ABSTRACT
In the ®rst session, the BA clinician listens to the client's story and assesses for the environmental factors in depression discussed in Part 1. Ideally, towards the end of the session the clinician has enough of a behavioral conceptualization of the client's problems to present a summary and rationale for treatment that incorporates major elements of the story. The summary should highlight the major environmental components of the story and their emotional impact on the client to establish the therapist as empathic, validating, and supportive. The summary should be non-blaming and focus on depression as a normal human reaction to dif®cult and negative life events. The summary also establishes the activation assignments to follow. For example, the clinician may say:
I have been listening to your story and I'd like to summarize what I've been hearing for a minute or two. Is that OK? Overall, I want to say that you really have gone through a lot and, in the context of everything you have and are going through, your depression makes complete sense to me. First, you mentioned how you broke up with your boyfriend, and it was not just the loss of the boyfriend, but you had really invested your hopes and dreams for the future into him, and these were lost too. Second, you mentioned how your parents just do not get who you are or what you need, and in fact your mom continually trying to push religion on you just makes you more distant. So, in an ideal world, you would have supportive parents, but in your world, that support is lost. Third, you talked about how you are struggling with school, how it is a constant source of stress for you, and
you don't really know why you are you want out of your life. So you are not or enjoyment out of that.
