This accessible, evidence-based book provides readers with a practical framework to understand, formulate, and treat PTSD using the cognitive model while creatively adapting for complexity.

Cognitive therapy for PTSD is a highly effective treatment, but aspects of clinical complexity can complicate treatment and limit its effectiveness. Trauma memories themselves can be complex, the associated meanings can resist change and people may struggle to engage with them without feeling overwhelmed. Problems that commonly arise alongside PTSD add to clinical complexity, such as comorbid psychological or physical disorders, social problems, and ongoing risks. Bringing together the science and art of therapy, this book demonstrates how to approach these issues by holding firm to the principles of CBT, whilst flexing and creatively adapting techniques for each unique circumstance. Rich case studies, top tips, and frequently asked questions are used throughout to demonstrate the approach.

Written by clinicians for clinicians, the book synthesizes the latest research into a practical treatment manual to help readers overcome obstacles in PTSD treatment and ‘supercharge’ their therapy skills.

part One|36 pages


chapter Chapter One|10 pages

Understanding PTSD and complexity

chapter Chapter Two|12 pages

Cognitive Therapy for PTSD

chapter Chapter Three|12 pages

Assessment and formulation

part Two|92 pages

Complexity in memory work

chapter Chapter Four|12 pages

Over-activation of trauma memories

chapter Chapter Five|10 pages

Under-activation of trauma memories

chapter Chapter Six|11 pages


chapter Chapter Seven|14 pages

Multiple trauma memories

chapter Chapter Eight|13 pages

Gaps in trauma memories

chapter Chapter Nine|10 pages

Recovered memories

chapter Chapter Ten|11 pages

Constructed memories

chapter Chapter Eleven|9 pages

Psychosis-related PTSD

part Three|63 pages

Complexity in cognitive work

chapter Chapter Twelve|13 pages

Strongly held or long-standing beliefs

chapter Chapter Thirteen|12 pages

Self-attacking beliefs and emotions

chapter Chapter Fourteen|11 pages

The head–heart gap

chapter Chapter Fifteen|12 pages


chapter Chapter Sixteen|13 pages

Moral injury

part Four|32 pages

Complexity in coping strategies

chapter Chapter Seventeen|10 pages

Drugs and alcohol

chapter Chapter Eighteen|10 pages

Reckless behaviour

chapter Chapter Nineteen|10 pages


part Five|50 pages


chapter Chapter Twenty|13 pages

Psychological comorbidity

chapter Chapter Twenty One|13 pages

Physical comorbidity

chapter Chapter Twenty Two|11 pages

Social comorbidity

chapter Chapter Twenty Three|11 pages


part Six|36 pages

Complexities for the therapist

chapter Chapter Twenty Four|11 pages

The therapeutic relationship

chapter Chapter Twenty Five|12 pages


chapter Chapter Twenty Six|11 pages

Looking after yourself