Cognitive behavioural therapists face numerous instances during each session and throughout the course of treatment in which they must make a clinical decision. These decision points include instances in which any number of clinical issues could be addressed, a specific intervention is not achieving its desired effect, the patient does not understand or accept the rationale for the technique, or a crisis has emerged that requires a shift in focus.

This book describes strategic decision making, a flexible yet evidenced-based approach to working through decision points in order to move treatment forward in cognitive behavioural therapy. It dispels the myth that there is a single right therapeutic intervention that must be delivered in any one instance; in fact, many courses of action can facilitate change provided they are implemented strategically.

Strategic decisions:

• follow logically from the case conceptualization
• are arrived upon collaboratively between the therapist and patient
• allow the patient to leave the session with something new
• are seen through in their entirety before their effectiveness is evaluated
• This compelling, accessible book will benefit all cognitive behavioural therapists, especially those who have mastered basic concepts and are refining their skills in applying them to complex cases.