When Stuck Points Keep You Stuck: Refining your skills in Cognitive Processing Therapy

Feb 23 / Kelly Maieritsch

If you’ve ever walked out of a CPT session thinking,
“We’re doing the worksheet. We’re identifying the belief. So why isn’t this moving?”

CPT works. The research is clear. It’s a first-line, evidence-based treatment for PTSD with strong outcomes across settings and populations.

And yet…

Even experienced CPT clinicians know that the difference between a session that shifts something and one that stalls often comes down to a crucial skill:

Clearly identifying and working with stuck points.

The Subtle Skill Beneath the Structure

On Paper, stuck point work looks straight forward:
  • Identify the belief
  • Examine the evidence
  • Generate alternatives
  • Practice the new thought
But in practice, real work lives in nuance.
  • Is this truly the core belief - or a surface-level statement?
  • Is the client assimilating or over-accomodating?
  • Are we challenging too early?
  • Does the alternative thought sound balanced...but not actually land?

Small imprecisions compound.
And when they do, sessions feel effortful instead of fluid.


What is the difference between Assimilation and Over-Accommodation?

One of the most common reasons CPT feels “sticky” is misidentifying the type of belief we’re targeting. When we clearly distinguish:
  • Assimilated beliefs (self-blame, hindsight bias, "I should have...
  • Over-Accommodated beliefs (global, rigid, “The world is unsafe,” “I can’t trust anyone”)
—we can guide treatment in the best order.
That sequencing decision can dramatically influence:
• Client engagement
• Emotional activation
• Cognitive flexibility
• Overall treatment momentum

Making Stuck Points More Precise (and More Powerful)

Many clinicians were taught to “write it in the client’s words.”
But not all stuck points are created equal.
Small refinements can transform the impact of the work:
  • Tighten vague language
  • Identify globalizing words
  • Clarify meaning statements
  • Organize multiple stuck points strategically

When wording becomes more precise, cognitive restructuring becomes more efficient.

And when alternatives truly resonate — not just look good on paper — belief change follows.

Want to sharpen you CPT skills?

Check out our course:
This workshop is designed for clinicians who already practice CPT.
Whether you:
  • Recently trained and want more confidence
  • Feel stuck alongside your clients
  • Or have been delivering CPT for years and want to sharpen your edge
You will leave with:
  • Clearer differentiation of belief types
  • A stronger sense of treatment sequencing
  • Practical language tweaks that support real cognitive shift
  • Increased fluency and efficiency in stuck point work
If You’ve Ever Thought…
  • "This doesn't feel like a core belief."
  • "The alternative sounds right but doesn't stick."
  • "I'm not sure what stuck point to target first."

This workshop is for you. CPT works best when stuck point work feels natural, organized, and intentional. Refining that skill can make your sessions more fluid — and more effective.

If you’re ready to strengthen the part of CPT that drives change, we’d love to have you join us.