Five Ways to Get the Most Out of Therapy

bouquet by couchSam and Alex entered individual therapy at about the same time, with the same therapist. Both wanted to work on similar relationship issues, and both have similar histories. Sam usually keeps appointments, but sometimes cancels. Alex almost always attends sessions and reschedules, rather than cancels, when conflicts arise. Sam is very reflective, open, honest, and willing to explore difficult areas in sessions, but life outside of the therapy room remains largely unchanged. Alex works hard in sessions and takes risks by trying on new behaviors between sessions. Alex also tries to do as much journaling and reflecting as time permits between sessions.

Who do you think will make the most progress? Who do you think will create positive change faster?

Truthfully, it is impossible to tell who will make the most progress and on what timetable. There are infinite variables, even in the cases of Sam and Alex, who have so many similarities right down to having the same therapist. Despite the similarities, they are still two unique human beings who could experience the exact same event very differently. It’s possible that Alex is getting started with gusto, but might begin to feel overwhelmed and terminate therapy prematurely. Sam might warm up a bit more slowly, but might ultimately stick with it and create tremendous positive change. The complexity of human nature and the uniqueness of every human being cannot be oversimplified, but it is certainly reasonable to think that someone in therapy who is attending sessions and working hard, both inside and outside of the therapy room, might get better results, faster than someone who is less invested and less committed. So, once you’ve taken the bold step of beginning therapy, the question becomes: How can you make the most of it?

First, make therapy a priority. When you have a conflict, try to work with your therapist to reschedule as opposed to canceling whenever possible. There will be times when rescheduling is impossible and the session just has to wait until the following week. If this happens, try to carve out some time, even if it is just a few minutes, to journal and/or reflect on what might have been discussed if you had a session that week. Perhaps you could do some reading on some of the issues you are dealing with in therapy. If you are further along in the process and have moved into a more action-oriented phase of therapy, consider trying on a new behavior or taking a risk during an off week. In other words, if you have to miss a session, try to do something on your own to further the process.

Second, talk to your therapist. Therapists are not psychics! While therapists are skilled at reading people, deciphering body language, and making meaning of the unsaid, they cannot read your mind. If you are feeling like things are moving along too quickly and you are overwhelmed, talk to your therapist about this. If your therapist knows this is happening, he or she might work with you to develop coping strategies that will help you to manage the emotions that come up in therapy. You might also find that at some point in therapy, you become angry at your therapist. Your therapist might say or do something, or not say or do something, that hurts or disappoints you. If this happens, talk to your therapist about this. These kinds of conversations are difficult to have with anyone, but having one with your therapist can be healing and instructive. Not only will you likely resolve the issue with your therapist, but you will develop a model for how to have these kinds of conversations with others in your life. It’s a safe space to practice handling conflict in a healthy way.

The therapy room is a great place to start taking these risks and trying new things, but for real change, you have to take this outside the therapy room.

Third, take therapy with you throughout the week. People often come to therapy because they are very unhappy with some aspect of their lives and they want things to be different. If you want to see changes in your life, you have to take risks and try new things. The therapy room is a great place to start taking these risks and trying new things, but for real change, you have to take this outside the therapy room. If you are having a difficult time making this transition, you might want to consider joining a therapy group. Groups can provide another safe, therapeutic environment for taking risks and trying out new behaviors. They can be a great intermediate step between practicing change in individual therapy and implementing change in your life.

Fourth, read, journal, and/or reflect between sessions. A therapy hour is a very different kind of hour. It can be packed with more thoughts and feelings than you might experience in a full day. You might find that you leave your sessions feeling like there is so much more to say and process (this may be especially true when you begin therapy or when you begin discussing a new issue with your therapist). Rather than trying to push it all aside and come back to it next week, consider digging into it. Read books, articles, and blogs addressing the issues you are working on. Journal and reflect on what you are thinking and feeling. This will keep the momentum of exploration and change moving forward.

Finally, take care of yourself physically. Getting a full night’s sleep, exercising, and healthy eating will give your body the resources it needs to take you down the path to growth and change.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Sarah Noel, MS, LMHC, therapist in Brooklyn, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • mel g

    March 11th, 2014 at 10:49 AM

    It does have to be a priority in your life for it to make a real difference. Anything that you want to make an inpact in life has to be that way. You don’t expect to make any big changes by going to the gym once a week or eating right only occasionally, so why should you expect to make any life changes on an emotional level by not committing to therapy except when it is convenient to you?

  • Amy Armstrong

    Amy Armstrong

    March 11th, 2014 at 1:47 PM

    I think I’m going to recommend this post on my website. Going to sessions is so important for continuing to make progress. Also, I don’t think anyone emphasizes enough that therapists are not mind-readers. I understand that people come to therapy for all kinds of reasons, but communication skills usually need work regardless of the presenting problem. So, I definitely do try to intuit as much as I can from the client’s natural way of sharing information with me. All that said, I have to make my own interpretations of their words, actions and behavior, and there’s a lot of guess-work involved. I really appreciate it when a client articulates his or her preferences. Even at that, it sometimes becomes clear that the client still does not know exactly what they want, but even having an incomplete thought out there to work with is better than starting from a guess.

  • peter

    March 13th, 2014 at 1:52 PM

    I would honestly be lost without my phone, so I don’t see what the big deal is about them. I don’t let it stand in the way of other people, but when I need it I do want it to be there.

    http://www.goodtherapy.org/blog/five-ways-to-get-the-most-out-of-therapy-0310144
    A big mistake that I made in the past was going to therapy, making so great breakthroughs in that hour that I was there, and then forgetting all of those things the minute that I walked out the door. It’s like I would do so well when I was there and someone was holding my hand and guiding me but then when I left I would forget everything that we would talk about and then slip back into what was familiar and routine. I know that this was not the healthy thing for me to do and I hope that in my new venture with therapy I am going to be able to take what I learn in my sessions and actually find a way to apply that when I walk out the door. I know that this is the only way to see some real changes that I need in my life.

  • June

    March 14th, 2014 at 4:03 AM

    definitely write down stuff during the week, stuff that comes up so that you don’t forget about what you need to talk about later

  • Sarah Noel, MS, LMHC

    Sarah Noel, MS, LMHC

    March 27th, 2014 at 9:04 PM

    June, writing things down during the week to serve as a reminder of what you want to discuss is a great strategy for maximizing session time.

    Peter, it sounds like you laid some pretty good groundwork in previous therapy and now you are ready to take it to the next level. If you have trouble applying what you are doing in the room in the outside world, ask your therapist for some help with that.

    Amy, I’m so glad that this resonated with you and that I am not the only therapist who sometimes wishes for psychic abilities!

    Mel, I agree 100%!

    Thanks everyone for reading and commenting!

  • maru

    November 8th, 2014 at 2:56 PM

    Having done a few therapy sessions I think having a journal would help, sometimes I have felt overwhelmed by the emotions that I feel talking about my life. And generally talking has helped I just need to remember the good advice.

  • Gina

    December 22nd, 2015 at 1:25 AM

    My husband has humored me in attending counseling. I’ve done it on and off most my life and find it beneficial for me and my baggage. Now on marriage issues, there has been times we saught help. New therapist rather than join mine as he automatically feels they are on my side. So i found a couple others. One session and he quit. Feels he’s always right. Despite below the belt verbal assaults. He will not listen to others as he beliefs he knows best. Hasn’t done the process long enough to know that what said in session stays there. He’d berate me at times after. Left pissed off when it’s not judgement but addressing what’s getting us stepping back. Manipulated the therapists words so that he’d manipulate them agreeing with his position. He brings up shit we’ve resolved 10 years ago. Fought about but must list my faults like I need reminding. He takes no responsibility. Realizing his anger is always first emotion he shares but I know 24 hrs I can see concern, fear, vulnerability, disappointment. I appear to let him Down often. His standards are high and anything less is unacceptable. I have health problems but I got to push through cause he’s had to. His pain tolerance high. Like my oldest. Aspergers my son DX at 8. Believe husband is as well. His vicious mouth, I’d rather be beaten. Can’t unring that bell of his true feelings he has of me because truth comes in anger. I’m accepting. I’m a pleaser. I do not expect perfection. He courted me like no other. I independent and took him a lot for me to eat a meal. I was 30, he’s younger few yrs. we agreed I’d be a stay at home mom long before I realized my oldest son of two had suffered until we knew his DX. Took 5 years. He’s 13. Last 4 years great but this year is like 101. Mind you it’s very stressful in the home. I husband didn’t read up on it. Thought I was insane in my pursuit for answers. BUT MY GUT TOLD ME I WAS RIGHT. He’s detached from school involvement, his therapy, treatments new resources etc. it’s an extra strain in a marriage. Yes he’s included to an extent but doesn’t see it as big as I make it. All the decisions I must choose alone; family denies his DX to. My son has no friends. Feels invisible. I battle schools not having a clue about these kids. Some are super great but some don’t follow accommodations which gets heated cause I gotta make sure the IEP is followed. All my therapists and doctors tell me ” for you, therapy will be on how to manage the family dynamic without them involved. I used to argue back with my husband in the early years. But it go on for hours. Repeating I’m lacking somewhere. When he pursued me, told him I’m not domesticated I hate cooking. I worked corporate America. Over time feels entitled to meals nightly, but he’s picky, what I know how to cook he won’t eat. I’m more a short order cook nightly so fuck it. I do not enjoy it. I do not want to take classes. I hate grocery shopping. He’s a good 275 so he’s well fed at lunch meetings but I’m not a nutritionist and what little free time I’m not studying dietary so he can lose weight o top of him poss expecting to home school my oldest. I’m educated but not a teacher for a special needs kid. Looks and acts normal. Doesn’t get jokes or sarcasm. Sensitive to feelings of others where my husband uses no filter and has crossed the line so mAny times lost count. I’m consumed with worry. Hubby self made. Hates school quit 9th grade so encouraging school to the kids is because it means so much to me. I can go on. I want to find a therapist he will see the process out some, someone who calls him out despite his intimidating and rude treatment. Berates who he feels attacks him first then he unleashes, even his wife. I’m tired of getting him in the process because some therapy would benefit everybody. Think he’s in denial about his boy. It’s complicated. Doubt this will be read anyways cause too long but thank you the release of these thoughts help some. Over time I do not stand up for myself with him as I cannot listens to his words. I will says over years less episodes but when an episode comes on it’s really really bad. Rather he hit me would hurt less. I’ll take anybody who can get in a man like this face. All therapists to this point refuse to see him further

  • D. Rachel C

    May 25th, 2017 at 4:26 AM

    Excellent article. Countless clients have plopped down in front of me and literally said fix me but return week after week without implementing what we discussed. They eventually drop out of therapy but want an instant appointment when they are in a crisis.
    I would add make sure the therapist has lots of experience in treating your concern. I limit my treatment areas to exogenous or situational depression and anxiety. This is where I am most effective and have years of experience. Clients who come to therapy and actually do the work only need a few sessions to get better.

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