CBT therapists use a particular session structure which at first glance to somebody learning CBT might think is too structured but it's really a wonderful way to approach each session. 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 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 check on how our client's doing. And in so doing, 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 then about 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 refer to that as the bridge. And that's also a way to reestablish that therapeutic alliance, sort of 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 experiment or the work they were going to do in between the two sessions. And we do this for a couple of reasons.
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 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 always make sure to ask about the action plan.
And then sometimes agenda items come right from that. Sometimes clients were unable to do their between-session work, and then of course we want to know why. Sometimes the client is very pleased about how they did their work between sessions and that gets reviewed. Next, the therapist asks 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 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 I'm certain to leave time for 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 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 think about what they learned and what's going to be most useful. And then I ask the client, and 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.