The impact of traumatic events first responders are exposed to can have significant consequences on their mental health, including post-traumatic stress disorder (PTSD). There are various treatment options for PTSD, and one of the most successful is cognitive processing therapy (CPT). 

What Is Cognitive Processing Therapy?

Cognitive processing therapy is a form of cognitive-behavioral therapy that focuses on identifying how thought patterns relate to life experiences. By challenging unhelpful thoughts and correcting those that may get in the way of healing, CPT helps people re-evaluate their experiences with self-compassion. Processing life events in a safe setting and disputing underlying beliefs can heal and encourage greater peace. 

Developed in the 1980s, CPT is a 12-session, structured treatment model initially used to treat sexual assault victims. It starts with education about the treatment and what to expect. Therapists then ask their clients to write about the impact of their trauma and share in follow-up sessions. CPT is effective for a variety of treatment needs, including:

  • Combat veterans
  • PTSD survivors
  • Torture victims
  • Abuse victims
  • Refugees
  • Addiction
  • Panic disorder
  • Anxiety
  • Depression

Cognitive Processing Therapy for PTSD

First responders and others with PTSD can benefit from CPT. One study showed that 69% of first responders do not get enough time to recover after a traumatic event before having to go out on another call. This can result in overwhelmed, multi-trauma lifestyles in which first responders struggle with their emotional health and are still trying to keep up with the demands of work. When traumatic events occur, the aftermath can cause ongoing psychological and physical challenges such as:

  • Sleep disturbances
  • Flashbacks
  • Intrusive thoughts
  • Mood dysregulation
  • Feeling on-edge or startling easily
  • Irritability
  • Concentration problems

PTSD can impact relationships, work life and one’s ability to cope. Cognitive processing therapy can help by sharing underlying thoughts and feelings that may contribute to these symptoms. It can help people develop a new framework for their experiences and learn new ways of thinking about their symptoms. 

Cognitive Processing Therapy for Alcohol Abuse and Drug Addiction

When left untreated, people who have experienced trauma may resort to alcohol or drug use to escape the discomfort. Substance use may temporarily disconnect a person from their thoughts and feelings but lead to greater problems in the long term. 

recent study estimated that 50% of male firefighters have engaged in binge drinking or heavy alcohol use in the prior month. Female firefighters in the study reported binge drinking at a rate of 39.5%. Addiction rates are often higher for people on the front lines of traumatic events, such as police officers, EMTs, firefighters and EMS workers. 

Exposure to trauma can cause so much distress and pain that substance use feels like a necessary escape. Cognitive processing therapy helps people struggling with addiction to address underlying causes, including the thoughts and feelings that may perpetuate use. 

CPT Treatment for First Responders 

The FORTITUDE program is ready to assist when it comes to helping first responders manage trauma, PTSD, and substance use disorder. This specialty track was developed to meet the specific needs of first responders who have struggled with substance use, trauma and any other co-occurring mental health conditions. With evidenced-based treatment options, including cognitive processing therapy, FORTITUDE can help the following populations:

  • Law enforcement
  • Fire service members
  • Military veterans
  • Correctional officers
  • Paramedics/EMTs
  • Emergency room personnel 

There is no need to face addiction or trauma alone. If you or a loved one is a first responder who could use the support of the FORTITUDE program, reach out today

Editor – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Medically Reviewed By – Paula Holmes, LCSW
Paula Holmes is a licensed clinical social worker, psychotherapist and freelance writer who lives and works in midcoast Maine. She received her master's degree in Social Work in 2008 from the University of Maine. Read more

American Psychological Association. “Cognitive Processing Therapy.”July 31, 2017. Accessed November 7, 2021.

Johns Hopkins Bloomberg School of Public Health. “Cognitive Processing Therapy (CPT).” Accessed November 7, 2021.

U.S. Department of Veteran Affairs. “Cognitive Processing Therapy for PTSD.” National Center for PTSD, January 10, 2020. Accessed November 7, 2021.

National Institute of Mental Health. “What is post-traumatic stress disorder, or PTSD?” 2020. Accessed November 7, 2021.

Substance Abuse and Mental Health Services Administration. “First Responders: Behavioral Health C[…]esponse, and Trauma.” May 2018. Accessed November 7, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.