Presenting Problem

Goal: To clarify what brings them to therapy and how they perceive the problem.

• What has brought you here today?

• How would you describe the main problem in your own words?

• When did you first notice this difficulty?

• Has it changed over time — become better, worse, or stayed the same?

• What tends to make it better or worse?

• What made you decide to seek help now?

Frequency, Duration, and Severity

Goal: To gauge how often, how long, and how strongly symptoms appear.

• How often does this happen?

• How long do these episodes or feelings last?

• How severe or distressing do they feel on a scale of 1–10?

• Are there any patterns or triggers you’ve noticed (times, places, people, activities)?

Thoughts

Goal: To identify automatic thoughts and core beliefs.

• What tends to go through your mind when this happens?

• Are there particular words, images, or “what ifs” that come up?

• How believable do those thoughts feel in the moment?

• What do those thoughts say about you, others, or the world?

• What do you think is the worst that could happen in that scenario?

• What do you think about that?

Emotions

Goal: To understand emotional responses and intensity.

• What emotions do you notice when this happens?

• How strong are those emotions (0–100%)?

• Are there any emotions you feel you shouldn’t or can’t show?

• What emotion would you use to describe this feeling/thought?

Physical Sensations

Goal: To capture the bodily reactions linked to distress.

• What happens in your body when you feel anxious/sad/angry?

• Do you ever avoid activities that bring on these sensations?

• Do you notice any changes in your body when this happens? If so, where?

• How does your body tell you that you are anxious?

• What does anxiety feel like?

Behaviours / Coping Strategies

Goal: To uncover what maintains the cycle.

• What do you do when you start to feel this way?

• Are there things you avoid or safety behaviours you use to cope?

• Do these things help in the short term? How about long term?

• How has this problem affected your daily life (work, school, relationships, self-care)?

• What do you do to manage that?

• Is there anything you’ve noticed you do less/ more of when you feel this way?

Triggers and Context

Goal: To understand the situation around the problem.

• When does the problem tend to appear most often?

• Are there particular people, places, or thoughts that trigger it?

• What was happening around the time it first started?

Maintenance Factors

Goal: To begin identifying the vicious cycle.

• What do you think keeps this problem going?

• Do you ever find yourself avoiding certain thoughts or situations?

• Are there any habits or routines that might maintain it?

• When you do that, does that help or make it worse?

Strengths, Values, and Coping

Goal: To balance the assessment with positives and resources.

• What has helped you cope so far?

• What are you good at managing?

• What matters most to you right now?

• What would tell you that therapy is working?

Goals for Therapy

Goal: To establish focus and motivation.

• What would you like to be different by the end of therapy?

• If therapy worked perfectly, what would change in your life?

• What small steps would move you towards that?

• What are you hoping to change by the end of sessions?

• what would success look like to you?

.