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What to Expect in Your First CBT Session

Georgina Hall

Georgina Hall

Thursday, 17th May 2018

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When it comes to taking ownership of your mental health, there are few steps more powerful than the decision to start therapy. Whether you're just setting out on your therapy journey or returning after a break away, stepping foot in the therapist's door can be daunting experience.

If you're planning to start Cognitive Behavioural Therapy (CBT) and you're struggling with those first-appointment jitters, it might be helpful to get a clearer picture on what your first session will look like.

Below I've shared my own personal experience in starting CBT to lift the lid on what to expect:

What is CBT?

CBT is one of the most widely used treatments for a range of different mental health issues, including anxiety and depression. Unlike other more traditional talk therapies (such as psychoanalysis, for instance), CBT is a highly practical approach, focused solely on the present and the future, instead of exploring past memories or experiences.

What happens in a CBT session?

Before my first CBT session, I imagined a clinical, white room with a therapist’s bed and a motivational quote on the wall. You’ll be pleased to know – it’s nothing like that! If you have a one-on-one session with a therapist, you will be seated in a private room, often on a sofa or an armchair. Your therapist will usually sit opposite you, and you’ll probably be offered a glass of water before you start.


First things first, your therapist will introduce themselves and ask a few questions about you. Don’t worry – you won’t be diving in the deep end here. You will probably be answering questions about your age, what you do for a living and where you live. This is a great opportunity for you and your therapist to break the ice, and you’ll likely find those nerves fading away as you begin to chat.

Mental health assessment

Next up, you’ll probably answer a short questionnaire on your current state of mental health. I was surprised to be answering the same questions that I had covered in a telephone assessment before the appointment, but many therapists like to repeat this questionnaire at the beginning of every session to track your progress.

Getting to know you as a person

Compared to a doctor treating a physical symptom, you’ll find that your therapist spends more time getting to know you as a person. Because your personal life and your mental health are closely linked, being open and honest will ensure that you can make the most of your sessions. Although you will be encouraged to talk about any personal issues you are experiencing, your therapist will never pressure you to open up before you are ready.

Explanation of symptoms and coping strategies

Once your therapist has a clearer idea of who you are and what you are struggling with, they will begin to equip you with practical tools to help you manage your mental health. This might include Exposure and Response Prevention (ERP), breathing techniques or writing down your thoughts and feelings. You’ll have the opportunity to try these techniques in the session and share feedback with your therapist.


After my first CBT session, I was surprised to leave the treatment room with a worksheet full of homework! Although you may only have 1-3 CBT sessions per week, the practical nature of the therapy means that you can integrate your new strategies into your day-to-day life. Although it can be tempting to ‘tune out’ from therapy once you return to your busy life, consistently practicing CBT techniques outside of your sessions will help you to make the most of your treatment.

Are you ready?

Feeling nervous about your first therapy session is totally normal. The good news is that your CBT therapist is trained to run their sessions in a safe space, making sure that you feel comfortable every step of the way.

It’s important to remember that every therapist works slightly differently according to their own training and the needs of each individual. Speak to one of our team to get help to find a therapist today.

Georgina is a 20-something writer, figure skater and recovering OCD sufferer. She can usually be found with a glass of wine, an acoustic playlist and a good book.