Jessica was resistant to doing cognitive restructuring work to begin with because she did not see how changing her negative thoughts, and adding homework assignments to her already busy schedule, would help with being overwhelmed with her many responsibilities. Jessica was at the contemplation stage of change at this point in therapy. Corwin (2002) described this stage as when the client recognizes that there is a problem, but rejects the idea of change because they fear change or ambivalent to change. The therapist educated Jessica about both CBT and how automatic thoughts can effect emotions, her two separate mental health diagnosis, and the research showing that CBT is effective for both depression and anxiety. Jessica’s strengths were also highlighted by the therapist, such as still going to work and keeping up with her children’s many extracurricular activities even though she was having anxiety and depression. Jessica was still unsure about the cognitive part of therapy, so motivational interviewing was used to create cognitive dissonance between what Jessica wanted and what her current course of action was getting her. At the end of the session she agreed to do cognitive work with the therapist.
After Jessica and the therapist had worked together on identifying and evaluating automatic