Getting the Most Out of Psychotherapy

Nobody wants to waste their efforts, and let’s face it, therapy is a significant investment of time, energy and financial resources. So I decided to write a this short piece to help you get the most out of the investment you are making in counseling. As a psychologist, nothing is more satisfying than seeing my clients improve. Some of the ways that I have seen people change has been truly inspiring. Because I want all of my clients to be able to experience this type of change, I started thinking about the characteristics of my most successful clients. Why is it that some clients, even those with very significant problems, can improve quickly and dramatically while others make only modest gains over long periods? Are some people just able to change quickly while others are not?

As it turns out, the characteristics that give someone the potential to make the most of therapy are quite simple and can be used by anyone. My hope is that in sharing this information, my clients will be able to use it to get the maximum benefit from the time we spend together.

1. Make your appointments a priority.

If you’ve ever tried to learn a new skill—from riding a bike to getting in shape at the gym—you have probably seen that consistency is key. Frequently canceling and pushing back appointments will hinder and prevent progress in therapy. The clients that get better the fastest come to every appointment without exception. When I worked in Buffalo, NY, I had one client who walked for two hours after a snowstorm to come to his session.  While that may seem extreme, his commitment to his treatment and working towards his own goals ultimately led to great success. When you make appointments a priority, we will be able to build much greater momentum towards change, and be able to accomplish goals faster.

2. Be willing to try new things.

"If you always do what you've always done, you'll always get what you've always got." –Henry Ford.

I like this quote and believe it has a lot to do with getting the most out of psychotherapy. Any time you learn a new skill, it feels strange at first. In therapy you are going to learn practices and techniques that might be unfamiliar at first, but with practice they can become second nature.  What will make the difference is your willingness to at least try the skills. Try to approach these skills with a curiosity and an eagerness to try new things.

3. Therapy requires you to set your own goals. 

Imagine if you went to your medical doctor’s office and when the doctor asked “so what brings you here today?” you just answered, “I don’t know.”  It’s a pretty safe bet that you would leave the office without receiving the right treatment. The same is true for psychotherapy. Therapy without goals is like driving without a destination. Ideal clients come prepared to each session with an agenda that they would like to have addressed in that session. They also identify the changes they would like to make at the beginning of treatment. 

4. Change happens outside of sessions.

The point of therapy is not to feel better for 45 minutes out of every week.  You come to therapy to make changes that affect the rest of your life. But if you only focus on change for 45 minutes a week, change may not come at all.  After all, a weekly session takes up less than 1% of your waking hours per week. For that reason, you should expect to think about and work on your therapy goals in-between sessions. Sometimes that might mean completing a worksheet or practicing a skill. Other times, it might just be taking some time to think about an important issue. I would go so far as to take notes on any improving or worsening of symptoms between sessions and bring these to your next session. It’s the completion of this “out-of-session practice” that can really make the difference.   

5. Give direct and honest feedback.

It is important to give any therapist feedback about what is and what isn’t working. You should never feel afraid of hurting your therapist's feelings. Honest feedback allows a therapist to do their job better and allows their services to become more effective. 

6. Finish Strong.

The length of time required for successful therapy varies based on the goals you set for yourself. But whatever the length of the treatment, it is important that treatment has a meaningful conclusion. Research has indicated that the way therapy is concluded affects how long the beneficial results last. As a result, it is important to have a conclusion to treatment where you and your therapist will review your progress and discuss your goals for the future. 

photo credit: Aproximando Ciência e Pessoas via photopin (license)