CPT Power and Control Worksheet: Processing Trauma-Related Autonomy & Social Boundaries

This worksheet guides clients through a systematic deconstruction of their beliefs regarding power and control across three structured pages. The initial phase prompts a qualitative exploration of what “control” means to the individual and identifies the specific domains where they feel control is most necessary. By documenting daily decisions, the worksheet reinforces the reality of the client’s current agency, counteracting the trauma-induced sense of powerlessness.

The second phase utilizes “worst-case scenario” questioning to uncover the underlying fears that drive the need for absolute control over self and others. This Socratic approach allows clinicians to help clients evaluate the actual costs of their control strategies, such as the “bad things” that result from over-controlling situations. The final phase concludes with a comparative list, requiring the client to explicitly categorize aspects of life into “Things I Can Control” and “Things I Can’t Control,” providing a visual anchor for future behavioral choices.

How This Worksheet Can Be Used

During sessions:
Clinicians use the worksheet to anchor the Power/Control module of CPT. It provides a structured starting point for identifying stuck points related to vulnerability and safety. Reviewing the client’s definition of “complete control” allows the therapist to challenge all-or-nothing thinking patterns and perfectionistic standards.

Between sessions:
Clients complete the log as a self-monitoring assignment to notice when the “need for control” arises in real-time. This increases metacognitive awareness of hyper-controlling behaviors and provides concrete examples for review in the next session.

As part of treatment planning:
The worksheet serves as a diagnostic indicator of the client’s relational style. It can help the clinician determine if the client needs additional work on boundary setting (if they have too little control) or relaxation and trust-building (if they seek too much control).

Benefits of the CPT Power and Control Worksheet

• Identifies specific stuck points regarding the perceived necessity of absolute control.
• Distinguishes between internal agency (control over self) and external boundaries (control over others).
• Exposes the “if-then” logic and fears that maintain hyper-controlling behavioral patterns.
• Reduces interpersonal conflict by helping clients recognize the limitations of their influence on others.
• Promotes emotional regulation by decreasing the anxiety associated with trying to control the uncontrollable.
• Provides a concrete list of controllable factors to focus on during moments of distress.

Integrating This Tool into Clinical Work

Integrating the CPT Power and Control Worksheet into treatment requires a delicate balance of validating the client’s need for safety while gently challenging the efficacy of their control strategies. Clinicians should help clients see that “giving up control” in certain areas is not the same as being vulnerable to harm; rather, it is an act of efficiency and emotional conservation. When reviewing the list of uncontrollable factors, it is often helpful to link these back to the client’s Impact Statement to see how the trauma initially skewed their view of power. As treatment progresses, the clinician can use the worksheet to help the client develop “adaptive control”—the ability to exert influence where possible while practicing acceptance where it is not. This shift is a key milestone in the integration phase of CPT, signifying a move from trauma-driven reactivity to value-driven living.

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 power and control dynamics in trauma recovery).