Which Trauma Treatment is Right for you?
A comparison of Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Narrative Exposure Therapy (NET)
If you’ve experienced trauma and are thinking about starting therapy, one of the first things you might wonder is: What kind of trauma therapy do I need?
It’s a great question—and a hard one to answer alone. There’s no one-size-fits-all approach to healing, but there are evidence-based treatments with solid track records. In my practice, I offer three of these: Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Narrative Exposure Therapy (NET). Each one is grounded in science, effective for PTSD, and powerful in its own way—but they take different routes to get you where you want to go.
Let’s break down the differences so you can start thinking about which approach might be the right fit for you.
Cognitive Processing Therapy (CPT): When Your Thoughts Keep You Stuck
CPT is a great option if your trauma has left you feeling tangled in self-blame, guilt, or shame. It’s especially helpful if your thoughts sound like:
“It was my fault.”
“I should’ve done something differently.”
“I can’t trust anyone now.”
CPT is all about identifying those beliefs, examining where they came from, and shifting them in a way that aligns with what you know to be true—even if it doesn’t feel true yet. We look at how the trauma changed your beliefs about yourself, others, and the world, and we work to untangle the distortions that are keeping you stuck.
This approach is structured, active, and includes written work between sessions. If you’re someone who likes to problem-solve, challenge your thinking, and understand the why behind your emotions, CPT might feel like a natural fit.
Who tends to benefit from CPT:
People who feel stuck in cycles of guilt, shame, or self-blame
Folks who ruminate or overanalyze
Thinkers who want to understand their trauma as much as they want to feel it
People who are ready to work through their trauma without needing to tell the full story out loud
Prolonged Exposure (PE): When You’ve Been Avoiding and It’s Running Your Life
Avoidance is one of the most common ways trauma shows up. You might avoid certain places, people, conversations—or you might avoid the memories themselves by staying constantly busy, numb, or disconnected. PE is designed to help you stop running and start approaching.
This approach has two major parts:
Imaginal exposure—revisiting the trauma memory in a safe, controlled way during sessions so your brain can begin to process it as something in the past.
In vivo exposure—gradually facing the situations you’ve been avoiding in daily life (with support and a plan).
It’s intense work, but it’s also incredibly effective. If trauma has been holding your life hostage and you’re ready to confront it head-on, PE gives you a roadmap.
Who tends to benefit from PE:
People whose trauma symptoms show up as intense avoidance, panic, or shutdown
Those who are tired of feeling hijacked by flashbacks or fear
Folks who feel like they’ve built their entire life around not thinking about the trauma
People who are ready to approach the hard stuff with guidance and support
Narrative Exposure Therapy (NET): When It’s Not Just One Thing
If you’ve experienced multiple traumas over time—especially if they started early in life or happened in the context of ongoing instability—NET might be the best fit. Rather than zooming in on just one event, NET helps you build a cohesive, chronological narrative of your life, weaving in the highs and lows, the pain and the strength.
In this version of NET, you’ll begin by creating a timeline of your life—one that includes both positive and negative experiences. From there, you’ll write about key events and we’ll process them together, looking for patterns and themes that have shaped how you see yourself, others, and the world. It’s a structured way to make sense of a story that may have felt fragmented or overwhelming, and to reclaim ownership of your narrative—on your terms.
NET is especially helpful for people whose trauma is complex, layered, or difficult to put into words. It’s about reclaiming your story and placing the trauma where it belongs: as a part of your life, not the whole thing.
Who tends to benefit from NET:
People with multiple or long-term traumatic experiences (e.g., childhood trauma, domestic violence, war)
Individuals who have a hard time identifying which trauma is “the one”
Those who feel disconnected from their life story or identity
People who find structure and storytelling helpful
So… How Do I Choose?
The truth? You don’t have to choose on your own.
There’s no “better” treatment here—only what works best for you. Some people come in certain that one approach is right for them, and they’re spot on. Others start with one method and pivot to another as we learn more together. Sometimes the decision is based on what you’re most ready for right now.
My job is to help you understand your options, listen to what’s working (and what’s not), and tailor a treatment plan that fits your story, your needs, and your goals.
Final Thoughts
Starting trauma therapy can feel overwhelming—especially if you’re someone who’s spent a long time avoiding the past just to get through the day. But you don’t have to keep doing it all on your own. These evidence-based treatments are not about endlessly reliving the past. They’re about healing it so you can move forward.
You don’t need to know the exact right fit to get started. You just need to be willing to take the next step.
Schedule a free consultation call to learn more or to see if we’d be a good fit to work together. I’m here to help you figure out what makes the most sense for you.
