This represents the last session of this course of psychotherapy. As such, it is important for the therapist to praise the patient's efforts during the course of therapy, to reinforce techniques that have been helpful to the patient, and to facilitate the patient's planning of a self-therapy session.


Review ofHomework. The therapist reviews both the patient's summary of what he/she has been learned in therapy and the Well-Being Diary covering the last 2 weeks. Although it is expected that patients will be able to identify specific tools they have acquired in the course of therapy, some patients provide only a global description of progress they have made (e.g., "I'm feeling better" or "I can cope better now"). In this case, the therapist needs to ask the patient for the specifics supporting such general statements. A review of the Well-Being Diary indicates whether a patient has reached the point of understanding the details of the interactions among his/her feelings, cognitions, and behavior. The therapist should, in any case, remind the patient of the depressed person's tendency to discount the positive and make internal, negative, global attributions. These should serve as signs to the patient that he/she is engaging in unhealthy thought processes. Another important message to reinforce with the patient is that continued self-monitoring and practice of techniques learned in therapy serve a vital role in protecting against relapse/recurrence.

Planning a Self-Therapy Session. In many ways, the patient has learned to be his/her own therapist through this 10-session course of psychotherapy. However, some patients may attribute much or all of their progress to the therapist's efforts and/or expertise. In such cases it is critical to remind the patient that he/she has done the majority of work in session and, of course, outside of session. If it seems necessary, the therapist can review the original problem list, the gains achieved, and the techniques used by the patient to make this progress. Particular emphasis is placed on highlighting specific situations in which the patient used these techniques in his/her life. The patient is asked to schedule a self-therapy session at the normal meeting time in 2 weeks. The therapist suggests that the patient follow the same format used in previous sessions. The patient can use imagery to help remind him/her of what it was like to participate in a therapy session. As in medication therapy, the therapist introduces the idea that "booster" therapy sessions are available in the future, while emphasizing that a period of going without psychotherapy is a positive sign and a step forward.

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