What Can You Really Expect from Cognitive Behavioural Therapy?

Cognitive Behavioural Therapy (CBT) is a proven method for addressing common mental health challenges such as anxiety and everyday stress. If you’re considering CBT, knowing what to expect can help ease any anxiety you might have. This post lays out what CBT entails, how sessions typically unfold, and the outcomes you could look forward to.

Understanding the Basics of CBT

At its core, Cognitive Behavioural Therapy is all about how our thoughts, feelings, body sensations and behaviours are connected. Unhelpful thought patterns (which by the way, stem from previous experiences and the way we see the world) thoughts can spiral into negative feelings, creating a cycle that many find hard to break. For example, someone may have the thought "I failed that presentation" which can lead to feelings of shame and avoidance of future speaking opportunities. Perhaps this based on a previous experience that you have had or a worry that you will fail which means it will trigger internal beliefs of being a failure or not being good enough. Those beliefs are shaped by our experiences! CBT aims to help individuals recognize these patterns and develop balances perspective on things whilst validating those negative parts you still continue experience. A side note, CBT is so much more than changing your thoughts. In my work, I find the behavioural changes much more powerful in changing perspective. Oh and it certainly isn't about positive thinking (a common myth about CBT).

What to Expect in a CBT Session

Initial Assessment

Your first session with me is likely to involve an in-depth assessment. I will ask about your background, current challenges, and what you hope to achieve from the sessions. It’s important to share your thoughts, feelings, and behaviours honestly, even if it feels awkward. I understand though that from the countless people I have worked with, this is not easy and takes time. Learning to trust me and feel comfortable with me also plays a part in that process. Whilst sessions with me will drawer from the past to make sense of the here and now, our work will focus on what is keeping you stuck now and following the first session, one of the first tasks set will be 'self monitoring' which will be the key in understand how the problem shows up and what may be maintaining things (yes sometimes those coping mechanisms can also maintain the way that we feel also). We will use this to work together to figure of the problem, the pattern and how to change it. This is usually done over 2 sessions and is a collaborative process (so less of me telling you what to do as you are also the expert...of your own experience).

Setting Goals

In your subsequent sessions, you will work with me to set clear, measurable goals. For example, instead of aiming to "feel better," you might set a goal like "reduce anxiety about social events by participating in one social activity this month." Breaking down large concerns into smaller, achievable targets gives you a sense of direction and progress.

Learning New Skills

CBT is very much about skill-building. Coping strategies might include journaling, practicing mindfulness, breathing or meditation but I like to think there is more depth to CBT so the first step (self monitoring) is key to figuring out anxiety patterns. Therapy may then include exposure therapy. For instance, if fear of public speaking is an issue, your homework may involve practicing in front of a mirror or with a trusted friend.

Structured Sessions

CBT sessions are usually structured and time-limited, generally lasting between 50 minutes to an hour. You'll focus on specific issues and engage in exercises designed to work through what is keeping you stuck in the cycle.

Homework Assignments

Homework (or take away tasks as I like to call them) is a vital aspect of CBT. You will often be given tasks to apply to what you've learned in everyday life. This could involve journaling your thoughts or testing out new coping methods. Completing these assignments is essential, as they reinforce lessons learned and provide material for discussion in our next session.

The Duration of CBT

Typically, CBT is a short-term therapy lasting between 5 to 20 sessions. The specific length will depend on your individual situation and how complex your issues are. Some may see progress in a handful of sessions, while others might require a more extended commitment to address deeper-rooted patterns. The process is not linear or quick fix by the way. Its hard work and its normal to see yourself moving one step forward and two steps back sometimes.

Potential Outcomes of CBT

Breaking Unhelpful Cycles

CBT equips individuals with the tools to disrupt harmful cycles of thinking and behaviour. For instance, by pinpointing triggers for negative feelings and developing adaptive coping strategies, many find they can adopt a more functional outlook.

Long-lasting Skills

The strategies you learn in CBT can stick with you well beyond therapy. This means that tools like thought reframing and coping techniques can be helpful throughout your life.

Enhanced Problem-solving Abilities

As you engage with CBT, you'll likely notice improved problem-solving skills. With practice, you can approach challenges more calmly and thoughtfully, instead of feeling overwhelmed. Many individuals find themselves making decisions that are more rational rather than emotionally driven.

Challenges in CBT

Emotional Difficulty

It’s important to remember that while CBT can be rewarding, it can also be emotionally taxing. Confronting ingrained negative thoughts and past experiences may be tough. It’s okay to feel discomfort during this process. Showing yourself compassion and patience can be vital in navigating these challenges.

Commitment to Change

Your success in CBT greatly depends on your dedication to the process. Regular session attendance and active participation in homework are crucial for progress. If you skip sessions or fail to engage with assignments, your growth could stall.

Embracing Your Therapy Journey

Cognitive Behavioural Therapy offers individuals a structured way to understand and manage their mental health. By focusing on how thoughts influence emotions and behaviours, it helps you cultivate practical skills with long-lasting benefits.

If you feel that you still aren't sure if CBT is right for you, do reach out to me as I offer a free 15 minute call to see if we are the right fit for one another.

A serene therapy environment for Cognitive Behavioural Therapy sessions.