Critical self-reflective overview of the Cognitive Behavioural Therapy (CBT) session
The purpose of this assignment is to facilitate learning through reflection.
It is a framework in which to situate your session and reflect upon on your performance. Regardless of how well we might have done, there is always room to improve and this is achieved through thinking about what went well; ‘strengths’, as well as what could have done better; ‘areas for development’.
Write up a description of the session following the guidelines on page 3.
Reflect upon the skills you demonstrated. These are a list of some of the things that you may want to consider (this list is not exhaustive):
• How did you employ a client-centred approach? (Rogers, 1961)
• How did you demonstrate ethical practice during the session? (See
BPS Website)
• Did you use your basic counselling skills: paraphrasing and summarising?
• Did you explain what CBT was?
• Did you set a clear agenda with the client?
• Did you help the client to set a SMART goal?
• Did you demonstrate socratic questioning to explore the client’s issues?
• In the ‘Observation’ phase did you identify a Negative Automatic Thought (NAT) that the client wanted to discuss the session?
• Did you use the ABC model to do this?
• Did you invite your client to rate their belief/conviction/likelihood regarding the NAT?
• In the ‘Theorising’ stage did you explore whether the client has previously been in a similar situation? Did you explore the resources they used at that time?
• Do you employ the ‘Evidence for and Against’ method?
• In the ‘Synthesizing’ Phase do you draw attention to your client’s resources from past examples to support the client to problem solve around the current NAT?
• Did you discuss with the client what factors were associated with their issues?
• Perhaps you set a Behavioral Experiment or Challenge their Cognitive Distortions or use Cognitive Restructuring?
• Do you invite the client to re-rate the NAT?
• Do you Summarize and bring the session to a closure?
Make sure that you use these to guide the content of your write-up rather than using them to structure what is required. This is provided below in more detail.
2. Incorporate some of the reflective model below (Gibbs, 1988), to guide your journey of reflection. cite Gibbs in your reference list.
Ensure that your transcript is transcribed verbatim and attached to the submission of reflective essay.
The word-count for this assignment is 1500 words (excluding the transcript).
Part 1 of the essay should describe what you did. This will take-up around half of the word-count. cite references within this part to support your actions. It is important that you provide illustrations of what you did and said to back this up.
Part 2 of the essay should constitute the rest of the essay and should be split into 2 further (roughly equal) sections. There should be 2 headings here; ‘Strengths’ (which should provide an overview of what you thought went well, and where the session closely mirrored the CBT approach.
The second heading should be ‘Areas for development’, here you should reflectively critique your performance. It is good to be critical of yourself here, as you will receive marks for developing your capacity as a reflective practitioner.
Note this section should not just be a list of what you did well and what you need to improve on. Rather this requires you to reflect on both of these sections and develop a clear argument to support either side. Check the word length so that you place equal weight to Part 1 and Part 2 in your write-up.
This is an additional list of CBT techniques that should have been covered.
Structure of session
Explain what CBT is to the client
Observation
(Set the Agenda)
Ask client about the problem.
Come up with a collaborative SMART goal
Break this down by identifying a series of Negative Automatic Thoughts
(NATs).
Either use the Thought Record and or use Socratic Questions to do this e.g.
When? What? Where? What goes through your mind?
Isolate one NAT to focus upon during the session.
Invite client to rate their belief/distress etc.
Talk about the NAT using basic counselling techniques: empathy,
paraphrasing and summarizing.
Theorising
Find the client’s resources, together with the client
Ask client about similar past experiences
Possible Socratic questions here:
‘Have you ever experienced anything similar before?’
‘What resources did you draw upon?’
Invite the client to engage in an experiment with you in which you will explore
the evidence for the NAT together.
Use the ‘Evidence for and Against’ sheet to explore the NAT.
Identify any cognitive errors/’thinking traps’
Further discuss client’s resources.
Synthesising
Possible Socratic questions here:
‘Can you think of any ways that you can apply these
(resources/approaches/adaptions/learning points) in your current situation?
Explore and re-iterate these (resources/approaches/adaptions/learning points)
raise them up and chew them over with the client.
Possible Socratic questions here:
‘How does this all fit together with the NAT?’ (…………………..) ?
Re-rate belief in the NAT/distress.
Making a Plan
Summarise first: Re-state the original problem that brought the client here.
Looks at the factors that contribute to issue (Precipitating, Predisposing, Maintaining)
Revisit the NAT
Recapitulate any resources/solutions/strengths/coping strategies that you and
your client identified when looking at their past experiences
Set a Behavioural Experiment – Inviting your client to collect evidence that
relates to their NAT
Draw out what you have discovered from this journey that can support your
client now.
Make a plan of where to go next – perhaps agreeing that the client will report
back on the behavioural experiment in the next session.
