We outline below an introduction to CBT and frequently asked questions about how therapy works and what is expected of both the therapist and client in treatment. If you have any additional questions that have not been addressed here, please contact us at 416-432-4587 or firstname.lastname@example.org.
What will happen in the first session?
Treatment always starts with a consultation. The purpose of the consultation is to discuss the major difficulties you would like some help with, your goals for treatment, and the treatment plan to help accomplish these goals. Ultimately, the goal of the consultation is to determine whether CBT is a suitable approach to help achieve the treatment goals you set for yourself. Consultations typically involve one 90-minute session.
What does a typical CBT session look like?
Your psychologist will often start each therapy session by asking for a review of your week and then working with you to set an agenda for the therapy session. CBT is typically focused on current specific and concrete problems such as reducing unpleasant symptoms (e.g., compulsive behaviours, panic attacks, depressed mood) or improving functioning (e.g., increasing activity level or socialization). Your psychologist will evaluate the thoughts, beliefs, and behaviours that might be maintaining the problems and will teach you a variety of strategies to help you make changes that you can maintain. In collaboration with your psychologist, you will plan how to practice the skills in your own environment between therapy sessions. You should always feel free to discuss your treatment progress with your psychologist and provide feedback at the end of each session so that the treatment can be tailored to suit your personal treatment needs.
What should I do between sessions to get the most out of CBT?
CBT is a skills-based treatment approach that teaches you to become your own therapist. You will learn new skills during your therapy sessions, but ultimately much of the change occurs between therapy sessions when practicing the skills in your own environment. For example, if you had a personal trainer and knew how to use the exercise machines, but only went to the gym one time each week and remained inactive the other days, it would have little impact on your health and muscle tone. CBT is no different in this respect—it requires practice between sessions to achieve the desired results.
Your psychologist will initially offer some suggestions for homework, such as monitoring your thoughts and behaviours, taking steps to reduce your avoidance behaviour, conducting experiments to test out your predictions, and completing worksheets to challenge your negative thoughts or beliefs. As treatment progresses, you will learn to set your own homework between sessions to help you accomplish your treatment goals and become your own therapist.
How long will therapy last?
CBT is a time-limited, focused treatment approach. The duration of treatment depends on the severity and complexity of the problems you are hoping to work on in treatment. Following the initial consultation and discussion of your treatment goals, your psychologist will outline a treatment plan and provide an estimate of the number of treatment sessions that will be required to accomplish your treatment goals. The typical duration of CBT for a variety of problems such as anxiety and depression ranges from 12 to 20 sessions. However, treatment duration is variable—some individuals experience significant improvement in 4 to 6 sessions, whereas others may require more than 20 sessions if multiple problems require treatment. Your treatment progress and goals will be reviewed periodically and your goals can be modified if necessary.
How frequent are the sessions?
CBT typically consists of weekly 55-minute sessions. As treatment progresses and you learn to become your own therapist, the sessions will taper in frequency. You may then return for an occasional “booster” session to maintain your progress.
What is a psychologist?
A psychologist is a regulated health professional trained in the assessment, diagnosis, and treatment of mental health issues. In Ontario, psychologists are registered and regulated by the College of Psychologists of Ontario. To become registered as a psychologist in Ontario, an individual must have completed a doctoral degree (approximately 10 years of post-secondary education) as well as a one year supervised clinical internship. Following completion of a Ph.D., an individual must complete an additional year of supervised clinical practice and pass written and oral professional examinations. Psychologists are required to practice in accordance with applicable legislation, regulations, standards of conduct, professional guidelines and professional codes of ethics.