Sacred Journey

Mental Health Does Not Currently Meet Criteria

Sacred Journey is an adaptation of Cognitive Processing Therapy (CPT) for American Indian and Alaskan Native populations designed to treat adults who are experiencing posttraumatic stress disorder (PTSD) or trauma symptoms. The program has a pre-session orientation on trauma and its effects on behavior followed by 12 sessions with homework assignments between sessions. During the first two sessions, the therapist helps the individual identify a primary traumatic event and process its meaning. In sessions 3–6, the therapist educates the individual on the relationship between events, thoughts, and feelings. Therapists also teach skills for challenging patterns of problematic thinking. In sessions 7–9, therapists focus on helping the individual increase feelings of safety, trust, power, and control. In sessions 10–12, the therapist addresses issues of respect, healthy sexual relationships, substance use, intimacy, and preparing for the end of treatment. Key adaptations from CPT include (a) adding content on relationships, safer sex, and substance abuse, (b) incorporating indigenous beliefs and values on spirituality, death, family, tribal-specific historical trauma, and the role of elders, and (c) altering skill-building activities to local indigenous images and protocols (e.g., smudging, seasonal ceremonies, memorials).

Sacred Journey does not currently meet criteria to receive a rating because no studies of the program achieved a rating of moderate or high on design and execution.

Date Research Evidence Last Reviewed: May 2022


The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manual, and the program or service developer’s website.

This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

Sacred Journey is designed to treat adults with PTSD or with extensive trauma histories. Sacred Journey is not appropriate for individuals without trauma symptoms, those who are an immediate danger to themselves or others, or those who are experiencing psychotic symptoms.


Sacred Journey consists of 12 sessions, typically held 2 times per week in a one-on-one format.

Location/Delivery Setting
Recommended Locations/Delivery Settings

Sacred Journey is delivered in clinical settings.

Education, Certifications and Training

Therapists must be licensed mental health professionals.

Program or Service Documentation
Book/Manual/Available documentation used for review

Kaysen, D., Pearson, C., Bedard-Gilligan, M., & Marin, R. (2013). Sacred Journey healing, hope, and recovery: Cognitive Processing Counseling manual. University of Washington.

Available languages

Sacred Journey materials are available in English.

Other supporting materials

Manual Request Form

For More Information


Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.

Results of Search and Review Number of Studies Identified and Reviewed for Sacred Journey
Identified in Search 1
Eligible for Review 1
Rated High 0
Rated Moderate 0
Rated Low 1
Reviewed Only for Risk of Harm 0
Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers. To receive a rating of supported or well-supported, the favorable evidence for a program or service must have been obtained from research conducted in a usual care or practice setting.

Studies Rated Low

Study 12753

Pearson, C. R., Kaysen, D., Huh, D., & Bedard-Gilligan, M. (2019). Randomized control trial of culturally adapted cognitive processing therapy for PTSD substance misuse and HIV sexual risk behavior for Native American women. AIDS and Behavior, 23(3), 695-706.

This study received a low rating because none of the target outcomes met measurement standards.