TTC Cognitive Processing Therapy 2 — Questions and Answers
Question 1: In CPT, what is the primary purpose of the Impact Statement written at the beginning of treatment?
- To document the client's trauma history for clinical records
- To help the therapist assess PTSD severity using standardized scoring
- To elicit the client's beliefs about why the trauma occurred and its impact on their life (Correct answer)
- To establish a therapeutic alliance by sharing personal experiences
Correct answer: To elicit the client's beliefs about why the trauma occurred and its impact on their life
The Impact Statement asks clients to write about their understanding of why the trauma occurred and how it has affected their beliefs about themselves, others, and the world.
Question 2: Which cognitive distortion in CPT involves a client believing they must always be on alert because danger is everywhere following trauma?
- Hindsight bias
- Overgeneralization of danger (Correct answer)
- Self-blame attribution
- Emotional reasoning
Correct answer: Overgeneralization of danger
Overgeneralization of danger is a stuck point where the client inappropriately extends the threat experienced during trauma to all situations in their current environment.
Question 3: A CPT therapist notices a client repeatedly says 'I should have fought back.' Which technique is MOST appropriate to address this?
- Prolonged exposure to the traumatic memory
- Socratic questioning to examine the evidence for and against the belief (Correct answer)
- Relaxation training to reduce associated anxiety
- EMDR to reprocess the memory
Correct answer: Socratic questioning to examine the evidence for and against the belief
Socratic questioning guides clients to examine the evidence supporting and refuting their stuck points without the therapist directly challenging or disputing the belief.
Question 4: What distinguishes CPT+ from the standard CPT protocol?
- CPT+ includes medication management as an adjunct
- CPT+ incorporates a written trauma account in addition to cognitive worksheets (Correct answer)
- CPT+ is delivered in group format exclusively
- CPT+ uses EMDR techniques alongside cognitive restructuring
Correct answer: CPT+ incorporates a written trauma account in addition to cognitive worksheets
CPT+ includes the written trauma account (Stuck Point Log and account writing) in addition to the cognitive worksheets used in the standard CPT protocol.
Question 5: During which CPT session does the therapist typically introduce the concept of 'assimilation' vs. 'accommodation' vs. 'over-accommodation'?
- Session 1, during the informed consent process
- Session 2, when explaining the cognitive model (Correct answer)
- Session 6, after completing the trauma account
- Session 10, during the final review
Correct answer: Session 2, when explaining the cognitive model
The therapist introduces assimilation, accommodation, and over-accommodation in Session 2 when explaining how trauma affects beliefs and how the brain processes new information.
Question 6: A CPT client states: 'Because I was assaulted, I know that all men are dangerous.' This belief BEST exemplifies which problematic pattern?
- Assimilation — altering the memory to fit pre-existing beliefs
- Accommodation — appropriately updating beliefs based on new evidence
- Over-accommodation — overgeneralizing the trauma to create extreme new beliefs (Correct answer)
- Hindsight bias — believing they should have predicted the assault
Correct answer: Over-accommodation — overgeneralizing the trauma to create extreme new beliefs
Over-accommodation occurs when a person over-adjusts prior beliefs in response to trauma, creating extreme, unhelpful new schemas (e.g., all men are dangerous).
Question 7: Which of the five CPT themes addresses a client's belief that they are inherently bad or deserve punishment following their trauma?
- Safety
- Trust
- Power/Control
- Esteem (Correct answer)
Correct answer: Esteem
The Esteem theme in CPT addresses beliefs about self-worth and the worth of others, including self-blame, shame, and feelings of being fundamentally flawed or deserving of harm.
TTC Cognitive Processing Therapy 2
In CPT, what is the primary purpose of the Impact Statement written at the beginning of treatment?