Know that CPT-C (cognitive only) skips the trauma narrative

A cognitive-only version of CPT omits the written trauma account and may be more tolerable for some people.

Why it works

The original CPT included a written trauma account (a detailed narrative of the event) as a component alongside the cognitive work. Resick’s research group subsequently tested "CPT-C" — the cognitive-only version — and found it produced equivalent outcomes in most populations. This matters because the written trauma account is the most distressing element for many people, and knowing that an equally effective alternative exists increases the options for who can engage with and complete treatment.

How to do it

1. When seeking CPT, ask prospective therapists whether they offer CPT-C (cognitive-only) as well as the full protocol.
2. If avoidance of the written account is specifically blocking you from engaging, explicitly discuss CPT-C as an option.
3. CPT-C follows the same stuck-point identification, Socratic questioning, and challenging beliefs process — it omits only the detailed narrative writing.
4. For some clients (especially those with severe avoidance or writing difficulties), CPT-C is preferable; for others, the written account deepens the processing.

Evidence

CPT vs. CPT-C (without written account) has been directly compared in RCTs, with CPT-C showing equivalent outcomes in most populations. This is a robust finding with direct relevance for treatment selection. (rct)

Equivalence was found at the group level; individual response to the written account vs. cognitive-only format may vary. A CPT-trained therapist is best placed to make individualized recommendations.

Sources

• Resick et al. (2008), comparing CPT, CPT-C, and written account only for PTSD, Journal of Consulting and Clinical Psychology

Common mistake

Assuming the written trauma account is essential to CPT’s effectiveness and avoiding the treatment because that component feels intolerable. The cognitive-only version removes that barrier without sacrificing outcomes for most people.