A day in the life of me as a cognitive behaviour therapist

When people imagine therapy, they might picture a therapist in a cosy office, a comfy chair, and a day full of asking, “And how does that make you feel?” While there is some truth to that image, the reality of a day in the life of a Cognitive Behaviour Therapist (CBT therapist) is both more structured and more dynamic. Here's a glimpse into what my day usually looks like—not just the sessions, but the work that happens behind the scenes.

7:00 AM – Mindfulness Before the Mayhem

I’d like to say I start my day with 10 minutes of mindfulness meditation but, in reality it takes me a little while to fully wake up and feel human! I shower and get dressed, wake my two boys, grab some breakfast and set off on the school run. Mindfulness however does help me centre myself before diving into the emotional terrain of others. As a CBT therapist, it’s essential to stay grounded; I can’t support others effectively if I’m not mentally present myself. I therefore regularly notice my surroundings in detail for a few minutes throughout the day using my strongest senses of sight, sound and touch. I also have two reminders in my phone to alert me throughout the day to take 3 breaths. These breaths are slow, calm, and deep belly breaths that get my circulation going and create a pause button for me to recentre and refocus. I attend a Tai Chi group once a week so use some of those stretches as a grounding technique also.

8:00 AM – Reviewing the Day Ahead

With a glass of water in hand, I open my schedule for the day. I typically see 3-4 clients, each with different presenting issues: anxiety, depression, obsessive-compulsive disorder, or sometimes social and health anxiety. I review their case notes and any progress since our last session, mentally preparing for each one. Even between sessions I am often holding them in mind, letting my curiosity flow. I find that going for a walk generates ideas and questions about things I would like to explore more about in the next session.

9:00 AM – First Session: Tackling Health Anxiety

Amy Langshaw in a therapy session with client

My first client today is a mum that struggles with health anxiety. We’re halfway through a 12-session treatment plan. Today’s goal is cognitive restructuring—identifying and challenging catastrophic thoughts like “Any chest pain means I’m having a heart attack.” We use thought records and role play to shift her thinking toward more balanced interpretations.

10:15 AM – Exposure Planning with OCD Client

Next up: a client with OCD and emetophobia (vomit phobia). We’re working on exposure and response prevention (ERP). Today’s session involves designing an exposure hierarchy—it might start with small, manageable triggers and gradually working up. It’s tough but powerful work. Progress in CBT often comes from sitting with discomfort rather than avoiding it. My role is to take this journey with them, not to reassure them but more to support and guide through the process.

11:30 AM – Clinical Supervision

Once a month, I meet with a supervisor to discuss challenging cases. Supervision keeps me sharp, ethical, and reflective. Today, I bring up a client who seems resistant to CBT strategies. We brainstorm ways to increase engagement—perhaps more behavioural experiments or adjusting the pace.

12:30 PM – A Breather

Lunch isn’t always glamorous—usually something quick to eat. If I can fit in a short walk to clear my head, I’ll do that at lunch time or while I’m waiting for my children at pick up time after school. If I can’t get out at lunchtime, I may use a bit of time to jot down notes, catch up on emails, write next month’s blog or plan my social media content.

1:30 PM – Discovery call

Today I have a discovery call on Zoom with a mum that is struggling with overwhelm. She came across my website when searching for CBT therapists in her area. I have some brief details that she worries a lot, struggles to concentrate and does not enjoy spending time with her baby daughter. The discovery calls are usually only about 25 minutes and is a chance for me to find out more about a person’s current struggles, see if CBT is a good fit, and a chance for them to ask me any questions about the process or about my experience. People often think that reaching out for help is the beginning of the journey to mental wellbeing. I prefer to see it as the first step. I believe the beginning of the journey to mental wellbeing starts when therapy ends, and they move forward with new learning and knowledge to make further positive changes in their life.

2:30 PM – Session with a dad struggling with stress.

I have some time before this session to refocus my thoughts and prepare for the session ahead. This dad has had four sessions where we have been talking about what may be causing his stress, what is maintaining it and possible ways forward. Using a daily diary noting the situation, thoughts, behaviours, emotions and physical sensations, we identified that there is no time for him or his partner. The day begins being a parent, goes straight into work mode, pauses later in the day to do parent tasks and puts the kids to bed, then back to work mode catching up on emails, to finish the day scrolling on social media until he falls into restless sleep. He doesn’t see friends anymore and misses the football club he used to belong to. Once we identify the patterns, we can then begin to challenge any unhelpful thinking styles, and list all the options he has for change such as experimenting with some alternative activities in the day like mindful breaks, alternative sleep routines, or building in time for socialising and exercising.

4:00 PM – End-of-Day Admin, school pick up, logging off and letting go

After my final session, I collect my children from school and begin preparing our dinner. There’s always admin for writing clinical notes, updating treatment plans, reading new studies or books and on particular disorders that interest me. The paperwork is crucial—accurate records ensure continuity and quality of care. However, I have two non-negotiable boundaries in place for my wellbeing which are time for me and time with my children. This might include my hobbies of cross-stitch, dancing, crafting or going to the gym; and also taking my children to their after-school clubs, watching a movie with them or going for a walk.

I keep my laptop and work phone in the study to keep it separate from home life. Closing my laptop doesn’t immediately switch off my brain, but over time I’ve learned the art of “emotional closure.” That evening walk or a good book helps me transition out of therapist mode and into my own life.

Why I Love This Work

Being a CBT therapist is helping people examine how their thoughts and behaviours influence their emotions—and how small, intentional changes can create real transformation. Every day brings new challenges, but also moments of genuine hope. Working for myself also challenges me to step out of my comfort zone at times like learning to do blogs, social media posts, networking with people I’ve never met, meeting up with colleagues and collaborating on new projects, and attending training sessions to further my knowledge.

If you would like to know more about CBT and how it could help you then you can use my contact form on the Home page, or email me at amy_langshaw@outlook.com