Leanne Chapman

If I were to help a new client using CBT, my approach would be individualized and structured, working collaboratively with the client to create an understanding of the barriers they face and developing strategies to overcome them.

The first step in working with a new client in CBT is to build a safe, trusting, and non-judgmental therapeutic environment. For clients to be able to explore their thoughts and feelings freely, they need to feel understood, supported, and respected. I would start by developing rapport and ensuring that the client feels comfortable in the space. This involves active listening, validating their feelings, and being open to their concerns. I would also explain the nature of CBT, its goals, and how it works, so the client has a clear understanding of what to expect from the therapy process.
Once rapport is established, the next step is to collaboratively explore the client's specific goals. Whether the client seeks to reduce anxiety, improve self-esteem, manage depression, improve relationships, or achieve personal or professional goals, I would help the client clarify what they want to achieve. Goal-setting in CBT is vital because it provides a direction and focus for the therapy.
Having a clear picture of what the client wants to achieve helps tailor interventions that are directly related to their aspirations. For example, if the goal is to reduce anxiety around social situations, we might focus on exposure techniques, while if the goal is to improve self-esteem, we may work on cognitive restructuring to challenge the client’s negative self-beliefs.
In order to help the client achieve their goals, we would begin by identifying their negative automatic thoughts (NATs) that contribute to distress. These are the thoughts that occur spontaneously, without much reflection, and often have a pessimistic or self-critical tone. I would help the client to track and recognize these patterns by asking them to keep a thought record. A thought record allows the client to record specific situations, the thoughts they experienced in those situations, and the emotions they felt. Over time, we would look for patterns in these thoughts.
Once negative automatic thoughts have been identified, the next step in CBT is to challenge these thoughts through cognitive restructuring. This process involves helping the client to evaluate the validity of their thoughts and look at situations from a different, more balanced perspective.
In addition to cognitive changes, CBT also focuses on changing behaviors that may be reinforcing negative thoughts and emotions. For a client to reach their goals, it's crucial that they engage in activities that are consistent with those goals. However, depression, anxiety, or fear of failure often lead clients to withdraw, avoid, or procrastinate.

Behavioral activation is a core technique used in CBT to help clients take positive actions toward achieving their goals. I would work with the client to identify specific actions or steps they can take to move closer to their desired outcome. These actions would be broken down into manageable, realistic tasks. For example, if a client’s goal is to improve social interactions but they experience social anxiety, we might begin by setting a goal to engage in a low-stress social situation, such as having a short conversation with a colleague or attending a social gathering for a brief period.

By focusing on incremental changes and reinforcing positive behaviors, clients begin to feel a sense of accomplishment and confidence, which further motivates them toward reaching their goals.

As the client begins to make progress, it’s important to equip them with coping strategies that can help them manage future challenges. Coping skills such as relaxation techniques, mindfulness, problem-solving, and stress management are integral components of CBT. These tools provide the client with ways to manage difficult emotions, stay focused on their goals, and prevent setbacks.

Additionally, relapse prevention strategies are important to ensure that the progress made in therapy is sustainable over time. I would work with the client to anticipate potential obstacles and stressors they may encounter in the future and develop a plan for how to address them. This might include identifying warning signs that they are beginning to slip into old habits or thought patterns, and creating action plans to intervene before those behaviors negatively affect their progress.

Throughout the therapy process, it is crucial to regularly assess progress toward the client's goals. We would review the goals periodically to evaluate whether they have been achieved, whether new goals need to be set, and whether any adjustments need to be made to the treatment plan.

By working collaboratively with the client to identify goals, challenge negative thinking patterns, change maladaptive behaviors, and build coping skills, clients can experience meaningful and lasting change.

In summary, I would guide the client through a structured process that is focused on identifying goals, understanding the relationship between thoughts, emotions, and behaviors, and taking concrete actions toward achieving those goals. With time, effort, and commitment, the client would develop healthier thought patterns, improve their emotional well-being, and make lasting changes in their life.