CPT Trauma History Questionnaire: Comprehensive Assessment for PTSD

The CPT Trauma History Questionnaire operationalizes the intake process across seven detailed pages. The first sections focus on developmental history and childhood environment, providing the “pre-trauma” context essential for identifying long-standing schemas. The “Target Trauma” section uses evidence-based prompts to screen for core PTSD symptoms, including nightmares, intrusive thoughts, avoidance, and hypervigilance, specifically within the last month.

Unique to this assessment is the “Identity” section, which explores the impact of trauma on gender identity, sexual orientation, and cultural connection, as well as exposure to racism or discrimination. By requiring clients to explain the “why” behind their mood shifts and health changes, the tool generates the qualitative data needed for effective Socratic challenging later in therapy. Finally, the “Treatment Overview” section anchors the client in the present, clarifying their hopes for change and establishing a collaborative therapeutic alliance from the outset.

How This Worksheet Can Be Used

During initial assessment:
Clinicians use this questionnaire to gather the foundational data required for a CPT case formulation. It helps the therapist identify the “index trauma” and screen for co-occurring issues such as depression or substance use that may require concurrent attention.

During treatment planning:
The information collected regarding the client’s identity, culture, and support systems allows the clinician to tailor the CPT protocol to the client’s specific life context, ensuring that treatment is both culturally sensitive and personally relevant.

To identify stuck points:
By reviewing the client’s childhood history and their “Target Trauma” explanations, clinicians can spot early indicators of stuck points related to blame, safety, and self-worth before the client even writes their formal Impact Statement.

Benefits of the CPT Trauma History Questionnaire

• Provides a structured, 7-page framework for a thorough trauma-informed intake.
• Screens for current PTSD symptoms, including avoidance, detachment, and hyper-arousal.
• Explores the impact of trauma on spiritual, cultural, and gender identity.
• Identifies substance use patterns and physical health problems related to the trauma.
• Establishes a clear baseline of current functioning and daily routines.
• Facilitates the identification of support systems and coping resources.

Integrating This Tool into Clinical Work

Integrating the CPT Trauma History Questionnaire into the initial sessions provides the clinician with the “narrative map” needed to navigate the complexities of PTSD recovery. It is important to administer this tool with a high degree of clinical sensitivity; while the structure helps maintain focus, the clinician should remain attune to the client’s level of distress during disclosure. The sections on “Blame” are particularly vital, as they often reveal the primary stuck points that will be targeted throughout the protocol. By the end of the assessment, the clinician should have enough information to explain the CPT rationale to the client, linking their current symptoms and belief shifts back to the historical and situational data gathered in this questionnaire.

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.
• U.S. Department of Veterans Affairs. (2024). Assessing PTSD with the Clinician-Administered PTSD Scale (CAPS). PTSD: National Center for PTSD.