How to get the most out of therapy.

Written by: Phil Landry M.Ed. LPC


Making the decision to start therapy is the first big step. Part of the therapy process involves not only showing up, but learning how to use therapy.  With so many clients who come through our practice as first timers to therapy, I spend a lot of time educating people on how to best use the hour we have together to help them produce the kind of changes in their lives they are seeking.  I have learned some lessons about what makes for a successful therapy experience for my clients, and I want to pass on that knowledge to all of you. So once you get here, we can start to move through the jumbled emotions and experiences you've been holding onto and start to gain clarity on things.


1. Let's set some clear and specific goals to get you there.

You may have heard that therapy is a process. You may not have realized it, but ever since birth, you've been subtly at work with strengthening neural connections when it comes to the way you think, feel, and relate to your experiences. To begin working a new lifestyle, we'll start to set goals to help you stay intentional and focused on where you want the change to happen. There are two major categories of goals in therapy: emotional goals and behavioral goals.  Emotional goals involve changing feelings in some way. For example, “I want to stop feeling depressed,” “I want to feel less anxious,” or “I want to be more happy.”  Behavioral goals involve things that you do.  This can be a skill you practice internally, aka “I want to be more aware of my body to notice when my stress starts to increase,” (body scans would work well), “I want to improve my ability to focus during conversations and not get lost in my own thoughts,” (mindfulness meditation or practicing expanding awareness would be great options), or externally, “I want to start working out again,” or “I want to call my friends more often.”  

The distinction between emotional and behavioral goals is important because typically we have far more immediate control over behavioral goals than emotional goals. There is very little I can do in session to take away your full on experience of depression or anxiety, BUT we can help you move toward your emotional goals by helping you create smaller behavioral goals, aka the things you DO have control over. 


By doing this, we can then focus on defining and overcoming the barriers to implementing the behavioral goals with the idea that over time, you will achieve growth toward your emotional goals. EVERYONE experiences anxiety in some form. There is no such thing as happiness without pain. Often, I find that my clients’ greatest lesson they learn in therapy is that they can have the life they have always dreamed of EVEN IF they continue to feel some unpleasant feelings. Focusing on building that life in spite of experiencing depression and anxiety is completely possible and something I seek to do with all of my clients by defining the behaviors that constitute their best life.  .


2. Do not settle for a therapist with whom you do not feel safe and connected.  

With every new client, I make a point to say that if they have any doubts about working with me by the end of their first session to please let me know and I would be happy to help them find another therapist who may be a better fit.   I say this because in my training I was taught that one of the most important factors in providing successful psychotherapy is in establishing a safe, connected, and non-judgmental relationship with clients. For you as the client, that means that if you are unable to build a solid, collaborative relationship with your therapist, then you are unlikely to achieve your goals.  It's perfectly OK to try a therapist and shift elsewhere if they don't feel like someone you can feel safe and open with.


3. Normal social rules do not apply in therapy.

I like to think of therapy as a safe haven against the normal societal pressures within which we are immersed every day.  One of the opportunities in psychotherapy is to learn about the ways you have conformed to societal rules about behavior without even realizing it.  As a therapist, I consider it part of my job to help you notice this.  For example, many people raised in the South, like me, were socialized to avoid giving honest feedback, particularly when feeling angry or hurt, to anyone for the sake of “politeness.”  This can show up in therapy as not talking with your therapist about the fact that they start nearly every session late or maybe a cue that they're disinterested (I have literally talked with my therapist about how much he yawned during our sessions - turns out he was just tired because it was the end of his day and not because he was so bored of meeting with me that he wanted me to stop coming forever - who knew??). 

I believe getting curious about what rules you have that keep you trapped within a limited range of living, and then practicing breaking those rules in therapy is a tremendously helpful part of the growing in therapy. Cut loose!


4. Share your darkest secrets.

One of the best ways I have seen for my clients to have breakthroughs around shame, anxiety, or other painful emotions is to discuss parts of their lives, thoughts, and experiences that they have never dared to bring up with anyone.  There is something transformative about sharing these dark parts and STILL BEING LOVED AND ACCEPTED. I see clients who dare to include me in these private experience gain huge increases in their ability to feel free in their inner experience and external life.  There is something about saying it and getting it out that takes away the burden of walking around with the secret. Plus, as a Licensed Professional Counselor I am ethically and legally obligated to keep your secrets and ethically obligated to not abandon you without a clinically significant reason, so rest assured that your secrets are safe and you will not be abandoned.  


5. Pay attention to your thoughts and feelings about your therapist, and talk about them with your therapist.

If your therapist pisses you off, tell them!  If you don’t think your therapist says enough in your sessions, and you feel like you are just talking for an hour without direction, tell them!  There is a distinction in therapy between “there-and-then” content and “here-and-now” content. There-and-then content involves talking about things like your issues with your mother or how depression is impacting your life.  These are things that are happening outside of the session. Here-and-now content involves everything happening during the session like your thoughts, your therapist’s thoughts, how you are feeling in your relationship with your therapist, what feelings you are evoking in your therapist, etc. 

When you bring up your thoughts and feelings about your therapist and your therapy, you give yourself the chance to learn about how you may be projecting your emotional and thinking issues onto your therapist in a way that you can notice in the here-and-now.

This kind of honesty can also help you start to get a better understanding of the types of things you do in relationships that push people away rather than help you get closer and more connected.  Finally, talking about things happening in the here-and-now, is also a great way to evoke emotions if you are working on feeling your feelings more deeply.


6. Be curious about the past origins of your present day thoughts and feelings.  

A simple question you can ask yourself in any moment to start to link your present day emotional experiences to their past origins is, “when have I felt this way before?”  I am always amazed by how effectively this simple question works. I have seen numerous times where a client, perplexed by a nagging sense of hopelessness or stuckness, becomes surprised when an old memory arises after I ask this question.  Suddenly, as we explore this memory, their story comes into sharp relief and they see through the emotional barriers that their childhood has placed on their lives and they get the freedom to step out of their old patterns. I LOVE IT.


7. Do the work.  

Guys, I assume you may be surprised to see me write this, but limiting your personal work to one hour a week with your therapist is not going to do very much to change your life.  I know, I know, I am therapist and I said that...can you believe it? What I mean is that an hour of working on deep seated issues is going to open up new insights, but without taking your work outside of session, you'll be limited in seeing significant change.  If you think about it, an hour a week is about 0.6% of your week that you are putting into working on changing. Let’s be real, that is such a small amount. Now, for clients who take what we discuss in therapy, convert them into intentional goals (remember tip #1?) and actively create time to allow what they are working on in therapy to influence their life outside of therapy, day to day, then we may start to see some significant changes.  This is also the reason why homework and intentionality are so important in therapy. Homework allows you to bridge the therapy hour into your life. It helps you bump up the percentage of your week spent on YOU, so that you can move that much faster towards the life you have secretly dreamed of in the back of your mind. That life is accessible and yes, it will involve work.


Wishing you the most out of your therapy hour! Haven't talked to a therapist and interested in cultivating a new emotional lifestyle? You can book online with us here for a session. Questions first? No sweat. You can book for a free 15 minute consult with us too.