Your First CBT Session: What to Expect
You may come to therapy knowing exactly what you want support with, but you may also arrive with a sense that something isn’t quite right and not knowing what that “something” actually is. Both are completely valid. Starting therapy can feel daunting, whether this is your first time or you’re returning after a break, and it’s very normal to wonder: What is my therapist expecting from me? What am I supposed to say?!
The truth? We’re just hoping you talk to us. And we also know that talking — especially about the things that feel tangled or uncomfortable — can be the hardest part. It’s our job to help you feel at ease, to help you feel comfortable enough to talk about that “something,” and to gently explore it with you.
Where to Start
CBT sessions usually begin with an agenda. It might sound formal, but there’s a reason for it. CBT is a structured therapy, and having an agenda helps us make the most of the time we have together. There are usually a few standing items:
A check‑in
A review of your week
A review of any home practice
Planning home practice for the week ahead
The rest of the agenda is shaped by you and your therapist. Sometimes you’ll come in knowing exactly what you want to focus on; other times, we’ll work together to figure out what feels most important that day.
Your First Session: Laying the Foundations
The first CBT session is about building a shared understanding. You can expect your therapist to talk through:
Confidentiality — what it means and the limits of it
Your reasons for seeking therapy — whether clear or unclear
Your goals — what you hope might feel different or easier
Your history — enough to give context, without pressure to share everything
How CBT works — and how it might support you
This session is also your chance to get a feel for your therapist’s style and to ask any questions you might have. Therapy is a collaborative process, and it’s important that you feel comfortable with the person sitting across from you.
Talking About the “Something”
Many people worry they won’t know what to say in their first session. You don’t need to arrive with a perfectly formed story or a list of issues. You can start anywhere — with a feeling, a moment, or even “I’m not sure where to begin.”
Your therapist will help you explore:
What’s been feeling difficult
How these difficulties show up day‑to‑day
What thoughts, emotions, and behaviours might be connected
What you’d like life to look like beyond the problem
CBT is practical and collaborative. It’s about understanding patterns and learning new ways to respond to them.
Home Practice: A Key Part of CBT
CBT often includes home practice — small, manageable tasks to try between sessions. These aren’t tests or assignments; they’re opportunities to apply what you’re learning in real life. Your therapist will help you choose tasks that feel achievable and meaningful.
Examples might include:
Noticing certain thoughts
Trying a new coping strategy
Practising a skill discussed in session
Reflecting on situations that felt challenging
Home practice is always agreed together. You won’t be given anything you haven’t talked through or anything that feels overwhelming.
Leaving Your First Session
By the end of your first CBT session, you should have:
A clearer sense of what CBT involves
An understanding of what you and your therapist will be working on
Space to ask questions
A feeling — hopefully — of being heard and supported
You don’t need to have everything figured out. Therapy is a process, and your first session is simply the beginning of that journey.
If you’re curious about whether CBT could help, you’re welcome to contact me — we can explore it at your pace.