Lesson 1Early-phase strategies (engagement, assessment feedback, motivational work, safety planning)This section details early-phase tasks in a brief protocol, including engagement, alliance building, assessment feedback, motivational enhancement, and safety planning, with attention to ambivalence, shame, and culturally responsive communication.
Structuring the first two to three sessionsDelivering collaborative assessment feedbackMotivational interviewing for ambivalence and shameSuicide, self-harm, and violence safety planningBuilding a strong working alliance quicklyLesson 2Emotion regulation modules from DBT and ACT: distress tolerance, emotion regulation skills, acceptance and values workThis section integrates DBT and ACT emotion regulation modules, including distress tolerance, emotion regulation skills, acceptance, and values clarification, tailored to high-functioning clients who struggle with intense affect and rigid control.
Functional analysis of emotion dysregulation patternsDistress tolerance skills for acute crisesEmotion regulation skills for everyday triggersAcceptance and defusion for difficult thoughtsValues clarification and committed action planningLesson 3Leveraging client strengths (high cognition, motivation, perfectionism) and preventing perfectionism-driven dropoutThis section focuses on leveraging client strengths such as high cognition, motivation, and perfectionism, while preventing perfectionism-driven dropout through expectation management, alliance repair, and flexible, compassionate standards.
Mapping strengths and vulnerabilities of perfectionismUsing cognitive strengths in formulation and skillsSetting realistic expectations for change and paceAddressing all-or-nothing engagement patternsRepairing alliance ruptures linked to self-criticismLesson 4Middle-phase strategies: schema therapy techniques (mode work, limited reparenting, imagery rescripting) for core schemasThis section presents schema therapy middle-phase techniques for core schemas, including mode work, limited reparenting, and imagery rescripting, adapted to a brief 12–16 session format while maintaining depth and emotional impact.
Identifying core schemas and modes collaborativelyPsychoeducation on modes and coping stylesLimited reparenting within professional boundariesImagery rescripting for formative memoriesIntegrating schema work with CBT and interpersonalLesson 5Late-phase strategies: relapse prevention, consolidation of new relational patterns, and maintenance planningThis section outlines late-phase strategies for relapse prevention, consolidation of new relational patterns, and maintenance planning, including booster options, self-monitoring plans, and preparing for predictable high-risk situations.
Reviewing gains and consolidating key skillsRelapse prevention mapping and risk scenariosStrengthening new relational and identity narrativesDesigning maintenance and booster session plansCreating self-monitoring and coping plansLesson 6Middle-phase strategies: CBT techniques (cognitive restructuring, behavioral experiments, exposure) targeted to impostor/perfectionism anxietyThis section focuses on CBT-based middle-phase strategies for impostor and perfectionism-driven anxiety, including cognitive restructuring, behavioral experiments, graded exposure, and behavioral activation tailored to high-achieving clients.
Case conceptualization of impostor and perfectionism cyclesCognitive restructuring of self-criticism and doubtDesigning behavioral experiments in performance domainsExposure to feared evaluation and imperfectionBehavioral activation to counter avoidance patternsLesson 7Tailoring session-by-session structure for a 12–16 session timeline with decision points for extensionThis section explains how to structure a 12–16 session protocol, including session-by-session planning, decision points for extension or step-down, and strategies for balancing depth with time-limited constraints and service demands.
Macro-planning across early, middle, late phasesSession-by-session micro-structure templatesDecision points for extension or step-down careMonitoring progress to guide protocol adjustmentsDocumentation to support flexible planningLesson 8Translating formulation to goals: selecting measurable treatment goals for anxiety, emotion regulation, and relationship patternsThis section explains how to translate an individualized case formulation into concrete, measurable treatment goals targeting anxiety, emotion regulation, and relationship patterns, ensuring goals are realistic, prioritized, and collaboratively negotiated.
Deriving goals from core maintaining mechanismsPrioritizing problems within limited session dosesOperationalizing goals into measurable indicatorsCollaborative goal negotiation and expectation settingAligning goals with client values and identityLesson 9Adaptations for dropout risk and alcohol use: motivational interviewing, harm reduction, brief CBT for substance-related triggersThis section addresses adaptations for dropout risk and alcohol use, integrating motivational interviewing, harm reduction, and brief CBT for substance-related triggers within the 12–16 session framework without derailing core goals.
Screening for alcohol use and dropout indicatorsMotivational interviewing for substance ambivalenceHarm reduction planning and safer use strategiesBrief CBT for craving and trigger managementCoordinating with external supports and referralsLesson 10Middle-phase strategies: attachment-focused and interpersonal techniques (mentalization, interpersonal restructuring, corrective relational experiences)This section covers attachment-focused and interpersonal middle-phase strategies, including mentalization, interpersonal restructuring, and corrective relational experiences, to shift rigid relational patterns and enhance reflective functioning.
Assessing attachment style and interpersonal cyclesEnhancing mentalization under emotional stressInterpersonal feedback and communication coachingUsing the therapeutic relationship as a laboratoryDesigning in-session corrective relational experiences
