Typical Session Format

 
 

Every therapy session is unique. While people often ask what a “typical session” looks like, the truth is that each meeting is shaped by your goals, your pace of growth, and your authentic pursuit of meaning, purpose, and happiness.

Modern CBT is no longer limited to rigid manuals. In real‑world practice, I use a process‑based, integrated CBT approach, drawing from multiple evidence‑based and evidence‑informed therapies to meet the needs of each individual.

1. Set the Foundational Goals

During our first few meetings, we clarify the goals that will guide our work together. I encourage clients to frame goals as “Start Goals” rather than “Stop Goals.”

  • Start Goals move you toward what you want Examples: “To discover my emotional resilience,” “To replace worry with problem‑solving,” “To learn assertiveness skills.”

  • Stop Goals focus on avoiding or suppressing unwanted experiences Examples: “To be less anxious,” “To stop worrying,” “To avoid arguments.”

Stop goals often create a rebound effect, increasing worry or fear of failure. Start goals help you move toward growth, meaning, and desired change.

2. Building Your Personalized Treatment Map

Together, we develop and periodically revise a conceptualization of your past, present, and future. This becomes our shared guide for treatment.

Each session typically begins with a brief review of how things have gone since our last meeting. From there, we focus on your Action Plan—the steps that move you toward your goals, values, and aspirations.

A warm, safe therapeutic relationship is central. We work as a team to support growth, emotional regulation, and resilience.

3. Using the Emotional Thermometer

The Emotional Thermometer (linked in the Treatment section Forms) is one of several tools we may use.

  • The base circle represents the therapeutic stance of Compassion without judgment and Curious Acceptance. This echoes the spirit of the 1960s humanistic message: “I’m okay, you’re okay, it’s okay — and when things are not okay, that’s still part of being human.”

  • The ladder of numbers reflects different states of the nervous system:

    • 4–7: Balanced, connected, safe (Ventral Vagal Complex)

    • 1–3: Shut down, frozen, low motivation (Dorsal Vagal Complex)

    • 8–10: Heightened, reactive, emotionally dysregulated (Sympathetic activation)

Understanding where you are on this ladder helps guide our work toward stability, connection, and growth.

4. Tools and Strategies We May Use

To support your progress, we draw from a wide range of CBT and integrated approaches, including:

Cognitive & Emotional Tools

  • Validating feelings

  • Practicing self‑compassion

  • Mindfulness to reduce automatic, emotion‑driven behaviors

  • Identifying and reshaping unhelpful beliefs

  • Exploring developmental, attachment, or trauma history when relevant

  • Understanding how beliefs shape attention, behavior, and emotional cycles

Behavioral & Experiential Tools

  • Behavioral Activation for depression and avoidance

  • Prolonged Exposure and relapse‑prevention strategies for anxiety

  • Skills for responding differently to situations you can and cannot change

  • Guided imagery, body scan, progressive relaxation

  • Mindfulness, breathing awareness, and loving‑kindness practices

Decision‑Making & Values Work

  • Evaluating emotional and cognitive pros and cons

  • Clarifying values, purpose, and likelihood of outcomes

  • Identifying obstacles that interfere with acting in your best interest

Interactive & Applied Work

  • Role‑playing difficult situations

  • Developing personalized “Own‑Work” / Action Plan assignments

  • Using apps (Calm, Headspace, HeartMath) or curated YouTube resources

  • Encouraging healthy routines: nutrition, exercise, restorative sleep

  • Discussing the role of inflammation in emotional well‑being

5. Between Sessions

Growth happens both inside and outside the therapy room. You are invited to review:

  • The Emotional Thermometer (linked in the Treatment Form section)

  • The Weekly Bridge / Continuity of Care Form (linked in the Treatment Form section)

  • Complete a personal insight or a “gratitude” journal

  • ATR Automatic Thought Record or Schema Worksheet

These tools help maintain continuity, deepen insight, and support your progress between sessions.