Approach: Cognitive Behavioral Therapy (CPT) and Acceptance and Commitment Therapy (ACT)
Duration: 15 Sessions

Session 1: Assessment & Psychoeducation

• Goals:
 – Establish rapport and complete a thorough clinical assessment (e.g., use PHQ‑9, mood logs).
 – Introduce the overall treatment model and explain how CBT (changing unhelpful thoughts/behaviors) and ACT (increasing acceptance and committed action) complement each other.
• Interventions:
 – Provide psychoeducation about depression, the CBT “cognitive model,” and ACT’s focus on psychological flexibility and values.
 – Set collaborative treatment goals.

Session 2: Thought Awareness & Mindfulness

• Goals:
 – Introduce self-monitoring of thoughts and emotions.
 – Begin practicing mindfulness to help clients observe internal experiences nonjudgmentally.
• Interventions:
 – Teach a simple mindfulness exercise (e.g., mindful breathing).
 – Begin using thought records to note automatic negative thoughts.
 – Explain the ACT concept of “defusion” (i.e., seeing thoughts as mental events, not facts).

Session 3: Cognitive Restructuring

• Goals:
 – Identify common cognitive distortions linked to depression.
• Interventions:
 – Review thought records from homework.
 – Guide the client through techniques to challenge and reframe distorted thoughts.
 – Practice reframing exercises in session.

Session 4: Values Clarification & Goal Setting

• Goals:
 – Help the client identify personal values that can guide meaningful action.
• Interventions:
 – Use ACT exercises (e.g., a values card sort or guided discussion) to pinpoint what matters most.
 – Set short‐term and long‐term goals aligned with these values.

Session 5: Behavioral Activation & Mindful Engagement

• Goals:
 – Increase engagement in pleasurable or meaningful activities.
• Interventions:
 – Develop an activity schedule (a CBT behavioral activation technique).
 – Incorporate a brief mindfulness check-in before and after activities to notice shifts in mood.

Session 6: Acceptance & Defusion Techniques

• Goals:
 – Deepen the client’s ability to “step back” from unhelpful thoughts and feelings.
• Interventions:
 – Introduce metaphors such as “Passengers on the Bus” to illustrate how one can move forward despite uncomfortable internal experiences.
 – Practice defusion exercises (e.g., repeating a negative thought in a silly voice).

Session 7: Integrating Cognitive Restructuring & ACT Strategies

• Goals:
 – Blend the skills learned so far by combining thought challenging with acceptance.
• Interventions:
 – Review instances where the client used cognitive restructuring and then practiced defusion.
 – Role-play situations to practice switching between “change” (CBT) and “acceptance” (ACT) strategies as needed.

Session 8: Exposure & Engagement

• Goals:
 – Address avoidance patterns by gradually confronting challenging situations.
• Interventions:
 – Develop a hierarchy of avoided or anxiety-provoking situations.
 – Use in‐session exposure tasks combined with mindfulness and acceptance skills to remain present during discomfort.

Session 9: Enhancing Psychological Flexibility

• Goals:
 – Increase the client’s ability to adapt and commit to actions aligned with their values, even in the presence of distress.
• Interventions:
 – Use ACT exercises (e.g., “Leaves on a Stream”) to practice letting thoughts and feelings come and go.
 – Discuss past successes in staying true to values despite challenges.

Session 10: Problem-Solving & Coping with Setbacks

• Goals:
 – Equip the client with structured problem-solving skills for real-life setbacks.
• Interventions:
 – Introduce a step-by-step CBT problem-solving model.
 – Combine with ACT’s stance of accepting setbacks as part of the process while recommitting to values-based actions.

Session 11: Deepening Mindfulness & Self-Compassion

• Goals:
 – Reinforce mindfulness skills and introduce self-compassion.
• Interventions:
 – Practice a guided mindfulness meditation that focuses on self-kindness.
 – Discuss ways to counter harsh self-judgment using ACT-inspired self-compassion exercises.

Session 12: Challenging Core Beliefs

• Goals:
 – Explore deeper core beliefs that sustain depressive thinking.
• Interventions:
 – Utilize cognitive restructuring to examine evidence for and against core beliefs (CBT).
 – Integrate ACT techniques to help the client observe these beliefs without fusion, letting them be while still moving toward valued action.

Session 13: Committed Action & Future Planning

• Goals:
 – Develop a detailed committed action plan that aligns with clarified values and goals.
• Interventions:
 – Collaboratively outline concrete steps for future actions (e.g., scheduling regular social activities, pursuing hobbies).
 – Reinforce commitment by setting measurable benchmarks for progress.

Session 14: Relapse Prevention & Maintenance Strategies

• Goals:
 – Consolidate all skills learned and plan for maintaining gains.
• Interventions:
 – Review a “toolkit” of coping strategies (both CBT and ACT based) for when depressive symptoms reappear.
 – Develop a written relapse prevention plan that includes warning signs, planned responses, and ways to re-engage in valued activities.

Session 15: Consolidation & Termination

• Goals:
 – Review progress, celebrate successes, and plan for long-term maintenance.
• Interventions:
 – Summarize the key skills learned over the course of treatment.
 – Discuss any remaining challenges and strategies to address them.
 – Establish a plan for booster sessions or follow-up if needed.