CBT结束阶段应对卡制作

在认知行为治疗终止阶段，与来访者协作制作个性化、具象化、可随身携带的应对卡，明确高频挑战情境、对应认知/行为障碍、具体可操作行动步骤，以及清晰的 re-engagement protocol，以巩固疗效、预防复发、支持自主应对。

Prompt

引导来访者回顾已掌握的CBT技术（如思维记录、自我肯定、认知重评），聚焦1–3个最常出现的困难情境；协同识别阻碍应对的具体认知/behavioral障碍；将应对策略转化为简明、可操作、第一人称的行动短句；写入后续行动路径（如‘若无效，则重新预约咨询’）；确保卡片内容具象、可随身携带、无需额外解释即可使用。

Objective

巩固治疗成果、提升自助能力、支持治疗后延续性应对

Applicable Signals

• 来访者能自主识别自动思维并尝试调整
• 作业完成率稳定≥80%且内容有反思深度
• 情绪稳定性持续2周以上，无新发功能损害

Contraindications

• 来访者处于急性危机、自伤/自杀意念活跃或安全风险未稳定
• 尚未完成至少2轮有效行为实验或核心信念初步修正
• lack of shared understanding of CBT model (e.g., cannot name ABC or cognitive distortion types)

Intervention Moves

• collaborative agenda-setting for card content
• Socratic questioning to elicit barrier-aware strategies
• behavioral rehearsal of card use in session
• normalizing re-engagement (e.g., ‘rebooking is part of skill-building’)

Workflow Steps

• Review progress and readiness for termination using agreed criteria
• Identify 1–3 high-frequency post-therapy challenge scenarios (e.g., work stress, social withdrawal)
• For each scenario: co-construct ‘what gets in the way’ (cognitive/behavioral barrier) + ‘what I can do now’ (concrete, present-tense action)
• Draft concise, legible card text — max 150 words; include ‘if this doesn’t help, I will…’ clause
• Role-play using the card in-session; troubleshoot ambiguity or avoidance cues
• Store copy in clinical record; give physical/digital version to client with verbal reinforcement

Constraints

• Card must contain at least one barrier-identified strategy and one explicit re-engagement cue
• No abstract affirmations (e.g., ‘I am strong’) without linked behavior
• All strategies must derive from prior session work — no new techniques introduced

Cautions

• Avoid overloading card with >3 scenarios or >5 total steps
• Do not omit the ‘next step if stuck’ clause — omission predicts lower post-termination adherence
• Monitor for subtle resistance (e.g., joking, deflection) during drafting as possible indicator of premature termination

Output Contract

• A single A6/A7-sized written or digital card containing: (1) 1–3 named real-world situations, (2) corresponding barriers (e.g., ‘I think “no one cares” → avoid calling friends’), (3) specific, observable actions (e.g., ‘Text one friend: ‘Hey, free for coffee this week?’’), and (4) clear re-engagement instruction (e.g., ‘If I use this 3x and still feel overwhelmed, I’ll email to reschedule’).

Example Therapist Responses

Example 1

• Client/Input: Client reports recurring low mood when working late; identifies barrier as ‘I’m too tired to think straight, so I just scroll instead of reaching out.’
• Therapist/Output: Situation: Working late → low mood. Barrier: ‘Too tired to think’ → scrolling instead of connecting. Action: ‘Open messages, send voice note to Sam: ‘Hey, brain’s fried — can we vent over tea tomorrow?’ If no reply in 24h, try Alex.’ Next step: ‘If I send to 2 people and still isolate 3 days, I’ll book a check-in.’
• Notes: Uses client’s language (‘brain’s fried’), links cognition to behavior, includes fallback.

Objective

巩固治疗成果、提升自助能力、支持治疗后延续性应对

Applicable Signals

• 来访者能自主识别自动思维并尝试调整
• 作业完成率稳定≥80%且内容有反思深度
• 情绪稳定性持续2周以上，无新发功能损害

Contraindications

• 来访者处于急性危机、自伤/自杀意念活跃或安全风险未稳定
• 尚未完成至少2轮有效行为实验或核心信念初步修正
• lack of shared understanding of CBT model (e.g., cannot name ABC or cognitive distortion types)

Intervention Moves

• collaborative agenda-setting for card content
• Socratic questioning to elicit barrier-aware strategies
• behavioral rehearsal of card use in session
• normalizing re-engagement (e.g., ‘rebooking is part of skill-building’)

Workflow Steps

• Review progress and readiness for termination using agreed criteria
• Identify 1–3 high-frequency post-therapy challenge scenarios (e.g., work stress, social withdrawal)
• For each scenario: co-construct ‘what gets in the way’ (cognitive/behavioral barrier) + ‘what I can do now’ (concrete, present-tense action)
• Draft concise, legible card text — max 150 words; include ‘if this doesn’t help, I will…’ clause
• Role-play using the card in-session; troubleshoot ambiguity or avoidance cues
• Store copy in clinical record; give physical/digital version to client with verbal reinforcement

Constraints

• Card must contain at least one barrier-identified strategy and one explicit re-engagement cue
• No abstract affirmations (e.g., ‘I am strong’) without linked behavior
• All strategies must derive from prior session work — no new techniques introduced

Cautions

• Avoid overloading card with >3 scenarios or >5 total steps
• Do not omit the ‘next step if stuck’ clause — omission predicts lower post-termination adherence
• Monitor for subtle resistance (e.g., joking, deflection) during drafting as possible indicator of premature termination

Output Contract

• A single A6/A7-sized written or digital card containing: (1) 1–3 named real-world situations, (2) corresponding barriers (e.g., ‘I think “no one cares” → avoid calling friends’), (3) specific, observable actions (e.g., ‘Text one friend: ‘Hey, free for coffee this week?’’), and (4) clear re-engagement instruction (e.g., ‘If I use this 3x and still feel overwhelmed, I’ll email to reschedule’).

Example Therapist Responses

Example 1

• Client/Input: Client reports recurring low mood when working late; identifies barrier as ‘I’m too tired to think straight, so I just scroll instead of reaching out.’
• Therapist/Output: Situation: Working late → low mood. Barrier: ‘Too tired to think’ → scrolling instead of connecting. Action: ‘Open messages, send voice note to Sam: ‘Hey, brain’s fried — can we vent over tea tomorrow?’ If no reply in 24h, try Alex.’ Next step: ‘If I send to 2 people and still isolate 3 days, I’ll book a check-in.’
• Notes: Uses client’s language (‘brain’s fried’), links cognition to behavior, includes fallback.

Files

• references/evidence.md

• references/evidence_manifest.json

Triggers

• 咨询进入结束阶段
• 来访者已稳定使用思维记录与自我肯定等核心CBT技术
• 双方共识需建立治疗后自助支持工具

Examples

Example 1

Input:

Client reports recurring low mood when working late; identifies barrier as ‘I’m too tired to think straight, so I just scroll instead of reaching out.’

Output:

Situation: Working late → low mood. Barrier: ‘Too tired to think’ → scrolling instead of connecting. Action: ‘Open messages, send voice note to Sam: ‘Hey, brain’s fried — can we vent over tea tomorrow?’ If no reply in 24h, try Alex.’ Next step: ‘If I send to 2 people and still isolate 3 days, I’ll book a check-in.’

Notes:

Uses client’s language (‘brain’s fried’), links cognition to behavior, includes fallback.