Jack: Hi, this is Jack from reachout.com. This is part one in a two-part series on how a CBT therapy session is conducted. For support and advice in a personal crisis, call Lifeline on 13 11 14 or go to lifeline.org.au. Speaker 2: In this episode, we meet Zach, who's seeing a therapist for the first time. Although he was reluctant to give it a go, a friend has recommended it due to some problem Zach has been having with what could be a form of depression. Jenny: Hi, Zach. You found the place okay? Zach: Yeah. Yeah. It was a little confusing, but yeah, yeah, I found it. Jenny: Most people get lost their first time, so don't worry. Zach: Cool. Jenny: So as we have a chat, I might take some notes which I'll refer to while I recap as we go. Is that okay? Zach: Yeah, that's fine. Jenny: So throughout the sessions, in particular, just while we're getting to know each other, you'll probably notice, I like to ask a lot of questions, mainly because I'm aiming to understand you as best as possible. However, feel free to ask me questions too. Okay? Zach: Yep. Okay. Jenny: Also, I like to check in with you at every session, just so that you can let me know how you think things are going. Is that all right? Zach: Yeah. That's all right. Jenny: So what's going on with you at the moment, Zach? Zach: My friend, Tam, she said she's been to see you before. Jenny: Yeah. Zach: She told me I should come. Jenny: Did you ask her to recommend a therapist? Zach: Oh yeah, mainly because I've been having trouble with work and that. Jenny: Okay. And what about work has been so difficult? Zach: I've been taking heaps of days off because I've been feeling really... I don't know. Like some days I just feel like I can't go in. My boss has given me an official warning and said that I just can't call in sick anymore. Jenny: And what sort of work do you do? Zach: At a cafe. Jenny: Is it a good place to work usually? Zach: Yeah. Yeah. I mean, as far as work goes, it's pretty good actually. Tam works there and a few of her mates, so yeah, yeah, I like it. Jenny: And why do you think it's occasionally been hard to go to work? Zach: Oh, I don't know. Some days I just feel really like... I'll be getting ready. Have a shower and stuff. But then, I'll start feeling really nervous, overwhelmed and sad. And I've been having trouble sleeping. So sometimes I wake up feeling really tired. And yeah, if I know I have to get up for a shift, I get even more stressed out so it's harder to get to sleep the night before. Yeah. Jenny: Mm-hmm (affirmative). Zach: I end up feeling so bad that I have to go back to bed and then call in sick. Jenny: Okay. And do you get that feeling on days when you're not working? Zach: Sometimes, yeah, but not as much. Jenny: And how long would you say it usually takes to go from feeling fine to feeling like you can't do what you were hoping to do? Zach: Well, I'll wake up with the feeling sometimes, but generally, 15 or 20 minutes. Once I start thinking it could get worse, it does. And I start to feel really stressed out and pretty anxious, I guess. Jenny: And do you notice any other physical symptoms when you're in that frame of mind? Zach: Yeah, my breathing's heavy and my heart's pounding, or else, I'm just like really exhausted. Jenny: Okay. And besides your friend Tam, do you have anyone else you talk to about the way you feeling? Zach: Nah, not really. I don't know many people in the city. Jenny: Mm-hmm (affirmative). Zach: I moved here from the Central Coast about a year ago. Jenny: Did you move by yourself? Zach: Yeah, I had to. I got kicked out of the house when I was 18. Jenny: Oh, okay. That sounds pretty difficult. Zach: Yeah. It got pretty intense. Jenny: And did the disagreements you had with your dad build up over a long period? Zach: Yeah. I mean, I think it's because, well, I'm gay. And when I told him, he didn't take it well. Jenny: And what about your mom? Zach: Oh, she left when I was 13. Jenny: Well, that must have been hard. Zach: Yep. Jenny: Do you have any siblings? Zach: Yeah, yeah. I have a younger brother. He's 12. And a step-brother and sister. They're both little, from my dad's second marriage. Jenny: And what's your relationship with dad's new partner like? Zach: Yeah, not good. Jenny: And what's the relationship like between your siblings and your dad? Zach: Pretty good. I mean, they're young, so it's pretty easy for them, I guess. Jenny: Mm-hmm (affirmative). Well, Zach, it sounds like you've been through a lot in the last couple of years. Zach: Yeah. Jenny: Do you think you can make some time to see me once a week or once every two weeks? Zach: Yeah. Yeah. Cool. Yeah. I've usually got a few days to myself each week. Jenny: Okay. That's great. Well, basically I'd like for us to have a look at your thoughts and feelings leading up to and during those days when you just can't leave the house. I may also give you a little homework exercise too, but don't worry, it's all pretty easy. So this is a process based around something called CBT or cognitive behavioral therapy. Have you heard of that before? Zach: No, I haven't. Jenny: Okay. So what it is, it's a process that's designed to give you, well, basically a set of tools for you to use in your daily life, to bring some awareness around your thoughts and emotions and the behavior that relates to those thoughts and emotions, basically, so that you can feel like you're more in control, and you won't be missing out on opportunities because you're feeling too overwhelmed. Does that sound okay? Zach: Yeah. Yeah, I think so. Jenny: So if you like, we can make an appointment for next Monday. And in the meantime, feel free to give me a call if you're feeling like anything is becoming too much and if you're finding it just basically too hard to get out the house. Zach: Okay. Thanks. Jenny: Well, Zach, thanks for taking the time to come and speak to me today. How do you reckon things went? Zach: Yeah. Good. I'm still a little unsure about... I mean, I don't know if- Jenny: Are you a little unsure about the idea of coming to therapy? Zach: Yeah. Sorry. Jenny: It's okay. Look, that's fine. And it's not necessarily easy. So basically, yeah, come and see me in a couple of weeks time and we'll take it from there. Zach: Cool. All right. I will. Jenny: Great. I look forward to seeing you then, Zach. Speaker 2: Zach made his way back home. In the back of his mind, he was fearful about how unpredictable his thoughts and emotions could be. But he liked Jenny and was happy to go back to see her again. He liked the way she made him feel comfortable and how the session felt easier than he'd expected it to. He had work the next day, but he was dreading it less than usual. Jack: Look out for part two in this series on how a CBT therapy session is conducted. To begin your journey towards CBT, ReachOut recommends the following apps, LifeCharge and Behavioral Experiments-CBT, both available in the App Store. And for support and advice in a personal crisis, call Lifeline on 13 11 14 or go to lifeline.org.au.