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What to Expect in Your First CBT Therapy Session

Writer: Jane WatkinsJane Watkins

I think it is totally understandable to be worried and anxious about what to expect in your first CBT therapy session with me. Even if you have experienced therapy before, you have not experienced therapy with me.

What to expect in your first CBT Therapy session

I thought it might be helpful to write a bit about it. You can then prepare and know what to expect. We all experience anxiety about new and unknown things. It is natural and so please do be fair to yourself about it and know that is is normal.


You will have already spoken to me on the phone. I always talk to new clients by phone to make sure I think I can help and so you can ask me any questions you may have.


Do think about your budget and if you have time for therapy. Not just for sessions, but also for the practice that makes therapy a success between sessions. If either of these elements is missing, then now may not be the right time.


Preparation for your first therapy session with me.


  • Before our first session please make sure you have filled out the new client questionnaire that you will have received by email and ticked off, electronically, that you agree to my terms and conditions. Please also make payment 48 hours in advance of our session.


  • Add my email address list to your address book on your email so that emails I send you won't got to spam. My email address is : mail@janewatkinscbt.co.uk


  • I encourage all my clients to get themselves a notebook. You can make notes of things you feel are important to remember in session and also between sessions. You can make notes about the practices you have tried out between sessions. It is what I call your 'therapy manual'. It is something you can look back on when therapy has ended to remind yourself about all the things we have talked about and the things that have helped. If you like stationery, it is such a good excuse to go shopping! This is your journal, and you never have to show it to me or anyone else.


  • Your first entry in your new therapy manual or journal could be about:

    • What has brought you into therapy?

    • Why does it feel like the right time?

    • How would you like to feel after therapy? what will have changed?


    I am deliberately not putting too many questions here as I don't want you to feel overwhelmed. If you don't know, that is fine, we will figure it out together.


What to expect in your first CBT therapy session


  • In our first therapy session we will look in detail at the topics you are bringing to therapy. If it is relevant we will look at your earlier life. This is relevant for most of my clients but we don't have to go back if you don't want to. We are a product of our life experience to date and so it helps me to help you if I know a bit more about you.


  • It is a first session. You don't have to tell me anything you don't feel comfortable about. It takes time to build trust and for you to feel comfortable.


  • It it entirely normal to come away from a first session and think, oh I should have said that, I wish I had said this. Write those things in your journal to keep them safe and remembered for the next session.


  • Not everything gets talked about in therapy. The important and relevant things are what we talk about. This will happen naturally.


  • I am human. I have a good sense of humour and we will laugh together. I will be supportive and kind for the difficult parts. I am down to earth, I don't use psychology jargon. If I am not making myself clear I would prefer you let me know so that I can explain it another way. I will share psychological theory with you, but in an accessible way that is relevant. I started off as a mental health nurse, part of the job description was to swear, so that is also fine, I won't be offended!


  • I will take notes, if we are on screen, that is the only reason I maybe looking away. It helps me to think about things when I write them down, and draw little diagrams! These notes are then transcribed, by me only, onto my electronic patient management system and the paper notes shredded.


  • My clients tend to fall into two camps! If you prefer to tell about yourself, what brings you to therapy and so on, in your own words, great! If you prefer me to help by asking questions, also great! Either works!


What you can expect from me:


It goes without saying you will have total confidentiality, my total attention in sessions. You will get electronic reminders about upcoming sessions to your email and as text message, unless you choose to opt out. If we are doing online therapy, I will make sure you have your zoom invite in advance.


  • My aim is to help you to understand yourself, what makes you tick and how to manage your mind so that you can reach your goals in therapy.


  • I will keep us focussed and on track. We will talk about how I can do that with you so that it feels ok.


Results from therapy


I totally get that you want to get results as soon as possible. Therapy does take time. It is better if neither of us feels under pressure for immediate results. All my clients want to know how many sessions they will need. I also understand this question, of course. You have a budget and your time to consider. It is very difficult for me to answer. Not because I am avoiding it but because I just don't know! Everyone is different. Everyone brings different things to therapy. In general my clients are with me for between 8-20 sessions, depending on you and the things you want to work on. Few clients are less, some are more.


I have tried therapy before and it has not helped. I am worried about this.


My new clients say this quite frequently. There can be a lot of reasons why therapy has not benefitted you in the past. First of all, I would like to say that it takes even more courage to come to a new therapist and try again. It could be that in the past, it was not the right time, not the right therapist fit, not the right type of therapy. The reasons are infinite and we may never know. I can tell you, that I will be checking in with you frequently, to make sure you are comfortable and finding sessions helpful.


Your first CBT session is about checking me out as well, to make sure you think I am the right fit or could be the right fit for you. You may not know immediately, and that is natural as well. I always say that finding the right therapist is like shopping for shoes. It can take a few tries to get to the right fit.


I am always happy to answer any question you may have and so do not hesitate to get in touch if there are any you would like me to answer.


I look forward to working with you.


Telephone : 07754 368541

or use my contact form, here

Jane Watkins, Specialist CBT Therapist for Anxiety, OCD and low self-esteem



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