Fortunately, evidence-based therapies can help people process trauma, reduce distressing symptoms, and regain a sense of control.

This guide explains how PTSD therapy works, with a focus on Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE)—the two gold-standard treatments for PTSD available at North Star Psychology.

Understanding PTSD Therapy

PTSD therapy is designed to help people process their trauma in a structured way, allowing them to reduce distress, regain a sense of safety, and move forward. Therapy doesn’t erase traumatic memories, but it changes how those memories are processed so they no longer have the same intense emotional impact.

Two of the primary therapies for PTSD—CPT and PE—take different but complementary approaches:

• CPT focuses on changing the way people think about their trauma and reshaping unhelpful beliefs.

• PE helps people confront trauma-related fears and avoidance behaviors so they can reduce distress over time.

Both treatments are strongly supported by research and have been shown to reduce PTSD symptoms significantly.

Cognitive Processing Therapy (CPT)

What is CPT?

CPT is a structured, cognitive-based therapy that helps people change unhelpful thoughts about their trauma. Many people with PTSD develop distorted or negative beliefs such as:

• “The trauma was my fault.”

• “The world is completely unsafe.”

• “I can never trust anyone again.”

These beliefs can keep PTSD symptoms active by reinforcing fear, guilt, or helplessness. CPT helps people recognize, challenge, and replace these thoughts with more balanced and accurate perspectives.

How CPT Works

CPT is typically completed in 12 structured sessions and follows a clear process:

1. Education About PTSD & Thoughts

   • The therapist explains how PTSD affects thoughts and beliefs.

   • The person learns how their trauma has influenced their current thinking.

2. Identifying & Challenging Unhelpful Beliefs

   • People write about their trauma and examine their thoughts around it.

   • The therapist helps identify “stuck points” (distorted beliefs that reinforce distress).

3. Cognitive Restructuring

   • The therapist teaches skills to reframe unhelpful thoughts.

   • People learn to test the accuracy of their beliefs and develop healthier perspectives.

4. Applying New Skills to Daily Life

   • The therapist helps integrate these thinking strategies into everyday situations.

   • The goal is long-term symptom reduction and better emotional regulation.

Why CPT Works: By changing the way trauma is interpreted, CPT helps people reduce emotional distress, build resilience, and regain a sense of safety in their own minds.

Prolonged Exposure Therapy (PE)

What is PE?

PE is a structured, behavioral-based therapy that helps people gradually confront their trauma-related fears instead of avoiding them. Many people with PTSD try to suppress memories, avoid reminders, or change their routines to escape distress. While avoidance provides short-term relief, it reinforces fear in the long run. PE breaks this cycle.

How PE Works

PE typically lasts 8-12 sessions and includes two key components:

1. Imaginal Exposure

   • The person recalls and verbally recounts the traumatic event in a structured way with a therapist.

   • By repeatedly processing the memory, distress decreases over time.

2. In Vivo Exposure

   • The therapist guides the person in gradually facing real-world situations they’ve been avoiding (e.g., driving after a car accident, going to crowded places after an assault).

   • Through repeated exposure, fear lessens, and people regain confidence in their ability to handle distress.

Why PE Works

• It teaches that avoiding triggers keeps PTSD active, while facing them helps reduce fear over time.

• People learn that distress naturally decreases (a process called habituation), even without avoidance behaviors.

• By systematically confronting fears, PE rewires the brain’s fear response, helping people feel safer and more in control.

How to Choose Between CPT and PE

Both CPT and PE are highly effective, and the choice depends on a person’s needs and therapy preferences:

Factor	CPT	PE
Best for people who:	Prefer to focus on thoughts and beliefs	Prefer to work through trauma-related avoidance
Main approach:	Cognitive restructuring	Exposure-based
Typical length:	~12 sessions	8-12 sessions
Key techniques:	Writing about trauma, challenging beliefs	Facing avoided memories & situations

A trauma-informed therapist can help determine which approach might be the best fit based on symptom patterns, personal comfort, and the nature of the trauma.

Does PTSD Therapy Work?

Yes—research shows that both CPT and PE are highly effective for reducing PTSD symptoms. Studies indicate that 60-80% of people who complete these therapies experience significant improvement (Resick et al., 2017; Foa et al., 2018). These treatments are recommended by organizations like the American Psychological Association (APA) and the Department of Veterans Affairs as first-line treatments for PTSD.

While no therapy erases trauma, CPT and PE help people change how trauma affects them—reducing distress, improving daily functioning, and increasing overall quality of life.

Speaking from personal experience, I have seen people make more progress in 10-12 sessions of one of these treatments than they had made in over 10 years of other therapy.

Take the First Step Toward PTSD Recovery

If you’re looking for PTSD therapy in Alabama, North Star Psychology offers Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE) via telehealth services. Our treatment approach is evidence-based, effective, and tailored to your needs.

Call us at (205) 797-1897 or email info@NorthStarPsyc.com to schedule a free consultation. We’ll usually respond within one business day.

Recovery is possible—let’s take the first step together.

References

American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. American Psychological Association. Retrieved from https://www.apa.org/ptsd-guideline

Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.

Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2018). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. Oxford University Press.

Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635-641. https://doi.org/10.1016/j.cpr.2010.04.007