Evidence-Based Treatments for PTSD and Complex PTSD: Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET)
Post traumatic stress disorder (PTSD) and complex PTSD (CPTSD) can profoundly shape how a person views themselves and experiences the world. The emotional and physiological symptoms of hyper vigilance, reactivity to triggers, intrusive memories, emotional numbing or intense anger, and deep self-blame can impact functioning in life. These symptoms and impacts can also be so severe that people believe traumatic disorders are permanent. However, over the past few decades, trauma therapy has evolved, offering evidence-based trauma therapies that genuinely help people heal.
Trauma-informed treatment helps you navigate the complexities trauma-related symptoms.
Two of the most effective and accessible approaches are Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET). Both focus on the power of language -- writing and reflecting on trauma and its impacts -- to process and ultimately transform our relationship with the past. Both trauma therapies are offered by Dr. Alicia Rozycki and AROSE eTherapy®. You are invited to read about PTSD and CPTSD, and decide which of these two trauma recovery approaches may be the best trauma-informed treatment for you.
Understanding PTSD and CPTSD
Before exploring the treatments, it's important to recognize the difference between PTSD and CPTSD. Many people have the misconception that PTSD is a condition that is only applicable to military and veterans. While the identification and study of trauma has its roots in post-war reactions of “shell shock,” we now know that trauma encompasses a range of experiences and can occur to military and civilians alike. Trauma therapy begins with identifying an individual's traumatic experiences, if only to make note of the experience and label the category, such as an accident abuse or assault.
PTSD often develops after a single traumatic event--such as an accident, assault, or natural disaster
CPTSD usually arises from prolonged or repeated trauma like childhood abuse, domestic violence, or captivity
With Cognitive Processing Therapy you are guided through a step-by-step approach to PTSD treatment.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy is one of the most established treatments for PTSD or CPTSD. Developed by Drs. Patricia Resick, Kathleen Chard, and Candice Monson, CPT helps people identify and challenge unhelpful thoughts related to their trauma--known as stuck points. Dr. Rozycki completed CPT training lead by Dr. Chard and can guide you through this step-by-step approach to PTSD treatment.
How CPT Works
CPT is usually delivered over 12 to 18 sessions and involves:
Education about trauma and its effects. Clients learn how trauma affects thoughts, emotions, and behaviors and how trauma comes to be from a neurobiological standpoint. Understanding what is happening in the brain when it comes to trauma can offer relief and understanding. Knowing the neurobiological underpinnings helps to reassure people that that there is nothing “wrong” with them; rather, neuropsychological processes are at play in keeping individuals stuck in trauma.
Writing assignments. Clients write about the impact of the trauma to clarify emotions and patterns of thinking related to five key areas. They explore the ways in which their relationship with themselves and others have been impacted in the five areas of:
a. Safety—physical and emotional
b. Trust—of self and others
c. Power / Control—living in balance without excess fear or submission
d. Self-esteem—confidence internally and with assertion
e. Intimacy—comfort with vulnerability emotionally and physically
Identifying stuck points. These are beliefs that are negative and extreme such as “it was all my fault” or “I can't trust anyone.” Stuck points may have been held lifelong in the case of CPTSD or they may have developed or changed following a trauma, which is more commonly seen with PTSD.
Cognitive restructuring. Through guided questioning and tools learned step-by step through worksheets, clients learn to re-evaluate these beliefs, replacing them with more balanced and compassionate perspectives.
Why CPT Helps
Cognitive Processing Therapy (CPT) helps individuals become more aware of their patterns of negative self-talk. Many people don’t realize how frequently critical or fear-based thoughts arise throughout the day until they begin to track them. Seeing these statements written out in their own words can be a powerful moment of insight, revealing how deeply such thoughts influence mood, behavior, and self-perception. Through the process of identifying, writing about, and actively challenging these distorted beliefs, individuals learn to replace them with a more balanced and compassionate perspective. This shift not only improves self-esteem and emotional well-being but also enhances relationships with others. Extensive research has shown that CPT effectively reduces symptoms of PTSD, depression, and guilt.
Written Exposure Therapy uses the power of writing to engage regions of the brain that calm vs. react.
Written Exposure Therapy (WET)
Written Exposure Therapy (WET) is a newer, streamlined approach to trauma treatment. Developed by Dr. Denise Sloan and Dr. Brian Marx, WET focuses on processing traumatic memories through structured writing exercises in session rather than in-depth verbal discussion.
How WET Works
WET typically involves five sessions, each lasting about 45-60 minutes:
The therapist provides psychoeducation about the trauma and the writing process.
Clients spend each session writing continuously about the traumatic event—what happened, how it felt, their thoughts about the trauma, and how it has affected their lives.
The therapist does not interpret the writing but does check to see that the target instructions were followed. It is the act of writing itself that facilitates emotional processing.
Why WET Helps
Engaging in writing about trauma within a safe and structured framework helps the brain organize and integrate the experience, gradually reducing avoidance and emotional intensity. One of the greatest strengths of Written Exposure Therapy (WET) is its brevity—making it both accessible and cost-effective. Research shows that WET can be just as effective as longer, more intensive treatments for many individuals with PTSD. The approach also has notably low dropout rates, suggesting that participants generally find it manageable and are able to complete the process. For those living with Complex PTSD, WET can serve as a gentle and empowering entry point into trauma processing – offering a way to engage with difficult memories while maintaining a sense of control and emotional safety.
Therapy should be tailored to your preferred style.
Choosing the Right Trauma Treatment
Both CPT and WET offer powerful, evidence-based ways to heal from trauma, but they fit different needs. Depending on circumstances, some individuals elect to use both treatments as WET can target a specific incident while CPT provides tools that can apply to a range of traumas or experiences. CPT offers tools that can also be effective in managing depression, anxiety, and even day to day frustrations.
Cognitive Processing Therapy (CPT)
· Duration: ~12-18 sessions
· Focus: Challenging and reshaping trauma-related beliefs
· Best for: Those ready to engage in structured cognitive work and reflection through active participation in sessions and the completion of homework; rehashing the trauma is unnecessary
Written Exposure Therapy (WET)
· Duration: ~5 sessions
· Focus: Writing-based emotional processing
· Best for: Those who prefer a brief and targeted therapy without homework and who want to tell the story of the trauma
The Power of Writing and Insight in trauma treatment
Beyond fostering ownership and insight, these strategies are also effective from a neuropsychological standpoint. Writing helps shift the brain’s activity from the primitive regions that govern the fight, flight, freeze, and fawn responses of PTSD to the frontal cortex, where higher-order thinking occurs. As a result, emotional and physiological reactivity gives way to calm reasoning and deeper understanding thus allowing individuals to respond thoughtfully rather than react instinctively.
Recovery from PTSD and complex PTSD is not about forgetting or minimizing the past; it's about learning to hold those memories with compassion, understanding, and emotional balance instead of fear. With the guidance of structured therapy, ongoing support, and self-kindness, the past can lose its power to define the present.
Dr. Rozycki offers online therapy for trauma treatment including CPT and WET for PTSD and CPTSD.
Final Thoughts about trauma treatment options
If you're considering CPT or WET, it's best to seek a licensed, trauma-informed psychologist, like Dr. Rozycki, who is trained in these approaches. Healing is deeply personal, but you don't have to do it alone. Both of these therapies offer clear, research-backed paths toward relief and renewed self-trust. Working alongside an expert guide, you will begin to see a reduction in symptoms. Nightmares can begin to decrease and subside and with restful sleep, you will be better able to manage emotional fluctuations. As the body begins to relax, jumpiness and fearful responses to triggers will minimize giving way to calm. Experiences that were painful to recall and discuss become neutralized and can become known without intense fear and reactivation. Interpersonal connections regrow and the positive aspects of life are experienced more fully. If you’re struggling today, take a brave step in reaching out for support; there is no reason to suffer when solutions are available.
About Dr. Alicia Rozycki
Dr. Rozycki is a licensed psychologist, military spouse, and the founder of AROSE eTherapy®. She is a trauma-informed psychologist with over 18 years’ experience and offers empirically validated treatments, including CPT and WET. Focusing exclusively on online therapy for women professionals and military affiliates, Dr. Rozycki offers virtual sessions in Colorado, Delaware, Florida, Maryland, and Pennsylvania. Learn more about Dr. Rozycki.
