The first couple of CBT sessions are devoted entirely to assessment. The psychologist asks lots of questions about presenting symptoms, life circumstances, past history of treatment, current work/family situation, medical history, etc. Most often brief psychological questionnaires are given to clients to complete at home (takes 45-60 minutes to complete) and a structured clinical interview may be administered as part of the assessment. At the end of the second or their assessment session, clients receive a diagnosis, explanation for their negative emotional state, and suggested treatment options. If an individual is considered a suitable candidate for CBT, the type of treatment, possible treatment goals, number of sessions, and expected outcome are discussed.
CBT treatment sessions are well-organized. Each session begins with the client providing a brief review of experiences over the past week, setting the session agenda, reviewing assigned homework, in-depth focus on 1-2 issues, and finally assignment of a new homework exercise for the coming week. The CBT therapist helps the client discover things about him/herself through a form of questioning called the Socratic dialogue. The atmosphere in CBT is one of collaboration, where the therapist and client work together to find solutions to the client’s troubling thoughts, feelings and behavior. As an author of several books on CBT, client manuals such The Anxiety and Worry Workbook or The Mood Repair Toolkit are often used in therapy. In fact you will gain an excellent understanding of the type of CBT offered in this practice if you consult The Anxiety and Worry Workbook for anxiety, or The Mood Repair Toolkit for depression. Normally CBT progresses in blocks of 5 sessions. After each 5th session, treatment progress is evaluated to determine whether or not to continue with further sessions. Thus you can expect CBT sessions to be highly goal-directed and time-limited, in which the therapist focuses more on current difficulties than past childhood experiences.