CBT is usually done for a limited number of sessions, unlike therapies like counselling or psychotherapy which can often be more long term in nature.

On average, people having CBT will have around twelve sessions, usually one hour or so at a time. These sessions would usually be weekly. There is always the potential to extend the number of sessions if you and your therapist think that would be helpful.

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Sessions can be delivered in several ways. These include:

One on one: Just you and the CBT therapist. Your sessions may happen at a private clinic, at the doctor’s office, outside or even at your house. Different therapists work in different ways so check which are available.

Group sessions: Sometimes sessions may be done with a group of people who have all been experiencing the same issue. These sessions are often cheaper than one on one sessions but some people aren’t comfortable discussing personal issues in front of strangers.

Online: CBT is becoming more common as an online process and the benefit of this is that it can be done at your own pace, at a time that suits you.

In the first session (or two) you would have an opportunity to explore what cognitive behavioural therapy might be like for you and to see if it has a chance of helping you to feel better.

It’s also a chance for the CBT therapist to meet you and get some more information to help them know if they have the potential to help you. Think of it as a kind of fact finding mission for you both to see what the scope of the project is.

After the initial phase there would be the treatment phase. This could be a small number of sessions or might be 12 or more.

Usually each treatment session would involve a catch up on what has happened since the last session and a conversation about any homework that had been set the previous session. There would be tools and techniques used in that session, designed to further your progress towards your goal and it is likely that if any homework is set that it would be a continuation of what was done face to face in that session.

- In the first session (or maybe the first few sessions) there would be a fairly detailed discussion of past and present situations where the problem state was experienced.

A plan would be made between client and therapist regarding what the therapy sessions will focus on and what the end goal is for the process.

Once you have had the first session (or two) looking at what it is that you want to change and what you want to achieve your CBT therapist will help you to begin to “chunk down” what was a big problem into its smaller parts and look at how they fit together. This can be done through a discussion but may also require you to keep a record of what you have thought or felt about the problem so it can be discussed at the next session.

By looking at this information together you can begin to assess the separate chunks of behaviour and really examine if they serve some kind of purpose to you now and in the future or if they are out-dated, unneeded and unnecessary. The things that are no longer needed could lead you to better alternative approaches which could dramatically change future situations.

The work to be done at home would be discussed at the end of each sessions so your would have a clear plan as to what is to be done and what the benefits of doing it could be.

You may be asked to keep a diary of specific thoughts or behaviours or what happens at certain times or places that were a challenge in the past.

You may be asked to write down features of what you would like the future you (who is feeling better) might be doing and how they would be living their life. By getting more familiar with your goal you could find it is more appealing to do the things that move you towards that goal.

Humans are creatures of habit and making changes can sometimes feel a little overwhelming. Having a therapist who is there to help, support and guide you could make that process of change a lot easier than it might otherwise have been. By practising the things you learn through Cognitive Behavioural Therapy sessions you could find you develop tools that could help you for the rest of your life.

There are a whole range of possible changes or benefits that you might experience as a result of CBT. Here are just some of those possibilities...

• Understand past triggers better
• Greater awareness of the power of the things you say to yourself in your own head
• Not accepting unhelpful or critical self talk
• Learn to tell the difference between anxious or fearful thoughts and reality
• Learn how to reframe what happened in the past and see things differently
• Develop greater insight or empathy for other people's circumstances and understand them better
• Become more aware of your own thoughts and feelings and notice their effect on you
• Learn to set goals and learn how to focus on achieving them

There is a wide range of different issues that CBT can be used to focus on and there is a large and growing evidence base for the effectiveness of the therapy.

Issues CBT can treat include:

• anxiety
• BPD
• panic attacks
• depression
• PTSD
• bipolar disorder
• OCD
• fears & phobia
• schizophrenia
• anger issues
• Sexual issues
• insomnia
• chronic pain

Exposure therapy can be a part of CBT sessions but isn't necessarily used as a part of everyone's therapy. As a technique, exposure therapy is about facing fears and gradually becoming increasingly exposed to them.

The technique focuses on bringing in a small amount of the issue that has caused problems for you in the past. Just enough to provoke a physical reaction. Your therapist would then help you to be with that discomfort and to allow it to pass in safety. This process is repeated in the treatment session itself and as part of homework.

In time the majority of people find that after a small amount of practise that their anxiety or fear does not climb as high as it did when thinking about or experiencing the same thoughts. Many people find the anxiety also doesn't last for as long as it did.

Once this has been worked through you then focus on an aspect of the problem that is more severe or provokes a stronger reaction and repeat the process to reduce and dampen the reaction

Cognitive Behavioural Therapy is very effective for some people but for others, it is not what they are looking for and they need an alternative therapy. Different people are different but it is possible that for those who don't like or don't want CBT that hypnotherapy or counselling could be helpful.

Hypnotherapy:

CBT is a fairly quick process in most cases (about 12 sessions are needed on average) but hypnotherapy is even faster. Some people have just three or four sessions of hypnosis. The reason the process is even faster is that CBT focuses on dealing with the conscious mind which can be a lengthy negotiation.

Hypnotherapy on the other hand taps into much more of the unconscious and some people find change happening without really even trying to make change happen.  This doesn't happen for everyone but it's not uncommon. Many of the techniques used consciously in CBT are also used unconsciously in hypnotherapy.

Counselling:

For some people, counselling is a better fit. It can be seen by some as being lower intensity than CBT and therefore more manageable. Some people really don't like the idea of exposure therapy through CBT as their problem seems so big and scary they can't face the idea of tackling it so directly.

For these people, counselling could be ideal.