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What to expect from a typical CBT session?

What to expect from your CBT sessions

You will usually meet with a therapist for weekly, or fortnightly. Each session will last for 50 minutes.  In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and this will also give you a chance to check that you feel comfortable with it.  The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.  You and the therapist will usually start by agreeing on what to discuss that day.

An example of some of the work involved in each session

With the therapist, you break each problem down into its separate parts.  To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

Together you will look at your thoughts, feelings and behaviours to work out:

  • if they are unrealistic or unhelpful
  • how they affect each other, and you.

The therapist will then help you to work out how to change unhelpful thoughts and behaviours.

It’s easy to talk about doing something, but of course it can be much harder to actually do it. So, after you have identified what you can change, your therapist will recommend “homework” – changes that you can begin to practise in your everyday life. Depending on the situation, you might start to:

  • question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT
  • recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

At each meeting you discuss how you’ve got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don’t seem to be helping.

They will not ask you to do things you don’t want to do – you decide the pace of the treatment and what you will and won’t try.  The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This can really help to make it less likely that your symptoms or problems will return.

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