CPT Trust Star Worksheet: Rebuilding Trust in Trauma Recovery

The CPT Trust Star Worksheet operationalizes the cognitive restructuring of trust through a visual and categorical assessment. The worksheet prompts clients to select a specific person and identify different “types” of trust relevant to that relationship. By using a 0-to-5 scale, the tool allows for a graded evaluation of reliability rather than a “yes/no” judgment. A critical feature of this worksheet is the “No Information” option, which validates that trust is an evidence-based process; if a client lacks data on a person’s reliability in a certain area, the most rational stance is to reserve judgment rather than default to distrust.

The second page of the worksheet utilizes Socratic inquiry to process the data gathered in the Trust Star graphic. Questions regarding the importance of specific trust areas and the distinction between professional skills (e.g., fixing a car) and personal traits help clients deconstruct “stuck points” related to global untrustworthiness. This helps the client move toward a “trust-but-verify” model that is both safe and functional.

How This Worksheet Can Be Used

During sessions:
Clinicians use the worksheet to anchor the Trust module of CPT. It provides a structured way to challenge the stuck point “I can’t trust anyone.” By breaking trust into parts, the therapist can help the client identify people who are actually “safe enough” for specific interactions, thereby reducing social withdrawal.

Between sessions:
Clients complete the Trust Star for various individuals in their life—ranging from a close friend to a professional service provider. This encourages the real-world application of cognitive flexibility and helps the client gather evidence that contradicts global beliefs about danger.

As part of treatment planning:
The worksheet serves as a diagnostic tool for the clinician to assess the client’s current level of social safety and discernment. It helps determine if a client is struggling more with “blind trust” (trusting too much) or “distrust” (trusting too little), allowing for a more targeted intervention strategy.

Benefits of the CPT Trust Star Worksheet

• Interrupts all-or-nothing thinking patterns related to social and professional trust.
• Introduces the concept of “nuanced trust,” allowing for safer interpersonal engagement.
• Validates the “No Information” state, reducing the pressure to make immediate judgments about others.
• Distinguishes between different domains of trust, such as competence, reliability, and emotional safety.
• Provides a visual and quantifiable record of a person’s actual trustworthiness based on evidence.
• Supports the “Trust” module of the official CPT clinical protocol.

Integrating This Tool into Clinical Work

Integrating the CPT Trust Star Worksheet requires a focus on “intelligent trust.” Clinicians should explain that trust is not a feeling, but a decision based on evidence over time. When a client identifies a stuck point like “everyone is out to get me,” the clinician can use the worksheet to find the exceptions—such as a mail carrier or a mechanic—who consistently fulfill their specific roles. This helps the client see that they are already trusting people in small ways every day. As the client progresses, the clinician can help them apply the Trust Star to more emotionally significant relationships, using the “Describe what you learned” section to solidify the shift from trauma-based hypervigilance to evidence-based discernment. This transition is essential for the survivor to move toward a more connected and empowered life.

References

• Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.
• American Psychological Association (APA). (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults.
• Chard, K. M., et al. (2012). Cognitive Processing Therapy: Veteran/Military Version. Department of Veterans Affairs.
• Monson, C. M., & Shnaider, P. (2014). Cognitive-Behavioral Conjoint Therapy for PTSD. (Focusing on the themes of trust and safety).