> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.

# Stuck point log

> CPT stuck-point identification and Socratic challenge — the cognitive piece of Cognitive Processing Therapy for PTSD.

A stuck point is an assimilated or over-accommodated belief that maintains
PTSD. *It was my fault. The world is dangerous. I can never trust anyone
again.* Cognitive Processing Therapy works by identifying these beliefs and
challenging them with a structured set of Socratic questions until a more
balanced alternative belief emerges.

Resick and Schnicke published the CPT model in 1992; the comprehensive manual
came out in 2017. The stuck-point worksheet is the core cognitive piece of
the protocol.

## What the worksheet captures

Three sections, in order.

### Identify the stuck point

Three fields:

* The stuck point — a stuck belief about the trauma, yourself, others, or
  the world (textarea)
* How much you believe it, 0-10 (not at all → completely)
* Primary emotion the stuck point produces

Naming the emotion alongside the belief matters because the cognitive work
is partly aimed at the emotional load the belief carries. A stuck point
that produces shame is worked differently than one that produces fear.

### Challenge the stuck point

Five Socratic prompts, each a large textarea:

* What evidence supports this belief?
* What evidence challenges this belief?
* Is this belief based on facts or on feelings? What were you not in
  control of?
* Is this a habit of thinking (something you tell yourself a lot) or
  actually a fact about this situation?
* Are you thinking in all-or-nothing terms or extremes? What is the middle
  ground?

The five prompts cover the cognitive territory CPT works with: evidence
examination, fact-vs-feeling discrimination, the role of hindsight, the
habitual nature of stuck thinking, and the all-or-nothing patterns common in
trauma cognition. Going through all five with the client is the work of the
session.

### Alternate belief

Three fields:

* A more balanced, accurate, and helpful way to think about it (textarea)
* How much you believe the alternate, 0-10
* How much you believe the original stuck point now, 0-10

The re-rating of the *original* belief is the outcome measurement. CPT's
mechanism is the gradual reduction of belief in the stuck point through
repeated challenge — the number that drops over the course of treatment is
the signal.

## When to use it

* **CPT for PTSD**, across the 12-session protocol. Different stuck points
  surface at different sessions; each one gets worked through with the
  Socratic challenge structure.
* **CPT-Cognitive (CPT-C) variants** that skip the trauma narrative — the
  worksheet is the central tool there.
* **CPT for moral injury** in military or first-responder contexts, where
  stuck points around responsibility, justice, and self-judgment dominate.

## In-session mechanics

Open **Stuck point log** from the top-right corner (**Clinical templates ▾**). You typically identify
the stuck point in the first part of the session, work the five Socratic
prompts together for the bulk of the session, and land the alternate
belief plus re-ratings at the end.

The whole worksheet copies to clipboard. Pasted into the session note, the
five Socratic answers and the before/after belief ratings become part of the
CPT progress record.

## A note on fidelity

CPT is a manualized protocol. The cognitive work depends on the practitioner
being CPT-trained — the Socratic prompts in the worksheet are *prompts*,
not a substitute for the clinical skill of challenging stuck points in the
right way for the client in front of you.

The worksheet exists to capture the work, not to do the work. Practitioners
using the worksheet outside formal CPT should know that the cognitive
challenging style CPT uses (gentler, more collaborative, less
debate-style) differs from how *evidence-for / evidence-against* prompts
might be read by a non-CPT practitioner.

## Citation

Resick, P. A., Monson, C. M., & Chard, K. M. (2017). *Cognitive Processing
Therapy for PTSD: A Comprehensive Manual.* Guilford Press.

Resick, P. A., & Schnicke, M. K. (1992). "Cognitive processing therapy for
sexual assault victims." *Journal of Consulting and Clinical Psychology,*
60(5): 748-756.

Stuck-point identification as a clinical concept is published peer-reviewed
method, uncopyrightable. Rivet's five Socratic prompts are original — they
cover the same clinical functions as the canonical CPT challenge questions
in our own wording.

## When not to use it

* **Trauma processing without CPT training.** The worksheet looks like a
  generic cognitive challenge tool, but the Socratic style and the timing
  of when to deploy it within trauma treatment depend on CPT-specific
  training. Practitioners using EMDR, PE, or generic trauma-focused CBT
  should use the [thought record](/clinical-templates/cbt/thought-record)
  or the [behavioral experiment](/clinical-templates/cbt/behavioral-experiment)
  inside their own modality framework.
* **Acute trauma not yet stabilized.** Cognitive challenging of trauma-
  related beliefs requires the client to be regulated enough to engage the
  prompts. Stabilization comes first.
* **Stuck points that aren't trauma-related.** Generic depression or anxiety
  cognitions belong in the thought record, not here.

## Related articles

<CardGroup cols={2}>
  <Card title="Thought record" icon="lines-leaning" href="/clinical-templates/cbt/thought-record">
    The non-trauma cognitive restructuring worksheet.
  </Card>

  <Card title="PCL-5" icon="clipboard-list" href="/clinical-templates/screening/pcl-5">
    PTSD symptom monitoring during CPT.
  </Card>

  <Card title="Target identification" icon="crosshairs" href="/clinical-templates/cbt/target-identification">
    The EMDR analog — different modality, related clinical problem.
  </Card>
</CardGroup>
