This book describes strategic decision making, a flexible yet evidenced-based approach to making clinical decisions in order to move treatment forward in cognitive behavioral therapy. It dispels the myth that there is a single “right” therapeutic intervention that must be delivered in any one instance; in fact, many courses of action can facilitate change provided they are implemented strategically. Strategic decisions (a) follow logically from the case conceptualization, (b) are arrived upon collaboratively between the therapist and patient, (c) allow the patient to leave the session with something new, and (d) are seen through in their entirety before their effectiveness is evaluated.