If you want to maximize the benefits of therapy, you should start by asking yourself these 10 questions:
- Are you taking your M.E.D.S.?
- Are you working on yourself in between sessions?
- Are you coming to your sessions prepared?
- Are you giving your full attention while you are in a session?
- Do you have clear and realistic goals for therapy?
- Do you have a way of tracking your progress?
- Have you communicated those goals to your therapist?
- Are you censoring yourself?
- Are you and your therapist a good match?
- Are you sharing what’s currently working and not working for you?
Are you taking your M.E.D.S. (Medication, exercise, diet, and sleep)?
There are countless reasons that you may be feeling off, but for your therapist to be able to help you feel better, they need to have some understanding of the cause. One of the things you can do to make sure you are getting the most out of your therapy session is to pay attention to: if you took your medication accordingly (if you are prescribed any); if you have been getting enough exercise recently; if your diet is well balanced; and if you are getting enough high quality sleep.
Human memory is fallible, so consider keeping a written record of these things, that way if you feel off you can be more confident that you know why. Then when you meet with your therapist asks you how you are doing that week, you can tell them, if you are having a hard time sleeping, for example. That way your therapist can work with you to figure out if your insomnia is a symptom of depression, which would be solved one way (with therapy), or a result of your neighbors having a baby, which is solved a very different way (with noise canceling headphones.)
Additionally, you won’t be able to tell if your therapy is working if factors like sleep and exercise are confounding the results. For example, if your anxiety is getting better, but because you’re sleep deprived for unrelated reasons, you may feel like your anxiety is the same or worse because the effect of sleep deprivation on the body, is similar to the effect of anxiety on the body.
Are you working on yourself in between sessions?
Every week for six weeks you’ve been meeting with your therapist for 30-60 minutes. They ask how you’re doing, and you update them on your problems. You feel a little better about your problems because you’ve been able to vent, but your problems aren’t getting any better. Why?
Well, your therapist isn’t supposed to “fix” you. Your therapist isn’t a repair man and you aren’t broken. They are more like a personal trainer for your mental health. If you are new to working out you may not be in great shape and your form may be all wrong - but that’s ok, it’s so much more important that you are actually willing to put in the work now. You didn’t hire a personal trainer to lift weights for you. You hired them to teach you how to do the heavy lifting safely while you become stronger, until such a time that you may not need them anymore depending on your goals. They are nice to have around to help you stretch out after a particularly hard session, to reduce soreness. It’s nice to know that you’ll always have someone willing and able to spot you if you know you are going to attempt something challenging for the first time.
The point is, you have to work on yourself in between sessions otherwise 30-60 minutes a week would never be enough time to see results. Ask your therapist for “homework” or reading if you have a hard time practicing what you learned in therapy in your daily life.
Are you coming to your sessions prepared?
Therapy sessions aren’t super long, but they are usually long enough if you come prepared. The problem is we often find ways of delaying talking about the very things we need to talk about the most, until we are out of time… because even though we are in therapy to talk about our problems, being vulnerable can still be aversive. (Fun fact: among therapists this phenomenon is called the “doorknob effect” or “doorknob revelations.”)
If you prepare for a therapy session, either by setting an agenda with your therapist about what you want to talk about before, or at the beginning of a session, you are much more likely to overcome your impulse to delay. Therapists can often tell when patients are avoiding touchy subjects, they probably even point it out to you incase you aren’t consciously aware, but they can’t force you to open up. As we discussed in the section above, the patient has to be willing to put in the work, and should only expect results proportionate to their own investment.
Are you giving your full attention while you are in a session?
Smartphones have a monopoly over our attention. If we aren’t compulsively checking them every few seconds, then they are ringing or vibrating, hijacking our thoughts. For this reason, it can be critical that you set your device to “do not disturb” while you are in a session. Your therapist will let you know when you are out of time, so unless there’s an emergency you owe it to yourself to be fully present for your therapy.
The other thing you can do to make sure you aren’t distracted during your meetings is to be thoughtful about when you schedule them. If you schedule your appointment during your lunch break, neither your Chick-fil-A nuggets nor your therapist will get the attention they deserve. Poor scheduling can also make therapy feel like just another chore on your to-do list, or a stressor that’s keeping you from more important things, like family and work. Sometimes you have to realize though that you can’t be your best self for your family, or at your job, if you aren’t taking care of yourself first. It’s one hour (or less) from your whole week (168 hours), you’re pay for it, you may as well get the most out of it. Before your next appointment, take a big deep breath, hold it in for five seconds, and then exhale for seven seconds. Remind yourself why you are getting therapy in the first place. Finally, thank yourself for doing something to secure your well being. If you still have a hard time staying focused with what you are talking about, or listening to your therapist, be sure to tell them so they can help.
Do you have clear and realistic goals for therapy?
You will get a lot more out of therapy if you know what it is you are working towards. It is totally okay for your goals in therapy to change overtime, so long as you are clear about what they are. Some people’s only goal in therapy is to talk to someone so as not to exhaust the goodwill of their loved one’s who may be unsympathetic to long standing issues -- that’s a perfectly good goal to have. Other people have goals to change how they feel or act in certain situations.
They say the trick with setting goals is to make them: specific, measurable, achievable, relevant and time-bound (i.e. “S.M.A.R.T.”). An example of a SMART therapy goal would be: to be able to eat at a restaurant alone in three months. (The timing is often the hardest component to be realistic about so ask your therapist for advice in your specific case.)
Do you have a way of tracking your progress?
As captured by the “M” in “SMART goals” it is important that you have a way of measuring whether or not you’ve made progress towards achieving your goals or not. Keep in mind that therapy sometimes makes people feel worse before they feel better, so “how you feel” may not be a representative measure of progress in therapy. The same is true of exercise, often the actual workout is physically unpleasant and taxing, but you do it because it’s going to make you stronger and healthier.
One of the easiest ways to track your progress in therapy is to talk to loved ones. Usually those closest to you will have the best sense of if you’ve changed somehow. Especially if they don’t see you that often, any changes will be more noticeable to them. Perhaps a better more precise way to track progress is to take a self-scoring inventory of your depression or anxiety levels before you being therapy, and then again after a few weeks, or months depending on what you are working on.
Have you communicated your goal to your therapist?
Psychologists are not mind readers… despite what your Uber might think. Again, your therapist is like a personal trainer. If you hire one and you don’t really have any fitness goals, they can still work with you, but you may not feel as motivated, or have an obvious way of tracking your progress. It’s better to just sit down with them and generate a few, and then change them as you start to learn more about yourself.
You may find that you hadn’t set goals because you were too scared. No goal felt realistic. Depression can make people feel hopeless like that. Your therapist will be able to show you how your thoughts are being distorted, and help you realize your goals.
Are you censoring yourself?
We can all get a little bit awkward when we have to talk about the birds and the bees… but if there’s anyone out there who isn’t going to kink shame you -- or whatever it is you are afraid of -- it’s your therapist. They’ve probably heard it before -- we tend not to be as special as we think -- but moreover your therapist essentially has a degree in not judging people.
Additionally, part of not censoring yourself in therapy is being able to confront your therapist if they have made you feel judged, or uncomfortable, or ashamed in any way, intentionally or otherwise, so that they can learn from their mistakes. Therapists are imperfect just like the rest of us, so don’t be afraid to give them feedback. They should respond positively, and if not… maybe they aren’t very good at their job and you should be working with someone else.
The point is, it’s very important you don’t censor yourself in therapy. Everything you say is strictly confidentially (so long as you don’t endanger yourself or anyone else). If you want to get the most out of therapy, don’t let your instinct to feel self-conscious hold you back.
Are you and your therapist a good match?
Now it is easier to not be self-conscious with some therapists than others, simply because we project. So when you are picking a therapist make sure you’re are going to be comfortable talking about sex with them uncensored. Maybe if they look like your grandma, it will be harder for you. Maybe not. Perhaps age makes no difference, but gender does. Especially if you are a victim of sexual assault by the opposite sex, working with a therapist of the opposite sex can be triggering.
Also while choosing a therapist if you have very severe or very specific issues, you want to make sure you are working with someone who is specialized in those areas. A good therapist will tell you if they come to realize they aren’t the best person to help you, and may refer you to someone else for further treatment.
If you want to get the most out of therapy, you need to be matched with the right therapist for you. That means that even if a co-worker really highly recommends a specific therapist, or the therapist’s resume is really impressive, it’s ok if things don’t click. Therapists are very understanding about these sorts of things, so even though it’s awkward, try not to be afraid to tell them if you intend to discontinue care.
Are you sharing what’s currently working and not working for you?
One last thing that you can do to get the most out of your therapy sessions is to tell your therapist what is and isn’t working for you. If you are just starting with a new therapist but you’ve been in some form of therapy before, share what did and didn’t work for you with your last mental health expert. You may need to meet more often, be assigned journaling activities, or simply just deal with logistics at the beginning of sessions instead of the end. Whatever your needs your therapist is there to support you, but they can’t if you don’t ask.
We hope this will act as a helpful resource to anyone currently undergoing or considering therapy. Please reach out if you have any questions as to how you can get more out of your sessions.