Understanding Cognitive Behaviour
Firstly and most importantly the therapist will always greet their client in a positive and welcoming manner. He will want to maintain a confident and encouraging relationship and make his client feel at ease. He must portray an immediate visual display of positive body language, demonstrate a strong desire to ‘listen to’ and ‘work with’ their client. If it is a first session then the subject of confidentiality and consent will be addressed.
A typical CBT session will give the client and therapist an opportunity to recap, discuss and work through their already approved session plan and see if they both agree they are on track. The therapist may have asked the client to keep a thought record so that they can both see how he feels and reacts to given situations and will wish to run through this quite early on within the session to gauge progress and/or identify stumbling blocks if any.
The therapist and client will decide together what topics need to be discussed, prioritised and addressed within the session that day. These may include perhaps new goals which may need to be added but this would only be the case if by mutual agreement and judged and determined on progress.
The client will be offered an opportunity to discuss any situations that they may have experienced since their last session i.e. how they coped, if they did, and what progress if any they feel they have made and whether they have been able to use the coping tools and recognise benefits of CBT thus far. Progress can only be based on what the client reveals to the therapist in terms of how he is feeling and coping in his every-day life. Therapist will continue to record and work closely from the client’s case conceptualisation map.
The client will also be invited, if he feels able, to share details of any personal situations which may have caused them distress or perhaps resulted in them slipping back into previous behaviour traits, if applicable. The therapist and client will then discuss and plan ways in which the client can avoid or address them in the future and not view this as a setback but as a test to learn from and how best to hopefully and positively move forward from this experience.
He has to ask for feedback on a regular basis and make any agreed changes. The therapist may have given the client an external assignment or activity to complete and he will ask how the homework went. Depending on the client’s responses the therapist will then perhaps decide whether this needs to be repeated again or whether this can be deemed a success and a task completed. The therapist may in some circumstances need to add/introduce an exposure exercise for a particular problem i.e. a phobia if part of the client’s issues to be worked through.
The therapist must ensure that the client is actually benefiting from the CBT and closely monitor how this is being achieved.