How to Get the Most Out of Therapy

As someone who has been in therapy, I feel like it’s one of the best investments one can make. Being able to speak with a non-judgmental third party in confidence allowed me to not only discuss topics I felt were “off limits” with others, but also helped me see situations in a new, thought-provoking way.

Of course, I use the word “investment” because therapy costs money. So, today’s blog post is all about how to get the most “bang for your buck” so that you can truly reap the benefits that therapy can offer.

1. Be honest with your therapist.

I always remind people that the only thing I care about is if something is helping or hurting you. For example, if you tell me you have 20 sexual partners and love it, I wouldn’t care about the number, though I might ask about if you’re using protection to ensure that you’re staying physically safe. If you tell me you are having sex with 20 partners but constantly feel ashamed of yourself, I would only care about that, not the number of people you’re sleeping with.

In addition to the fact that therapists are literally trained to be non-judgmental, know that we have honestly heard it all. It’s nearly impossible to say something that will shock me in session because talking about emotions, “embarrassing” behaviours, addictions, drugs, porn, etc. is my normal. Just as a massage therapist sees a back for its musculature versus its nakedness, I see your behaviours as symptoms and/or resources versus “problems.”

Finally, you’ll likely get a lot more out of therapy if you're fully honest with your therapist. There’s not much to gain from paying someone to help you with the PG version of what you’re going through; we want the raw stuff because working on that usually catalyzes the most change.

2. Set realistic expectations.

Look, I get it: maybe you’ve been feeling like crap for a really long time and you’re starting to feel really hopeless. You’re sick of feeling depressed. You’re sick of worrying about nonsensical things all day long. I hear you and am so sorry that you have gotten to this point.

BUT…

Change takes time. Your therapist is trying to change habits you've been doing for maybe your entire life. Our 50-minute sessions have a lot to go up against, so don’t expect to come in for one session and leave a new person. Don't expect to come for twenty sessions and leave a new person if your presenting concern is something pervasive and deeply engrained. While I promise I will work my butt off during our sessions—and provide whatever tools I can to help you in between—I am a therapist, not a wizard.

Also, while my knowledge and expertise play a significant role in your journey, I'm relying on you to want to change. I'm relying on you to know that change takes work, which can be completely and utterly uncomfortable at times. In a culture that is so used to instant gratification, this can be a really hard pill to swallow so take some time to process this if need be. And have some compassion for yourself. We are looking for progress, not perfection.

As an aside, it’s worth noting how quickly I have seen change happen in my practice. When I reflect on why this typically happens, it usually occurs with individuals who do the work, embrace the discomfort, and collaborate with me so we can use both of our knowledge and expertise to get the ball rolling.

My goal is to get you to the stretch zone!

That said, I am also aware that change looks different on everyone. For some people, simply imagining setting a boundary is a humongous step that’s worth celebrating, whereas another person’s victory might mean saying yes more. It’s all relative. The point is that you and I create metrics of success that mean something to you and find that balance between pushing yourself out of your comfort zone without going too far (see graphic to the left).

3. Be specific about your goals.

Consider this scenario:

Doctor: So, what brings you to my office today? Chest pains? Blood pressure issues?

Patient: I don’t know.

Doctor: …Are you having any symptoms?

Patient: Yeah, just not sure what.

Doctor: How would you like me to help you then?

Patient: I just want you to make me feel better.

^ accurate portrayal of my face in these situations

This is a common experience for me as a therapist. People will come in saying they “aren’t happy” and “want to feel better” without having any idea of what they’d like to work on. Don’t get me wrong: therapy is a collaborative process and it’s my job is to help you articulate this with more precision, but the key word here is collaborative. After all, you’re the expert of your own life!

Saying you just “want to be happier” is tough for me as a practitioner, too. I don’t know what “happy” looks like on you. I don’t know what you value or what you’d like to be working towards. Here are some examples of how you can clarify your goals:

• I want my relationship to be better —> I want us to avoid escalating during arguments.

• I want to be happier —> I want to reconnect with activities that used to bring my joy.

• I want to feel less lonely —> I want to develop deeper connections with people.

Now we’re talking!

4. Give your therapist feedback.

If I’m working on something you don’t want to be working on, tell me. If the ‘homework’ I’m giving you feels totally useless, let me know. It’s important to be open with your therapist for two reasons:

a) Your therapist will adjust themselves accordingly so that your time together is as valuable as possible.

b) Giving your therapist feedback is an example of you practicing assertive communication and boundary setting in a safe place—something that many people struggle with in the real world.

Of course, a good therapist will create an environment that makes is less scary and awkward to voice these concerns in the first place and won’t take your feedback as a personal attack. (If you feel as though your therapist is completely closed off to your preferences or needs, find a new one.)

5. Do your homework.

I only get 50 minutes with someone once every week or two. While there’s a lot of important work that happens during that time, the real work often happens between sessions—in the other 23 hours of the day and the rest of the week.

For example, exposure and response prevention (ERP) is often a key component of treating anxiety disorders. This involves slowly and gradually exposing yourself to your fears so that you can rewire your brain and help it learn that the perceived threat is not actually threatening. However, research tells us that ERP only works when it happens repeatedly and for a long enough period of time. In other words, working on this once a week with your therapist won’t be nearly as beneficial.

Additionally, another function of “homework” exercises is for us to gain data; it helps us look at how symptoms are showing up in the real world and identify common themes, patterns, triggers, and more, which gives us a lot to work with in session so we can create effective, lasting change. I know you’re busy—and I know adding “therapy homework” to your to-do list can be stressful—but again, it’s a great way to make sure you’re getting bang for your buck from your investment.

The Bottom Line

Therapy was literally a life-changing endeavour for me and I’m so passionate about providing others with a similar experience. I will always do my absolute best to help you feel supported and respected—and believe me when I say that I spend countless hours outside of our sessions trying to be the best therapist I can for you, whether that’s through reading books, brainstorming ideas between sessions, watching webinars, and more.

That said, two heads are better than one. Be a team-mate to your therapist by communicating openly, clarifying your goals, and doing the work between sessions when applicable. I promise you’ll thank yourself later.

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