CBT (Cognitive Behavioural Therapy) – Ten Things To Expect

Attending your first ever session with a therapist can be a really daunting and nerve-wracking prospect but definitely worth the trouble.  Therapy can play an extremely important role in your recovery from Anxiety, Depression or OCD and I personally credit at least 70% of my own recovery to it.  Although I touched on several other therapies (for example EMDR and Transactional Analysis) it was CBT (Cognitive Behavioural Therapy) that helped me the most.

Brown leather armchair. Cognitive Behavioural Therapy - CBT
Photo by Cater Yang on Unsplash

Today I want to share a few things I wish I’d realised from the outset of my CBT experience.

Expect to self-advocate to even get an appointment

Sadly, waiting times for CBT on the NHS can be awful so be prepared for the fact that you may have to chase and self-advocate in order to access a therapist. Much as I hate that our system works this way, the squeaky wheel does indeed get the grease. So be as squeaky as you can be!

Expect to feel nervous

When you’re already suffering from Anxiety you’re likely to feel on edge and panicky a lot of the time anyway but don’t be surprised to feel a spike in these nerves as your first therapy appointment approaches.  Try to remind yourself that this is a normal emotion and not a sign that your Anxiety is worsening.

Expect to feel emotionally exhausted

Both during sessions and during the days that immediately follow you may feel especially sensitive, drained or tired.  This is all part of the process and, in fact, I found that the most emotional and challenging CBT sessions were the ones that ended up yielding the best results in the longer term

Expect to focus on the present and future, not the past

It’s a common viewpoint that therapists spend a lot of time making you focus on your childhood, your relationship with your family or your past experiences.  I was pleasantly surprised to discover CBT isn’t like this.  It’s all about re-training our current thought patterns and finding a more effectively way to deal with your thoughts and emotions going forward.  Since I had a wonderful childhood and no mental health difficulties before the birth of my son it was a big relief to me that my CBT therapist wasn’t going to spend lots of time digging around in my past for a cause or reason for my illness.  There are other forms of therapy that focus on this method when needed.

Cartoon of two women talking, one with head in hands. CBT (Cognitive Behavioural Therapy)

Expect ups and downs

Just like any other area of recovery, you should expect there to be peaks and troughs as you go through CBT.  Some weeks you’ll feel like you’re really making progress and others not so much, but believe me when I say you are always learning and those weeks where you don’t feel so positive about your session will still end up being very important to the overall process.

Expect it to take time

I naively thought I’d feel better after only a couple of sessions of CBT but unfortunately it can take a little longer, and plenty of practice, to see definite progress. If you consider the fact that you’ve probably been thinking in this way for most of your life so changing those thinking habbits is going to take time too.  Having said that, when I was at my most unwell the anxiety management techniques I was initially shown did bring some much needed relief quite quickly.

Expect to take responsibility for your own recovery

Another mistake I made was wasting a lot of time waiting for a professional to “fix me.” This isn’t exactly how therapy works, particularly CBT. Your therapist can give you comfort and coping strategies but the real purpose is to show you the techniques you need to put into practice yourself. A good therapist provides wonderful support and information but it’s down to you to take it all the way to recovery.

Expect homework

As above, you will be required to implement much of what you learn at home in between sessions. This can feel overwhelming at first but actually the act of carrying out these exercises ended up bringing me lots of relief, in the moment as well as the longer term.

Expect to learn practical techniques

One of the reasons I personally love CBT over other forms of therapy is because it’s very practical and logical. Not to say the exercises are easy but they are certainly straightforward and make a lot of sense. It isn’t “airy fairy” as some would think.

Expect to change for life

I’m planning a whole post about this soon but I can safely say I have drawn a lot of what I learnt through CBT into my everyday life as a recovered person. CBT techniques have undoubtedly helped me through other difficult situations such as miscarriage or grief and I fully expect to rely on them again in the future too.

I hope nobody feels overwhelmed by this list but instead it helps prepare you a little better.  Going into therapy with an open mind and as positive an attitude as you can muster at that point goes a really long way.


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Related posts:

Getting The Most Out Of Therapy

12 Tools For Managing Anxiety

Anxiety Toolkit Video Series

2 comments on “CBT (Cognitive Behavioural Therapy) – Ten Things To Expect

  1. Although I’ve never needed CBT myself, I do know people who have said that this has helped them with whatever they had been going through. Your list will be very helpful for people about to go through therapy themselves.

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