Structure of a CBT Session

Structure of a CBT Session



Session structure allows both the client and therapist to be on the same page and maintain the flow from session to session.

[Music] CBT therapists use a particular session structure which at first glance to somebody learning CBT might think is too structure but it's um it's really a wonderful way to approach each session and I can I can explain why first of all structure helps the therapist be more time efficient and helps the client begin to understand what they can expect from each session and and generally this is how our sessions flow first of all when a client comes into the office a therapist wants to maintain and reestablish that Therapeutic Alliance and so the first thing we do is we want to a check on how our client's doing and in so doing we're we're conducting a mood check we'll also look over the measures that a client filled out right before they saw us and if anything pops out from those we can ask our clients right there and there about uh responses on the measures we also ask if there's anything that happened between last session and this session that's important for us to know about we we um refer to that as the bridge and that's also a way to um reestablish that Therapeutic Alliance sort of um drawing the client's attention from last session to the current session and then very important next step is to ask about the action plan or the the experiment or the work they were going to do in between the two sessions and we do this for a couple of reasons um first of all clinicians understand that a lot of learning takes place between sessions we want the client to understand that we think it's important to check on that and um if we don't ask about the action plan the client might get the sense that it wasn't important if they did it or not so we we always make sure to ask about the action plan and then uh sometimes agenda items come right from that sometimes clients were unable to do their between session work um and then of course we want to know why uh sometimes the client um very pleased about how they did their work between sessions and and that gets reviewed next the therapists ask what the client would like to work on we collaboratively set the agenda very often clients will bring up three four or more items for the agenda and then the therapist would want to know what's most important if we only have time to cover one or two items what would that be and and together we decide what would be most important sometimes clients don't know what to suggest for an agenda item and in that case I might ask something like well is there anything you've got coming up that you could use my help with and we work on the agenda items and then we I'm certain to leave time for uh setting the action plan for the next week you don't want your clients to leave your session without knowing what they're going to work on what they're going to experiment with what they're going to try one of my favorite parts of the um therapy session is asking the client for a summary asking the client what he or she will remember this week what's going to be most important for you to keep in mind this week what was most helpful that we talked about and right then I'm kind of helping the learning take place it's kind of like a moment where the client can can think about what what they learned and what's going to be most useful and then I asked the client this is always a surprise to someone who's new to CPT I always ask the client for some feedback about the session itself I say something like how do you think the session went and is there something I could have done to make it a better session for you is there something I could have done a little more of or a little less of and clients really really appreciate this and therapists appreciate it because we're always growing and learning as well

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