ABSTRACT
The debate about structure is sometimes confused because the term `structure' is used in two rather different but interrelated ways. Firstly, structure may refer to a series of behavioural steps that the therapist and/or client can follow within a session or series of sessions. Cognitive therapy has a de®nite session structure to be followed quite closely (Beck, 1995). The structure consists of a number of sequential steps, beginning with conducting a `mood check' on how the client is feeling and then setting an agenda for the session. Agenda items, including checking homework tasks, are then pursued as session targets. The session ®nishes by setting a new homework task and by taking client feedback on the session. Structure in this sense can also be extended to the characteristic shape of the therapeutic intervention over time; for example, CBT usually begins by targeting symptom relief and proceeds later to preventative work on underlying vulnerabilities (Beck et al., 1979b; Wells, 1997).
