Beck Ch 9 Flashcards
What do you develop your treatment plan based on?
- Your diagnostic evaluation and the cognitive formulation of the disorder(s);
- The principles of treatment and general treatment strategies for that disorder;
- Your conceptualization of the client
- The client’s aspirations, strengths, values, and sense of purpose;
- The obstacles they face in taking steps to reach their goals.
What is the most general question your should ask yourself when planning a session?
“What am I trying to accomplish, and how can I do so most efficiently?”
As you review your notes from the previous session before the session, ask yourself: (8)
- Alliance: “What, if anything, do I need to do today to strengthen our alliance?”
- Conceptualization: “What is the cognitive formulation [most important cognitions, coping strategies, and maintaining factors] for the client’s disorder? What is my conceptualization of the client?”
- Individual characteristics: “Do I need to vary treatment to accommodate the client’s individual characteristics?”
- Progress: “What has happened in the past few therapy sessions? What progress have we made toward the client’s goals and helping the client achieve a better level of functioning and sense of well- being? What obstacles have been interfering?”
- Strengths: “How can I build on the client’s strengths, assets, and resources, and how can I help the client experience positive affect in the session?”
- Stage of therapy: “At which stage of therapy are we [beginning, middle, or final], and how many sessions do we have left [if there is a limit]?”
- Cognitive level: “At which cognitive level have we primarily been working: automatic thoughts, intermediate beliefs, core beliefs, or a mixture? What behavioral changes have we been working toward? Which skills do I need to reinforce or introduce?”
- Action plan: “What was the client’s Action Plan? What, if anything, did I agree to do [e.g., call client’s health care provider or find relevant bibliotherapy]?”
As you begin the therapy session and check on the client’s mood,
ask yourself (3)
1.“How has the client been feeling since our last session compared to earlier in treatment? Which moods predominate?”
2.“Do objective scores match the client’s subjective description? If not, why not?”
3.“Is there anything about the client’s mood we should put on the agenda to discuss more fully?”
As the client provides a brief review of the week, ask yourself: (3)
- “How did this week go compared to previous weeks? When was the client at his best in general?”
- “What signs of progress are there? What positive experiences did the client have? What conclusions did the client draw about these experiences and about herself?”
- “Did anything happen this week [positive or negative] that we should put on the agenda to discuss more fully?”
As you check on the client’s use of alcohol, drugs, and medication (if applicable), ask yourself:
“Is there a problem in any of these areas? If so, should we put it on the agenda to discuss more fully? And/or does the client have a goal in any of these areas?”
As you and the client set the agenda, ask yourself:
“Which goal(s) does the client want to work toward this week?
OR
“what problem(s) does the client want my help in solving?”
As you and the client prioritize agenda items, ask yourself:
1.“Which agenda item is most important to discuss first?”
2. “How much time will each agenda item take?
3. How many items can we discuss?”
4. “Are there any goals or issues the client could resolve alone or with Someone else, or bring up at another session?”
As you and the client review the Action Plan, ask yourself:
1.“When was the client at his best in relation to his goal(s) in the past week?”
2.“How much of the Action Plan did the client do? What obstacles or challenges, if any, got in the way?”
3.“Was the Action Plan useful? If not, why not?”
4. “What did the client learn from the Action Plan? What did the client conclude about her experiences and about herself?”
5. “How much does the client agree with the therapy notes from last week [and previous weeks, if still relevant]?”
6.“Which Action Plan items [if any] would be beneficial for the cli- ent to continue in the coming week?”
7.“How, if at all, should we modify the Action Plan we create today to make it more effective?”
As you and the client discuss the first agenda item, ask yourself questions in four areas: (4)
- Defining the issue or goal
- Devising a strategy
- Choosing techniques
- Monitoring progress
What questions should you ask yourself related to defining the issue or goal?
- “What is the specific issue or goal the client wants to work on?”
- “How does this issue or goal fit into my overall conceptualization of the client?”
What questions should you ask yourself related to devising a strategy?
1.“What has the client already done to try to resolve the issue or reach the goal?”
2.“What would I do if I were in the client’s position and had this issue or goal?”
3.“Do we need to do problem solving? What cognitions might interfere with problem solving, carrying out a solution, or making progress toward the goal?”
What questions should you ask yourself related to choosing techniques? (6)
1.“What specifically am I trying to accomplish as we discuss this agenda item?”
2. “Which techniques have worked well for this client [or for similar clients] in the past?
3. Which techniques have not worked well?”
4. “Which technique should I try first?”
5. “How will I evaluate its effectiveness?”
6. “Will I employ the technique or employ it and teach it to the client?”
What questions should you ask yourself related to monitoring progress? (6)
1.“To what degree are we working together as a team?”
2.“Is the client having interfering automatic thoughts about himself, this intervention, our therapy, me, the future?”
3.“Is the client’s mood improving? How well is this technique working? Should I try something else?”
4.“Will we finish discussion of this agenda item in time? If not, should I suggest continuing this item and curtailing or eliminating discussion of another item?”
5.“What Action Plan might be beneficial?”
6.“What should we record for the client to review at home?”
Following discussion of the first agenda item, ask yourself:
1.“How is the client feeling now?”
2. “Do I need to do anything to reestablish rapport?”
3. “How much time is left in the session? Do we have time for another agenda item? What should we do next?
