How do I get the most out of therapy?
There’s a lot more to therapy than just booking your session and turning up. Psychological support can be time-consuming and expensive, so here’s how to get the most out of it:
1. Come prepared
Coming prepared to a therapy session is one of the best ways to get the most out of it.
I always tell clients to start a new note in their phone titled ‘therapy’ or ‘things to raise with psychologist’. In between each session I get them to log when they experienced a particular emotion or thought, or when their depression/anxiety/trauma/eating disorder seemed strongest, or anything that occurred during the time between sessions that they don’t want to forget – such as an argument, or skill practice, or new thought, memory, or idea.
At the very least, write a mental list as you drive to the session or even whilst you sit in the waiting room. Ask yourself – when did I feel my best this week, why was that? When did I feel my worst this week, why was that? Did I try anything different this week in regards to my mental health? What got in the way of doing something different, what barriers presented themselves? What thought patterns did I notice most, was there a particular ‘story’ that my brain got caught up in?
However, if you can’t think of anything, or nothing comes to mind – don’t necessarily assume you have to cancel your session, or that it will be a waste of time. Let your psychologist know and ask them for what they think you still need to work on, or anything that can be picked up from previous sessions.
2. Be honest
Let your psychologist know how you’re feeling about therapy. If something isn’t working, share it. If you don’t understand the reason for doing something, tell them. If you think the homework they’ve set isn’t achievable, raise this. If you’re unsure if you’re making progress, or if you want to come less frequently or stop coming all together, let them know. If they tried to summarise what’s happening for you and it doesn’t fit, correct them. If they make a suggestion about your experience that feels like it missed the mark, say it.
Don’t be afraid to be radically honest in therapy. Your psychologist can’t (always!) guess how you’re thinking or feeling, so you need to share it.
I often tell clients to never put their psychologist’s feelings above their own – don’t be afraid to hurt your psychologist’s feelings. I guarantee that they can handle it, in fact – they want to know when they’re wrong or when it’s not working for you!
3. Know that most of the work happens out of the room
If you come to therapy once a week, that’s 1 hour in 168 (or .6%). If you come once a fortnight, that 1 in 336 hours (or .3%). Once a month, it’s 1 in 744 hours (or .1%). This is a tiny fraction of your life.
Now – we know quantity doesn’t always equable quality! Just a few hours of therapy spaced over a few weeks or months can have a huge effect on someone’s life.
However, we have to be realistic that the vast majority of your life is spent outside of the therapy room. What you do outside the room is going to have an impact. Depending on your goals for therapy, it’s probably going to be helpful if you end each session with a summary of ‘take home’ points and an achievable list of things to practice or action.
There are also a range of self-guided therapy resources to help you continue your therapy journey outside of sessions. These are often much more affordable than psychological sessions, and help you learn about mental health concepts to raise with your psychologist.
Ask your psychologist for recommendations of books to read or podcasts to listen to. There are also free self-paced therapy courses online (such as ‘This Way Up’ by St Vincent’s Hospital). Simple journaling can also be amazingly powerful – and there are many free prompts found online if you’re not sure where to start. Alternatively look for a ‘Thought Log’ worksheet.
4. Be curious about your own expectations
What did you think therapy would be? Before you attend therapy, ask yourself – what do I want to get out of this? What do I imagine therapy to be? Do I want it to be structured and practical? Or do I want it to be a safe place to share my inner world? Do I expect this to be easy or hard? What type of character do I want my psychologist to have?
If you’re currently doing therapy, or have done therapy in the past – ask these questions also. Are your expectations matching reality?
Expectations of therapy are tricky! Because therapy is always done behind closed doors, often the only knowledge we have of psychology sessions comes from television and movies. However, this isn’t always very accurate (namely – the whole ‘lying down on the couch’ thing!). So we want to acknowledge and explore our expectations, and we want to use them to guide what our needs for therapy are. However, it’s best to go into therapy with an open mind about what actually happens.
5. Notice ‘the process’
Some of therapy is the content. Some of therapy is the process. Content is anything that you discuss or learn – it’s the topics covered and skills learnt. The process, however, is the experience of doing this. It’s what happens in your body and your mind as you discuss the topics or skills. It’s noticing what it’s like for you to share and learn things. It’s the awareness of what happens in the therapeutic relationship between you and your psychologist as you do therapy.
To give an example: a few years ago, a friend of mine tried to teach me to drive a manual car (after 10+ years of driving an automatic). The content I learnt was how to change the gears, and when to use the clutch, how to do a hill start, and which gear to be in when. The process was noticing that I didn’t like having thoughts that I was ‘bad’ at something, it was noticing that I felt ‘small’ around a friend I previous felt equal to as they taught me, it was finding myself reluctant to make mistakes, and frustrated at myself for not picking up things ‘quick enough’. I learnt cars, driving, and myself in this situation!
It’s the same in therapy. You’ll obviously want to pay attention to what content your learning (perhaps what triggers your mental health concerns, which skills help you regulate, how to sleep better, how to communicate more effectively, etc). But also notice the process of therapy – what thoughts and feelings and sensations arise in your mind and body when you do the work. Mindfulness or present moment awareness can help with this. As you become aware of the process, you can raise our observations with your psychologist by saying things like:
- ‘as you said that, I noticed that I felt embarrassed and scared’
- ‘I’m finding that I’m struggling with a mental block around this topic’
- ‘when you suggest things like that, I’ve found it makes me less likely to speak to you about -----‘
- ‘last session, I noticed there was a feeling in my chest I couldn’t make sense of, and it was weird’
- ‘I think I sometimes overshare about ---- topic, because I’m trying to avoid bringing up ----‘
- ‘one part of me felt excited to try that, and another part of me feels sceptical’
It’s never too late to begin trying to make the most of therapy. Overall, it’s a process that takes time and is always adaptable to change.
