Write a structured impact statement exploring how the trauma has affected your beliefs about safety, trust, power, esteem, and intimacy.
Trauma Impact Statement (CPT)
PreviewHow has the trauma affected your life?
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Safety: How has it affected your sense of safety?
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Trust: How has it affected your ability to trust?
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Power/Control: How has it affected your sense of control?
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Esteem: How has it affected how you see yourself?
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Intimacy: How has it affected closeness and relationships?
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This is a read-only preview. Sign up to assign it and let clients complete it on any device.
The Trauma Impact Statement (CPT) is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for trauma and PTSD.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.
Most people work through it in around 30 minutes. It centres on one focused exercise:
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
In common with other CBT methods, the Trauma Impact Statement (CPT) works by noticing the links between situations, thoughts, feelings, physical sensations and behaviour — and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
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Explore how the traumatic event has affected your beliefs about yourself, others, and the world.