CPT vs STAIR

A side-by-side comparison of recorded mechanisms, evidence review status, related condition topics, and philosophical roots.

By Expert review not yet recorded Updated

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

    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

  • 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

  • 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

  • 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

  • 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

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

STAIR

Tradition
Cognitive-Behavioral
Founder
Marylene Cloitre (2002)
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.

Focus
Skill + Processing
Format
Individual
Duration
Short (16)

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.

Complex Trauma / Developmental Trauma

Population and scope: Adults aged 18–65 with CAPS-5 PTSD after repeated childhood sexual or physical abuse; eight STAIR sessions followed by 16 EMDR sessions, compared with 16 immediate EMDR sessions. Entry did not require a complex-PTSD diagnosis.

Randomized studies

Van Vliet et al. (2021) reports 135 randomized adults; analyses used 121 after 11 withdrawals before treatment and three delayed eligibility exclusions. Only 28.9% met SIDES complex-PTSD criteria at baseline; this was not an ICD-11 diagnostic interview. Both groups improved, with no statistically significant endpoint advantages for adding STAIR through six months or in treatment dropout. Immediate EMDR showed faster early improvement in self-reported PTSD symptoms, interpersonal problems and post-traumatic cognitions. The authors found no need for a preparatory phase in this sample. The study was not an equivalence trial, did not test standalone STAIR and had no inactive control. Twice-weekly STAIR may have limited time to practise skills between sessions. Exclusions included ongoing abuse, acute suicidality requiring crisis intervention and screened substance misuse/dependence. These findings do not establish that every person with complex PTSD needs, or should avoid, preparation.

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')

STAIR

Core mechanism: Phase 1 builds emotion regulation and interpersonal skills; Phase 2 uses modified narrative exposure with these new capacities

Ontology: Complex trauma disrupts both affect regulation and interpersonal functioning; skills needed before narrative processing

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.

2 shared · 0 CPT-only · 0 STAIR-only

Linked to both entries

PTSD & Acute TraumaComplex Trauma / Developmental Trauma

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.

STAIR

Philosophical roots: Herman (phase-oriented treatment); Cloitre (skills before exposure); developmental psychopathology; attachment theory

Blind spots: Two-phase structure lengthens treatment, and Phase 1 can feel slow to clients who are ready to process; the premise itself is contested, since a number of trauma researchers argue that phase-based sequencing delays effective treatment without clear evidence that a skills phase is necessary

Therapeutic voice: Let's practice naming what you're feeling with more precision, not just 'bad,' but specifically what kind of bad.

Choosing between them

CPT and STAIR both sit within the Cognitive-Behavioral tradition — they share a worldview about what suffering is and how change happens. Differences are more often about technique and emphasis than about underlying theory.

For deeper coverage: see the full CPT and STAIR pages, or use the interactive comparison tool to add more modalities to this comparison.