First Cbt Appointment - Prompt Page 2

CBT Assessment

Name......................................ID........................

What helps?

What makes things better?

E.g. avoidance, substances, safety behaviours

Impact

How does this problem affect your daily life?

work, home, family/friends, study

Coping resources

What helps you cope generally?

Enjoyment, achievement, relationships, spirituality etc.

What brings you to therapy now? At this time?

What do you hope to achieve in therapy? What will be different?

What medication do you take?

Do you use alcohol, drugs, tobacco, other substances? How much?

General mental state

Mood, concentration, memory, sleep, weight changes etc.

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Parent category: Education