The Blame Game

Client presentation and choice of therapy is often a challenge for clinicians. There are often many facets of a client’s experience of PTSD. This includes dissociative experience, multiple traumas, chronicity, severity, experience of tonic immobility and self-blame. All these may be considerations in the choice of therapy. Research suggests that cognitive processing therapy (CPT) may be a particularly well suited intervention for trauma survivors who endorse self-blame. However, the question, “Does it work with clients who don’t describe self-blame as a significant component of their PTSD”, has not been answered. In a June 2018 article in the Journal of Traumatic Stress ( this was examined.
The authors examined veterans with PTSD. They divided them into two groups prior to treatment. Those who endorsed low levels of self-blame and those that endorsed high levels of self-blame. They found that there was no difference in treatment response between the low and high self-blame groups.


CPT is effective treatment for PTSD in client’s who endorse self-blame and those that don’t.


Stayton, L.E., Dickstein, B.D. and Chard, K.M. (2018), Impact of Self-Blame on Cognitive Processing Therapy: A Comparison of Treatment Outcomes. JOURNAL OF TRAUMATIC STRESS, 31: 419-426.

Resick, P. A., Nishith, P.,Weaver, T. L., Astin,M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.