CPT vs Prolonged Grief Disorder Treatment (PGDT/CGT)
A side-by-side comparison of recorded mechanisms, evidence review status, related condition topics, and philosophical roots.
At a glance
Source checks, condition-specific assessments and expert review are separate steps. Each assessment applies only to its stated population and use. Topic links do not establish comparative effectiveness.
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
Recommendation for the stated population
CPT is explicitly strongly recommended.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
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
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
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.
- Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury
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.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
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.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
- 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
- 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
Prolonged Grief Disorder Treatment (PGDT/CGT)
- Tradition
- Integrative
- Founder
- M. Katherine Shear (2005)
- Review status
- 1 condition assessment available
- Official sources
Guidelines and official sources (1)
1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Prolonged Grief Disorder: patient and family information
Discussed in the source
The association discusses prolonged-grief therapy in patient information. This is distinct from a clinical practice guideline, and DSM recognition of the diagnosis is not treatment endorsement.
Scope: Information about prolonged grief disorder and treatment approaches.
- Prolonged Grief Disorder: patient and family information
- Focus
- Processing + Restoration
- Format
- Individual
- Duration
- 16 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.
Grief & Loss
Population and scope: Bereaved adults aged 18–95 with clinically primary complicated grief in the 2016 trial; 16-session CGT added to placebo plus structured clinical management.
Randomized studies
Shear et al. (2016) randomized 395 adults to citalopram or placebo, with or without CGT. At 20 weeks, CGT plus placebo improved grief-response rates compared with placebo plus clinical management. Adding citalopram did not significantly improve the grief-response outcome, although depressive symptoms improved. This was not an IPT comparison. Missing assessments remained a limitation despite statistical adjustment; the sample was predominantly White, female and well educated. The historical complicated-grief criteria are not identical to current PGD criteria. Findings do not grade routine early bereavement, every grief therapy or suicide prevention.
Source assessment dated
How they work
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')
Prolonged Grief Disorder Treatment (PGDT/CGT)
Core mechanism: Revisiting the death narrative integrates the reality of loss + imaginal conversations transform the continuing bond + restoration goals rebuild engagement with life
Ontology: Prolonged grief as a failure of natural adaptation: the attachment system cannot update to accommodate the permanence of loss, leaving the bereaved stuck between wanting the person back and knowing they are gone
Related condition topics
These editorial cross-references organize reading. A shared link does not mean both approaches are effective, recommended, or interchangeable for that condition.
0 shared · 2 CPT-only · 1 Prolonged Grief Disorder Treatment (PGDT/CGT)-only
Linked only in the CPT entry
Linked only in the Prolonged Grief Disorder Treatment (PGDT/CGT) entry
What each assumes — and misses
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.
Prolonged Grief Disorder Treatment (PGDT/CGT)
Philosophical roots: Bowlby (attachment); Shear (complicated grief as attachment disorder); Foa (emotional processing applied to grief); Klass & Silverman (continuing bonds); Stroebe & Schut (dual process model, source of the loss-oriented and restoration-oriented halves of the protocol); Worden (task model of mourning); DSM-5-TR nosology
Blind spots: Revisiting exercises may feel coercive for clients whose culture doesn't value explicit grief narration; the highly structured protocol may not suit every grieving style; much less evidence for non-death losses than for bereavement; 16-session format may be insufficient for losses compounded by other traumas; PGD diagnosis itself is debated as potentially pathologizing normal grief
Therapeutic voice: I'd like you to close your eyes and tell me the story of the day he died. Start a little before you knew, and tell it as though it's happening now, in the present tense. We'll go about ten minutes. I'm recording it so you can listen at home, and I'm right here the whole time.
Choosing between them
CPT (Cognitive-Behavioral) and Prolonged Grief Disorder Treatment (PGDT/CGT) (Integrative) 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 CPT and Prolonged Grief Disorder Treatment (PGDT/CGT) pages, or use the interactive comparison tool to add more modalities to this comparison.