EMDR vs CPT Therapy: Understanding Your Options for Trauma Treatment

When seeking therapy for trauma, you may encounter two highly effective, evidence-based approaches: Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Processing Therapy (CPT). Both treatments have strong research support for addressing trauma-related symptoms, but they function quite differently in practice. Understanding these differences can help you make an informed decision about which approach might better suit your needs and preferences.

How EMDR and CPT View Trauma Differently

The EMDR Perspective

EMDR is based on the Adaptive Information Processing model, which suggests that trauma becomes problematic when memories are stored in isolation, disconnected from wider memory networks. These isolated memories retain their original emotional intensity and negative beliefs.

According to EMDR theory, trauma symptoms persist because the brain has been unable to process these experiences properly. The goal is to help the brain reprocess these memories so they can be integrated into normal memory networks.

The CPT Perspective

CPT is grounded in cognitive theory, focusing on how trauma affects our thoughts and beliefs. It suggests that trauma symptoms persist because of “stuck points”—problematic thoughts and beliefs that developed during or after the traumatic event.

CPT proposes that by identifying and challenging these unhelpful thought patterns, we can reduce the emotional impact of the trauma and develop more balanced beliefs about ourselves, others, and the world.

Experiencing the Therapy: Session Structure and Process

What EMDR Sessions Feel Like

EMDR therapy has a distinctive rhythm and structure:

• Minimal talking: While you’ll need to identify traumatic memories, you don’t have to discuss them in detail
• Bilateral stimulation: During processing, you’ll experience side-to-side eye movements, alternating tones, or taps while focusing briefly on the traumatic memory
• Free association: Your mind is allowed to go wherever it needs to during processing—there’s no “right” way for it to unfold
• Bodily awareness: You’ll track physical sensations as well as thoughts and emotions
• Variable pace: Processing can move quickly or slowly depending on your unique experience
• Between-session experience: You might notice dreams, insights, or emotions emerging between sessions as processing continues

A typical EMDR session includes periods of bilateral stimulation lasting 30-60 seconds, followed by brief check-ins with your therapist. The processing often feels less verbal and more experiential than traditional talk therapy.

What CPT Sessions Feel Like

CPT follows a more structured, cognitive approach:

• Active discussion: You’ll talk about traumatic experiences and their impact on your thoughts and beliefs
• Written work: You’ll complete written exercises, including an “impact statement” and accounts of traumatic events
• Thought challenging: You’ll learn to identify and question unhelpful thoughts using structured worksheets
• Skills practice: Each session builds specific skills for examining and modifying beliefs
• Homework focus: Regular between-session practice is essential to progress
• Educational component: Your therapist will teach you about how thoughts influence emotions and behaviour

CPT sessions typically feel more directive and educational. Your therapist will guide you through specific exercises designed to help you question and modify unhelpful beliefs connected to your trauma.

Key Differences in Approach and Experience

Processing vs. Cognitive Restructuring

EMDR primarily works through neural processing—helping the brain reprocess traumatic memories without necessarily changing their content. The focus is on allowing your brain’s natural healing abilities to work, with the bilateral stimulation believed to facilitate this process.

CPT works through cognitive restructuring—actively identifying and challenging unhelpful thoughts and beliefs. The focus is on developing more balanced thinking patterns through rational examination of your thoughts.

The Role of Homework

EMDR may involve some between-session coping skills practice, but doesn’t heavily emphasize formal homework assignments. The processing work happens primarily during sessions.

CPT includes substantial homework components. You’ll complete thought records, practice challenging beliefs, and apply new skills between sessions. This consistent practice is considered essential to the therapy’s effectiveness.

Narrative Engagement

EMDR doesn’t require detailed verbal descriptions of traumatic events. You’ll identify memories to target, but the processing often happens with minimal talking.

CPT typically involves writing about traumatic events in detail (though some versions modify this requirement). This written narrative helps identify stuck points that can then be addressed.

Which Approach Might Be Right for You?

Consider EMDR if you:

• Find it difficult to talk about your trauma in detail
• Feel that your trauma is stored more as sensations or emotions than as thoughts
• Prefer a less structured, more intuitive approach
• Experience strong physical responses when recalling trauma
• Are sensitive to the language used to describe your experiences

Consider CPT if you:

• Prefer a highly structured approach with clear session agendas
• Connect well with the idea that thoughts influence emotions
• Are comfortable with written exercises and homework
• Find that unhelpful thoughts and beliefs significantly impact your daily life
• Want to develop specific skills you can continue using after therapy ends

Many people find that their preference for one approach over the other relates to their learning and processing style. Some respond better to the more experiential, less verbal nature of EMDR, while others prefer the concrete, skills-based approach of CPT.

Similarities Worth Noting

Despite their differences, both therapies:

• Are evidence-based treatments with strong research support
• Typically involve 12-16 sessions for full implementation
• Help reduce PTSD symptoms and improve quality of life
• Can be modified to address complex trauma
• Focus on both past experiences and current triggers
• Aim to help you move forward rather than remain defined by trauma

Making Your Decision

The “right” therapy is ultimately the one that resonates with you and your healing style. Some questions to consider:

• How do you typically process difficult experiences?
• Do you prefer structure or flexibility in your approach to challenges?
• What has been helpful in previous therapy experiences?
• Do you have any physical or cognitive limitations that might impact either approach?

At Centre Wellness, we offer both EMDR and CPT, provided by therapists with specialized training in these approaches. We’re happy to discuss which option might be most appropriate for your specific situation during an initial consultation.

Our Trauma-Focused Therapists at Centre Wellness

Centre Wellness offers both EMDR and CPT therapy with our highly qualified psychologists:

Dr. Leah Todd specializes in both EMDR and CPT therapy, bringing extensive experience in trauma-focused treatment. Her compassionate approach creates a safe environment for clients to process difficult experiences using either modality.

Dr. Simone Cunningham also offers both EMDR and CPT, allowing her to tailor treatment recommendations to each client’s unique needs and preferences. Her integrative approach is particularly effective for complex cases.

Centre Wellness has additional therapists trained in CPT as well. You can view our full team page to explore all our clinicians who offer trauma-focused therapy.

To learn more about these treatment options or to schedule a session with any of our trauma-specialized therapists, you can use our convenient online booking portal or contact our office directly. We’re here to support you in finding the approach that best fits your healing journey.