English for Psychotherapy and Counselling: Handbook for Practitioners. Английский для психотерапии и консультирования: практическое руководство

establish rapport – устанавливать раппорт

sensitive information – деликатная/конфиденциальная информация

engage fully – полностью включаться

maintain professional boundaries – поддерживать профессиональные границы

open-ended question – открытый вопрос

closed-ended question – закрытый вопрос

narrative responses – повествовательные ответы

follow-up questions – уточняющие вопросы

onset – начало

duration – продолжительность

frequency – частота

severity (of symptoms) – тяжесть (симптомов)

daily functioning – повседневное функционирование

previous attempts – предыдущие попытки

developmental history – история развития

family history – семейный анамнез

family structure – структура семьи

educational history – образовательный анамнез

occupational history – профессиональный анамнез

employment status – статус занятости

job satisfaction – удовлетворенность работой

work-related stress – связанный с работой стресс

relationship history – история отношений

social history – социальный анамнез

social support network – сеть социальной поддержки

interpersonal relationships – межличностные отношения

medical history – медицинский анамнез

current medications – принимаемые лекарства

chronic illnesses – хронические заболевания

past psychiatric history – предшествующий психиатрический анамнез

psychiatric hospitalizations – психиатрические госпитализации

psychotropic medication – психотропные препараты

substance use – употребление веществ

systematic observation – систематическое наблюдение

psychological functioning – психологическое функционирование

appearance and behaviour – внешний вид и поведение

eye contact – зрительный контакт

motor activity – моторная активность

speech patterns – речевые паттерны

mood – настроение

affect – аффект

emotional state – эмоциональное состояние

observable emotional expression – наблюдаемая эмоциональная экспрессия

labile affect – лабильный аффект

thought process – мыслительный процесс

thought content – содержание мыслей

delusions – бред

obsessions – обсессии/навязчивости

suicidal ideation – суицидальные мысли/идеи о самоубийстве

homicidal ideation – мысли об убийстве

perception – восприятие

hallucinations – галлюцинации

perceptual disturbances – нарушения восприятия

cognition – когниция

orientation – ориентация

attention – внимание

concentration – концентрация

memory – память

intellectual functioning – интеллектуальное функционирование

insight – инсайт/озарение

judgment – суждение

self-harm – самоповреждение

suicide – самоубийство

harm to others – вред другим

suicidal thoughts – суицидальные мысли

specific plan – конкретный план

protective factors – защитные факторы

reasons for living – причины жить

future orientation – ориентация на будущее

preliminary understanding – предварительное понимание

formulation framework – модель концептуализации случая

predisposing factors – предрасполагающие факторы

precipitating factors – провоцирующие факторы

perpetuating factors – поддерживающие факторы

early trauma – ранняя травма

recent events – недавние события

stressors – стрессоры

job loss – потеря работы

relationship breakup – разрыв отношений

poor coping strategies – плохие стратегии совладания

lack of social support – отсутствие социальной поддержки

avoidance behaviour – избегающее поведение

supportive relationships – поддерживающие отношения

resilience – устойчивость

motivation for change – мотивация к изменениям

treatment planning – планирование лечения

tangentiality – тангенциальность

circumstantiality – обстоятельность

vulnerable – уязвимый

informed consent – информированное согласие

transparency – прозрачность

active listening – активное слушание

empathy – эмпатия

unconditional positive regard – безусловное позитивное принятие

collaborative – совместный

coping strategies – стратегии совладания

UNIT 4.

TREATMENT PLANNING AND THERAPEUTIC SESSION

LEAD-IN:

Session Structure and Goal-Setting

Activity 1: Ordering therapy session stages

The stages of a typical therapy session are jumbled below. Put them in the correct order (1•6):

___ Working section (exploring issues, applying techniques)

___ Check-in (reviewing the week, current state)

___ Closing and homework assignment

___ Agenda setting (deciding session focus)

___ Summary of progress and key points

___ Bridge from previous session

Activity 2: Brainstorming – From the first session to termination

Work in small groups. You have 5 minutes to brainstorm and write down:

• Components of a first session (intake)

• Components of regular sessions

• Components of a final session (termination)

Share your ideas with the class.

Example components:

• First session: building rapport, gathering history, setting initial goals, explaining the therapeutic process…

• Regular sessions: check-in, agenda, interventions, homework review…

• Final session: reviewing progress, relapse prevention planning, saying goodbye…

Activity 3: Discussion questions

Discuss these questions with your partner:

1. Why is structure important in a therapy session?

2. How can a therapist and client determine if therapy is working?

3. What does “measuring progress” mean in psychotherapy?

4. Should every session follow the same structure, or should it be flexible?

5. When should therapy end? How do you know?

6. What is relapse prevention?

Key vocabulary for this unit:

Match the words with their definitions:

1. Check-in

2. Agenda setting

3. Treatment plan

4. SMART goals

5. Intervention

6. Termination

7. Relapse prevention

8. Homework

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a) A structured document outlining objectives, methods, and expected outcomes of therapy

b) Brief opening discussion about the client’s current state and recent experiences

c) Goals that are Specific, Measurable, Achievable, Relevant, and Time-bound

d) Collaborative process of deciding what to focus on during the session

e) The planned ending of the therapeutic relationship

f) Therapeutic technique or strategy used to address client’s difficulties

g) Strategies to help clients maintain gains and avoid returning to problematic patterns

h) Tasks or practice activities assigned between sessions

READING:

Managing Sessions and Planning Treatment: From Structure to Goals

Pre-reading task

Before you read, discuss:

1. What do you think should happen at the beginning of every therapy session?

2. Why might clients need homework between sessions?

3. What makes a good therapy goal?

4. How should therapy end?

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Managing Sessions and Planning Treatment: From Structure to Goals

Effective psychotherapy requires both skilled therapeutic intervention and careful planning. Whether working with clients experiencing depression, anxiety, trauma, or relationship difficulties, psychologists must structure their sessions thoughtfully and develop comprehensive treatment plans that guide the therapeutic process from the first meeting to successful termination.

The Therapeutic Frame and Session Structure

The concept of the therapeutic frame refers to the consistent boundaries and structure that provide safety and predictability in therapy. This includes the regular time and place of sessions, duration (typically 45—60 minutes), confidentiality agreements, and the overall format of each meeting. A consistent therapeutic frame helps clients feel secure and allows them to focus on their inner experience rather than worrying about unpredictable elements.

Each therapy session, whether it is the second meeting or the twentieth, generally follows a recognizable structure that includes several key components. This structure provides organization while remaining flexible enough to respond to clients’ immediate needs.

The session typically begins with a check-in, a brief opening where the therapist asks about the client’s current state and experiences since the last meeting. During check-in, clients might share how their week went, whether they experienced any significant events, or how they are feeling in the present moment. This helps the therapist assess the client’s immediate emotional state and determine if any crisis or urgent issue requires immediate attention. For example, a therapist might ask, “How have things been since we last met?” or “What’s been on your mind this week?”

Following the check-in comes agenda setting, a collaborative process where therapist and client decide together what to focus on during the session. The therapist might say, “What would be most helpful to work on today?” or “Let’s think about what we want to accomplish in our time together.” Agenda setting empowers clients by giving them voice in their treatment and ensures that sessions address their most pressing concerns. The agenda might include reviewing homework from the previous session, discussing a recent difficult situation, practicing a new skill, or exploring a longstanding pattern.

The working section forms the main body of the session, where the therapeutic work takes place. This is when a therapist and a client engage with the chosen agenda items using various therapeutic techniques and interventions. In CBT, this might involve identifying and challenging negative automatic thoughts. In psychodynamic therapy, it might mean exploring unconscious patterns or discussing transference. In humanistic therapy, the therapist might reflect the client’s feelings and help them explore their experience more deeply. The working section is flexible and responsive to what emerges during the conversation.

As the session approaches its end, the therapist initiates closing and summary. During this phase, the therapist and client review what was discussed, highlight key insights or progress, and ensure the client feels grounded before leaving. The therapist might ask, “What are you taking away from today’s session?” or “How are you feeling right now?” This is also the time for homework assignment – therapeutic tasks that help clients practice new skills or continue therapeutic work between sessions. Homework might include keeping a thought diary, practicing relaxation techniques, or trying new behaviour in a real-life situation.

Research shows that clients who complete homework assignments between sessions make faster progress and achieve better outcomes. Homework bridges the gap between the therapy room and real life, allowing clients to apply what they learn in session to their daily experiences.

Treatment Planning: Creating a Roadmap for Change

While individual sessions follow a predictable structure, the overall course of therapy requires comprehensive treatment planning. A treatment plan is a structured document that outlines the client’s presenting problems, diagnosis (if applicable), therapeutic goals, specific objectives, planned interventions, and methods for measuring progress. Treatment planning typically begins after the initial assessment and may be revised as therapy progresses.

Effective treatment plans are collaborative. Rather than the therapist imposing goals on the client, both parties work together to identify what the client wants to achieve and how they will get there. This collaboration increases client motivation and investment in the therapeutic process. When clients feel ownership of their goals, they are more likely to work actively toward achieving them.

SMART Goals: Making Objectives Measurable

One of the most important elements of treatment planning is setting SMART goals. SMART is an acronym that stands for:

Specific: goals should be clear and well-defined, not vague. Instead of “feel better,” a specific goal might be “reduce panic attacks.”

Measurable: goals should be quantifiable so that progress can be tracked. For example, “reduce panic attacks from 5 per week to 1 per week” is measurable.

Achievable: goals should be realistic given the client’s resources, abilities, and circumstances. Setting impossibly difficult goals sets clients up for failure.

Relevant: goals should align with the client’s values, needs, and overall life situation. They should matter to the client personally.

Time-bound: goals should have a specific timeframe. “Within 12 weeks” or “by the end of treatment” creates urgency and allows for evaluation.

For example, a vague goal like “improve mood” becomes a SMART goal when reframed as: “Within 8 weeks, reduce depression symptoms (as measured by the PHQ-9: Patient Health Questionnaire-9)) from a score of 18 to below 10 through weekly therapy sessions and daily behavioural activation exercises.”

Treatment plans distinguish between goals (the broader aims of treatment) and objectives (the specific steps needed to achieve those goals). A goal might be “reduce social anxiety,” while objectives would include “learn and practice relaxation techniques within the first four sessions” and “engage in one social situation per week using coping strategies learned in therapy.”

The treatment plan also specifies interventions – the therapeutic techniques and approaches that will be used to help the client reach their objectives. Interventions might include cognitive restructuring, exposure therapy, mindfulness practice, family therapy sessions, or emotion regulation skills training. The choice of interventions depends on the client’s diagnosis, goals, and the therapist’s theoretical orientation and training.

Measuring Progress and Outcomes

How do therapists and clients know if therapy is working? Outcomes refer to the results of therapeutic intervention – the changes that occur in the client’s symptoms, functioning, and well-being. Measuring outcomes is essential for evaluating treatment effectiveness and making adjustments when needed.

Many therapists use standardized outcome measures or assessment scales to track progress systematically. For depression, the PHQ-9 provides a numerical score that can be tracked over time. For anxiety, the GAD-7 (Generalized Anxiety Disorder-7) serves a similar purpose. When a client’s score decreases from 20 to 8 over the course of treatment, both therapist and client have concrete evidence that therapy is working.

Progress is also measured through regular check-ins during sessions. Therapists might ask, “Are you noticing any changes?” or “How are you managing the situations that used to trigger your anxiety?” Client self-reports of improved mood, better relationships, or increased coping abilities all indicate positive outcomes.

Termination and Relapse Prevention

All therapy relationships eventually end, and termination – the planned conclusion of therapy – is an important phase that requires careful attention. Termination is appropriate when clients have achieved their treatment goals, learned skills for managing their difficulties, and feel ready to continue their progress independently.

Effective termination is not abrupt. Therapists typically begin discussing termination several sessions before the final meeting, giving clients time to process their feelings about ending therapy and to consolidate their gains. The termination phase includes reviewing progress, celebrating achievements, and acknowledging the relationship that has developed.

A crucial component of termination is relapse prevention planning. While clients may have made significant progress during therapy, they remain vulnerable to returning to old patterns when faced with stress or new challenges. Relapse prevention involves helping clients identify their warning signs, develop strategies for managing future difficulties, and create a plan for what to do if symptoms return.

Relapse prevention planning might include: identifying high-risk situations that could trigger old patterns; reviewing coping strategies learned in therapy; creating a written plan for managing warning signs; discussing when to seek additional therapy in the future; and ensuring clients feel confident in their ability to maintain their gains.

Research shows that structured therapies that include explicit relapse prevention planning help clients maintain their improvements long after therapy ends. By preparing clients for potential challenges and giving them tools to manage independently, therapists set them up for lasting success.

From the structured framework of individual sessions to the comprehensive roadmap of treatment planning, effective psychotherapy balances organization with flexibility, always keeping the client’s goals and well-being at the center of the work.

Comprehension questions:

1. What is the “therapeutic frame” and why is it important?

2. What happens during the check-in at the beginning of a session?

3. What is agenda setting and why is it collaborative?

4. What is the purpose of homework in therapy?

5. What does SMART stand for in SMART goals?

6. What is the difference between goals and objectives in a treatment plan?

7. How can therapists measure whether therapy is working?

8. When is termination appropriate?

9. What is relapse prevention and why is it important?

10. Give an example of a SMART goal for a client with depression.

VOCABULARY:

Treatment Planning and SMART Goals Terminology

A. Find words in the text that match these definitions:

1. The consistent boundaries and structure that provide safety in therapy (paragraph 2): _______

2. A brief opening discussion about the client’s current state (paragraph 4): _______

3. Process where therapist and client decide what to focus on during session (paragraph 5): _______

4. The main part of the session where therapeutic work happens (paragraph 6): _______

5. Therapeutic tasks that help clients practice between sessions (paragraph 7): _______

6. A structured document outlining problems, goals, and interventions (paragraph 9): _______

7. Tools or techniques used to help clients achieve their objectives (paragraph 14): _______

8. The results of therapeutic intervention (paragraph 15): _______

9. The planned conclusion of therapy (paragraph 17): _______

10. Strategies to help clients maintain gains and avoid returning to old patterns (paragraph 19): _______

B. Complete the collocations from the text:

1. therapeutic _______

2. check-_______

3. agenda _______

4. homework _______

5. treatment _______

6. SMART _______

7. measurable _______

8. relapse _______

9. outcome _______

10. session _______

C. Word families

Complete the table:

Discussion questions:

1. How structured should therapy sessions be?

2. Why is it important for clients to participate in setting their own goals?

3. What should a therapist do if a client doesn’t complete homework assignments?

4. How can therapists balance following a treatment plan with being responsive to clients’ immediate needs?

5. Should all therapy have a planned ending, or can it continue indefinitely?

6. What are the risks of not having a relapse prevention plan?

GRAMMAR FOCUS:

Future Simple, “going to,” and Present Continuous for Plans and Timelines

When discussing treatment plans, session structure, and therapeutic goals, we use different future forms depending on the type of plan or prediction.

A. Future Simple (will + main verb)

Use: predictions, spontaneous decisions, promises, and general future facts

Form:

• Affirmative: Subject + will + main verb

• Negative: Subject + will not (won’t) + main verb

• Questions: Will + subject + main verb?

Examples from therapy:

• This intervention will help you manage anxiety better.

• Therapy will take approximately 12—16 sessions.

• The therapist will review your progress regularly.

• I will support you throughout this process.

• These coping skills will be useful in stressful situations.

B. “Going to” + main verb

Use: planned intentions, decisions already made, and predictions based on present evidence

Form:

• Affirmative: Subject + am/is/are + going to + main verb

• Negative: Subject + am/is/are + not + going to + main verb

• Questions: Am/Is/Are + subject + going to + main verb?

Examples from therapy:

• We are going to work on your communication skills.

• I am going to assign homework to practise between sessions.

• The client is going to keep a thought diary this week.

• We are going to focus on relapse prevention in our final sessions.

• They are going to terminate therapy after achieving their goals.

C. Present Continuous for arrangements

Use: fixed arrangements and scheduled appointments

Form:

• Affirmative: Subject + am/is/are + main verb-ing

• Negative: Subject + am/is/are + not + main verb-ing

• Questions: Am/Is/Are + subject + main verb-ing?

Examples from therapy:

• We are meeting next Tuesday at 3 PM.

• I am seeing my therapist this week.

• The client is coming for their intake session tomorrow.

• We are having our termination session next month.

• They are not attending group therapy this week.

Exercise 1: Choose the correct form

Complete the sentences with the correct future form of the verb in brackets:

1. In our next session, we _______ (explore) your childhood experiences.

2. I think this treatment plan _______ (be) effective for your symptoms.

3. We _______ (meet) every Wednesday at 4 PM for the next three months.

4. The therapist _______ (use) CBT techniques to address your negative thoughts.

5. Look at your progress! You _______ (achieve) your goals soon.

6. I _______ (assign) you homework to practise assertiveness skills.