Socratic Questioning: The Art Of Guided Self-Discovery

Socratic questioning is the cornerstone for CPT, as well as other cognitive behavioral treatments. According to this method, true change within a patient’s problematic cognitions can only take place if it comes from them, through their own words, self-questioning and discovery. In this video, you will see two examples of a therapist questioning a patient. In the first, the therapist is questioning the patient with a clear agenda or direction in which she wants to take the conversation. You will notice that this type of questioning can miss potentially important areas of information that need to be explored. In the second example, the therapist is using the Socratic method to let the patient lead the topic. This type of questioning may take a bit longer, but its open nature allows the patient to share more information and come to conclusions on their own, leading to a deeper understanding and belief in their cognitive shifts.

Working With Guilt In CPT

Guilt is an emotion that is commonly encountered when working with trauma.  It can be difficult to know how to address guilt in therapy regardless if the guilt is realistic or not.  In this video, you will learn ways to help a patient process through guilt and cognitively challenge stuck points.  This video will first demonstrate ways you might assist with manufactured guilt through challenging the patient to reconsider their responsibility in the trauma event.  The second part of this video will demonstrate how you might handle a trauma where the patient had both intent and responsibility, and the guilt is more realistic.  In both cases, you will see how to identify and challenge the patient’s cognitions about the event and their role, and help them move forward in the path toward recovery.​

Identifying The Index Trauma

Sometimes clients who have experienced multiple traumas express difficulty in choosing one trauma on which to focus.  By asking specific questions and providing a careful explanation of the rationale behind this approach, the therapist works with the client to determine which trauma is most likely causing the majority of symptoms.  In addition, the therapist works to resolve misunderstandings or concerns the client may have regarding the choice of one trauma over another.​

Helping A Client To Choose Between CPT And CPT-C

Cognitive Processing Therapy (CPT) can be delivered with a written trauma account (CPT) or without a written Account (CPT-Cognitive Only, or CPT-C). In this video, a description of both CPT and CPT-C are discussed with the client. Of note is how the therapist uses questions to elicit information and engage the client in deciding which approach to use.

Introducing A Patient To Prolonged Exposure And Cognitive Processing Therapy

Given that both PE and CPT have strong empirical support and have been found to be equally effective in reducing symptoms of PTSD when compared to each other, it may be difficult to decide which approach to use with a client. Presenting a balanced description of each treatment will help your client to make an informed decision that aligns with their unique goals and preferences for treatment. The following videos will provide examples of concise descriptions of the rationale, main interventions, and key differences between CPT and PE. The first video is an example of an abbreviated discussion that may occur at the end of a treatment planning session. The second video is lengthier and provides an example of a more through, detailed discussion.​​

Identifying Stuck Points

Identifying stuck points and using the stuck point logs are integral techniques in CPT, but can be challenging for novice CPT therapists.  Patients frequently share thoughts and statements that are not quite stuck points.  Fortunately, therapists and patients can work collaboratively to identity the underlying stuck point.  This segment will demonstrate how to clarify the stuck point associated several different types of statements.  

Utilizing The PCL-5 In CPT: The Unidentified Stuck Point

The PCL-5 is an essential tool that will assist you in monitoring changes in PTSD symptoms as your client moves through the CPT protocol. In this video, you will see brief demonstrations of a therapist using the PCL-5 to address an unidentified stuck point that may be contributing to ongoing symptoms, to differentiate between symptoms of PTSD and general symptoms of distress, and to highlight significant improvement in symptoms during the course of CPT.​

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