Pre-Session Briefing
Marcus J. · 34, he/him · PTSD · CPT · Session 6/12 · Tomorrow, 10:00 AM
Last Session — Apr 1, 2026
Key Themes
- ▸Began processing index trauma using ABC worksheet
- ▸Identified stuck point: 'I should have been able to prevent it'
- ▸Reported increased nightmares this week (4 of 7 nights)
Interventions Used
- Socratic questioning around self-blame stuck point
- Introduced challenging questions worksheet for stuck points
Clinician Note
“Marcus showed significant emotional activation during trauma processing. This is expected at session 6 of CPT. He was able to stay present and engaged despite distress. The self-blame stuck point is deeply held and will likely require multiple sessions to challenge effectively.”
Client Check-In
“Dr. Anand, I started the challenging questions worksheet but had to stop halfway through. It brought up a lot. I did finish the trauma account though. Nightmares were bad again this week, 5 nights. But I noticed something — I'm starting to question the 'I should have known' thought on my own, even outside the worksheet.”
Journal Excerpts
Apr 3
Tried the worksheet. Got to question 4 and felt my chest tighten. Took a break. Came back an hour later and finished questions 4 and 5 but couldn't do 6 and 7.
Apr 5
Caught myself telling my brother 'you couldn't have known that was going to happen' about something at his job. Realized I can say that to other people but not to myself.
Suggested Threads
Marcus's journal shows emerging capacity for perspective-taking ('I can say that to other people but not to myself'). This is a key inflection point in CPT — the ability to apply the same logic to oneself that one applies to others. Resick (2016) identifies this as a precursor to stuck point resolution.
Source: Domain knowledge: Resick's CPT Manual
Nightmare frequency increased from 2/week (session 3) to 5/week (session 6). This is expected during active trauma processing in CPT but warrants monitoring. If nightmares persist above baseline at session 8, consider adjunctive imagery rehearsal therapy.
Source: Longitudinal analysis + Domain knowledge
Despite emotional difficulty, Marcus completed the trauma account and attempted the full challenging questions worksheet. Engagement with trauma material is strong.
Source: Between-session data
Mood This Week
Avg: 3.4/10
Homework Status
1/1
1/1
7/7
Treatment Progress
Session 6 of 12· Started Feb 25, 2026