Is EMDR or CPT Better for PTSD Treatment?
If you've been researching PTSD treatment, you've probably come across these two really effective approaches: EMDR and CPT. Both have strong research backing them. Both can help you heal from trauma. But which one is right for you?
The short answer? It depends. Your brain, your body, your trauma, and your healing process are unique. What works best for one person might not be the ideal fit for another.
At Aspire Counseling in Lee's Summit, we value both approaches. Our trauma therapists are trained in EMDR, CPT, and other evidence-based methods. We believe the best treatment is the one that fits your specific needs and circumstances.
Let's explore how these two powerful trauma therapies work and what might help you decide.
How Does Trauma Affect Your Brain and Body?
Before we dive into treatment options, it's helpful to understand what's happening inside you when trauma strikes.
When something traumatic happens, it doesn't just affect your thoughts. It impacts your entire nervous system. Your brain, emotions, and body are all connected. They work together as one system.
Think of your nervous system like a smoke detector. When it senses danger, it sounds the alarm. Your heart races. Your muscles tense. Your breathing changes. This happens automatically to keep you safe.
After trauma, this alarm system can get stuck. Your body might react as if you're still in danger, even when you're safe. You might feel anxious, jumpy, or on edge. You might have flashbacks or nightmares. This isn't your fault. It's your nervous system trying to protect you.
The good news? Your brain has an amazing ability to heal and create new pathways. Both EMDR and CPT tap into this natural healing process. They just do it in different ways.
Does Change Happen "Top Down" or "Bottom Up"?
In the trauma therapy world, there's ongoing discussion about whether healing happens "top down" or "bottom up."
"Top down" means starting with thoughts and working down to emotions and body sensations. "Bottom up" means starting with body sensations and working up to thoughts and emotions.
Here's what we've learned from years of helping trauma survivors: change happens both ways. Sometimes you need to start with your thoughts. Sometimes you need to start with what your body is holding. Often, you need both.
This is why working with a specialized trauma therapist matters. They can help you figure out what type of trauma and ptsd treatment will work best for your specific situation.
What Is CPT and How Does It Work?
Cognitive Processing Therapy (CPT) focuses on how you think about your trauma. It examines the beliefs you've developed about yourself, others, and the world since your traumatic experience.
Here's the thing: many trauma survivors develop similar thought patterns. You might think your beliefs are uniquely yours, but we often see common themes. Thoughts like "I'm not safe," "I can't trust anyone," or "It was my fault" are actually quite common among trauma survivors. Some of these thoughts lead to shame and guilt. They may result in your feeling fearful. They may serve as reminders. It’s typically coming from a place of trying to understand what happened and keep yourself safe in the future.
We don't judge these thoughts. They made sense at the time. Your brain was trying to make meaning of something that felt senseless. But now, these beliefs might be keeping you stuck.
CPT gives you tools to examine your beliefs more closely. You'll learn to look at your thoughts and ask questions like:
Is this belief helping me or hurting me?
Is there evidence for and against this belief?
What would I tell a friend who had this same thought?
How is this belief affecting my daily life?
Then you get to choose. Which beliefs serve you? Which ones need to be updated? Which ones can you let go of entirely?
The Structure of CPT
I love the structure of CPT. It was originally designed to be exactly 12 sessions. Now, we usually offer variable length treatment. This means you might need fewer than 12 sessions, or you might benefit from a few extra.
We work with what you need. Some people feel significantly better after 8 sessions. Others need 15 or 16 sessions to feel ready to move forward.
At Aspire Counseling, we also offer trauma therapy intensives using CPT. We can complete 10 sessions over one week, meeting twice a day. Some clients choose to add a second week a few weeks later where we finish the full course of CPT and incorporate some EMDR work as well.
You can learn more about our intensive approach in our blogs How Cognitive Processing Therapy Works for PTSD and What to Expect During Trauma Therapy Intensives.
What Is EMDR and How Does It Work?
Eye Movement Desensitization and Reprocessing (EMDR) takes a different approach. Instead of starting with thoughts, EMDR focuses on how your brain and body respond to trauma memories.
Here's something important to understand: when you're having a strong reaction to something in the present, you're often actually responding to something from the past. Your nervous system doesn't always distinguish between "then" and "now."
EMDR helps your brain process traumatic memories in a new way. It uses bilateral stimulation (usually eye movements, but sometimes sounds or taps) while you think about the trauma. This helps your brain integrate the memory more naturally.
During EMDR, you might notice changes in how the memory feels in your body. Images might become less vivid. Emotions might feel less intense. Negative beliefs about yourself might lose their power.
EMDR taps into your body's natural healing wisdom. It works with what your nervous system is already trying to do: process and integrate difficult experiences.
You can read more about how EMDR works in our blogs What Most Surprised Me About EMDR: That it Actually Works and What is Resourcing in EMDR?.
How Do I Know Which Approach Is Right for Me?
This is where working with a specialized trauma therapist becomes absolutely essential. Not every therapist who can legally provide trauma therapy has the specialized training and experience needed to help you choose the most effective approach.
A trauma specialist can help you figure out what might work best based on:
Your specific symptoms: Some people respond better to cognitive approaches. Others benefit more from body-based work.
Your learning style: Do you like to understand things logically? CPT might be a good fit. Do you prefer to work more intuitively? EMDR might appeal to you.
Your trauma history: The type and timing of your trauma can influence which approach might be most helpful.
Your current life situation: Sometimes practical factors matter. EMDR often requires fewer sessions. CPT provides specific tools you can use on your own.
Your comfort level: Some people feel more comfortable with the structured, educational approach of CPT. Others prefer the more intuitive process of EMDR.
An experienced trauma therapist will consider all of these factors and more. They'll use their specialized knowledge to guide you toward the approach that's most likely to help you find relief and healing.
Can I Use Both EMDR and CPT?
Absolutely. Both are great trauma and ptsd treatment options. At Aspire Counseling, we offer a variety of trauma therapies that are well researched and shown to help. You might start with one method and add the other later.
The goal isn't to pick the "perfect" therapy from the start. It's to work with a trauma specialist who can adapt their approach based on what you need and how you're responding.
Our therapists try to stick pretty closely to one specific method at a time. But because we’re trained in multiple trauma therapy methods, we may be able to weave in elements of another to individualize your treatment. But know that we’re most likely going to follow one specific treatment pretty closely.
Why? Because we want to give you the absolute best chance of finding relief from PTSD symptoms.
At Aspire Counseling, PTSD treatment isn’t “treatment as usual.” We may ask how your week went briefly at the start of a session, but that’s not going to be the focus of your session. We’re going to direct the conversation back to a treatment plan that is intended to get much deeper results.
What If I'm Not Sure Where to Start?
That's completely normal. Most people aren't sure which approach to trauma treatment would work best for them. That's why your first few counseling sessions are so important.
A good trauma therapist will get to know you, your symptoms, and your goals. They'll explain different options and help you make an informed decision together.
Remember, you're not locked into one approach forever. Treatment can evolve based on what you're learning about yourself and what's working.
Start Your Healing Journey in Lee's Summit
Both EMDR and CPT can be powerful tools for healing from trauma. The most important factor isn't which therapy you choose—it's finding a therapist who understands trauma and can work with you to create a treatment plan that fits your needs.
At Aspire Counseling, our trauma specialists are trained in both approaches. We're here to help you figure out what might work best for your unique situation. Whether you're interested in traditional weekly therapy or our intensive trauma treatment options, we'll work with you to create a path toward healing.
You don't have to carry the weight of trauma alone. You don't have to figure out which therapy is "right" before reaching out. That's what we're here for.
Ready to take the first step? Contact us today to schedule a free consultation. Together, we can explore what healing might look like for you.
About the Author
Jessica Oliver, LCSW, is the founder and Clinical Director of Aspire Counseling. She specializes in trauma therapy and is passionate about helping trauma survivors find relief through evidence-based treatments like CPT and EMDR. Jessica is our intensive trauma treatment program provider and loves helping clients make significant progress in a short amount of time through trauma therapy intensives.
