Agenda:
Review mood and measures
Review between-session tasks (activity scheduling)
Introduce and discuss values and goal setting
Plan next steps in behavioural activation
Review In-between session:
Client attempted to use the activity schedule, completed 3 of 5 planned activities. Noted mild improvement in mood on days with activity. Reported difficulty with motivation in the mornings. Identified mornings as a potential focus area for planning pleasant/routine tasks.
Content of session:
Reviewed activity schedule and explored patterns of mood and behaviour. Normalised difficulty with initiation and reinforced progress made. Introduced values and goal-based planning using workbook. Client identified “feeling useful” and “connection with others” as core values. Linked these to activity ideas. Discussed strategies to increase motivation and manage avoidance (e.g., planning tasks in smaller chunks, cueing routine).
Agreed between session tasks:
Complete 3–4 specific planned activities based on identified values (e.g., 10-min morning walk, phone call to friend)
Track mood before and after activities
Reflect on link between values and mood in journal or workbook
Treatment Plan:
Continue with behavioural activation through structured activity planning and values-based engagement. Monitor mood weekly. Consider problem-solving strategies if client encounters barriers. Introduce cognitive techniques in session 5 if appropriate.
Suicidal Thoughts:
Client reports occasional fleeting passive thoughts (e.g., "I wouldn't mind not waking up") but no active ideation or plan.
Current Plan:
No plan or intent to act on thoughts. Client recognises these as part of depressive thinking and is open to support.
Access to Means:
No known access or intention to acquire means.
Intent Rating:
Low
Self-harm Thoughts:
None reported currently or historically.
History:
No previous suicide attempts or self-harm.
Risk Factors:
Low mood, social isolation, reduced daily structure, recent job loss (3 months ago)
Current Triggers:
Unemployment, lack of routine, low self-esteem
Protective Factors:
Supportive sister, desire to improve mental health, insight into current state, willingness to engage in treatment
Safety Plan (if applicable):
Discussed coping strategies: contacting sister, engaging in planned activities, calling GP or crisis line if thoughts intensify. Not formally documented as risk is low.
Risk Formulation:
Low risk of self-harm or suicide currently. Passive thoughts linked to depressive mood and loss of routine. Protective factors outweigh current risk.
Risk Rating:
Low