Adaptive Disclosure vs CPT
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
Adaptive Disclosure
- Tradition
- Trauma-Focused
- Founder
- Brett Litz & colleagues (2017)
- Evidence
- RCT-supported
- Focus
- Processing + Meaning-Making
- Format
- Individual
- Duration
- Brief (12 sessions)
CPT
- Tradition
- Cognitive-Behavioral
- Founder
- Patricia Resick (1992)
- Evidence
- Guideline-recommended
- Focus
- Skill-building
- Format
- Individual + Group
- Duration
- Short (12)
How they work
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. These are phenomenologically and neurobiologically distinct.
CPT
Core mechanism: Identifying and challenging stuck points (distorted trauma-related beliefs) restores balanced appraisals of safety, trust, power, esteem, intimacy
Ontology: Trauma disrupts pre-existing beliefs or generates distorted accommodations about self and world
Conditions treated
2 shared · 1 Adaptive Disclosure-only · 0 CPT-only
Both treat
Only Adaptive Disclosure
What each assumes — and misses
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: Developed for military populations — unclear how well it 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.
Choosing between them
Adaptive Disclosure (Trauma-Focused) and CPT (Cognitive-Behavioral) come from different traditions, which means they assume different things about what a person is, what causes suffering, and what the therapeutic relationship is for. The choice between them is often less about "which works better" and more about which set of assumptions fits the client and the therapist.
For deeper coverage: see the full Adaptive Disclosure and CPT pages, or use the interactive comparison tool to add more modalities to this comparison.