Welcome to Your 2nd Online Psychotherapy Session


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Select the face that represents your anxiety rating for this goal.

What is your anticipated anxiety for this challenge?

Let's talk more about CBT

The type of therapy that you have been referred for is called Cognitive Behavioural Therapy, (CBT) for short.

Cognitive means thoughts that you have, any thoughts.

Behaviour means anything that you do.

So this therapy works with your thoughts and behaviour to help you make some changes in your life.

This Is The CBT Model

This may look complicated, but I will explain it.

There are 4 things that we all share as humans. We all have Thoughts, Emotions, Physical Symptoms, and Behaviours.

These 4 things all influence each other.

For example, my thoughts influence my emotions and my emotions influence my thoughts.

Let's look at an example

Imagine you are busy working from home and taking care of the kids.

Since morning you have been constantly coughing and sneezing.

What do you think is the reason for all the coughing and sneezing.

Maybe It Is My Allergy!

If you have had seasonal allergies for years, with the spring coming, the sneezing and coughing could be due to your allergy.

Let's say you thought it was your allergy. What emotion might you be experiencing?

I don't know about you, but I would just pop some antihistamines and go back to my life.

We are in the middle of a pandemic!

But this is not like any other spring. COVID-19 has been rampant and many people in your city have contracted the disease.

Knowing that, what might you think was the cause of your sneezing and coughing?

Maybe you have caught it too!

What Now?

  • If you thought you caught COVID,
  • How might you feel?
  • What physical symptoms would you have?
  • What would you do?

How Does CBT Work?

Notice how these answers are different from when you thought it was just your seasonal allergy. You can have entirely different experiences based on what you think, even without evidence of what caused the coughing and sneezing.

CBT works with this idea. It works to change the thoughts that are causing your anxious feelings. It’s not the situation that causes our experiences, but how we interpret the situation.

What We Cannot Change

There are many reasons for why we might think something bad will happen.

Our brains might be sensitive to incoming information.

Or we may have learned from past experience to be afraid.

These are the things that we can't really change.

What We Can Change

Our thoughts and our behaviours can also make things seem scary. But the good news is, we can change these.

How Does CBT Work?

CBT works with this idea.

It works to change the thoughts that are causing your anxious feelings.

It's not the situation that causes our experiences, but how we interpret the situation.

Let's talk about Deep breathing

There are different breathing exercises that you could try and see which one works better for you in  each situation. Some might work better then others.

Belly Breathing

Belly breathing is easy to do and very relaxing. This can be done anytime you need to relax or relieve stress.

To do belly breathing, you should do:


Sit or lie flat in a comfortable position and put one hand on your belly just below your ribs and the other hand on your chest.

You should take a deep breath in through you nose, and let your belly push your hand out.


Your chest should not move.

You should breathe out through pursed lips as if you are whistling.


You should feel the hand on your belly go in, and use it to push all the air out.

You should do this breathing 3 to 10 times and take your time with each breath out through pursed lips as if you are whistling.


Take a moment and notice how you feel at the end of the exercise.

4-7-8 Breathing

Another breathing exercise that uses belly breathing to help you relax is 4-7-8 breathing.


The exercise can be done either by sitting or laying down.

To start, one hand should be on the belly and the other hand on the chest as in the belly breathing exercise


You should take a deep slow breath and silently count from 1 to 7.

Then you should breath out completely as you silently count from 1 to 8 and try to get all the air out of your lungs by the time you count to 8.


You have to repeat these 3 to 7 times or until you feel calm.

Try to document how you feel at the end of the exercise.

Roll Breathing

  • Roll breathing helps to develop full use of your lungs and to focus on the rhythm of your breathing.
  • You can do it in any position. But while you are learning, it is best to lie on your back with your knees bent
  • You should put your left hand onyour belly and your right hand on your chest and notice how your hand moves as your breath in and out.
  • You should practice filling your lower lungs by breathing.
  • You should always breathe in through your nose and breathe out through your mouth and do these 8 to 10 times.
  • When you have filled and emptied your lower lungs 8 to 10 times, you should add the second step to your breathing, you should inhale first into your lower lungs as before, and then continue inhaling into your upper chest by breathing slowly and regularly.
  • You should practice breathing in and out in this way for 3 to 5 minutes and notice the movement of your belly and chest rises and falls like the motion of rolling waves.

Again take a moment and notice how you feel at the end of the exercise.

Morning Breathing

This is a breathing exercise that can be tried when you first get up in the morning to relieve muscle stiffness. Then use it throughout the day to relieve back tension.

In this breathing exercise, from a standing position, bend forward from the waist with your knees slightly bent, letting your arms dangle to the floor.

As you inhale slowly and deeply, you return to a standing potion by rolling up slowing lifting your head last, you will hold your breath for just a few seconds in this standing position and then exhale slowly as you return to the original position, bending forward from the waist.


Practice one of the breathing techniques you learned today, in a stressful situation which makes you feel anxious.

Next Session

Congratulations on completing session two.

Your therapist will give you feedback on your assignments and will answer your questions on the next session.