The Subsequent Sessions of Cognitive Behavioral Therapy

Abstract

As with the initial assessment and orientation sessions, which were discussed in the previous chapter, subsequent therapy sessions are highly structured. There are nine general steps that should comprise these sessions (Beck 1995; Moorey and Greer 2002): • Brief Update on Therapy Goals and Symptom Check • Feedback and Homework from Last Session • Setting the Agenda for Today's Session • Working through Today's Agenda • Ongoing Assessment and Socratic Questioning • Therapist's Periodic Summaries and Summary Statements • Setting New Homework • Client's Final Summary of Today's Session and Feedback about the Session • Relapse Prevention and Preparation for Termination These steps will each be described in more detail in the following sections. Before proceeding it is important to note that the steps are considered important to include in every therapy session. How much time is spent on each step within the session depends on the client's needs. However, the therapist must be sure to structure the session so that all the steps can be fit into the therapy session. For the experienced therapist, this process will become second nature. However, the therapist beginning cognitive behavioral therapy may wish to use the cognitive behavioral therapy session checklist, which is located in the Appendix. This initial part of the session involves two elements, which are updating goals and doing a symptom check. The goal update involves • Revisiting the client's goals • Reviewing the steps he or she took toward those goals since the last session • Troubleshooting any difficulties that arose Step 1: Brief Update on Goals and Symptom Check 68