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What to Expect from a Cognitive Behavioral Therapy Session

Therapist talking to patietn in a cognitive behavioral therapy session

A form of talk therapy, cognitive behavioral therapy (CBT) employs behavior-based solutions to deal with emotional and physiological difficulties. Evidence suggests it may be as effective as medication and other types of treatment, either on its own or in conjunction with them, to manage chronic neurologic conditions.

“At its best, CBT is a time-limited program in which the therapist clarifies the issues at hand and implements an active plan,” says Scott E. Hirsch, MD, associate professor of neurology at NYU School of Medicine.

It requires a full commitment from patients who must agree to attend every session and do the homework and follow the action plan, says Teshamae Monteith, MD, FAAN. It doesn’t work for everyone, she says, but the treatment is safe and affordable and can be very effective, especially when combined with existing therapies.

Here are the parameters of a typical CBT experience.


Patients usually meet with a therapist or psychologist in an office, but sessions can also be conducted via teleconferencing or smartphone apps.


Sessions generally last between five and 20 weeks, depending on the patient’s needs.


Therapists help patients establish specific goals—such as “I’d like to miss fewer workdays due to migraine pain” or “I’d like to reduce the anxiety I feel about taking my medications”—and then focus on achieving those goals.


Patients learn and practice mindfulness and relaxation exercises. They may also be asked to track their progress in a notebook or online. The therapist may provide a printed manual or handout to help with daily work. The goal is to apply CBT techniques to everyday challenges throughout the course of therapy and beyond.