Addressing comorbid disorders and conditions

Prior chapters have reviewed the research evidence from both clinical trials and more applied research studies. These chapters have touched on issues around whether cognitive processing therapy (CPT) can work for clients with comorbidities and whether the comorbidities tend to improve along with the posttraumatic stress disorder (PTSD). Often there is a temptation to bring in elements from other therapies when faced with multiple comorbidities, but is that always the right choice? In this chapter, we discuss how to use CPT with clients with specific psychiatric (depression, substance use, panic disorder, personality disorders) and medical (TBI, chronic pain, sleep disorders) comorbidities. These particular comorbidities can be a challenge for clinicians to manage. We particularly focus on how to determine whether to use CPT or not with these comorbid presentations, when to adapt CPT to address these comorbidities, as well as ways to use CPT skills to address each of these conditions, along with the PTSD. In many cases, key research studies have been conducted that can help inform clinical decision-making regarding what to do and how to do it.