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To monitor progress with the patient throughout treatment, facilitate LICBT telephone working (Chapter 1) and form the basis of case management supervision (Chapter 9), a brief and succinct written problem statement associated with the presenting problem in the here and now is developed.

Table 2.5The CBT Handbook

Three key features of the presenting problem are broken down to form the problem statement that is returned to regularly with the patient throughout the treatment period to monitor change:

 Trigger

 Symptoms

 Impact.

It is not uncommon for patients to present with several problems and when this arises the LICBT practitioner and patient work collaboratively using a 0–100 scale to identify how severe, distressing or impactful each of the problems is. A collaborative decision is then reached to prioritise the problems and identify the first problem to tackle.