School of Behavioral Sciences


Doctor of Philosophy in Counselor Education and Supervision (PhD)


John C. Thomas


Cognitive Processing Therapy - Cognitive (CPT-C), PTSD, Single Case Research Design (SCRD), Spiritual Intervention, Spiritual Struggle, Trauma


Counseling | Counselor Education | Other Social and Behavioral Sciences


A Single Case Research Design (SCRD) with a multiple-baseline across participants was used to investigate the effects Spiritually Oriented Cognitive Processing Therapy-Cognitive (SOCPT-C) had on spiritual struggle, posttraumatic stress disorder (PTSD) scores and depression in four Christian sexual assault survivors with PTSD reporting spiritual struggle. A complex reciprocal relationship between spiritual struggle and PTSD is suggested in the literature as influencing posttraumatic adjustment and treatment for Christian trauma survivors. Many empirically supported treatments (EST) for PTSD lack spiritual interventions to directly target effects from this relationship. Individuals completed an online pre-screening evaluation and an assessment was scheduled with those meeting inclusion criteria. Staggered treatment occurred in the counseling setting and included either (1) Cognitive Processing Therapy-Cognitive (CPT-C) or (2) SOCPT-C, a spiritually modified version of CPT-C. Data was collected through continuous assessment with two sessions weekly for eight weeks. Visual analysis was conducted through examining data patterns related to (1) level, (2) trend, (3) variability, (4) immediacy of the effect, (5) overlap and (6) consistency of data patterns across similar phases. Results indicated change was often gradual with no rapid shift and mixed treatment effects. The study findings indicated SOCPT-C was an effective intervention for decreasing spiritual struggle and PTSD. For depression scores, results were mixed and inconclusive for both interventions and their influences. Future research that evaluates the effects an EST inclusive with spiritual interventions have on the identified reciprocal relationship remains are indicated.