Addressing Stuck Points in Cognitive Processing Therapy

D.I.V.E. Therapy & Consulting, LLC

Key Points

  1. CPT focuses on identifying and addressing stuck points, which are maladaptive beliefs hindering recovery from trauma.
  2. Therapists must distinguish between overgeneralized beliefs and valid concerns about safety, especially in culturally diverse contexts, to avoid invalidating experiences.
  3. While therapists should avoid questioning the likelihood of racism, they can effectively challenge overgeneralized beliefs about safety and trust, particularly in cases of cumulative trauma.
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Cognitive processing therapy (CPT) involves identifying unhelpful beliefs, known as stuck points. These are obstacles where an individual remains unable to recover from trauma due to maladaptive thinking or understanding. The process involves exploring beliefs related to safety and trust, identifying potential stuck points in these areas.

Cultural Responsiveness in Therapy

When working from a culturally responsive stance, it is crucial to distinguish between overgeneralized problematic beliefs (e.g., “no one is safe”) and valid concerns about safety. For instance, Mr. Johnson, as a Black male in the United States, has legitimate worries about racism and injustice based on his past experiences. It’s important not to question the validity of someone’s beliefs about racism or the likelihood of racist incidents occurring.

Challenges in Cognitive Behavioral Therapy (CBT)

In CBT, while assessing the probability of certain events, therapists should avoid questioning the likelihood of racism. Doing so can invalidate a person’s experience, potentially leading to feelings of disbelief or minimization of their experiences. This approach is not helpful in identifying and challenging certain types of thoughts.

Addressing Overgeneralized Beliefs

Overgeneralized beliefs about safety and trust, common in individuals who have experienced trauma, especially cumulative trauma, are appropriate targets in therapy. For example, the belief that “no one can be trusted” is a significant stuck point that can be addressed effectively.

Importance of Sensitivity to Nuanced Beliefs

Therapists must be attentive to the nuances of different types of beliefs around safety and trust. Failing to do so risks enacting microaggressions within the therapeutic relationship. These microaggressions, often subtle and not as explicit as overt racism, can invalidate the experiences of individuals from minoritized backgrounds, including Black, Indigenous, People of Color, LGBTQ individuals, and others with minoritized identities.

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Addressing Stuck Points in Cognitive Processing Therapy