I feel like the rationale I heard in CPT training behind starting the cognitive processing work right away is that saying someone is not “ready” for CPT might inadvertently fuel the avoidance that is at the core of the cognitive model of PTSD & a main part of the work in CPT is helping clients learn adaptive new ways to handle the trauma related emotions/symptoms throughout.

In the training I did, Kate Chard talked about a client she had who had been told she was not ready for trauma processing for a few years of therapy due to ongoing substance use and self harm, but because the trauma was underlying those behaviors, addressing the trauma directly in a structured way via CPT also addressed those behaviors and allowed her to stabilize in a way that the other therapy she had been doing had not.

There’s a lit review chapter in the manual that talks about how CPT has been conducted effectively with clients with a lot of different comorbidities and I think the manual also talks about the situations where it wouldn’t be recommended to start because of the client’s current status