Adaptive Disclosure vs CPT

Adaptive Disclosure

Tradition

Trauma-Focused

Founder

Brett Litz & colleagues (2017)

Review status

1 condition assessment available

Official sources

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

• Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder

  VA/DoD · 2023 · Clinical guideline · Recommendation 10; pages 51–54

  Insufficient evidence for or against

  Adaptive Disclosure is explicitly listed among therapies with insufficient evidence for or against their use for PTSD. It is not absent from the guideline.

  Scope: Adaptive Disclosure for adults with PTSD.

  Source checked 2026-09-06

Focus

Processing + Meaning-Making

Format

Individual

Duration

Brief (12 sessions)

Condition-specific assessments

Each conclusion applies to the population and use described. These source-based assessments do not certify the full entry or replace expert clinical review.

PTSD & Acute Trauma

Population and scope: Adults with PTSD.

Guideline evidence inconclusive

VA/DoD 2023 recommendation 10 finds evidence insufficient for or against Adaptive Disclosure.

Source assessment dated 2026-09-08

• VA/DoD (2023): PTSD and acute stress disorder clinical practice guideline

CPT

Tradition

Cognitive-Behavioral

Founder

Patricia Resick (1992)

Review status

1 condition assessment available

Official sources

Guidelines and official sources (5)

4 clinical guideline checks · 1 professional reference check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

• Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder

  VA/DoD · 2023 · Clinical guideline · Recommendation 8; Table 6, p.36

  Recommendation for the stated population

  CPT is explicitly strongly recommended.

  Scope: Adults with PTSD

  Source checked 2026-09-06

• Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults

  American Psychological Association · Approved February 2025; 2025 update · Clinical guideline · Psychological intervention recommendations, printed page 7 (PDF page 11)

  Recommendation for the stated population

  APA strongly recommends CPT as a first-line adult PTSD treatment compared with no intervention or treatment as usual.

  Scope: Adults with PTSD; comparison with no intervention or treatment as usual

  Source checked 2026-09-06

• Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder

  VA/DoD · 2023 · Clinical guideline · Recommendation 34; Table 6, p.38; discussion pp.82–83

  Discussed in the source

  VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.

  Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.

  Source checked 2026-09-06

• Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury

  VA/DoD · June 2021; version 3.0 · Clinical guideline · Recommendation 12; pp.23, 35–36

  Discussed in the source

  The guideline discusses CPT versus SMART-CPT while directing treatment of co-occurring behavioral disorders to their relevant guidelines. It does not make a new CPT recommendation for mTBI itself.

  Scope: Co-occurring PTSD in people with a history of mild-to-moderate traumatic brain injury.

  Source checked 2026-09-06

• mhGAP evidence profile STR1/STR2: PTSD psychological interventions

  World Health Organization · 2023 evidence profile; file 2023-12-20 · Professional reference · Evidence profile §3.2, p. 14; guideline STR1, p. 46

  Discussed in the source

  The evidence profile includes CPT within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for CPT.

  Scope: Adults with PTSD.

  Source checked 2026-09-06

Focus

Skill-building

Format

Individual + Group

Duration

Short (12)

Condition-specific assessments

Each conclusion applies to the population and use described. These source-based assessments do not certify the full entry or replace expert clinical review.

PTSD & Acute Trauma

Population and scope: Adults with PTSD receiving individual, manualized Cognitive Processing Therapy (CPT). This assessment does not grade all acute post-trauma symptoms, prevention after exposure, childhood PTSD or every adaptation of the protocol.

Guideline recommendation

VA/DoD 2023 recommendation 8 strongly recommends individual, manualized CPT for adult PTSD. The American Psychological Association’s 2025 guideline also strongly recommends CPT compared with no intervention or usual care (printed p. 7). NICE NG116 (2018) recommendation 1.6.16 names it among individual trauma-focused CBT options after more than one month. These recommendations do not establish that CPT is superior to every active psychotherapy or validate the catalogue’s legacy response rates.

Source assessment dated 2026-09-06

• VA/DoD (2023): Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder — Recommendation 8; Table 6, printed/PDF p. 36; discussion pp. 46–49
• American Psychological Association (Approved by APA Council of Representatives, February 2025): Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults — Tier definitions, printed p. 6 / physical PDF p. 10; psychological recommendations, printed p. 7 / physical PDF p. 11; active comparisons, printed p. 9 / physical PDF p. 13; university-hosted copy
• NICE (2018-12-05): Post-traumatic stress disorder (NG116) — Recommendations 1.6.16–1.6.17, printed/physical PDF p. 20

Adaptive Disclosure

Core mechanism: Exposure-based processing for life-threat trauma + imaginal conversation with deceased for traumatic loss + compassionate moral authority dialogue for moral injury: each wound type matched to its mechanism

Ontology: Combat creates three distinct wound types: fear-conditioned threat responses (classic PTSD), unresolved grief for lost comrades, and moral injury from acts that violate deeply held moral beliefs. Litz's argument is that these are phenomenologically distinct and call for different interventions. Whether they are neurobiologically distinct is an open question; the imaging work on moral injury is early.

CPT

Core mechanism: Identifying and challenging stuck points (distorted trauma-related beliefs) restores balanced appraisals of safety, trust, power, esteem, intimacy

Ontology: Trauma is absorbed either by bending the event to fit prior beliefs (assimilation, most often self-blame) or by over-generalizing from it (over-accommodation, most often 'nothing is safe and no one can be trusted')

Linked only in the Adaptive Disclosure entry

Adaptive Disclosure

Philosophical roots: Litz (moral injury as distinct from PTSD); Shay (Achilles in Vietnam: betrayal of what's right); Brock & Lettini (soul repair); Janoff-Bulman (shattered assumptions); existential phenomenology of guilt (Heidegger, Buber)

Blind spots: Designed specifically for military service members, so using it with a non-military client is a fit question rather than a safety concern: it is unclear how well the protocol transfers to civilian moral injury (healthcare workers, first responders); relatively new with limited replication; 12-session format may not be sufficient for complex presentations

Therapeutic voice: I want you to imagine your buddy sitting across from you right now. What would you want to say to him that you never got to say?

CPT

Philosophical roots: Beck (cognitive model); Horowitz (stress response theory); Piaget (accommodation/assimilation); constructivism (meaning is actively constructed)

Blind spots: Cognitive focus may underemphasize somatic and emotional processing; structured protocol can feel rigid

Therapeutic voice: You wrote that the assault was your fault because you didn't fight back. Let's look at that stuck point together.