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Make playdates with friends' pets or get your own. Play with babies and young children. The real authorities in human play are children, especially young children. At times, clients may feel better during individual sessions but fail to make progress over the course of several sessions. If you're an experienced CBT therapist, you may not need to ask yourself the preceding questions. Instead, first make sure that you have a correct diagnosis, conceptualization, and treatment plan tailored for the client's disorder (and have correctly employed techniques). Then you can assess the following, alone or with a supervisor: Do the client and I have a solid therapeutic alliance? Do we both have a clear idea of his values and goals for therapy? Is he committed to working to achieve these goals? Does the client truly believe the cognitive model [that her thinking influences her mood and behavior, that her thoughts may be inaccurate or unhelpful, and that responding to her dysfunctional cognitions positively affects her emotions and behavior]? Is the client socialized to CBT--does he contribute to the agenda, collaboratively work toward resolving problems and obstacles, do Action Plans, and provide feedback? Is the client's biology [eg, illness, medical condition, medication side effects, or inadequate level of medication] or her external environment [eg, an abusive partner, an extremely demanding job, or an intolerable level of poverty or crime in her environment] interfering with our work together? On 28 April 1996, thirty-five people were slaughtered in Tasmania during a horrific shooting spree dubbed the `Port Arthur Massacre'. A couple of years ago I went to an inspiring and heart-rending talk by Walter Mikac, whose wife and two young daughters were killed on that fateful day. There was not a dry eye in the house as he talked about the horrors he'd had to endure. And we were all deeply inspired by Walter's message: he knew it was impossible for him to change the past or bring his family back from the dead - but he desperately wanted to create something positive from the devastation. And so he did. He not only played a major role in tightening Australia's gun laws, but he established a thriving children's charity, the Alannah and Madeline Foundation (named after his daughters), which provides support to child victims of violence. This is a shining example of living by one's values in the face of a truly enormous reality gap.

So if, for one reason or another, our goal truly is impossible, then let's acknowledge that, make room for the pain, and simultaneously get in touch with our values. We could ask ourselves, `Ten years from now, when I look back on this period in my life, what would I like to say that I stood for; IN AND OUT OF THE COMFORT ZONE Playing with children who know you and trust you is a wonderful way to learn from the experts. Play with customer service people. Most people in the service industry are very social; You find them in places such as checkout stands, restaurants, and reservation counters. As humor and play become an integrated part of your life, your creativity will flourish and new discoveries for playing with friends, coworkers, acquaintances, and loved ones will occur to you daily. Humor is a ladder that can take us to a higher place, where we view the world from a more relaxed, positive, creative, joyful, and balanced perspective. You have added immeasurably to your emotional intelligence with the communication skills you have now learned to develop: Managing stress Experiencing and managing your intense emotions Effectively communicating nonverbally and with emotional intelligence REMEDIATING PROBLEMS IN THERAPY Depending on the identified problem, you might consider the advisability of one or more of the following: Doing a more in-depth diagnostic evaluation Referring the client for a medical or neuropsychological examination Refining your conceptualization and checking it out with the client Reading more about the treatment of the client's disorder(s) Seeking specific feedback from the client about his experience of therapy and of you

Reestablishing the client's aspirations, values, and goals for therapy (and possibly examining the advantages and disadvantages of working toward them) Reviewing the cognitive model with the client (and eliciting doubts or misunderstandings) Reviewing the treatment plan with the client (and eliciting concerns or doubts) Again and again and again throughout our lives, we're going to get stuck in our comfort zones. Sometimes we'll only stay there briefly. Sometimes we'll get stuck there for ages. But although we'll never be perfect, we can improve. We can get quicker at recognising when we're stuck, quicker at getting ourselves unstuck, and better at staying on track for longer stretches. The FEAR and DARE acronyms will help you to do this. So I encourage you to memorise them. You could even write them on a card, and carry them around in your wallet. Refer to them repeatedly until you have internalised them. And of course, don't just intellectualise them; Bringing a sense of humor into your home and work relationships These skills have prepared you to redefine your relationship with conflict. The two remaining articles will help you understand how to sustain meaningful relationships at home and at work by taking conflict in stride, forgiving easily, and not overreacting or underreacting in emotionally charged situations. Conflict in relationships can be a deal breaker and a heartbreaker. But resolved conflict can build trust and become a cornerstone for growth in relationships. The way we respond to differences and disagreements in home and work relationships can create hostility and irreparable rifts, or it can initiate the building of safety and trust. That is why conflict is like a velvet hammer--an opportunity that can be at once difficult and rewarding.

The capacity to take conflict in stride and forgive easily is supported by our ability to manage stress, to be emotionally available, to communicate nonverbally, and to laugh easily. Painful upset is a part of life. Two people can't possibly always have the same needs, opinions, and expectations. Assessing the client's expectations for how she's going to get better (What does she think you need to do? What does she think she needs to do? Emphasizing setting and reviewing Action Plans in session and accomplishing Action Plans throughout the week Working consistently on key automatic thoughts, beliefs, and behaviors across sessions Checking on the client's understanding of session content and recording the most important points Based on the client's needs and preferences, changing (in one direction or the other) the pace or structure of the session, the amount or difficulty of material covered, the degree of empathy you've been expressing, the degree to which you have been didactic or persuasive, and/or the relative focus on resolving obstacles In addition, you should monitor your own thoughts and mood when seeking to conceptualize and remediate difficulties in therapy because your cognitions may at times interfere with problem solving. It's likely that all therapists, at least occasionally, have negative thoughts about clients, the therapy, and/or themselves as therapists. Typical therapist assumptions that interfere with making changes include: If I interrupt the client, he'll think I'm controlling him. Doing this will pay huge dividends, not least of which is avoiding . Has anyone ever told you they can do something that is humanly impossible? I regularly work with clients who make such claims. Here's what they typically say: `I want to do it, but I have no motivation. To `have no motivation' is quite simply impossible. Unless you're dead, that is. Every action we take has some underlying motivation;

Whether we're adjusting our position in a chair, eating a piece of toast, shooing away a fly, riding a bike, giving a speech, digging for fossils, commenting on the weather, asking someone to pass the salt, cancelling a social event, ringing in sick, putting off going to the gym or flaking out on the couch, there is always some underlying purpose or intention to our actions; In fact, we always have multiple motivations, and we can never consciously know every single influence on our behaviour. But we can get good at recognising the main motivation underlying whatever we're doing. A relationship devoid of challenge stops growing and becomes routine and predictable (maybe even boring), but developing emotionally intelligent communication skills enables you to gracefully overcome relationship challenges. Conflict Resolution Requires Both Verbally and Emotionally Intelligent Skills Successfully resolving differences is essential for the preservation and growth of any relationship. If you can address and resolve conflicts swiftly--without resorting to punishing criticism, contempt, or defensiveness--your relationships will become stronger, and a level of intimacy and trust will develop that can never be obtained without such a test. However, successes and failures hinge on your ability to apply the nonverbal skills that create attuned attachment. Here are some common examples of people who confront--rather than attend to--conflict without using emotionally intelligent communication skills that could bring about successful resolution. These are examples of trying to end conflict by using a hammer without any velvet: David is a guy everyone loves. He is charming and generous, and he has many admirers, but his irrational rages intimidate friends and family. If I structure the session with an agenda, I'll miss something important. If I record a session, I'll be too self-conscious. If my client gets annoyed with me, she'll drop out of therapy. You may benefit from a model of personal practice in which you reflectively focus on your development, both personal and professional, on an ongoing basis. A workarticle can facilitate this work (Bennett-Levy et al. Finally, when you encounter a problem in treatment, you have a choice. You can catastrophize about the problem and/or blame yourself or the client.