Ирина Архипова – English for Psychotherapy and Counselling: Handbook for Practitioners. Английский для психотерапии и консультирования: практическое руководство (страница 29)
TASK 2: Answer the Questions
1. How is James feeling compared to before he started therapy?
2. What are the three main issues James wants to address in therapy?
3. What does SMART stand for in goal-setting?
4. What is James’s first SMART goal about work presentations?
5. How often is James currently having trouble sleeping?
6. What percentage of social invitations does James want to be able to accept?
7. What three main techniques will Dr. Roberts use to help James?
8. What is James’s homework assignment for next week?
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TASK 3: Personal Response
Discuss:
1. James feels “overwhelmed but also relieved” after setting goals. Why do you think clear goals can create both feelings at the same time?
2. Dr. Roberts says, “The homework is where most of the change happens.” Do you agree that practice outside therapy sessions is more important than the sessions themselves? Why or why not?
3. One of James’s goals is to attend at least two social events per month. Do you think this is realistic for someone with social anxiety? Would you set the goal higher or lower?
TASK 4: Role Play
Work in pairs. One person is a psychotherapist, the other is a client.
The client presents with:
• Chronic stress from work overload
• Frequent headaches and muscle tension
• Difficulty saying “no” to additional responsibilities
• Feeling burned out and exhausted
The psychotherapist should:
• Ask questions to understand the client’s difficulties
• Help the client formulate 2—3 SMART goals
• Suggest appropriate interventions (e.g., stress management techniques, assertiveness training, relaxation exercises)
• Assign homework for the coming week
• Summarize the treatment plan
Time: 10—15 minutes
After the role play, discuss:
• Was it easy or difficult to create SMART goals?
• Did the goals feel realistic and achievable?
• What interventions seemed most appropriate for this client’s problems?
PROFESSIONAL PRACTICE:
Creating Effective Treatment Plans
Sample Treatment Plans
Client: 32-year-old female with major depressive disorder
Presenting Problems: Low mood, loss of interest in activities, difficulty concentrating, sleep disturbance
Treatment Approach: Cognitive-behavioural Therapy
Goal: Reduce depressive symptoms and improve daily functioning within 12 weeks
SMART Objectives:
1. Within 4 weeks, client will identify and challenge 3 negative automatic thoughts daily using thought records
2. By week 6, client will engage in 3 pleasurable activities per week (behavioural activation)
3. By week 12, client will score below 10 on PHQ-9* (currently 18)
Interventions:
• Cognitive restructuring
• behavioural activation
• Sleep hygiene psychoeducation
• Homework assignments (thought records, activity scheduling)
Outcome Measures: PHQ-9 administered every 3 sessions
Planned Duration: 12—16 weekly sessions
Relapse Prevention: Identify warning signs, maintain activity schedule, know when to seek additional support
* PHQ-9 (Patient Health Questionnaire-9) – Опросник здоровья пациента-9
Client: 25-year-old male with social anxiety disorder
Presenting Problems: Fear of judgment, avoidance of social situations, physical anxiety symptoms
Treatment Approach: Cognitive-behavioural therapy with exposure
Goal: Decrease social anxiety and increase participation in social activities within 16 weeks
SMART Objectives:
1. Within 4 weeks, learn and practise relaxation techniques with 80% success rate
2. By week 8, attend one low-anxiety social situation per week using coping strategies
3. By week 12, give a presentation at work (previously avoided)
4. By week 16, report anxiety in social situations decreased from 8/10 to 3/10
Interventions:
• Cognitive restructuring of social anxiety thoughts