I've seen a number of CBT therapists in my time. I've also done a number of graduate courses that are part of the clinical psychology training program - where most of that was focused on training CBT therapists.

One way to think of it would be to consider what you think a `well you' would look like and compare that to what you think you look like now. To get some kind of grip on the things you would like to be able to do that you don't feel that you are able to do now. Then the thought is that the work will consist in trying to bridge that gap.

There could be all kinds of specific things. Here are some (just for ideas - I know I find it most helpful to see examples of things and then to modify them into things that make sense for me).

- There could be specific instances when anxiety is high - and you would like to know how to reduce your anxiety in those circumstances.
- There could be situations when you aren't as assertive as you feel you would like to be so you would like to learn how to be more appropriately assertive.
- There could be specific things that you think would be good for you (e.g., having regular exercise, eating healthier etc) that you are finding it hard to do regularly.

And so on...

The CBT approach is (for the most part) an educational one. Pick a treatment target and the therapist will typically have a whole 'educational bundle' of techniques to teach you and help you employ so that you can effect the changes that you want to effect. Different treatment goals will give you a different package of educational techniques. For example, the techniques to help a person deal with compulsive thoughts / ruminations are a little different from the techniques to help a person deal with feeling depressed. I'd say that your therapist is trying to get a grip on what you would like to work on so that she can figure out and put together a list of techniques to teach you / help you effect the changes that you most want to effect in your life.

Homework is common for the CBT approach. The basic idea... Is that the CBT treatment approach is an eclectic one where what is distinctive about it is that it is a collection of whatever techniques have been empirically shown to be most effective for effecting the relevant changes for the relevant treatment target. One of the problems for therapy is how well the skills taught in a therapy context generalize such that the person can employ them outside the therapy context. Homework is one way of trying to blur the boundary between 'in therapy' and 'outside therapy in the real world'. While it is useful to practice the skills and techniques in the comparatively safe therapy setting in the first instance I'd get used to homework because as you work on your treatment targets your therapist will probably provide homework for you to practice the skills that she teaches you outside therapy in the real world and then to report back to her on how it went. That way you can both make sure that she is in fact being helpful to you with respect to you effecting the changes in your life (outside therapy) that you want to effect.

I wouldn't worry too much if you have some difficulty with coming up with treatment targets, though. If you struggle with this then that makes that the first treatment target to be dealt with next session :-)