First CBT Session

I have just finished my first telephone CBT (Cognitive Behavioral Therapy) session and it went pretty well. Prior to the session I was given a big booklet containing all of the information and task pages I would need throughout my CBT and was asked to read through the first 8 pages. Most of it was about what I am agreeing to, what I am prepared to do and what will happen, followed by the usual questionnaire (You can do this yourself here) .

We went through my questions and my depression score had actually gone up, meaning I had gotten worse since my initial assessment. I think this was to be expected though as I have just come back to university this week and I have had a rough few weeks with a lot of stuff going badly and effecting me. I thought it was okay as I knew why but my therapist (pseudonym: Karen) was surprised by my score and sounded worried. She asked me deeper questions about why and I had to explain in detail, which made me cry again.

Recently, I have been experiencing a lot of suicidal thoughts and feelings of being hopeless and pointless. I thought about calling Samaritans but I explained to Karen that I felt that I would be wasting their time and there are people worse than me that need help more. This was all in my head. Karen told me that I am important and I can get help from these people as much as anyone else can, whether they are better or worse it did not matter. All that matters is myself and ensuring I can get the help when I need it. Karen really made sure that I understood that and that Samaritans, and other helplines, are trained to help anyone in need. If you ever feel low or get any suicidal thoughts don’t think like I did, call Samaritans on 116 123, they do have time for you and you are important enough to get their help. I will if I ever feel like that again.

Karen also told me about how to look after any self harming injuries to ensure they do not get infected. She told me to use antiseptic creme on any to ensure any hospital treatment will not be needed. But the best way to avoid hurting yourself physically is to not self harm in any way – which I know is so much harder than it seems!

To combat some of my thoughts I have a table to fill in with any daily tasks I do. For example, going to work, watching t.v, having a shower or even lying in bed and at what time. Sort of like an activity diary. Once I have wrote down the activity I have to write down one word to describe my mood. I must then rate the activity on a scale of 0 – 100 for the intensity of my mood then on a scale of 0 – 10 for my sense of achievement from the task, how close to others it makes me feel, how much I enjoyed it. I will do this over the next week and then Karen will be able to see what I do and what I don’t do and how this effects me. I think the point of the activity diary is to change any of my behaviors that effect me negatively and by changing these, I can change my thoughts and feelings.

Karen also told me to think about setting some small goals for myself. I have to set myself a short term goal (4 – 6 weeks), a medium term goal (6 months) and a long time goal (1 year +). She told me these goals can be on anything I want, for example doing more exercise. However, these goals need to be:

  • Specific – e.g I will go for a run.
  • Measurable – e.g I will go for a run around the park.
  • Achievable – do not set yourself the task of running a marathon before you start any training.
  • Realistic – If your goals are unrealistic, you may feel worse about yourself when you can’t achieve them.
  • Time bound – e.g I will go for a run around the park for 10 minutes in the next week.

These bullet points make your goals better and easier to manage and you won’t feel too bad if they should be easy to achieve.

We also briefly talked about relaxation, breathing techniques and muscle relaxation. My anxiety is mild but it cannot be ignored so Karen told me to try out some of these and see how I feel afterwards. I will write a separate post on how to practice these as I still need to test them out. Sleep was also a small issue for me but there is a section in the book which I will test out and write about too. The same goes for the types of food I eat.

By the end of the session, which went pretty quickly, we went through quite a lot of things to think about and focus on. Karen gave me tasks to do ready for next time:

  • Read through section 1 of the booklet (including all of the above)
  • Complete the activity diary
  • Practice relaxation and breathing techniques
  • Make one positive change to eating or sleeping habits.

On the whole it went pretty well and I feel a bit better after talking about my feelings with someone and knowing I am on my way to getting better. If you feel any of the issues I have wrote about may effect you in any way and you would like to talk about it, feel free to email me at



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