Starting therapy is a brave decision and often an important step towards a more balanced and manageable future. It is completely normal to feel a little nervous before your first appointment. Many people wonder what they will be expected to talk about or whether the setting will feel formal or uncomfortable.
Understanding how therapy works can help reduce that uncertainty. Cognitive Behavioural Therapy (CBT) is one of the most widely used and effective talking therapies. It is practical, structured, and focused on helping you understand the connection between your thoughts, feelings, and behaviours. Rather than being a passive experience, CBT is a collaborative process where you and your therapist work together to identify challenges and develop practical ways to manage them.
This guide explains what typically happens during a CBT session, from the initial appointment through to completing a course of therapy, so you know what to expect at each stage.
The First Session: Initial Information and Assessment
Your very first meeting is often called an initial assessment. This is not a test. It is a chance for your therapist to understand your world and for you to see if you feel comfortable with them. This is the start of your psychological therapy journey, where we look at how your current challenges affect your daily life.
Getting to Know Your Story and Mental Health
During this first appointment, your specialist will ask about the challenges you are currently facing. They might ask when your symptoms started and how they affect your daily life. While CBT often focuses on the “here and now,” we may briefly discuss past experiences to understand how certain patterns formed. It is a safe space to share as much or as little as you feel ready to. We want to understand the big picture of your mental health so we can tailor the support to fit you perfectly.
Defining Your Goals for Therapy
CBT is a goal-oriented type of therapy. This means we focus on where you want to go, not just where you have been. Your practitioner will help you identify what you want to achieve. This could be anything from wanting to manage anxiety to stop panic attacks, to wanting to address symptoms of depression so you can feel motivated again.
This psychological therapy is also highly effective for more specific mental health conditions. This includes post-traumatic stress disorder, obsessive-compulsive disorder, and even helping to manage the symptoms of bipolar disorder or schizophrenia. Having clear goals helps us measure your progress together.
Building the Relationship for Mental Health Support
The bond between you and your mental health professional is an important part of the therapeutic process. The first session is an opportunity to ask questions, understand your practitioner’s experience, and explore how this type of therapy compares with other approaches you may have come across. From the outset, the focus is on creating a space where you feel heard, respected, and supported, helping to build trust and confidence as therapy begins.
The Standard Structure of CBT Sessions: What to Expect Every Week
One of the reasons this approach is so successful is its structure. Once the assessment is complete, your weekly cbt sessions will usually follow a predictable pattern. A typical cbt session is designed to be efficient, helping you get the most out of every 50-minute appointment.
The Check-in and Setting Content for the Session
Every session begins with a quick check-in. You and your professional will discuss how your week has been and how your mood has changed. After this, you will set the content for the hour together. This is a list of one or two specific things you want to focus on. This ensures the session stays on track and focuses on what matters most to you right now.
Reviewing Your Action Plan
In a course of cbt, the progress does not stop when you leave the room. At the end of each session, you will usually agree on a small task to try at home. We call this an Action Plan. At the start of your next meeting, you will review how this went. You might have kept a diary of your moods or tried a new way of reacting to a stressor. If it was hard, we look at why and find ways to fix it. If it went well, we celebrate that win.
The Main Work of Behavioural Therapy
This is the core of the appointment. You will use specific techniques from behavioural therapy to unpick a problem. Your professional might use “guided discovery.” This involves asking questions to help you see a situation from a new angle. You might look at a specific event from your week and break it down to see how your thoughts and behaviours influenced your feelings.
Understanding the CBT Cycle in Practice
The main idea behind cognitive psychotherapies is that our feelings and actions are heavily influenced by the way we think.
Identifying Thought Patterns
We all have automatic thoughts that pop into our heads. Sometimes, these thoughts are unhelpful and lead to negative thinking. For example, if a friend does not text back, you might have negative thoughts like they are annoyed with you. This thought makes you feel sad, which might lead you to avoid talking to them. In your session, your cbt therapist will help you learn to spot these patterns as they happen.
Challenging Unhelpful Beliefs to Help You Progress
Once you have identified a pattern of negative thinking, your professional will provide help to look for the evidence. Is it true that your friend is annoyed? Could there be another reason, like they are busy at work? By looking at the facts, you can find more balanced ways of thinking. This reduces the emotional weight of the situation and helps you feel better.
Developing Your Practical Toolkit
The goal of therapy is to support your emotional wellbeing by helping you become more confident in understanding and managing your own thoughts and behaviours. This involves building a practical toolkit of CBT techniques that you can use not only during sessions, but throughout everyday life.
Learning New Coping Skills
Depending on your goals, you might learn different cbt techniques. This could include breathing exercises for managing stress or behavioural activation for low mood. These skills are helpful for a wide range of mental health problems, including chronic fatigue syndrome and managing the distress associated with psychosis. These are practical skills that you can use the moment you feel stressed or low.
Creating Your New Action Plan
Before the session ends, you will decide on a new task to try before the next meeting. This is always a choice you make together. We will never force you to do something you are not ready for. The task might be as simple as keeping a thought diary for ten minutes a day or trying a new coping strategy when you feel overwhelmed.
Ending the Session: Feedback and Reflection
As the session draws to a close, we make sure you feel settled and clear about the next steps.
Providing Feedback to Your Therapist
We value your input. Your therapist will often ask how you found the session. Did anything feel particularly helpful? Was there anything you disagreed with? This feedback ensures that the work continues to meet your needs and helps you reach your goals faster.
Summarising the Takeaways
You will leave with a clear summary of what was discussed. Many people find it helpful to jot down a key point from the session to keep in their pocket or on their phone during the week. This keeps the progress fresh in your mind.
Why Choose Select Psychology for Your Therapy?
While support for various disorders is available through many routes, choosing private care offers several benefits. At Select Psychology, we provide immediate access to highly qualified, accredited clinical psychologists and practitioners. This means you do not have to wait on long lists when you need help today.
We work with adults, families, and children and young people, ensuring that every age group receives the right health and care. Our clinics provide a comfortable and private environment where you can feel at ease. We also understand that for some mental health conditions, a combination of therapy and medication is most effective, and we can work alongside your other healthcare providers to ensure a joined-up approach.
Conclusion
Starting therapy can feel like a big step, but CBT is designed to offer clarity, structure, and practical support from the very first session. By breaking challenges down into manageable parts, CBT helps you understand your thoughts and behaviours while building skills you can rely on long after therapy ends. You are not expected to have all the answers – progress comes from working collaboratively, at a pace that feels right for you.
At Select Psychology, we are committed to providing expert, compassionate care tailored to your individual needs across the North East. Whether you are looking for private therapy in Newcastle or prefer the flexibility of online sessions, our experienced practitioners are here to support you every step of the way.
If you are looking for Cognitive Behavioural Therapy (CBT) in Newcastle, you can contact Select Psychology today to book an initial consultation and take the first step towards improved mental wellbeing and lasting change.