Frequently asked questions – the answers
Who is CBT for, and does it work?
There is a growing body of evidence which shows that CBT can help with a range of problems. The National Institute for Health and Clinical Excellence (NICE) recommends CBT in the treatment of depression, anxiety, obsessive-compulsive disorder, psychosis and bipolar disorder. There is also strong evidence that CBT is helpful in treating anger, chronic fatigue, chronic pain, sleep difficulties, behavioural problems in children and anxiety in children. My experience shows that CBT works just as well for teenagers as for adults.
How long is a session?
Each session is 50 minutes long and usually once a week to start with. Towards the end of therapy, sessions may be less frequent – perhaps fortnightly or monthly – so that you can put new ways of thinking/feeling/behaving into practice in-between times and see how things go for you.
What will happen in our first session?
Our first session gives us the opportunity to get to know each other, and we will each sign a contract outlining how we will work and agreeing to the confidentiality boundaries (see below). We will spend some time assessing your problems, prioritising what you want to work on, and setting clear goals to work towards. This means that you will get the very best out of your sessions.
How many sessions will I need?
It will depend on the issues you bring to therapy and what you want to work on. Our first session together will involve an assessment of your difficulties and you can decide whether you want to continue with further sessions. I will prepare a plan for treatment and we will usually agree to 6 sessions initially.
During session 6, we’ll review how therapy is going and agree to more sessions as required. Many clients see an improvement within 6-8 sessions, and 10 sessions may be enough, but we’ll decide this together depending on the issue you want to address.
If the issue is something more recent or a new occurrence, fewer sessions may be needed. However, if the problem is more complex and has deeper roots in your past, then change and improvement may take longer and require more sessions of therapy.
What about confidentiality?
In the first session of therapy, I will outline my confidentiality boundaries which are ‘
‘Everything that is discussed in all sessions will be confidential. However, if you give me information that indicates a threat to your own health or life, or to that of someone else, I will need to report that information to an appropriate person. If I need to consult with another professional or a third party you will be informed of this beforehand if possible.’
We will both sign a contract to show that we agree to these boundaries. If you are under 18, the same level of confidentiality applies.
Does my parent/carer need to attend my therapy sessions with me?
This is entirely up to you. You can bring them into the session with you if you wish and they can stay for part or all of the session. Or the session can be just between you and me. Any arrangement is flexible and you can change your mind at any time. A client under the age of 16 must be accompanied by a parent/carer who must remain in the building for the duration of the session.
Will my parent/carer find out what I talk about in my session?
Our sessions are confidential and I will not disclose any information to your parent/carer without your permission. However, if you tell me something in the session which I think puts you or another person at risk, I need to break confidentiality and tell a third party. This may be your parent/carer, social worker or your GP. I will always tell you that I need to do this.
I will encourage you to share important information from the session with your parent/carer when appropriate.
Will I have to do anything extra between sessions?
A key feature of CBT and an important part of the work we do together in our sessions, will be to set some practice or self-help for you to do between sessions. Just as you wouldn’t brush your teeth once a week to keep them clean, so it is important to look after you and your mental wellbeing daily. Think of it as your homework.
So we may agree on some reading to do before the next session, or perhaps keeping a diary or a mood log, or trying out a new behaviour, for example, starting a conversation with the shop assistant in your local shop.
At the start of each therapy session, we will review how the self-help went for you and use this feedback to help work out something new to try next.