Day | Group CPT Session Content | Individual CPT Session Content | Homework |
---|---|---|---|
Pre-IOP | N/A | • Call client • Introductions • Program overview • Cognitive Processing Therapy  ○ 15 daily sessions  ○ Trauma-focused  ○ Can initially be challenging but we have found it to help with symptom reductions • Questions? • Motivation for treatment • Barriers • Needed support • Check-in about reactions to call | • Call therapist if questions come up |
Week 1 Monday | N/A | • Set agenda, make introductions and explain check-in process • PTSD symptoms  ○ Intrusions  ○ Avoidance  ○ Negative alterations in cognitions and mood  ○ Hyperarousal • Trauma recovery and Fight-Flight-Freeze response • Cognitive theory • Role of emotions in trauma recovery • Brief review of most traumatic event • Therapy rationale – stuck points • Anticipating avoidance and increasing compliance • Overview of treatment – structured • Discuss group readiness • Check-in about reactions to session | • Write Impact Statement |
Week 1 Tuesday | • Agenda, introductions, and check-ins • Group rules • Provide treatment rationale  ○ Cognitive theory  ○ Types of emotions  ○ Biological basis of PTSD • Not everyone responds to trauma the same • Importance of support among group members • First Impact Statement • Reminder: Impact Statement assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Patient to read Impact Statement • Discuss meaning of Impact Statement • Describe stuck points more fully • Identify stuck points & generate Stuck Point Log • Examine connections among events, thoughts, and feelings • Introduce ABC Worksheets • Check-in about reactions to session | • Complete 3 ABC Worksheets focused on assimilated stuck points |
Week 1 Wednesday | • Agenda and check-ins • Share Impact Statements • Introduce connections between events, thoughts, and feelings • Reminder: ABC Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review ABC Worksheets, further differentiating between thoughts and feelings • Use Socratic questioning on ABC worksheets related to the index event to help patient identify alternative hypotheses • Continue to add to Stuck Point Log • Check-in about reactions to session | • Complete 3 ABC Worksheets focused on assimilated stuck points • Write first Trauma Account |
Week 1 Thursday | • Agenda and check-ins • Continue to share Impact Statements • Discuss ABC Worksheets • Introduce Socratic questioning in group, practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: ABC Worksheet assignment, Trauma Account assignment, and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Patient to read full Trauma Account aloud with affective expression • Identification of stuck points • Use Socratic questioning to challenge assimilated stuck points • Explain difference between responsibility and blame • Continue to add to Stuck Point Log • Check-in about reactions to session | • Complete 3 ABC Worksheets focused on assimilated stuck points • Write second Trauma Account |
Week 1 Friday | • Agenda and check-ins • Share thoughts and feelings about writing Trauma Account • Practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: ABC Worksheet assignment, Trauma Account assignment, and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Patient to read full Trauma Account aloud with affective expression; help identify differences between first and second account • Introduce Challenging Questions Worksheet • Use Socratic questioning to challenge assimilated stuck points • Check-in about reactions to session | • Complete 3 Challenging Questions Worksheet |
Week 2 Monday | • Agenda and check-ins • Discuss re-writing Trauma Account • Assess for and normalize strong emotions at this phase of therapy • Practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: Challenging Questions Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Challenging Questions Worksheet  ○ Focus on assimilated stuck points • Continue cognitive therapy for stuck points • Introduce Patterns of Problematic Thinking Worksheet • Check-in about reactions to session | • Complete 1 Patterns of Problematic Thinking Worksheet |
Week 2 Tuesday | • Agenda and check-ins • Practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: Patterns of Problematic Thinking Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Patterns of Problematic Thinking Worksheet  ○ Complete challenging Questions if patient is still struggling with content • Continue cognitive therapy for stuck points • Introduce Challenging Beliefs Worksheets • Introduce first of five problem areas: Safety • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets • Review Safety Module |
Week 2 Wednesday | • Agenda and check-ins • Practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining assimilated stuck points or Safety stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Challenging Beliefs Worksheets • Introduce second of five problem areas: Trust • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets • Review Trust Module |
Week 2 Thursday | • Agenda and check-ins • Practice challenging assimilated stuck points  ○ Up to two patients share • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining assimilated stuck points or Trust stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Challenging Beliefs Worksheets • Introduce third of five problem areas: Power/Control • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets • Review Power / Control Module |
Week 2 Friday | • Agenda and check-ins • Practice challenging assimilated/over-accommodated stuck points  ○ Up to two patients share • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining assimilated stuck points or Power/Control stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Challenging Beliefs Worksheets • Introduce fourth of five problem areas: Esteem • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets • Review Esteem Module |
Week 3 Monday | • Agenda and check-ins • Practice challenging assimilated/over-accommodated stuck points  ○ Up to two patients share  ○ Focus on trauma themes • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Brief check-in • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining assimilated stuck points or Esteem stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Challenging Beliefs Worksheets • Introduce fifth of five problem areas: Intimacy • Initiate contact with community provider in patient’s area • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets • Review Intimacy Module |
Week 3 Tuesday | • Agenda and check-ins • Practice challenging assimilated/over-accommodated stuck points  ○ Up to two patients share  ○ Focus on trauma themes • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Challenging Beliefs Worksheets • Continue to establish contact with community provider in patient’s area • Check-in about reactions to session | • Complete 3 Challenging Beliefs Worksheets |
Week 3 Wednesday | • Agenda and check-ins • Practice challenging assimilated/over-accommodated stuck points  ○ Up to two patients share  ○ Focus on trauma themes • Reminder: Challenging Beliefs Worksheet assignment and problem solve completion • Check-in about reactions to session | • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Assign Final Impact Statement • Continue to establish contact with community provider in patient’s area • Check-in about reactions to session | • Final Impact Statement |
Week 3 Thursday | • Agenda and check-ins • Discuss Final Impact Statement • Involve patients in reviewing the course of treatment and patient’s progress • Help identify goals for the future and delineate strategies for meeting them • Check-in about reactions to session/program | • Complete practice assignment review and set agenda • Review Challenging Beliefs Worksheet  ○ Address remaining stuck points • Help patient confront problematic cognitions and generate alternative beliefs using the Challenging Beliefs Worksheet • Patient to read Final Impact Statement • Involve patient in reviewing the course of treatment and patient’s progress • Help identify goals for the future and delineate strategies for meeting them • Continue to establish contact with community provider in patient’s area • Check-in about reactions to session | N/A |
Week 3 Friday | N/A - Graduation | • Review course of treatment and patient progress • Go over discharge plan • Assess patient goals for the future • Continue to establish contact with community provider in patient’s area • Review referrals and plan for aftercare | N/A - Graduation |