Cognitive Processing Therapy: E2i Toolkit

Cognitive Processing Therapy (CPT) is an evidence-based, cognitive behavioral treatment for posttraumatic stress disorder (PTSD) delivered by a behavioral health therapist trained in CPT. In collaboration with HIV experts and community members, E2i adapted CPT for the Ryan White HIV/AIDS Program (RWHAP) and produced a toolkit that provides the resources needed to implement CPT within RWHAP settings and other HIV care organizations.


  • To reduce symptoms of PTSD and related disorders (e.g., depression)
  • To help people with HIV stay engaged in HIV care

Priority Population

  • People with HIV who have a diagnosis of PTSD 

Core Elements

1. Assessment and Symptom Monitoring

  • All clients are screened for PTSD. Positive screens receive further assessment for PTSD
  • During treatment, clients are monitored weekly for changes in symptoms of PTSD

2. CPT Sessions 

  • CPT sessions are delivered by a behavioral health therapist who follows the protocol and worksheets in the CPT Manual
  • Sessions can be delivered one-on-one or in a closed group

3. Socratic Dialogue

  • Socratic dialogue is a technique that values clients coming to know something for themselves, rather than the therapist telling them what to do. This technique is helpful when addressing clients’ thoughts regarding their personal experiences with trauma

4. Identifying and Challenging “Stuck Points”

  • “Stuck points” are unrealistic or unhelpful thoughts related to trauma that prevent recovery from PTSD. Clients learn to identify, evaluate, and challenge stuck points


  • Clients may receive between 6 and 24 weekly or biweekly sessions. Most clients receive about 12 sessions. Individual sessions are 50-60 minutes (individual sessions); group sessions are 90 minutes
  • CPT treatment length is determined by monitoring the client’s PTSD symptoms in response to intervention


CPT can be delivered in any organization that serves people with HIV and employs a behavioral health therapist

Toolkit Components

This Guide includes:

  • How to plan and implement the intervention
  • Lessons learned during implementation in RWHAP settings
  • Outcomes from the E2i initiative

CPT E2i Implementation Guide (PDF)

A Spanish version of the Implementation Guide is coming soon!

Watch an instructional dramatization of how to deliver CPT to clients.

Download posters and a brochure that explain CPT and its benefits for clients. You can add your organization's contact information to these materials and distribute them in your clinic. 

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