What Happens During Therapy?
CBT requires effort, an open mind, a leap of faith, and hope for something better.
A Collaborative Process
Cognitive-Behaviour therapy is, to the greatest degree possible, a collaborative process. Your therapist will work with you to agree what topics will be discussed during the therapy sessions and what strategies will be used in treatment.
Setting Treatment Goals
Early in the therapy process, your therapist will work with you to set treatment goals for therapy. Cognitive-Behaviour therapy is typically focused on helping people achieve concrete goals, for example, reducing the symptoms of anxiety and depression, stopping panic attacks, increasing the person’s ability to function at work, at home or socially. After setting the goals, progress is monitored to track whether you are moving towards achieving these goals. If progress is slower than expected or if the therapy stalls, it is important for you and your therapist to discuss the situation, evaluate what might be impeding progress and examine what change(s) in the treatment or treatment plan is needed. Your therapist might recommend an increase or trial of medication, more frequent therapy sessions or perhaps a medical exam to ensure that no medical problem is interfering with your progress.
A Typical Therapy Session
Most clients meet with their therapist on a weekly basis for a session, which lasts approximately 50 minutes. Your therapist will often begin by asking you to review how things have gone for you since your last session and then work with you to set an agenda for the therapy session. Typically the therapy session focuses on current concrete and specific problems with which you would like some help.
As therapy involves learning new skills, learning and practice outside the therapy session are essential parts of treatment. Part of the therapist’s role is to identify what skills are needed and provide active skills teaching. Part of the client’s role is to take steps to learn these skills (e.g. reading recommended books, logging and monitoring behaviours and thoughts), and practice them during and outside the therapy session.
The Therapeutic Relationship
A productive therapy depends on a collaborative, trusting client-therapist relationship. At each stage of treatment the therapist and client work together as a team on the common, identified problem. This is not unlike having a personal fitness trainer, who works with you to design a program to fit with your current level of abilities. If this collaboration breaks down, your CBT therapist will try to work out why, and then identify how to repair it. It is also possible to use the therapy relationship directly, to sample and re-evaluate thoughts, feelings and behaviours, which occur in the client’s other relationships.
If at any point you feel uncomfortable with your therapist or experience a problem in the working relationship, please discuss this with your therapist in the first instance.