What's actually helped you

The end-of-treatment review is one of the most underused tools in clinical practice. Most cases close with a verbal recap that tries to summarise months of work in fifteen minutes and ends up being neither comprehensive nor portable. The client leaves without a written record of what helped them, which means three months later when symptoms flare, they have no document to revisit and the gains soften.

This worksheet runs the review as a structured reflection across multiple categories: skills they learned, insights they had, books or resources that mattered, decisions they made, habits they built. The breadth of the categories matters because clients often think only about “what we worked on in session” and forget that their progress involved decisions outside session, books they read between sessions, habits that built quietly. The full picture is wider than the in-session work alone.

Use it for monthly review during ongoing therapy with longer-term clients, for end-of-treatment closure, and at any point a client gets stuck and would benefit from looking back at what’s actually worked. The end-of-treatment use is the most clinically valuable. The client leaves with a written document they can revisit when needed.

The clinical move at submission review. The final question about the one thing that mattered most is the most informative item in the form. Clients often write something the therapist didn’t predict. The technique you thought was central wasn’t, the throwaway comment in session four was. That answer is worth taking seriously. It tells you what landed for this person, which is information the therapist couldn’t have known without asking, and it’s also clinically useful because the thing that mattered most to the client is what they’re most likely to draw on during a slip.

A specific use: depressed clients with depression-related forgetting often lose sight of their own progress mid-treatment. Re-assigning this worksheet at month three or four, even though treatment isn’t ending, produces a written record that the client can read back when their cognitive filter is denying that anything has changed. The data argues with the filter.

In my-cbt, the worksheet is one of the bundled system templates. Assign it in the closing weeks of treatment, or quarterly during longer cases. The submission saves in the case file as the client’s working document, accessible to the client through their portal after termination if they need to revisit it.