Originally published: April 12, 2025 • Updated: November 2026
Here's the Gist:
If you're considering trauma therapy, you might be wondering which treatment would actually help with what you're experiencing.
Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Narrative Exposure Therapy (NET) are structured approaches that work through trauma in different ways.
CPT focuses on beliefs that developed because of trauma. PE focuses on processing traumatic memories and reducing avoidance. NET examines significant experiences across your life, including the good and the difficult.
Understanding the differences can help you know what to expect, but you don't have to choose a treatment before scheduling a consultation.
Cognitive Processing Therapy (CPT): When Your Thoughts Keep You Stuck
CPT can be particularly helpful when trauma has left you struggling with guilt, shame, self-blame, or beliefs that are difficult to shake. You might find yourself thinking:
"It was my fault."
"I should've done something differently."
"I can't trust anyone now."
These thoughts can feel like facts, even when they don't tell the whole story. CPT helps you identify these beliefs, often called stuck points, and examine how accurate they are. We'll look at how trauma has affected what you believe about yourself, other people, and the world, and whether those beliefs still fit the facts.
CPT is a structured, active treatment that includes written practice between sessions. You don't have to describe every detail of what happened to work through the impact it's had on you.
CPT May Be Worth Considering If:
You keep replaying what happened and wondering what you should have done differently.
You blame yourself for things that were outside your control.
Your experiences have changed how you think about trust, safety, control, or your own worth.
You want to work through trauma without having to recount every detail of what happened.
Learn more about what to expect in Cognitive Processing Therapy (CPT).
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, or conversations. Or maybe you've gotten really good at staying busy so you don't have to think about what happened. PE helps you gradually approach the memories and situations you've been avoiding instead of continuing to organize your life around them.
PE has two main components:
Imaginal exposure: During sessions, you'll repeatedly talk through the traumatic memory in a structured way. This gives you an opportunity to process what happened and learn that remembering the experience isn't the same as being back in danger.
In vivo exposure: Between sessions, you'll gradually approach situations, places, or activities that are objectively safe but have felt threatening since the trauma. We'll develop a plan together so you know what you're working toward and why.
PE can be challenging, but you're not thrown into difficult situations without preparation. We'll work together to identify what you've been avoiding, develop a plan, and practice approaching those experiences so they have less control over your everyday life.
PE May Be Worth Considering If:
You've stopped going places or doing things you used to enjoy because they remind you of what happened.
You spend a lot of energy trying not to think about the trauma.
Memories, reminders, or situations trigger fear that feels difficult to manage.
You're tired of making decisions based on what you need to avoid.
Learn more about what treatment looks like in Prolonged Exposure Therapy (PE).
Narrative Exposure Therapy (NET): When It’s Not Just One Thing
Sometimes it's not one particular experience that's bothering you. You've had a lot happen throughout your life, and you want to understand how those experiences fit together and how they've influenced who you are today.
NET is a structured trauma treatment that looks at your entire life, including positive experiences, difficult ones, significant relationships, and aspects of your identity such as race, religion, sexual orientation, and gender identity.
We'll start by creating a timeline of your life. From there, you'll work through your experiences chronologically, writing about one period at a time. During sessions, you'll share what you've written aloud, and we'll process it together, looking for patterns, recurring themes, and connections you may not have recognized before.
There's also room for creativity. Some people write traditional narratives, while others use poetry, music, or other forms of expression. The structure stays the same, but how you express your experiences can be personal to you.
The goal is to understand how your past has shaped you without assuming it has to determine what comes next.
NET May Be Worth Considering If:
You've experienced a lot throughout your life and want to understand how it all fits together.
Different experiences have influenced how you see yourself, your relationships, or the world.
You want to examine the good and difficult parts of your life rather than focusing exclusively on traumatic events.
You're interested in a structured approach that gives you room to explore your experiences in your own words.
Learn more about how I approach Narrative Exposure Therapy (NET).
How Do You Know Which Treatment Is Right for You?
One of the most common questions I get is, "Which one should I choose?" The answer is that you probably don't need to figure that out before reaching out. Some men come in convinced they need one treatment and end up choosing another after we talk through their experiences and goals. Others have done their research and already have a good idea of what they want.
Choosing a trauma treatment isn't just about finding one that sounds appealing. We'll consider what you're struggling with, what you've already tried, what the research tells us about different approaches, and what you're comfortable working on.
You should understand what a treatment involves and why I'm recommending it before we begin. We'll talk through your options together so you can make an informed decision about what makes the most sense for you.
FAQ About Picking a Trauma Treatment
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For PTSD, Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are among the treatments with the strongest research support. Narrative Exposure Therapy (NET) also has research supporting its use, although the evidence is not as extensive. The right approach depends on what you're experiencing, your treatment history, your goals, and your preferences. A trauma therapist should help you understand the options rather than expect you to choose one on your own.
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CPT focuses on examining beliefs that developed because of trauma, particularly those involving guilt, blame, safety, and trust. PE helps you process traumatic memories and gradually approach situations you've been avoiding. NET looks at significant experiences across your life, including positive and difficult ones, to help you understand how they fit together and have influenced you over time.
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You don't have to decide before scheduling a consultation. We'll talk about what you're struggling with, what you've already tried, and what you're hoping to accomplish. A more thorough assessment may be needed before we settle on a treatment, but you'll understand what I'm recommending and why before we get started.
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Yes. Sometimes a treatment doesn't work as expected, or your needs change as therapy progresses. That doesn't necessarily mean it's time to switch immediately. We'll look at your progress, discuss what's working and what isn't, and decide whether adjusting the treatment or trying another approach makes sense.
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Not necessarily. In CPT, you can work through trauma-related beliefs without recounting every detail of what happened. PE involves talking through traumatic memories in a structured way, while NET includes examining and sharing significant experiences throughout your life. You won't be expected to describe everything in your first appointment. We'll discuss what each treatment involves so you know what to expect before beginning.
Ready to Figure Out Which Treatment Fits?
You don't need to know whether CPT, PE, or NET is right for you before reaching out. That's something we can work through together.
I offer a free 20-minute consultation where we can talk about what you're experiencing, what you're hoping to change, and what working together might look like. If we decide to move forward, we'll take the time to determine which treatment makes the most sense for you.
Explore related topics:
| Trauma & PTSD | Trauma Therapy | Stress & Emotional Regulation | Guilt & Shame |Life Transitions & Habits | Relationships & Connection |
About the Author
Brittany Shannon, Ph.D., is a trauma therapist for men with more than 10 years of experience. She trained in the VA system, working with veterans at both outpatient and residential levels of care, and brings that expertise into her private practice today. Based in Kentucky, Dr. Shannon offers virtual therapy across all 43 PSYPACT states, specializing in trauma recovery, PTSD treatment, and men’s mental health. Her work focuses on helping men heal from painful experiences, break free from survival mode, and move forward with clarity and confidence.
You don’t have to keep pushing through this on your own.
