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A general understanding regarding events or impacts that may have contributed to the problem in the here and now should be obtained. The presenting problem may have started suddenly (e.g. the end of a significant relationship, redundancy, a panic attack when stuck on a ride) or had a gradual onset (e.g. becoming progressively anxious and worried about things). The progress of the problem may indicate that it has remained the same since it started. The patient may have had periods when the problem was significantly better or worse, or it may have been getting gradually worse over time. It is important to ensure that questioning around onset and progress is used to understand the context associated with the presenting problem only. This is different to finding out what factors may have initially contributed to the onset of the problem that forms part of the assessment to derive a longitudinal cognitive-behavioural formulation undertaken within HICBT (Chapter 1).