From the outset of therapy, mental health professionals support clients as they grow their skills, helping them reach their goals and tackle the problems that stand in their way (Nelson-Jones, 2014).
While plans will capture the higher-level approach and timelines involved in treatment, they are typically broken down into individual counseling sessions that serve vital functions and help the client progress toward a successful outcome (Gehart, 2016; Nelson-Jones, 2014).
Counseling sessions are opportunities for the therapist and client to get to know one another and for the client to talk about the issues that have brought them to counseling.
Each session will vary between clients based on their specific challenges and the treatment style.
Examples of individual sessions and samples of scripts include (Nelson-Jones, 2014):
Early (and ongoing) sessions
Early on in counseling, session time is spent developing each of the following five therapeutic elements:
A strong relationship
A robust therapeutic bond is vital to successful counseling.
A working model
The therapist builds a working model – a “set of hypotheses about how clients function in problem areas and is a statement of how they feel, think, and act” (Nelson-Jones, 2014, p. 125).
A shared definition of problems in terms of skills
Client problems should be restated in terms of skills (or lack of skills) that perpetuate issues.
Working goals and interventions
Aim to agree on preliminary statements of working goals as skills to be developed.
A framework for future work
Decide on a practical approach for how, when, and where to meet–potentially digital–plus fees.
Meeting and greeting counseling skills are fundamental early on and may include the following types of opening statements and scripts (modified from Nelson-Jones, 2014, p. 127):
Meeting outside the office
“Hello [client’s name], I’m [your name]. Please come in.”
Permission to talk
“Please tell me what has brought you here today.”
Acknowledging a referral
“You’ve been referred by [other person’s name]. Now how do you see your situation?”
Responding to bodily communication
“You seem nervous. Would you care to explain what is bothering you?”
Crisis counseling sessions
Therapists will sometimes face a client in crisis. They must make “immediate choices to help clients get through their sense of being overwhelmed” (Nelson-Jones, 2014, p. 139).
During crisis sessions, the following is vital (Nelson-Jones, 2014):
Define the crisis
The therapist must be able to define the crisis and know what is causing excessive stress;
The therapist should be ready for a crisis, maintain a sense of calm, listen closely and observe well, and assess the severity and risk of damage to the client and others.
Understands the client’s strengths and coping skills
The client may be unaware or have forgotten that they have the tools to cope. The therapist can remind them by asking selective questions.
Variations of the following comments can be helpful (modified from Nelson-Jones, 2014):
“You have spoken a lot about the negative aspects of your life. Can you think of any positive aspects as well?”
“From what I’m hearing, you are facing your problems all on your own. Can you think of any friends or family members who may be able to offer you some support?”
Where problems are complex, several sessions may be needed to fully understand where help is most needed (Sommers-Flanagan & Sommers-Flanagan, 2015).
How To Plan Your Counseling Session
Planning is vital to moving clients (and their counselors) from where they are to where they want to be (Nelson-Jones, 2014).
A therapeutic plan offers a potential route from initial engagement to termination—both of which are vital to the overall therapeutic outcome (Joyce et al., 2007).
It should be individual and specific to the client and their needs while remaining flexible for adaptation in response to new information or changing circumstances.
A typical therapeutic plan contains placeholders for each of the following elements (Gehart, 2016; Nelson-Jones, 2014):
Counseling begins with some form of evaluation—often before the client attends their first session and may include the client’s history, symptoms, and current situation to determine an appropriate counseling approach to treatment.
‘Case conceptualization’ involves organizing the information about the client, including their “situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination” (Sperry & Sperry, 2020, para 6).
2. Goal setting
Specific, measurable, achievable, relevant, and time-bound (SMART) goals should be developed collaboratively and goal setting form an essential part of the therapeutic process.
They must be tailored to the client’s needs, preferences, and expectations and align with the therapeutic approach.
3. Specific treatment plans
Following assessment and goal setting, the therapist and client collaborate to develop a more detailed treatment plan outlining the strategies and interventions required to address the client’s needs and overcome what stands in the way of a meaningful and fulfilling life.
4. Monitoring progress
Tracking client progress during treatment is essential for supporting them in achieving their goals. It involves regularly reviewing treatment plans, tracking symptom changes, and identifying and addressing obstacles or setbacks to ensure the therapy remains effective and relevant.
5. Evaluation and termination
Once significant progress has been made toward the client’s goals (or the predetermined time frame for therapy is nearing the end), the therapist and client should evaluate the overall effectiveness of the treatment.
Working together, they reflect on their therapeutic relationship, explore additional areas of growth, decide on the appropriate time to terminate therapy, and agree on a plan for maintaining gains and addressing any potential relapses.
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6 Templates & Examples of Topics To Address
Clients arrive in counseling for many different reasons. Understanding coping styles, setting goals, identifying negative thoughts, exploring character strengths, and managing irrational and unhelpful beliefs are valuable for supporting client growth (Nelson-Jones, 2014).
The following six templates help assess some of their needs and the obstacles that stand in the way of working towards goals:
1. Coping styles formulation – it is essential that the client and therapist arrive at a shared understanding of the problems the former is facing and develop more adaptive coping strategies.
2. Goal setting for self-esteem – goal setting is a powerful and vital tool within counseling. In this worksheet, the client reflects on areas where they feel inadequate or upset and use goals to boost their self-esteem.
3. Identifying ANTS: Challenging different types of automatic thoughts – automatic thoughts impact how we think, feel, and behave – often without us being aware. This worksheet helps clients understand their ‘automatic negative thoughts’ (ANTS).
4. Exploring character strengths – awareness and understanding of personal strengths can help clients overcome challenges, meet value-driven goals, and lead more energized and fulfilling lives.
5. Decatastrophizing – often, we filter out positive beliefs and only think of worst-case scenarios. This worksheet is helpful for decatastrophizing and seeing the challenges we face more realistically.
6. It could be worse… – learning how to move forward from setbacks and find a new path if necessary is essential. In this worksheet, the client identifies problems they are struggling with and puts them into context by imagining how they could be much worse.
How To Perform an Intake & Termination Session
Intake and termination sessions are at opposite ends of the treatment journey and yet are equally vital to a successful client outcome (Gehart, 2016).
Performing an intake session
When conducting an intake session with a new client, gathering as much information as possible is essential to ensure that the therapist provides the best care and support (Intake interview, n.d.).
The intake session typically includes (Beck, 2011; Nelson-Jones, 2014):
Reviewing client intake forms
Pay close attention to any information that may indicate a need for immediate attention, such as suicidal ideation, self-harm, or abuse. Note any concerns and prepare to address them with the client during the session or refer them for specialist help if appropriate.
Using active listening skills
Allow clients to share their stories and express their concerns. Show that you are present, available, and open to hearing about their experiences.
Asking open-ended questions
Gather additional information and deeply explore the client’s thoughts and feelings. Examples of open-ended questions include “Tell me more about that,” “What led you to seek counseling at this time?” and “What do you hope to achieve through counseling?”
Being mindful of your reactions and biases
Work to create a safe and non-judgmental space for the client to share; counseling should center on the client, not the therapist.
Summarizing and reflecting back to the client
Ensure you have understood their concerns and experiences accurately – help the client feel heard and validated.
Following these steps while being compassionate, respectful, and non-judgmental will support you in gathering essential information about the client and building a therapeutic relationship based on trust and empathy (Nelson-Jones, 2014).
Think of a time when things didn’t go well for you. What did (and didn’t) you do?
Think of something that somebody else does that makes the problem better. Who are they, and what do they do?
Overall, how would you describe your mood?
How connected do you feel to the people around you?
Think of a behavior that you consider unhelpful:
What do you typically feel before that happens?
What happens to you physically before this happens?
How do you usually act right before this happens?
Our article Counseling Interview Questions contains various other questions that help prompt further discussion and increase understanding of a client’s needs.
How To Write Effective Progress Notes
Effective note-taking plays a valuable part in treatment planning and tracking client progress.
“The Subjective, Objective, Assessment and Plan (SOAP) note is an acronym representing a widely used method of documentation for healthcare providers.” It is a helpful guide for writing practical and valuable progress notes, as follows (Podder & Ghassemzadeh, 2022, para 1):
Record the client’s experiences, feelings, or perspectives. Include information provided by the client’s family or other individuals involved in their care.
Capture objective data obtained during the session, including measurements, assessments, and observations; be specific and concise while avoiding making assumptions or subjective interpretations of the data.
Analyze the information collected in the subjective and objective sections to help make diagnoses, identify patterns, and develop treatment plans. Consider the client’s strengths, limitations, and goals when writing the evaluation.
Outline the next steps in the client’s treatment, including interventions, referrals, and follow-up appointments. The plan should be continuously updated and tailored to the client’s specific needs and goals.
Platforms like Quenza–explicitly created for the counselor or therapist–offer a powerful solution for capturing and storing therapy progress notes.
Evaluation Form & Checklist For Therapists
Treatment feedback and evaluation offer vital information for therapeutic interventions given to the client and the overall development opportunities for the therapist (Nelson-Jones, 2014).
This Session Feedback Form provides a helpful set of prompts and an opportunity for the client to evaluate the therapist and the treatment provided.
Feedback forms can be hosted and completed online (using tools such as Quenza) and tailored to the branding of the mental health professional making evaluations readily available for future reference.
While client feedback is vital, so too is practicing self-care. The Self-Care Checkup is a valuable checklist for the therapist to ensure they maintain their wellbeing and good health.
A Look At Online Counseling Sessions
With dramatic technological advances and improved software design, online counseling has become a practical solution to clients’ hectic schedules (Richards & Vigano, 2013).
Clients can meet their therapist on video calls and receive digital counseling interventions when circumstances do not allow them to meet at the therapist’s practice. And despite the need for counselors to acquire new skills, client attitudes to remotely offered counseling have been chiefly positive (Tuna & Avci, 2023).
The therapist’s contribution to treatment success is well documented. Knowing their strengths can help the mental health practitioner perform at their best, more of the time, while protecting them from burnout:
Step one – take a moment to reflect on your strengths as a therapist:
What do you think they are?
How do you use them?
How have they developed over time?
Step two – reflect on the strengths identified and how you use them:
When are they most helpful?
How could you use them more often?
How could you develop your strengths further?
Countering Compassion Fatigue
Compassion is a vital element of therapy. And yet, over time, it can take its toll on therapists – professionally and personally.
Practicing self-care and self-compassion is essential to providing good service to clients:
Find a comfortable position and take several slow, deep breaths.
Focus on your in-breath – thinking of whatever you need right now [for 30 seconds].
Next, focus on your out-breath. Visualize a loved one or someone that is suffering [for 30 seconds]
Repeat the process for several minutes, savoring the experience of self-compassion flowing in and out of your body.
Counseling is a relationship, a process, and a repertoire of interventions – all of which benefit from good planning (Nelson-Jones, 2014).
Indeed, detailed yet flexible planning can leave the therapist confident that the client can navigate from what brought them to counseling to a successful outcome based on their needs and the challenges they wish to overcome.
When done well, it is possible to create stronger relationships, clear working goals and interventions, and a framework for future success.
The counseling plan will likely define the treatment approach and include assessments, goal-setting, interventions, monitoring, and evaluation that will increase the likelihood of a successful client outcome.
Along the treatment journey, a clearer understanding of the client’s concerns, difficulties, and negative thinking can be sought and managed through improved coping styles and increased awareness and use of strengths.
This article introduces examples of sessions and samples of scripts, templates, and checklists to plan and manage your counseling sessions more effectively to help build a meaningful, value-driven life for the client.
Barnett, J. E. (2016, October). 6 strategies for ethical termination of psychotherapy. Society for the Advancement of Psychotherapy. Retrieved April 18, 2023, from https://societyforpsychotherapy.org/6-strategies-for-ethical-termination-of-psychotherapy/
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
Gehart, D. R. (2016). Theory and treatment planning in counseling and psychotherapy. Cengage Learning.
Intake interview. (n.d.). In APA dictionary of psychology. Retrieved April 18, 2023, from https://dictionary.apa.org/intake-interview/
Joyce, A. S., Piper, W. E., Ogrodniczuk, J. S., & Klein, R. H. (2007). Termination in psychotherapy: A psychodynamic model of processes and outcomes. American Psychological Association.
Nelson-Jones, R. (2014). Practical counselling and helping skills. Sage.
Podder, V., & Ghassemzadeh, S. (2022). Soap notes – StatPearls – NCBI Bookshelf. SOAP Notes. Retrieved April 19, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK482263/
Richards, D., & Vigano, N. (2013). Online counseling: A narrative and critical review of the literature. Journal of Clinical Psychology, 69(9), 994–1011.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. Wiley.
Sperry, J., & Sperry, L. (2020, December 7). Case conceptualization: Key to highly effective counseling. Counseling Today. Retrieved April 20, 2023, from https://ct.counseling.org/2020/12/case-conceptualization-key-to-highly-effective-counseling.
Tuna, B., & Avci, O. H. (2023). Qualitative analysis of university counselors’ online counseling experiences during the COVID-19 pandemic. Current Psychology, 1–15.
About the author
Jeremy Sutton, Ph.D., is a writer and researcher studying the human capacity to push physical and mental limits. His work always remains true to the science beneath, his real-world background in technology, his role as a husband and parent, and his passion as an ultra-marathoner.