What to Expect in Your First CBT Session

 

Starting CBT can feel a bit nerve racking, especially if you have never had therapy before. Many people worry about what will be expected of them, whether they need to prepare anything, or what the therapist might ask. The good news is that your first CBT session is designed to put you at ease, help you understand how the process works, and give you space to talk about what is troubling you.

CBT is a structured, practical and collaborative approach. Your therapist will work with you at a pace that feels comfortable, and you will never be pushed to talk about anything before you are ready. This guide explains what usually happens in the first session, so you know what to expect.

1. A gentle welcome and introduction

Your therapist will begin by explaining how the session works and giving you a chance to settle in. They will outline:

• their role
• how CBT sessions are structured
• what you can expect going forward
• confidentiality and boundaries
• how you will work together

This helps you feel grounded and reassured before you begin talking about what has brought you to therapy.

2. Talking about what has been troubling you

You do not need to prepare a perfect explanation or have everything figured out. Your therapist will guide the conversation with gentle questions such as:

• “What has been feeling difficult recently?”
• “How have things been affecting your day to day life?”
• “When did you first notice the problem?”

The aim is not to go into your entire history, but to get a clear picture of the main issue you would like support with.

3. Understanding how your thoughts, feelings and behaviours connect

CBT focuses on the link between:

• how you think
• how you feel
• how you behave

Your therapist may help you explore a recent situation where you felt anxious, overwhelmed, low or stuck. Together, you begin to understand the patterns that keep you feeling distressed.

This is not about blame. It is about noticing habits and reactions that may be adding pressure to your life.

4. Setting realistic goals together

Towards the end of the first session, your therapist may gently explore what you would like to achieve from therapy.

These goals do not need to be big or complicated. They might sound like:

• “I want to feel less anxious at work.”
• “I want to stop avoiding certain situations.”
• “I want to understand my thought patterns better.”
• “I want more stability in my mood.”

You and your therapist set these goals together, and they help guide the direction of future sessions.

5. Introducing practical tools and strategies

Depending on what you talk about, your therapist may introduce a simple CBT idea to help you start understanding your patterns. This could be:

• noticing automatic thoughts
• understanding triggers
• exploring physical symptoms of anxiety
• recognising helpful and unhelpful coping strategies

Your therapist will always move at a pace that feels right for you.

6. Optional between session tasks

CBT sometimes includes small between session tasks, often called “home practice”. These are not tests, and you are not expected to get them perfect.

Examples include:

• writing down thoughts during a stressful moment
• noticing physical sensations
• practising a grounding technique
• trying one small behaviour change

These tasks help you make progress between sessions, but they are always agreed together and based on what you feel able to do.

7. Space for questions

Your therapist will always give you time to ask questions such as:

• How many sessions might I need?
• How often should I come?
• How will we know if CBT is working?

There are no silly questions, and your therapist is there to help you feel comfortable and informed.

8. How CBT and Counselling Surrey can help

At CBT and Counselling Surrey, our qualified CBT therapists work with a wide range of difficulties, including:

• anxiety
• panic
• worry and overthinking
• low mood
• stress
• confidence issues
• intrusive thoughts
• patterns that keep you feeling stuck

You can choose a therapist, read their profile and book an appointment at a time that works for you.

Book an appointment here:
CBT and Counselling Surrey booking.

Sessions are £68 for a full one hour appointment, and you can book online quickly and easily.

9. Ready to begin?

Your first CBT session is simply a chance to meet your therapist, feel understood and explore what you need support with. You do not need to prepare anything or be at your best. You only need to show up as you are.

Taking the first step can feel daunting, but most people feel relieved once they begin talking.