Lecture 4 - Structure of CBT sessions

Question 1

What is the time management of CBT sessions?

Answer 1

50-75 min
3 stages for every session
Stage 1 - Opening
Stage 2 - Probing and Intervention
Stage 3 - Closing

Question 2

How do you formulate the opening? (3-5 min)

Answer 2

Greeting
Confidentiality
Approximate duration of course therapy
Cost of therapy
Other important information requested by client
Ends with " What brings you here today?"

Question 3

How is the opening in subsequent sessions? (5-15 min)

Answer 3

Greetings

Summary of previous session: presenting issues, compliments, intervention, reiterate agenda and goals

Mood check (emotion type and scaling)

Any new issues to bring up

Assess whether new issues are worth delving into, or else continue from previous session

Review homework - positive or negative reactions to homework, if not done, what would be the reason?

Question 4

What to do during Probing? (40-50 min)

Answer 4

Presenting issues (limit to 2-3 issues max)

Prioritise problems

Mood check on the problem to be discussed- clarify the the type of emotion, ask for scaling question for the emotion.

Probe for dysfunctional Automatic negative thoughts (nATs) and negative intermediate Beliefs (nIBs)

Probe and set agenda and goals

Need to confirm with client before proceeding to next phase

Question 5

What to do during Intervention?

Answer 5

Challenge client’s thinking and behaviour (in any order)

Question 6

How do you challenge client’s thinking and behaviour?

Answer 6

Check for Any dysfunctional coping strategies?

Any dysfunctional AT’s

Facilitate awareness of dysfunctional coping strategies

Discuss nIBs and NCBs (e.g. through “Downward arrow technique” or Metaphor technique”

Administer any appropriate psychotherapeutic intervention (limit to 2 or 3, maximum) - Use eclectic psychotherapy whenever necessary

Set new homework (do not overburden client)

Assess likelihood of client doing the homework

Question 7

What to do during Closing?

Answer 7

Summarise session - presenting problem - Agenda (reiterating the goals is optional) - List the administered interventions.

Emphasise doing the homework

Any questions?

Feedback - Anything I have missed out? Of all things discussed, which one gave the most impact?