What is typically the first step in cognitive-behavioral therapy?

The first step in cognitive-behavioral therapy (CBT) involves identifying cognitive distortions. This foundational aspect is essential because CBT focuses on the relationship between thoughts, feelings, and behaviors. By recognizing and understanding cognitive distortions—such as all-or-nothing thinking, overgeneralization, or catastrophizing—clients can begin to see how these flawed thought patterns contribute to their emotional distress and problematic behaviors.

Identifying cognitive distortions allows both the therapist and the client to pinpoint specific thoughts that may be contributing to issues such as anxiety, depression, or other emotional challenges. This step is crucial for framing future sessions, guiding conversations around feelings and behaviors, and ultimately facilitating changes in thought patterns.

While setting goals for therapy, developing a treatment plan, and building a therapeutic alliance are all important components of the therapeutic process, they typically occur after the initial identification of cognitive distortions. Identifying these distortions sets the stage for the specific goals and interventions that will follow in the therapy.