If you’re new to therapy, the whole process can seem daunting, confusing, or even scary.
It’s also common to wonder how to pick the right therapist, alongside having questions around general session etiquette, like what you should say — or not say. If you can relate, know that you’re not alone.
To provide some reassurance, we spoke with two therapists for their tips on how to get the most out of your therapy sessions. Here’s their take on what to keep in mind before, during, and after your therapy sessions.
Research different therapists
There are several different types of therapy you can try. Since every individual is unique, there’s no one-size-fits-all approach for any mental health condition.
For example, if you’re living with depression, you may find CBT (Cognitive Behavioral Therapy) to be a useful modality. If you are ready to work through some difficult memories from your past, you might gravitate more towards EMDR (Eye Movement Desensitization and Reprocessing). Further, those living with a substance use disorder may prefer group therapy with peers.
With so many options to choose from, you may find it helpful to run questions by a few different licensed therapists, licensed clinical social workers (LCSWs), and family therapists, based on your needs.
Finding the right fit is important, as research indicates that the better the therapeutic alliance, the better the treatment outcomes will be. It’s okay if it takes a couple of tries to find the right fit.
Steven Band, a Grow Therapy LPC with 17 years of experience, advises, “When looking for a new therapist, you can look for someone who has experience in the areas that you are seeking support and growth. Ask them for a 10-minute conversation to see if you have a good vibe or connection before scheduling the first appointment.”
Early in the therapeutic process is also a good time to discuss specific “lenses” of experience that are important to you, like an LGBTQIA therapist or someone with a specific religious or cultural background. You can also discuss different formats for talk therapy, like face-to-face sessions, virtual, or even sessions with a family member.
Eliminate distractions
When it comes time to schedule your first appointment, be sure to pick your slot carefully. It can be difficult to fully engage in therapy if you know you have a big deadline looming or a difficult class coming up. Think about scheduling your appointments during a lighter part of your week.
Before the session starts, find a few minutes to collect yourself and become fully present. This could look like turning off your phone and taking some deep breaths. You may also find it helpful to wear comfortable clothing so you feel as relaxed as possible.
If you’re doing therapy over the phone or virtually, make sure you’re in a place with few distractions; this could mean closing the windows or putting pets in another room — unless they provide some much-needed comfort, of course.
You can even close your door and put a sign on it to ensure that you have plenty of uninterrupted alone time.
Handle the ‘admin stuff’ up-front
Before you arrive in therapy, research co-pays and insurance policies to ensure there are no surprises. This will help make sure that you can spend as much time as possible focusing on the prescribed therapy techniques, rather than on administrative matters.
Also make sure you’ve filled out all the necessary paperwork before your first session.
“Be sure to complete the intake form and any assessments your therapist has emailed you so they can prepare for your session better and make good use of your initial session,“ says Band.
Additionally, some people like to set their next appointment date at the beginning of the session, so it’s one less thing to take care of. Others prefer to wrap up the session by setting up the next appointment as a transition. Discuss with your psychotherapist what works best for you.
Set clear intentions
There is some research to suggest that setting clear goals can help with therapy outcomes, but there’s no one way to go about it. Figure out what works best for you and discuss this with your therapist.
“Setting goals is important for maximum success in therapy,” says Band. “If you don’t have clear goals, your therapist can help you clarify them at your first session and then ongoing as needed. Goals and clarity of your motivation are crucial for focusing on what you’re working towards and how to push yourself when you feel uncomfortable during your growth process.”
Spend some time thinking about what brought you to therapy and what you’d like to achieve. Some of your goals may include:
- An improved quality of life.
- A reduction in your symptoms.
- Better work and home relationships.
- A clear path forward about a certain issue.
- Sticking to your self-care or medication regime.
Try to be as specific as possible without putting too much pressure on yourself. For example, rather than “I want to feel better,” perhaps you could aim for something more concrete, like, “I want to learn how to manage my panic attacks more effectively.”
Remember to be patient and gentle with yourself when working toward your goals. While you may have “aha” moments, the big and lasting changes often take time. It’s probably not going to happen overnight — and that’s okay.
John Neiska Marshall, an LPC with Grow Therapy, says, “Sometimes goals can be very difficult to stick to. I really believe in long-term and short-term goals; most modern therapists use the SMART (Specific. Measurable. Achievable. Relevant. Time-bound.) goal format, and it works.”
Before each session, think about your goals. You may find it helpful to jot down a couple of topics that you’d like to touch on. For example, maybe you want to go over the big events that happened during the last week, or talk about insights you’ve had since your last session.
Understand the therapeutic relationship
Your relationship with your therapist is different from a typical confidante.
“Keep the relationship professional and have clear boundaries with each other. This doesn’t mean you can’t be cordial and friendly during a session; it’s OK to laugh and enjoy the process,” says Band.
In the first session, a good therapist will go over their code of ethics and professional boundaries with you. For example, everything you say is confidential, with a few exceptions about self-harm or harming others, according to the American Psychological Association (APA).
You also don’t need to worry about the rules of a normal conversation or reciprocity in individual therapy, like asking them about their life or other personal questions. While it may feel awkward at first, you are allowed to keep things 100% about you.
The only other time a therapist would share your notes is for psychiatric purposes, and only with your permission. If you’re working with a psychiatrist (PsyD) who is prescribing you medication, it’s important for them to understand your treatment plans.
Let your therapist facilitate the flow
It’s natural to wonder what you’re supposed to say when you get to therapy. If you find it difficult to open up — don’t worry. Your therapist is trained to facilitate a dialogue and get the ball rolling. The only thing you need to do is go in with an open mind.
You also don’t need to worry about the clock. Your therapist will gently let you know when it’s time to wrap up, likely with plenty of time to transition out of the session. Just try to focus on why you’re there and what you’d like to discuss.
For some people, it takes time to develop a rapport and build trust. In this case, you may find it helpful to start with lighter topics, like venting, and slowly move towards the “big stuff” whenever you’re ready.
Be authentic
Many people have fears about doing therapy “right.”
The good news is, there is no right way to do it. Therapy is a highly individualized process; it looks different for everyone. This is, perhaps, the one place in your life where you don’t have to worry about coming in looking perfect.
You are encouraged to:
- Ask questions.
- Be open and honest.
- Process your raw emotions.
- Say when you feel nervous.
- Avoid filtering or self-editing.
- Ask for clarification on tricky topics.
- Take notes to remember important points.
- Speak up if things get uncomfortable.
- Express any concerns about therapy.
If possible, try to avoid the temptation to lie or omit details about your life, like substance use or relationship issues. Research shows that many people lie in therapy, which means your therapist won’t have the whole picture to work with. Try to remember that they aren’t there to judge you; they’re there to support you. Therapy is a confidential space and you’re allowed to come in exactly as you are.
Steven explains, “Being authentic is important and is a goal I encourage my clients to strive towards. In session, you can be open and honest with your therapist. You don’t need to put on a pretense or facade to look good, you can let your ego defense down and be comfortable with your emotions and feelings.”
Come prepared to do ‘the work’
Doing “the work” can look different for everyone. JohnNeiska says it could be “challenging yourself, getting comfortable with the uncomfortable and processing — all the things you’ve never done before.”
While a therapist can act as a great guide and gently point out certain patterns, know upfront that they can’t tell you exactly what to do. The therapeutic process is more like a collaboration between the two of you.
Not only that, but therapy itself is hard work. Not only is it a time and financial commitment, but some sessions can feel draining, confusing, or like you’re spinning your wheels. For some, it can feel like things are getting a little worse before they get better, the same way that it hurts to pull out a splinter (but once it’s out, it’s out).
“Explore inside yourself, be open and honest about your feelings of shame or guilt and become open to being vulnerable. Vulnerability is not a weakness as many people think it is, it actually takes courage and inner strength to be vulnerable,” advises Band.
“I challenge my clients to explore their core fears and irrational beliefs, which can be uncomfortable for some, yet this is all part of doing your personal growth work for the rest of your life.”
Expect that there will be days when you want to quit therapy — and that’s OK. Try to stick with it anyway and remember your “why.” Those difficult feelings will pass if you trust the process.
Schedule sessions consistently
It’s easier to stay on the treadmill then stop and start, right?
Research shows more favorable outcomes for people that receive therapy on a consistent schedule in outpatient settings. It’s common for people to seek therapy about once a week, but work with your therapist to figure out the best schedule for you.
At a certain point, you may feel like it’s appropriate to see your therapist less frequently. Instead of once a week, for example, you may scale back to once a month or once a quarter. You can always come back and do “tune-ups” for big life changes or whenever you’re having a hard time, as needed.
Think about aftercare
Be kind to yourself always, but especially after therapy.
It can be difficult to jump right back into everyday life after you’ve been talking about heavy topics — especially trauma. Think about a soothing debrief strategy, like a nice walk in the park or some quiet time. Try to leave some space between therapy and the next thing you have to do.
If you need to, set boundaries with loved ones. Some people like to talk to a trusted confidant about what happened in therapy, while others don’t like to rehash it. It’s up to you what works best.
In general, try to practice good self-care outside of sessions and pay attention to your physical health. Make sure you’re eating balanced meals, sleeping enough, and spending time on your hobbies. It’s important to balance out “the work” in therapy with restful, nourishing activities.
Put your insights into practice
Therapy is one of those areas of life where you will get as much out of it as you put in.
The good news is, therapy doesn’t have to end when you leave the office. A mental health professional may assign you some homework assignments to practice in between sessions, especially if you’re doing CBT.
Individuals who incorporate the skills and insights gained from therapy into their daily lives tend to achieve better outcomes compared to those who do not, with a percentage ranging from 20% to 50% of study participants.
The homework tasks will be dependent on your goals in therapy, but some examples could be setting boundaries with a loved one, putting yourself out there, or doing something that challenges you (within reason, of course).
“Staying accountable during therapy can be staying mindful of your goals and motivation for change and being honest with yourself. It can also be setting healthy boundaries and maintaining them to respect yourself, and holding the people in your life accountable to respect your boundaries,” says Band.
Another way to keep the momentum going in between sessions is to develop a reflective practice to help you connect with yourself on a regular basis. You could consider meditation, unplugged walks in nature, creating artwork about your feelings, or journaling about your day.
Schedule periodic check-ins
Accountability can be a potent motivator in therapy. Discuss how to best monitor your progress and track positive changes over time with your therapist.
During periodic check-ins, you can talk about:
- How things are going, overall.
- Any changes to your goals.
- Adjustments in your treatment plan.
- Changes you’d like to make to the therapeutic process.
On particularly tough days, or when you feel like things aren’t working fast enough, it can be really encouraging to have your therapist read back old notes to see how far you’ve come. “The motivation that comes from seeing progress in real-time can make goals easier to stick to. This is why I always incorporate some type of scheduled questionnaire and a personable narrative therapy session once a month,” says Marshall.
It’s also important to be honest with your therapist if you feel like something’s not working. Band adds, “If you ever feel that you’re not getting what you need from your therapist, you should communicate that and let them know what you need or want from them in your sessions.”
Try to enjoy the process
While psychotherapy can be an uncomfortable process, there will be good moments, too.
Don’t forget to celebrate the fact that you’re doing something transformative and powerful for yourself. Not everyone is up for the task! But you’re showing up, in spite of the challenges, and that’s a really big deal. When you reach a goal or milestone, take time out to celebrate that important win before diving into the next one.
Key takeaways
It’s natural to feel apprehensive about therapy and need some reassurance.
There are many tips that can help ensure things go smoothly before, during, and after therapy sessions, like setting clear goals, giving yourself plenty of time to achieve them, and setting up periodic check-ins to see how things are going.
When in doubt, talk to your therapist about any questions that you have. You are not the first person to ever ask those questions, and you certainly won’t be the last. If you’re ready to start the process and find a therapist who meets your needs, begin your search today.