Therapy can seem like a mystery. What do you talk about? Can you really be honest? How do you know if you’re getting better?
Before you even walk through the door, you also may have certain preconceived notions, which can stifle your progress: Being a good client means being polite and rarely asking questions. Being a good client means never disagreeing with your therapist.
Below, clinicians spill 10 important ways you can make the most of therapy.
1. Choose carefully.
“You may be in a hurry to find answers for your problems, but it’s a good idea to take the time to carefully choose your therapist,” said Ryan Howes, Ph.D, a clinical psychologist in Pasadena, Calif.
He suggested researching different types of therapists and approaches, selecting several clinicians who seem to offer what you seek, and talking over the phone with each one, or trying out a single session.
“Evaluate them not just on their credentials, but on how comfortable you feel talking with each of them. Then pick one, and dive in.”
If you’re not sure about your new therapist or the process overall, psychotherapist Bridget Levy, LCPC, suggested giving it at least three sessions — “unless it is very clear after the first or second session that the therapist is not a fit.”
2. View therapy as a collaboration.
According to Susan Lager, LICSW, a psychotherapist and relationship coach in Portsmouth, New Hampshire, therapy is an interactive process. Express your needs, ask questions, read books, and do the “homework assignments,” she said.
For instance, this may involve telling your therapist what you’d like to discuss during a session, informing them that a certain appointment time doesn’t work for you or asking for clarification, she said.
Couples may do homework assignments that include taking turns brainstorming ideas for quality time and creating a plan of action, she said.
3. Schedule sessions at a good time.
This means scheduling your appointments when you can give them full attention, Lager said. For instance, avoid scheduling a session in “the middle of a work day when you have to be ‘on’ right afterward. Give yourself time and space to process and reflect around the therapy hour.”
4. Say anything in therapy.
“Some people censor themselves in therapy for fear of judgment or appearing impolite,” said Howes. However, he encourages clients to say whatever they want, because doing so is what really leads to progress.
He gave this example: A client discloses that they didn’t want to come to therapy today. This opens the door to honestly discussing how they feel about therapy, making adjustments that’ll help or clarifying what makes today feel so difficult.
Mentioning seemingly unrelated points also can be helpful. For instance, “a discussion about their work brings to mind a memory from their childhood that doesn’t seem to fit, and we work to find the connection.”
Even a client saying that Howes looks tired or might be frustrated because of something the client said can uncover important insights.
“Being a ‘good client’ doesn’t mean being on your very best behavior, it means being the most authentic, unfiltered version of yourself.”
5. Talk about therapy in therapy.
“To use an academic analogy, therapy is both a lecture and a laboratory,” Howes said. In other words, the issues you have outside of therapy often show up in session, he said. This is helpful since it gives you an opportunity to practice healthy coping and relational skills in a safe environment with your clinician.
Howes gave these examples: If you’re passive, you can practice being assertive. If you’re afraid of seeming “too needy” or you feel like you need to be strong for others, you can discuss just how tough your days have been.
6. Set markers for change.
“Establish markers with your therapist for positive change, so that you’ll be better able to track your progress and stay motivated,” Lager said. These markers include anything behavioral, emotional or attitudinal, which you can observe, she said.
For instance, this may include feeling happier or more energized, letting go of toxic people in your life, planning social dates or communicating to your boss about workplace issues, she said.
“Markers are like signposts, positive or negative, telling you what direction you’re moving toward.”
7. Have an order of operations.
Howes suggested handling “business first,” which includes “payment, scheduling, insurance and any other logistics.” (This is “much easier than trying to rush through it on your way out the door or after having a big emotional breakthrough.”)
Next, talk about any issues you have with your therapist. This is vital “because problems you have with her may have an impact on any other work you want to do.”
For instance, maybe your therapist angered you last week. Maybe you’d like to end therapy. Maybe you have a question about what you talked about last session. Raise these concerns in the beginning of your session, so you have plenty of time to process them, Howes said.
“Oftentimes, confronting your therapist can strengthen the therapeutic alliance and thus the therapy in general,” said Levy, director of business development at Urban Balance, a counseling practice in the Chicago area.
8. Do the work outside your sessions.
A therapy session typically lasts 50 minutes; however, in order to get the most out of it, it’s important to think of therapy as 24/7, Howes said.
“Keep a journal, reflect on your last session, prepare for your next one, and generally pay attention to your thoughts and feelings throughout the week. You’ll have much more material for your sessions, and you’ll find that you are applying the work to your everyday life.”
9. Set boundaries around therapy.
Create boundaries around who you talk to about your therapy, Lager said. This might mean not sharing details of your sessions with people who gossip or give unsolicited advice, she said.
When setting boundaries, the key is avoid “creating social pressure or unhelpful spheres of influence which might undermine your own self-trust, and confuse you.”
If you’re not selective about what you share, according to Lager, you’ll “unwittingly create a ‘peanut gallery,’ which can become opinionated, loud and an intrusive presence in the therapy work.”
10. Savor the process.
According to Howes, “Therapy is like taking a course where you are the topic. Enjoy the journey and soak in every tidbit you can; you never know when it might come in handy.”
“Therapy … can be an amazing, transformative process toward living a conscious life,” Lager said.