| 0–5 min | Opening, check-in, and client priorities | “How have things been since we last met?” “What feels most important to address today?” Briefly confirm the proposed agenda and invite additions or changes. |
| 5–10 min | Current state and orientation | Assess current mood, stress level, functioning, and immediate concerns as clinically appropriate. Identify whether any issue requires reprioritization. |
| 10–22 min | Review of shorter preparation routine | Explore what the client tried, when and how they used it, what helped, and what was difficult. Identify effects on preparation, anxiety/stress, confidence, or follow-through without assuming outcomes. |
| 22–37 min | Process the difficult meeting | Invite the client’s account of the meeting. Explore key events, thoughts, emotions, bodily responses, actions, perceived outcomes, and what remains unresolved. Consider distinguishing facts, interpretations, and areas of uncertainty. |
| 37–44 min | Integrate learning and identify options | Summarize themes collaboratively. Identify what the client would like to repeat, modify, stop, or test. Generate a small number of practical options and consider likely barriers and supports. |
| 44–48 min | Agree next steps | Develop one to three specific, achievable actions before the next session. Clarify timing, cues, anticipated obstacles, and how the client will know whether the plan was useful. |
| 48–50 min | Review and close | Ask what was useful or missing, confirm the agreed plan, check the client’s current level of distress and support needs as clinically indicated, and confirm the next appointment or follow-up arrangements. |