Beck Chpt 3 – First Therapy Session – Flashcards

* To make process of therapy understandable to both therapist and patient * Adhering to standard format, make efficient as possible * Teach tools of therapy to patient * Explain and adhere to session structure

* Breif Update (mood check, medication compliance) * Bridge from previous session * Setting Agenda * Review of Homework * Discussion of issue(s) * Setting new Homework * Summary and Feedback

* Review Intake evaluation * Diagnositic evaluation for planning treatment effectively (Axix I/II) * Attention paid to symptoms, presentign problem, current functioning, history. * Start development of conceptulization and therapy plan * Jot down agenda items to be covered during initial session on therapy note sheet

1. Establish Rapport and Trust 2. Socializing the patient into CT 3. Educate patient about disorder, about cognitive model and process of therapy 4. Normalising patient difficulties and instilling hope 5. Eliciting (and correcting, if necessary) patient expectations 6. Gathering additional information about patients difficulties 7. Using this information to develop goal list

1. Setting agenda (and provide rational to do so) 2. Doing mood check, including objective scores 3. Breifly reviewing the presenting problem and obtaining an update (since evaluation) 4. Identifying problems and setting goals 5. Educating patient about cognitive model 6. Eliciting the patients expectations for therapy 7. Educating the patient about disorder 8. Setting homework 9. Providing a summary 10. Eliciting feedback

* If patient is hopeless and suicidal, goals and format of the first session are modified. * Paramount to assess patients degree of suicidality to discover what the patient is so hopeless about, and to undermine the hopelessness * Crisis intervention also takes precedence about all else when the patient is in danger from others or is a potential danger to others.

As with all areas of CBT provide a rational for the client to help socialise and educate the client. Commences termination process.

* Provide rational to make more understandable and elecit particpation * Quick and to the point * Failure to set explicit agendas frequently results in at least some unproductive discourse * Homework can be to think about agenda and what they would like to contribute to it.

After agenda setting, breif mood check conducted. * Subjective report, objective self-report questionnaires such as Becks Depression/Anxiety Inventories, Becks Hopelessness scale. Help track how patient is doing. * Teach and ask patient to rate their mood 0-100 scale. * May graph mood scales to make patients progress evident to both of them.

Help C to break down problem into more managable size * Get patient to specify in behavioural terms what happier or feeling better are for them * Getting C to participate more actively in the goal setting process * Guide patient in writing the goal list

* Important and overarching goal of CT is to teach patient to become their own therapist. * Therapist elicits and corrects (if necessary) what patients already knows about CT and use her own words to educate and explain CT. * Guide patient to document the model * Make sure client can verbalise the model * Therapist explains, illustrates, and records the cognitive model with the patients own examples.

* educate client that therapy is orderly, rational and help patients better understand themselves, solve problems and learn tools they can apply themselves. * Inform client how long therapy maybe based on disorder

Asking for feedback further strengthens rapports, providing a message that the therapist cares about what the patient thinks. * Gives patient chace to express, and the therapist to resolve, any misunderstandings. * Verbal and maybe a written therapy report.