First, review the patient’s progress by comparing the current PHQ-9 score with the one from the previous visit and provide feedback to the patient. Remember to assess and manage suicide risk as a priority based on the patient’s current score.

Then, explain the importance of setting an agenda and mention that the patient ought to actively participate with you in the HAP treatment process. Give them time to add suggestions to the agenda or ask questions. Go over the problems discussed in session 1 and ask if the patient needs to talk about any of them.

Go over new problems and ask if the patient would like to discuss any of them. List agenda items including discussing homework, recording the patient’s activities and how he/she feels when doing them, planning to identify at least one activity that can help them feel better and scheduling it until the next session, setting the next session date, and asking the patient if they agree with the list and have anything else to add.

Ask directly if they did the homework or have any questions about what they read. You can ask them to describe what they understood about the treatment and fill in the gaps or correct any misunderstanding. If the patient did not do the homework, ask directly but non-judgementally what happened.

This helps understand what obstacles the patient is facing and leads towards helping them overcome these obstacles. It is common for patients to not complete the homework. You can complete the assignment during the session so the responsibility of completion is shared and the patient feels supported.

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