First Cbt Appointment - Prompt Page 3

CBT Assessment

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

Risk – self-harm: thoughts, plans, likelihood to act etc.

Other risks

(neglect, aggression/violence, abuse etc)

Previous therapy / treatment

What have you tried before? What helped? What didn’t help?

Problem summary

Initial formulation

(or use separate sheet)

Give brief explanation of CBT

Homework?

Check out understanding, any questions etc

Arrange next appointment

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Parent category: Education