CBT for Post Traumatic Stress Disorder (PTSD)

What Is PTSD?

Posttraumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a life-threatening or deeply distressing event.

Examples include:

  • Assault or violence

  • Serious accidents

  • Natural or community disasters

  • Combat exposure

  • Repeated or chronic trauma in childhood or adulthood

After trauma, it is normal to experience disturbing memories, sleep disruption, heightened alertness, or feeling “on guard.” Daily activities such as going to work, attending school, or spending time with loved ones may temporarily feel more difficult.

For many people, these reactions gradually decrease over weeks or months.

PTSD may be present when symptoms persist beyond several months, intensify, or interfere significantly with daily life. In some cases, symptoms emerge later or fluctuate over time.

When past traumatic experiences interfere with living

PTSD often involves intrusive memories, nightmares, avoidance of reminders, heightened anxiety, and changes in mood or thinking.

When anxiety feels overwhelming, many people begin avoiding situations, places, conversations, or internal experiences that trigger distress. Some may engage in safety behaviors or mental rituals (such as repeatedly checking for danger) to reduce anxiety.

Although these strategies provide short-term relief, they reinforce the cycle of fear and avoidance over time.

Gradually:

  • Confidence decreases

  • The world feels less safe

  • Activities become restricted

  • Sleep becomes disrupted

  • Mood may decline

Life becomes organized around preventing danger rather than pursuing meaning.

Evidence-Based Treatment: Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is the gold-standard, evidence-based treatment for PTSD.

CBT for trauma is structured, active, and collaborative. Treatment focuses on helping individuals process traumatic memories, reduce avoidance, and rebuild a sense of safety and confidence.

Research consistently shows that well-delivered CBT reduces:

  • Intrusive memories

  • Hypervigilance

  • Avoidance behaviors

  • Compulsive safety behaviors

  • Depressive symptoms

CBT for PTSD may include approaches such as:

  • Prolonged Exposure Therapy

  • Cognitive Processing Therapy

  • Exposure and Response Prevention (when appropriate)

  • CBT for Depression

  • CBT for Insomnia (when sleep disruption is present)

From an Acceptance and Commitment Therapy (ACT) perspective, treatment also involves building psychological flexibility, learning to make space for painful memories and emotions while choosing actions aligned with your values rather than fear.

At Atlanta CBT, Dr. Nathan Mascaro, Ph.D., ABPP has specialized experience treating PTSD, including prior clinical work within the Department of Veterans Affairs serving veterans with trauma-related concerns. Dr. Mascaro utilizes empirically supported, scientifically grounded cognitive-behavioral interventions tailored to each individual.

What About Medication?

Some individuals with PTSD are prescribed medications such as antidepressants or benzodiazepines.

Medication can help reduce anxiety and improve sleep, particularly in the short term. However, research indicates that long-term improvement typically requires behavioral and cognitive changes.

Without learning new skills and shifting avoidance patterns, symptoms often return after medication is reduced or discontinued.

CBT can be used alone or in combination with medication. If you are working with a prescribing physician, we are happy to coordinate care, with your permission, to ensure an integrated treatment plan.

What are realistic goals for therapy?

 

The goal of PTSD treatment is not to erase the past. The goal is to reduce the grip of trauma on the present.

Through structured, evidence-based therapy, individuals can decrease avoidance, improve sleep, rebuild confidence, and return to living a full and meaningful life, even in the presence of difficult memories.