Before you decide to go to therapy, you may be hesitant about trying cognitive behavioral therapy (CBT). While you may have read up on what CBT is and why it is useful, you still may be unsure if it is right for you.
Let’s just say that there is a reason why so many people seek treatment with a cognitive behavioral therapist.
Here, I am going to give you a glimpse into what a first session of CBT would be like. Hopefully, this will give you some insight into whether or not you should find a CBT therapist.
Of course, each CBT session is individualized for the patient and what he/she wants to focus on in the session. However, this first session is pretty similar for everyone, as it usually gives an overview of what CBT is, how CBT is useful for your particular disorder, and details of the treatment plan that you and your therapist will develop collaboratively.
An Introduction to CBT
The first session of CBT, after the intake session(s), is usually comprised of a lot of psychoeducation. Psychoed is education about your symptoms and the treatment that you will be provided with by your therapist.
First, psychoeducation will discuss your symptoms. This is the part that is individualized for each person. However, people with similar disorders tend to have similar symptoms. For example, everyone with anxiety has worry thoughts. Though the content of each person’s worry thoughts may be different, the way to treat them will be the same.
The CBT Triad
CBT focuses on a triangle, with each leg contributing to your overall mood and well-being: thoughts, behaviors and feelings.
So, let’s take an example: if you get passed over for a promotion, you may have the thought “I’m worthless.” This thought can make you feel sad, and you may engage in a depressive behavior, such as sleeping, crying, or leaving work. Any of these behaviors will likely continue to make you feel sad, which causes a cycle of depression.
In the opposite way, let’s say you do get the promotion. You may have the thought “I’m amazing!” or “I deserve this!” These thoughts may make you feel happy, and the behavior may be to reward yourself or to work harder, which in turn will likely cause you to feel happier.
As we can see, one of these cycles seems better than the other. In CBT, we will try to restructure your thoughts to be more of the positive rather than the negative. Often, our negative thoughts are not facts, and are therefore susceptible to questioning and to change.
For example, when you get passed over for that promotion, rather than thinking “I’m worthless,” you may think, “I didn’t try my hardest on that last assignment,” or “I may not be doing great at work, but I am doing great in my relationship, and I know I am worthwhile there.” We are not trying to lie to ourselves, but rather to look at the whole picture rather than one specific negative event.
The Structure Within and Between CBT Sessions
You and your therapist will also develop a treatment plan for you. This is the way you will address your specific symptoms both in session and for homework. Depending on your symptoms, your treatment plan will be different than someone else’s.
At the beginning of each session from here on out, you and your therapist will set an agenda for the session, review your homework, go through as many agenda topics as you can while providing enough time for each topic, assign new homework, and give each other feedback. Feedback is important for you to let your therapist know you are feeling and what you like and don’t like about your sessions. This is the way you and your therapist will keep an open, honest, and non-judgmental relationship that is the key to success in therapy.
If this lesson seemed good to you, you should try CBT for yourself! Each therapist has their own style, but CBT is an evidence-based treatment that is known to be effective for those who follow its principles.
For a more advanced introduction to cognitive behavioural therapy and to experience the value of this perspective before entering therapy, take a look at my list of the 10 Best CBT Self-Help Books and Workbooks.