Practice and PTSD treatment

Practice Makes Perfect Less PTSD Symptoms

Engaging your clients in practice outside a session has always been thought an important factor for improvement in many therapies. In a 2017 article in the journal Behavior Therapy (doi:10.1016/j.beth.2017.12.001) this commonsense idea was supported by the data for Cognitive Processing Therapy (CPT).

What you should know when thinking about CPT practice and your clients.

There are two versions of CPT. One includes a written trauma account and the other omits it.  The research found that both are equally effective for the reduction of PTSD symptomatology.

Like many therapies CPT asks the client to complete practice outside the therapy session. The research found that the more a client completes home practice the lower his or her PTSD symptoms are after treatment.  However, in the short-term – before session five – the decrease in symptoms may be slow. It is important for clients to know that the more they practice during the early stages of treatment the greater the symptom changes over the course of treatment.

This focus on practice also applies later in the therapy. The study found that those who complete more practice after session seven have even greater gains than those who complete less practice.

Client characteristics in relation to treatment outcomes or adherence to practice were also examined. This study found that age, years of education, months since rape, and minority status were not related to how much someone practised. Remember practice was related to good outcomes.

Another finding of this study was that in the second half of treatment the more practice the client did the less likely they were to drop out. This is potentially very useful information to share with a client, especially if they are struggling with motivation or avoidance.


Stirman, S. W., Gutner, C. A., Suvak, M. K., Adler, A., Calloway, A., & Resick, P. (2018). Homework Completion, Patient Characteristics, and Symptom Change in Cognitive Processing Therapy for PTSD. Behavior therapy49(5), 741–755.