Inside a Cognitive Behavioral Therapy Session: What to Expect

Starting therapy can feel daunting. Knowing what to expect from a Cognitive Behavioural Therapy (CBT) session can ease anxiety and help you feel more prepared. CBT is a structured, goal-oriented approach that focuses on changing unhelpful thoughts and behaviours. It is widely used to treat anxiety, depression, and other mental health challenges.

In this guide, we’ll walk you through a typical CBT session, explain the key steps, and offer practical tips to help you get the most from your therapy. Whether you are new to therapy or considering CBT for the first time, this overview aims to provide clarity and reassurance.

What Happens During a CBT Session?

A typical CBT session lasts about 50 minutes. It is a collaborative process where you and your therapist work together to understand your difficulties and develop strategies to manage them.

Sessions usually begin with a brief check-in about your experiences since your last appointment. Your therapist may ask questions about challenges, progress, or situations that triggered distressing thoughts or behaviours. This helps identify patterns that maintain difficulties and sets the agenda for the session.

The core of CBT involves identifying and challenging negative or distorted thoughts. For example, if social situations trigger anxiety, your therapist might help you examine the evidence for and against your fears. This encourages more balanced and realistic thinking.

Towards the end of the session, you will often agree on homework tasks to reinforce learning outside the therapy room. These may include keeping a thought diary, practising relaxation techniques, or trying new behaviours in real-life situations. Homework is essential because it helps translate insights from the session into lasting change.

A typical CBT therapy room setting

How to Prepare for Your Session

Preparation can enhance the effectiveness of therapy. Here are some steps to consider:

• Reflect on your goals: Think about what you want to achieve and note any specific problems or situations to discuss.

• Track thoughts and feelings: Keep a journal or use a notes app to record experiences during the week; these can guide your session.

• Be honest and open: Sharing your thoughts, even uncomfortable ones, allows your therapist to understand you fully and tailor the therapy accordingly.

• Trust the process: CBT progresses at your pace, and your therapist will guide you gently.

The Five Steps of CBT

Understanding the main steps can demystify the process:

1. Assessment and Goal Setting: Gathering information about your history and setting clear, achievable goals.

2. Identifying Negative Thoughts: Recognising automatic negative thoughts that influence emotions and behaviour.

3. Challenging and Restructuring Thoughts: Evaluating the accuracy of these thoughts and developing balanced alternatives.

4. Behavioural Experiments and Exposure: Gradually testing new behaviours or facing feared situations to reduce avoidance and build confidence.

5. Relapse Prevention and Maintenance: Learning strategies to sustain progress and manage setbacks independently.

These steps are flexible and tailored to your unique needs.

Tips for Getting the Most Out of CBT

• Be consistent: Attend sessions regularly and complete homework.

• Ask questions: Clarify anything you do not understand to feel more in control.

• Be patient: Change takes time; some sessions may feel challenging.

• Use your notes: Bring thought diaries or journals to guide discussion.

• Practice skills daily: Apply techniques learned in therapy to everyday situations.

• Communicate openly: Share your feedback about the therapy process; your therapist can adjust the approach if needed.

  
  

A notebook used for recording thoughts during CBT

Moving Forward with Confidence

Attending a cognitive behavioral therapy sessions can be a transformative experience. It offers practical tools to manage difficult emotions and improve your quality of life. By understanding what to expect in a CBT therapy session, you can approach therapy with greater confidence and readiness.

Remember, therapy is a journey. It is normal to encounter ups and downs along the way. With the support of a skilled therapist, you will develop self-awareness and coping skills that empower you to face challenges more effectively.

If you are considering therapy, take the first step by reaching out to a trusted practice. Tailored psychotherapy can help you build a happier, more confident future.