New Patient Next Steps

Step One: Intake

At West Coast CBT, we believe effective treatment starts with an in-depth clinical assessment. In fact, our work starts before you even step foot in the clinic. Prior to your first meeting, you will fill out an online intake packet, which helps the clinician plan an effective intake appointment. During the initial intake session, the clinician will ask you a series of semi-structured questions and may request that you fill out assessment measures designed to objectively measure psychological symptoms. Gathering this data informs diagnosis, guides treatment planning, and empowers the clinician to monitor clinical change during your time in treatment. As our clinicians were trained as scientist-practitioners, we rely heavily on data to inform clinical decision making so our patients receive the most effective and efficient treatment available.

In addition to gathering clinical data, a significant portion of the intake appointment will be dedicated to learning more about the lived experience of each patient. Specifically, the clinician will ask you about your family of origin, education and career history, relationships, treatment history, and other domains to learn more about you and your treatment goals. The clinician will also save time to answer any questions you have about their experience, the assessment process, or the proposed treatment plan.

Step Two: Pretreatment

Once you have completed the initial intake session, the subsequent 2-3 sessions will be dedicated to what is referred to as “pretreatment”. During pretreatment, you and the clinician will agree on a treatment plan, set specific and measurable goals for treatment, participate in an orientation to the components of the selected treatment, and work to problem-solve anything which might interfere with the successful delivery of the agreed upon treatment plan. This is also a time to assess your comfort and connection with the clinician and to address anything which may adversely affect your therapeutic relationship.

Step Three: Therapy

During therapy, you will meet regularly with a clinician to carry out the selected treatment plan. Therapy sessions typically occur weekly and last for 45 minutes. Some treatments, such as prolonged exposure, call for more frequent or longer sessions and this will be discussed during pretreatment.

Sessions at West Coast CBT always follow an agenda set collaboratively by you and the clinician. Agenda-setting is a critical component of effective CBT and DBT and agendas form the backbone of each of the evidence-based therapies we practice. While the content of the agenda items vary by treatment, every session has some form of agenda keeping the session targeted and adherent.

Therapy sessions continue until the agreed upon treatment duration is met or you have met all of your treatment goals.

Step Four: Titration

"Titration" is a medical term meaning to adjust the doseage of a treatment. In therapy, we begin to titrate clients down in terms of the frequency of sessions once they have met their treatment goals and are no longer exhibiting symptoms. The tiration period allows clients to adjust back to life without a therapist and to practice using their newly acquired skills for increasing periods of time between sessions. A typical titration pattern might involve decreasing session frequency to twice a month for two months and then to once a month for two months.

Another aspect of the titration step is to build a relapse-prevention plan. During this time, you and your therapist will create a plan that anticipates the possible recurrence of symptoms in the future. If and when sytmptoms do recur, you will be armed with an actionable plan for using skills to self-correct and, ideally, prevent future full-severity episodes.

Step Five: Post-treatment

Once therapy concludes, you will discontinue regular meetings with the clinician and you will continue practicing the strategies learned in sessions to sustain your recovery and continue working on your life goals. However, unexpected stressful events sometimes arise necessitating further or different types of intervention. If this occurs, you can reach back out to your clinician at West Coast CBT, who can either provide booster sessions (for short-term issues) or suggest a new treatment plan (for longer-term issues). Regardless, your clinician at West Coast CBT will remain a resource for referrals should you need to get connected to mental health services in the future.