How to Make the Most Out of Therapy - 10 Tips
Did you know that mental health counseling can result in powerful and permanent biological changes in your brain? Were you aware that psychotherapy can help you lay down new neural pathways and that it can positively recalibrate your nervous system? It can truly be a powerful and amazing modality. Therapy can help facilitate a significant transformation within you.
But therapy is not something that happens to you.
The reality is that you can’t just show up, passively sit by, and expect your therapist to change you. Although you might wish your therapist could simply wave a magic wand over you and make all your goals come true (one big wave and poof, you’d no longer struggle with binge eating!), the reality is that you need to be an active, engaged participant in the process. Oh, and you’ll also want to be engaged beyond just the time you spend with your therapist . . . read on to learn more!
Here are ten ways to help you make the most out of your therapy sessions
1. Select the Right Therapist
This is the first step in the process. Did you know that one of the most important factors for change is the relationship you have with your therapist? In fact, it can matter more than any specific skill-set they might have. It can be tempting to seek out a therapist who operates from a certain theory or who employs a certain technique. You may be thinking that the type of therapy and the therapeutic tools employed by a particular therapist will be the magic cure you’ve been chasing. But research shows that having good rapport with your therapist matters much more than any particular treatment modality they might use. So one of the biggest things to consider is - do you feel comfortable with the therapist and do you like them?
It can be helpful to look for a therapist who is specialized in the areas in which you’re struggling. Do they have a good understanding of what you’re dealing with? If you find you can’t stop binge eating, is the therapist familiar with this challenge and do they have insight regarding how to assist you with this? Not all therapists do. This is to be expected because it is very difficult to be all things to all people. No therapist can know everything.
It might also be useful to consider what background they might have. For example, are you Christian (or Jewish or Muslim, etc.) and would you like for your therapist to be familiar with your faith? It might matter to you, or maybe it doesn’t. Keep in mind that your therapist does not need to be a mirror image of you. Be mindful that therapy is focused on you, and is not about what your therapist thinks about the world. In fact, counseling programs train us to be nonjudgmental and to put ourselves aside. The therapy session is about you, not the therapist. The conversations held in therapy are unlike any you will have elsewhere as they are very one-sided. Your therapist might share parts of themselves, but only if it is in service of you.
Nowadays, many therapists offer a consultation which gives you the chance to chat with them and helps you assess their style. Do they seem warm and inviting? Do you feel listened to? What does your gut tell you when you speak with them?
2. Prioritize Therapy
Attend your sessions. Be on time. It is usually best to have a set, standing appointment. This helps ensure a time is blocked off for you on your therapist’s calendar (nobody else can take your spot!) and helps increase accountability.
Keep in mind that when sessions are too infrequent, or when they are spaced too far apart, there is an interruption in the process and the benefits are often negatively impacted. When you see your therapist less often, treatment may be less effective and there may be too much between session drift – for example, skills are not being reinforced and explored frequently enough.
3. Prepare for Your Therapy Appointment
What do you think will benefit you most – telling your therapist your week was fine and you don’t know what you want to talk about, or coming prepared with things which have been on your mind which you’d like to work on?
Many people will arrive at their therapy appointment and say they have no idea what they want to talk about. This is normal and quite common, but as you might guess it doesn’t necessarily allow you to make the most of treatment.
Usually, when I first begin seeing a client, I tend to provide more education and structure. In part, there is typically information I feel you would benefit from knowing. Also, too, I know it can be awkward sharing with someone you don’t know too well. However, therapy isn’t just showing up and expecting your therapist to give a TED Talk each week. Yes, education is an ongoing component, but therapy is not a formal weekly lecture series.
Over time, I expect you to become more active and involved. The therapy session is your chance to work on your goals and make progress. We can’t do that effectively if we spend the time talking about the less meaningful minutia of your life because you haven’t given any thought to what you want to work on and talk about during our time together.
Your therapist can certainly help guide you, but there’s much you can do to better take advantage of the appointment and make the most out of your time. For example, when you’re not in session, be mindful of thoughts which come up for you, along with any important topics you might want to discuss in session. Spend time reflecting on what has happened since your last session – what has been challenging? What isn’t working and where might you be getting stuck? Did you have any relationship struggles and communication difficulties? Did something over the past week cause you upset and distress? Was there anything that went well and which provided you insight?
Therapy isn’t for spectators. It’s a full-on contact team sport. Your therapist is there to work with you, but you have to carry the responsibility of sharing and opening up about the challenges in your life.
In reality, even if you sat in bed all week doing nothing, you probably had lots of thoughts and emotions brewing inside you. You perhaps had quite a few conversations in your head and reflections on things past and future. Share them. Write them down if it helps and bring them to your session.
I know you likely don’t want to pay to spend time talking to me about irrelevant stuff – so come prepared with what you do want to work on. What has been happening in the past week and what do you think about it? Let’s talk about it!
4. Practice Between Sessions
If your therapist assigns homework and asks you to do stuff throughout the week it usually means they are invested in helping you reach your goals. They’ve taken time to think about what is happening for you and have selected activities which they believe will benefit you. Maybe there is an article they think you should read, or perhaps there is a journaling exercise they think you’d benefit from completing, or they might even suggest venturing out into the world to complete an experiment. Trust that your therapist has a good sense of the things that work. Make the effort to follow through on your assignments.
As a therapist, a big difference I’ve noticed between the clients who achieve their goals and those who stay perpetually stuck involves who is practicing outside of sessions. If a client is actively engaged in the work outside of our 50-minute weekly session, I expect their progress to usually be better and faster. For those who don’t spend much (if any) time working on things between sessions, I am never surprised when they decide therapy just isn’t working for them.
Again – remember that therapy does not happen to you, it happens with you!
Sure, the in-session work matters. But you’re only with your therapist for a brief time. It’s the work which you do outside your appointments which will really move the needle forward. Without between session homework, all the insight, planning, and positive intentions you talked about with your therapist can easily be overshadowed by the unhelpful thoughts and behavior patterns which brought you to therapy in the first place. One hour of therapy stands little chance against the many hours you spend outside the therapy office. Homework is valuable for continuity of care throughout your week.
And if you’re not doing your homework? It’s important to discuss this with your therapist. Are you avoiding it because it makes you uncomfortable? Would something a little different be more suitable? It’s important to explore what is happening so that you and your therapist can work through it.
5. Remember it Takes Time and it is Not Easy
Therapy can be hard. It can mean finally sitting down to take a long, deeper look at some uncomfortable stuff. Change, in general, is not easy – and your therapist can help you understand more about why it is so difficult.
You come to therapy because what you’ve been doing isn’t working. You need to learn a different way. That requires effort. It requires patience and persistence. And if you find yourself confused or unsure about something, let your therapist know. We can’t help you if you don’t tell us!
Keep in mind that therapy is not a quick fix, so don’t give up without considering whether you’ve been really showing up and been active, and whether you’ve given it enough time. There is no set timeline on healing or growth, but it likely will take more than a few weeks. Many people will spend multiple months on the work, and for others it might be a process that lasts over a year. It might be helpful, too, to consider how you view therapy - do you view it from an illness or from a wellness perspective? With the illness model, therapy is akin to going to a physician in that you have certain symptoms and care concludes when you’ve addressed them. This might last several months. Alternatively, with the wellness model, therapy is more like going to the gym. You might have some problems which you wish to focus on, but then you also want to go further in developing yourself to your fullest potential. This might continue for years. Neither is better or worse. It just all depends on what you want. That said, be aware that some therapists only provide short term counseling and are not open to providing longer term wellness based therapy - so this might be something you wish to ask about before deciding on which therapist is the right fit for you.
Note that you may feel better just by simply beginning to talk with someone, yet you probably won’t reach your goals in just two or three weeks. Usually, it may take your therapist two or three sessions to really get a full understanding of your challenges - you’re a complex person, after all! And remember that it might take time before you really feel comfortable sharing some of your more personal, intimate details. It certainly can be hard to tell your secrets to someone during your first appointment.
It’s not uncommon for people to stop attending sessions once they start noticing some positive changes. Be wary of stopping too soon. Ending too quickly may mean you have not really gotten to the root of the problem. Only addressing superficial concerns can result in relapse. Sure, you maybe felt some symptom relief, but then you probably will find yourself returning to therapy again because you only put a band-aid on what is actually a much deeper wound. Before terminating, your symptoms should feel well controlled and you should feel well able to manage them if they resurface. You’ll also want to have a good sense of how to maintain the gains you’ve made.
All told, it’s important to be patient. We all grow and change at a different pace. Your story is unique to you - and your healing will likewise be unique.
6. Have Faith in the Process
Therapy might seem like it’s just a bunch of talking. But your therapist has spent a considerable amount of time on education and training. This isn’t your typical chat between friends. Your therapist is actively listening to you to notice patterns, cognitive distortions, barriers, faulty core beliefs, and a plethora of things you might not be noticing. You would probably be surprised by how much is going on in your therapist’s mind – it’s a lot! And your therapist thinks about you outside of sessions, too.
At times, it might seem like your therapist is forgetting your goals or going way off topic. Your therapist could simply be picking up on something which needs to be focused on. The therapist might hear something relevant you’ve said and may feel it’s important to spend time on that. Know that your therapist is very deliberate and they are always asking themselves “why” before they do things. We take the work seriously and don’t go about things in a willy-nilly fashion.
Additionally, be aware that each session probably won’t end neatly. Problems are managed over time rather than being solved in fifty minutes or less. Some weeks you might have good clarity, and other weeks you might be more confused. It’s all okay. The conversation will be ongoing.
7. Take Exceptionally Good Care of Yourself
You perhaps come to therapy expecting to talk – but talking will do little to move you toward your goals if your lifestyle is fast tracking in the opposite direction. If you aren’t willing to explore and adjust your daily behaviors (nutrition, sleep, movement, sun exposure, etc.), you will likely find yourself saying that therapy “isn’t working.” So, for example, if you drink large amounts of caffeine, it will be near impossible for us to talk your anxiety away. If you get barely any sleep then we will probably find ourselves stuck when it comes to making progress with your depression.
Because I specialize in treating binge eating and disordered eating, my clients usually expect that we will be discussing food. But in general, if you’re in therapy it will benefit you to be open to discussing all lifestyle factors. Be willing to consider how your habits might be impacting your progress.
Also, therapy can be heartbreaking, enlightening, exhausting, and invigorating. Do the work, but also be kind to yourself and take a break. So be proactive about growing and learning, but also be sure to give yourself room to rest – because change can take a lot out of you. And rest is actually an important component of good mental and physical well-being.
8. Consider Diving Deeper and Being More Vulnerable
It’s super easy to just shrug and say everything is fine. But it’s important to stop pretending that everything is okay. You need to talk about the stuff you don’t want to talk about.
There tends to be a lot of awkward, weird, confusing, and embarrassing stuff going on in our lives and in our heads. And sure, you perhaps don’t want to discuss these sort of things during your very first therapy session. Fair enough. A good therapist knows it takes time to build rapport and to develop comfort. We aren’t expecting you to open the floodgates right away – although if you do, that’s okay, too.
But do you really want to pay someone to help you work on your problems only to never actually talk about the down deep stuff? The more you say everything is okay, the less you will get from your treatment.
It is not unusual for clients to avoid the more troubling details for a very long time. In some cases, you want to appear like a “put together” person – the person you aspire to be. You end up putting on a bit of a show for your therapist. In such cases, you might even get upset because your therapist isn’t actually helping you with what you need help with. But are you giving them the chance to help or are you faking that you’re doing well?
Your therapist has, more than likely, seen and heard a lot. Most therapists have, at some point, worked with individuals who are severely mentally ill. You should expect them to be able to handle whatever you might tell them. You should expect that they won’t judge you for it. And unless you have plans to harm yourself, whatever you share will be kept confidential.
If you’re unsure about sharing, and feel nervous, simply tell your therapist that you are afraid to share. Your therapist can be expected to respond with care and compassion. Your reluctance to open up is something the therapist can work with you on. If the therapist doesn’t respond well, then perhaps finding an alternative therapist would be best.
But don’t keep things bottled up. Don’t spend forever keeping the dark stuff hidden. Be willing to expose it. Your therapist is not a mind reader and won’t know what you’re actually struggling with if you hesitate to share. Your therapist needs you to tell them what is happening and what you need. When you leave out information you prevent your therapist from gaining insights and from making connections that could be quite useful for helping you.
9. Try to Focus More on You and Less on “Them”
It feels good to vent about other people. But if you spend the majority of your therapy session talking about what other people are or are not doing, that is less time you spend focused on the only person you have control over – you. Perhaps you want to learn to communicate with other people better, or you need to work on setting better boundaries. Maybe you need to develop some coping skills to handle stress more effectively. Make the time more about you and your goals. It’s perfectly fine to vent, but be sure it isn’t all you do.
10. Use a Therapy Notebook
A lot of discussion can happen in a therapy session. It’s very easy to forget the useful stuff which might be covered. Taking notes can be helpful. It can be assistive to sit down after the appointment and reflect more on what you talked about. What are the tips you want to practice? What things can you be doing in your daily life? What insight did you gain during your session? It gives you a way to keep track of progress and have a record of what you’re learning. Additionally, it is a great reflection tool in that it allows you to see how you’re changing over time.
You might also want to use your notebook in between sessions as a place to track thoughts and happenings you’d like to talk about with your therapist. Write down your worries and fears. Encounter a problem during your week? Write it down! Often, we think of something meaningful we’d like to talk about, but then find ourselves unable to recall it while we are in session. Your therapist can only help you with the things you tell them about. Keeping a record helps you keep your therapist up to date on what is bothering you.
Remember, therapy is a great investment in yourself and you’ll likely notice much better progress if you fully commit to it. Show up AND do the work!