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James Pretzer June 17th, 2010 09:18 PM

Reinforcing change between sessions
New harbinger Publications sent out an email that included some suggestions from Michael Tompkins, Ph.D. on "How do you reinforce behavioral change between sessions?" His suggestions started me thinking. Here's my list so far:
  1. Explicitly ask the client to practice between sessions. It may be obvious to us that the client needs to intentionally practice behavioral and cognitive changes between sessions, but many clients assume that change will just happen without effort on their part.
  2. Have the client decide when they will practice (then they're less likely to let it slide indefinitely). Ask them to come up with some reminders.
  3. Plan a simple way for them to record the results. I particularly like the "Action Plan" and "Behavioral Experiment" forms from Mind Over Mood.
  4. Consider working with the client to identify a friend or family member who can coach the client between sessions. Discuss how to set this up so that it doesn't seem like nagging.
  5. Consider setting up a simple way for the client to report in between sessions. For example, they could leave a message on your voicemail updating you on how their practice is going.
  6. Follow up during the next session. Find out what they did, what the results were, and what conclusions they're drawing. Make a point of appreciating their efforts rather that criticizing the imperfections in their practice.
When clients realize that their efforts between sessions produce results, therapy progresses more quickly and improvements are more likely to persist.

James Pretzer November 13th, 2010 10:04 PM

More on Reinforcing change between sessions
The forum archives contain quite a bit more on getting clients to follow through on therapeutic activities between sessions. The thread can be found at

Jettrav November 27th, 2010 11:48 AM

Re: Reinforcing change between sessions
Thanks. Very helpful.

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