Cognitive Behavioural Therapy is one of the most commonly recommended talking therapies available on the NHS. It is often suggested as a treatment for various mental health conditions, including anxiety, depression, panic disorders and obsessive-compulsive disorder (OCD). If you have been referred to CBT, or if you are contemplating it as an option, then you are likely to feel anxious about what to expect from your first session and understanding how the process will work will aid this.
The initial CBT session typically revolves around an assessment and examination of what the problems are. Rather than the therapist jumping into treatment strategies, they will ask about your symptoms, history and what has led you to therapy, enabling the treatment to be personalised for your needs.
Questions will likely be about your moods, sleep, energy levels, anxiety symptoms and the specific thoughts and behaviours causing distress. It is also likely the therapist will ask about the daily structure and your routine, your work life, relationships and any prior mental health help. You will not be being judged or assessed; this will merely be for the therapist to understand and support you.
Understanding the CBT Approach
Your therapist will also provide you with information on what CBT is and how it operates. The basic assumption behind CBT is that thoughts, emotions, and behaviours all affect each other. Specifically, having negative thoughts can result in uncomfortable feelings, which may influence your behaviour and, in turn, increase your thoughts. Your therapist will provide examples on how CBT can apply to your experiences, you can ask any questions you have and air any concerns.
The final crucial element to consider in the first session is exploring goals. CBT is essentially a goal-directed type of therapy; this indicates that it’s all about the desired changes that you’re looking for. Your therapist and you need to come up with goals that work for you. Some possible examples include the reduction of anxious thoughts or feelings; improvement of mood; reduction of distressing intrusions; and increases in social or work confidence. Having goals allows the course of therapy to be directed appropriately.
It is perfectly normal to feel nervous, unsure, or emotional before or during your first session. It is likely that you won’t feel completely comfortable talking about personal information; particularly if you haven’t before.Rest assured that a therapist will work to ensure the environment is safe and supportive, without judgment. It is unlikely you will be required to share personal feelings or information straight away.
