If you or a loved one are struggling with addiction or mental health, we can help. Request a call.

Topbar Forms

This field is for validation purposes and should be left unchanged.
Name(Required)
(774) 341-4502
Verify Insurance
(774) 341-4502
(774) 341-4502
Verify Insurance
(774) 341-4502

CBT for Anxiety and Depression: What to Expect in Your First Session

CBT for Anxiety and Depression: What to Expect in Your First Session

When you’re living with anxiety or depression, starting therapy can feel overwhelming—especially if you don’t know what to expect. But taking that first step is often the beginning of meaningful change. One of the most effective and evidence-based approaches for both anxiety and depression is Cognitive Behavioral Therapy (CBT).

At Lion Heart Behavioral Health, we specialize in CBT Therapy Programs in Massachusetts tailored to individuals seeking relief from persistent worry, sadness, or emotional overwhelm. Whether you’re entering our Intensive Outpatient Program, Partial Hospitalization Program, or stepping into therapy through our Outpatient Treatment Program in Massachusetts, this guide will walk you through what CBT is—and what your first session will look like.

What Is Cognitive Behavioral Therapy (CBT)?

CBT is a structured, goal-oriented form of therapy that helps you identify and change unhelpful thought patterns and behaviors. It’s based on the idea that your thoughts, emotions, and actions are interconnected—and by addressing one, you can positively influence the others.

CBT is widely used for:

  • Generalized Anxiety Disorder
  • Social Anxiety
  • Panic Disorder
  • Major Depressive Disorder
  • OCD and intrusive thoughts
  • Trauma-related symptoms

CBT is a core part of all our Anxiety Therapy Programs in Massachusetts and Depression Therapy Programs in Massachusetts because it’s consistently proven to reduce symptoms and improve quality of life.

What to Expect in Your First CBT Session

Your first CBT session is more about getting to know you than diving deep into your symptoms. It’s a safe space to share your story and begin building a therapeutic relationship.

Here’s what typically happens:

1. Initial Intake and Goal Setting

  • Your therapist will ask about your mental health history, current symptoms, and what led you to seek help.
  • You’ll be asked about your daily routine, sleep patterns, appetite, work, and relationships.
  • Together, you’ll set goals for therapy—these could include reducing panic attacks, improving mood, or managing social fears.

2. Explaining the CBT Model

  • The therapist will introduce how thoughts, feelings, and behaviors interact, often using simple diagrams or examples.
  • You’ll begin to see how automatic negative thoughts may be feeding your anxiety or depression.

3. Identifying Patterns

  • You may be asked to describe a recent situation that triggered strong emotions or anxiety.
  • Your therapist will help you identify the thoughts that ran through your mind and how they impacted your emotions and actions.

4. Homework and Next Steps

  • Yes—CBT often includes homework! You might be asked to keep a thought journal or track moods throughout the week.
  • These exercises build self-awareness and reinforce learning between sessions.

Understanding the Root Cause: CBT Doesn’t Ignore the Past

While CBT focuses on the present, it doesn’t dismiss your past experiences. Your therapist may gently explore childhood experiences, trauma, or early relationships to understand how your core beliefs were shaped—such as feeling “not good enough,” “unsafe,” or “unlovable.”

By linking current patterns to past events, CBT helps you:

  • Recognize outdated beliefs still running your inner world

  • Challenge their accuracy and relevance

  • Replace them with healthier, self-supportive thoughts

This integrative approach is especially effective for those in our Trauma Therapy Program in Massachusetts and Depression Therapy Programs who struggle with recurring emotional pain.

Progress Tracking in CBT: How You’ll Know It’s Working

One of the benefits of CBT is its structured, measurable progress tracking. Your therapist will regularly revisit your goals and monitor changes in mood, anxiety levels, and coping skills.

You may use:

  • Symptom rating scales (weekly or monthly)

  • Thought records comparing past and present thinking

  • Mood journals to identify patterns and triggers

In our Intensive Outpatient Program in Massachusetts or Partial Hospitalization Program in Massachusetts, these tools are reviewed frequently to ensure care is working—and adjusted if needed.

What Happens After the First Session? A Look at Week 2–5 in CBT

After your first session, the following weeks typically include:

  • Week 2: Learning to track automatic thoughts and emotional triggers

  • Week 3: Identifying cognitive distortions (e.g., catastrophizing, black-and-white thinking)

  • Week 4: Replacing irrational thoughts with more balanced alternatives

  • Week 5: Practicing behavioral changes—such as facing fears or increasing pleasurable activities

As clients move through our Outpatient Treatment Program in Massachusetts, this process becomes second nature—leading to greater self-awareness and emotional regulation.

CBT for Anxiety and Depression: Your First Session

Tools Used in CBT for Anxiety and Depression

Our CBT Therapy Programs in Massachusetts often include tools such as:

  • Thought Records: Track and challenge negative beliefs
  • Behavioral Activation: Increase engagement in activities that boost mood
  • Exposure Techniques: Reduce avoidance behaviors in anxiety
  • Cognitive Restructuring: Reframe irrational or distorted thoughts
  • Relaxation & Breathing Techniques: Calm the body and mind during panic or overwhelm

These strategies are gradually introduced and tailored to your specific needs during the first few sessions.

How CBT Differs from Talk Therapy

While traditional talk therapy often explores past experiences, CBT is present-focused and solution-oriented. It’s about:

  • Identifying problems
  • Understanding the thought patterns behind them
  • Developing skills to change those patterns

If your symptoms are getting in the way of your daily life, CBT provides practical tools to create change, not just insight.

Where CBT Fits in Our Levels of Care

At Lion Heart Behavioral Health, CBT is integrated across all treatment levels:

No matter where you begin, CBT helps stabilize symptoms and provide lasting tools for change.

Is CBT Right for You?

CBT may be an excellent choice if:

  • You struggle with overthinking, worry, or fear
  • You often feel stuck in cycles of guilt or hopelessness
  • You want a more structured, skills-based approach to healing
  • You’re ready to take an active role in your recovery

If your symptoms are more severe, our Partial Hospitalization Program or Intensive Outpatient Program can offer daily or near-daily CBT-focused support until you’re ready for less intensive care.

Ready to Take the First Step?

Your first CBT session isn’t about fixing everything—it’s about starting the conversation. At Lion Heart Behavioral Health, our team is here to walk with you through every step of your healing journey.

Whether you’re struggling with anxiety, depression, or trauma, our compassionate clinicians will help you build the insight and tools to move forward—starting with that very first session. Call us today at 774.238.5533 to schedule your CBT intake and learn more about our programs across Massachusetts.

Frequently Asked Questions (FAQs)

Is CBT only for anxiety and depression?

No. CBT is also effective for trauma, OCD, eating disorders, sleep issues, and more.

How long does CBT take to work?

Many people begin to notice changes in 6–12 sessions, though long-term therapy may be recommended for complex issues.

Will I have homework after every session?

Often, yes. Homework reinforces what you learn in therapy and helps you apply it in real life.

Can I do CBT in a group setting?

Absolutely. We offer CBT-based groups as part of our IOP and PHP programs.

Can CBT be combined with other therapies like DBT?

Yes. Many clients benefit from a blend of CBT and DBT, especially those also receiving care in our DBT Therapy Programs in Massachusetts.

Call Now (774) 341-4502
Contact Us Today
Verify Insurance

Addiction Treatment

Mental Health Therapy

Programs

*The stories shared in this blog are meant to illustrate personal experiences and offer hope. Unless otherwise stated, any first-person narratives are fictional or blended accounts of others’ personal experiences. Everyone’s journey is unique, and this post does not replace medical advice or guarantee outcomes. Please speak with a licensed provider for help.

Tom believes that meaningful change begins with feeling heard, respected, and genuinely understood. His therapeutic approach is grounded in compassion, authenticity, and trauma-informed care, creating a safe, supportive, and judgment-free environment where clients feel empowered to explore challenges, build resilience, and move toward lasting healing.

As a Licensed Alcohol and Drug Counselor II (LADC II), Tom has experience working with individuals facing a wide range of mental health and substance use concerns across multiple levels of care. He is passionate about helping clients recognize their strengths while developing practical tools to navigate life’s challenges with greater confidence, emotional awareness, and self-compassion. Tom views therapy as a collaborative partnership, tailoring his approach to meet each person’s unique experiences, goals, and values.

Currently pursuing a Master of Science in Clinical Mental Health Counseling at Bay Path University with a concentration in Trauma-Informed Care, Tom is committed to continually expanding his clinical knowledge and providing evidence-based, culturally responsive care. He has a particular passion for working with LGBTQ+ individuals, supporting men’s mental health, and helping adolescents and young adults navigate anxiety, depression, trauma, life transitions, and identity development.

Known for his calm presence, genuine empathy, and approachable style, Tom strives to foster meaningful therapeutic relationships built on trust, respect, and collaboration. He believes that healing occurs when individuals feel accepted for who they are while being encouraged to discover who they can become.

Outside of the therapy room, Tom enjoys spending time with family and friends, camping, weightlifting, and staying active. He believes that maintaining balance, practicing self-care, and prioritizing overall wellness enhances his ability to support others as they pursue healthier, more fulfilling lives.

Arielle is a compassionate mental health clinician who believes that meaningful change begins with feeling safe, heard, and genuinely understood. As a Licensed Certified Social Worker (LCSW), she is dedicated to creating a welcoming, collaborative therapeutic environment where clients feel empowered to explore their experiences, build on their strengths, and move toward lasting emotional wellness.

Arielle’s approach is rooted in authenticity, empathy, and trust. She believes the therapeutic relationship serves as the foundation for growth and strives to balance compassion with thoughtful accountability. By helping clients recognize patterns, deepen self-awareness, and develop practical coping strategies, she supports individuals in creating meaningful, sustainable change both inside and outside of the therapy room.

Working collaboratively with each client, Arielle tailors treatment to meet their unique needs, values, and goals. She has experience supporting individuals navigating anxiety, depression, stress, and major life transitions, meeting clients where they are while encouraging growth at a pace that feels both supportive and achievable. Her person-centered approach emphasizes resilience, self-compassion, and empowering clients to develop the confidence and skills needed to navigate life’s challenges.

Arielle earned her Master’s degree from Salem State University and completed her undergraduate education at The Pennsylvania State University. She is passionate about helping individuals discover their strengths, cultivate resilience, and create fulfilling lives built on hope, healing, and personal growth.

Jill is a dedicated behavioral health clinician who believes that healing begins when individuals feel truly seen, heard, and accepted for who they are. Since beginning her career in behavioral health in 2015, she has been honored to support children, adolescents, adults, and families through some of life’s most challenging moments. Her diverse clinical experience has reinforced her belief that meaningful and lasting change begins with genuine connection, compassion, and a therapeutic relationship built on trust.

Throughout her career, Jill has served in a variety of clinical roles, including high school intervention specialist, family specialist and outreach worker, program clinician in a children’s emergency residence, and Partial Hospitalization Program (PHP) clinician before joining Lion Heart Behavioral Health in 2026. These experiences have provided her with a broad understanding of the unique challenges individuals and families face across the lifespan while strengthening her commitment to providing personalized, client-centered care.

Jill earned her Master of Science in Psychology with dual specializations in Educational and Counseling Psychology from Capella University and her Bachelor of Science in Criminal Justice with a concentration in Forensic Psychology from Kaplan University. Her therapeutic approach is grounded in Cognitive Behavioral Therapy (CBT), integrating evidence-based interventions with warmth, authenticity, and genuine curiosity about each client’s unique experiences.

Known for her compassionate and approachable style, Jill creates a welcoming, nonjudgmental environment where clients feel safe exploring challenges, identifying strengths, and developing practical skills to navigate life’s obstacles. She recognizes the courage it takes to seek support and considers it a privilege to walk alongside individuals as they build resilience, foster self-understanding, and work toward meaningful, lasting recovery.

Jill is passionate about helping every client leave therapy feeling empowered, supported, and hopeful. She believes that with the right support, meaningful change is always possible and is committed to helping individuals discover the confidence and resilience needed to create fulfilling, purpose-driven lives.

Kevin brings a unique combination of professional expertise, lived experience, and genuine compassion to his work as a therapist. Since beginning his own recovery journey in 2016, he has remained committed to helping others discover that lasting recovery is not only possible, but transformative. His personal experiences have shaped his deep understanding of addiction, resilience, and the courage it takes to create meaningful change.

Over the past seven years, Kevin has dedicated his career to working with individuals navigating substance use disorders and recovery. He earned his Licensed Alcohol and Drug Counselor II (LADC II) credential in 2024, further strengthening his clinical knowledge and commitment to evidence-based care. Clients appreciate Kevin’s authenticity, empathy, and ability to build trust through genuine connection. His approach is grounded in the belief that every individual possesses the strength and capacity for growth, regardless of where they are in their recovery journey.

Kevin’s work is driven by a passion for empowering others to rediscover hope, develop confidence, and build fulfilling lives in recovery. He recognizes that healing extends beyond sobriety and focuses on helping clients develop the tools, insight, and resilience needed for long-term success.

Outside of the therapy room, Kevin is a devoted husband, father, brother, son, and friend. He has also been deeply involved in music throughout his life, performing as a lead vocalist with local bands for more than 30 years. His love of music, combined with his personal and professional experiences, allows him to connect with people from all walks of life in an authentic and meaningful way.

Kevin believes that some of life’s greatest challenges can become the foundation for purpose, healing, and personal transformation. His warmth, humility, and unwavering commitment to those he serves make him a trusted guide for individuals seeking lasting recovery and a renewed sense of hope.

Nicole brings nearly a decade of experience in substance use disorder treatment, having worked across multiple levels of care since 2015. With a background in psychology and extensive experience supporting individuals throughout their recovery journeys, she has developed a compassionate, person-centered approach that recognizes there is no single path to healing. Nicole believes that every individual’s lived experience is unique and deserving of respect, understanding, and individualized care.

Throughout her career, Nicole has been dedicated to helping clients move beyond symptom management by exploring the underlying patterns that contribute to substance use. She works collaboratively with individuals to strengthen emotional regulation, develop effective coping strategies, and build the insight and resilience necessary to support long-term recovery. Her therapeutic approach considers the whole person, recognizing the powerful connection between thoughts, emotions, behaviors, relationships, and life experiences.

Known for her calm presence, genuine empathy, and ability to foster meaningful therapeutic relationships, Nicole creates a safe and supportive environment where clients feel empowered to explore challenges, celebrate progress, and embrace lasting change. She is passionate about helping individuals discover their strengths, restore hope, and build lives that reflect their values and recovery goals.

Nicole believes recovery is about more than achieving sobriety—it is about creating a fulfilling, balanced life built on self-awareness, resilience, and purpose. She is committed to walking alongside each client as they navigate the challenges of recovery while helping them develop the confidence and skills needed to sustain meaningful, lifelong change.

Emily is a Licensed Certified Social Worker (LCSW) dedicated to helping individuals navigate mental health challenges, substance use disorders, and the path toward lasting recovery. She earned her Master of Social Work, with a Certificate in Trauma Practice, from Simmons University in 2024 and has continued to expand her clinical expertise through advanced training in co-occurring disorders and evidence-based treatment. Emily completed a Substance Use Disorders Certificate in Assessment and Treatment Strategies with Teens and Adults through Bridgewater State University and is currently pursuing a Certificate in Substance Abuse Counseling at Bristol Community College to further strengthen her clinical knowledge and specialized skills.

Emily’s therapeutic approach is grounded in Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), integrating practical, evidence-based interventions with genuine compassion and collaboration. She works alongside clients to better understand the relationship between their thoughts, emotions, and behaviors while helping them develop healthier coping strategies, strengthen emotional regulation, and create meaningful, sustainable change. Emily believes that healing begins with feeling understood, and she is committed to creating a safe, supportive environment where every individual feels empowered to grow at their own pace.

Known for her warmth, authenticity, and positive energy, Emily quickly builds strong therapeutic relationships founded on trust, respect, and encouragement. She is passionate about helping clients recognize their strengths, overcome life’s challenges, and move toward lives that are aligned with their values and goals.

Outside of the therapy room, Emily is an accomplished lacrosse coach at both the club and collegiate levels. Having played competitively throughout high school and college, she enjoys mentoring athletes and helping them develop confidence, resilience, and leadership skills that extend far beyond the field. In her free time, Emily enjoys reading and creating diamond art, finding creativity and balance through these hobbies.

Emily believes that growth is possible for everyone and is honored to walk alongside clients as they build resilience, discover hope, and create lasting change.

Amanda Campbell, MSN, PMHNP-BC, is a board-certified Psychiatric Mental Health Nurse Practitioner dedicated to providing compassionate, evidence-based psychiatric care to adults experiencing a wide range of mental health and co-occurring conditions. 

Amanda provides comprehensive psychiatric evaluations, medication management, and ongoing treatment planning as part of a multidisciplinary team. She believes in partnering with patients through shared decision-making, recognizing that each individual’s experiences, goals, and recovery journey are unique.

Amanda is committed to fostering a safe, supportive, and nonjudgmental therapeutic environment where patients feel heard and respected. She emphasizes evidence-based treatment, patient education, and practical strategies that empower individuals to build resilience, improve daily functioning, and achieve lasting mental wellness.

Nicole Hunter serves as Program Director with a leadership style rooted in authenticity, compassion, and lived experience. She has been in recovery from substance use for several years, and while recovery is the foundation of the life she has built, it is far more than something in her past—it continues to shape who she is, how she leads, and why she is so deeply passionate about helping others find their own path forward.

Nicole remembers what it felt like to walk into treatment, unsure of what life could look like on the other side. She also understands that recovery isn’t something we simply “graduate” from. Even years later, there are seasons when we need to reconnect with the tools, principles, and support that keep us grounded. Having experienced her own mental health challenges alongside recovery, she understands that healing is rarely one-dimensional. This perspective allows her to genuinely relate to individuals navigating both substance use and mental health, meeting them with empathy instead of judgment and hope instead of shame.

For Nicole, this work has never been just a career—it is deeply personal. Her passion comes from walking alongside people who are making one of the hardest and bravest decisions of their lives: choosing to rebuild. She believes there is something incredibly powerful about witnessing someone begin to believe in themselves again, often before they are able to see their own potential. Being trusted to share in that journey is something she never takes for granted.

Nicole believes every person deserves to feel seen, heard, and valued—not for who they might become someday, but for who they are the moment they walk through the door. No two clients are the same, and she is committed to ensuring treatment reflects the unique strengths, challenges, goals, and experiences of each individual. She believes healing happens through individualized care, genuine connection, and creating an environment where people feel safe enough to be honest and supported enough to grow.

Nicole’s clinical philosophy combines evidence-based practices with the belief that the therapeutic relationship itself is one of the most powerful tools for change. Throughout her years working in behavioral health across a variety of clinical and leadership roles, she has developed a flexible, person-centered approach that meets individuals where they are while empowering them to discover where they are capable of going. She celebrates every step forward, knowing that meaningful progress is often made through small, consistent victories rather than dramatic breakthroughs.

Whether she is supporting clients or leading the multidisciplinary team at the program, Nicole lives by the principle of unconditional positive regard. She believes people grow when they feel respected, challenged, supported, and genuinely believed in. She strives to create a culture where clients and staff alike feel empowered to learn, take healthy risks, and recognize their own strengths.

Above all, Nicole believes that recovery is possible, healing is possible, and that every person deserves individualized care, unwavering respect, and the opportunity to build a life they are proud of. Her goal is simple: to help create a space where people feel safe enough to be honest, supported enough to grow, and empowered enough to realize that lasting change is within reach.

Bill Abbate brings more than 16 years of experience in the substance use disorder field, along with over 17 years of sustained recovery, providing him with a unique combination of professional expertise and lived experience. Throughout his career, Bill has remained deeply committed to helping individuals and families discover hope, healing, and lasting recovery through compassionate, person-centered care.

Beginning his career as a Recovery Aide, Bill gained invaluable hands-on experience across the continuum of addiction treatment, developing a comprehensive understanding of the challenges individuals face at every stage of recovery. His dedication, leadership, and passion for serving others have guided his progression into his current role as Director of Patient & Family Services.

At Lion Heart Behavioral Health, Bill leads the Patient and Family Services Department, overseeing the Family Support and Recovery Coaching Program. He is responsible for developing and coordinating recovery coaching services, supporting and training family coaches, and ensuring patients and their loved ones receive consistent, evidence-informed care throughout the recovery process. Bill believes that lasting recovery extends beyond the individual and that empowering families is an essential component of long-term healing.

Bill holds credentials as a Licensed Alcohol and Drug Counselor II (LADC II), Certified Addiction Recovery Coach (CARC), and National Certified Peer Recovery Support Specialist (NCPRSS). His leadership style blends clinical best practices with the power of lived experience, allowing him to build authentic relationships while fostering resilience, accountability, and hope among both patients and staff.

Known for his warmth, authenticity, and unwavering commitment to the recovery community, Bill is passionate about helping individuals recognize that recovery is not only possible—it can become a foundation for a fulfilling and purpose-driven life.

Outside of his professional role, Bill remains actively involved in recovery communities and enjoys attending recovery-focused events across the country. When he’s not supporting others, he enjoys traveling, motorcycling, surfing, and snowboarding. He is also a proud father who values family, connection, and living a life rooted in gratitude and service.

From the beginning of her career, Liz Forgue-McRae has believed that the best leaders are coaches first.

Her passion for helping others began long before entering the counseling profession as a competitive swim coach and manager at the YMCA, where she coached and mentored nearly 200 swimmers. Known for her unwavering encouragement and enthusiasm, Liz spent years helping young athletes push beyond perceived limitations, celebrate accomplishments, and develop confidence both in and out of the water. That same philosophy continues to shape her leadership and clinical approach today.

Liz earned her Bachelor of Arts in Philosophy from the University of Massachusetts Dartmouth before completing her Master of Arts in Mental Health Counseling at Bridgewater State University. She is a Licensed Mental Health Counselor in both Massachusetts and Rhode Island and is a Certified Clinical Supervisor through the Massachusetts Mental Health Counselors Association (MAMHCA).

With more than a decade of experience across the behavioral healthcare continuum, Liz has provided leadership and clinical services within inpatient, outpatient, partial hospitalization (PHP), intensive outpatient (IOP), and community-based treatment settings. Her professional experience includes program development, clinical supervision, staff training, compliance and quality improvement, and multidisciplinary leadership.

Liz has extensive experience working with first responders, active-duty service members, veterans, healthcare professionals, and individuals navigating co-occurring mental health and substance use disorders. She is passionate about creating environments where individuals feel supported, empowered, and equipped to achieve lasting recovery and personal growth.

As Clinical Director, Liz is dedicated to fostering a culture of clinical excellence through compassionate leadership, evidence-based treatment, and meaningful collaboration. She believes exceptional care begins with exceptional teams and is committed to mentoring clinicians while ensuring every client receives high-quality, individualized treatment.

Whether leading a clinical team, developing innovative programming, or supporting individuals through life’s most difficult challenges, Liz remains guided by the same principle that first inspired her career: helping people recognize their strengths, overcome obstacles, and realize their full potential.