How To Get The Most Out of Therapy

Explained By A Therapist

By: Lynne Cole – Therapist & Counsellor | Last Updated: June 2022

Table of Contents

Therapy can be a great help for many people, but it is not a passive process; it requires work on your part as well.

Your therapist can make suggestions for how to do this, but it’s a good idea to come in with some initiative of your own.

With decades of experience as a therapist, I’ve learnt how to encourage and guide people to get the most out of their therapy sessions. I’ve also heard so many questions around this topic, the most common of which I’ve answered below, along with a few other ideas on how you can make the most of therapy.

How do I Prepare for a Therapy Session?

Before even starting, you have hopefully shopped around to find the therapist best suited to you. Some therapists specialise, so choose one who can work with your specific issue. It may also make you more comfortable to see a therapist with something in common with you, e.g., gender, racial background, etc.

Once you have your appointment booked, think about what you hope to get out of therapy. Do you hope to stop smoking, overcome a phobia, decrease problems caused by depression or anxiety? Specific goals will give you something to aim for. Try the SMART model for setting goals: Specific, Measurable, Achievable, Relevant, Time-bound. Your therapist can help you refine these goals.

It’s also a good idea to sort out payment up front, so that’s not hanging over your head in the session and you don’t forget.

How Many Therapy Sessions do I Need?

NHS counselling and therapy usually lasts for between five and twenty sessions, depending on various factors. Private therapists and counsellors may book individual sessions depending on client needs. You can always book more if you need to. It’s recommended to finish a course of therapy once you start, as your mood may fluctuate for a while.

Are six sessions of therapy enough?

In my experience lasting benefit has been seen in many clients after only three sessions [1], but some problems may take longer to fully process. To get the most improvement in the least time, listen to your therapist, do the assigned exercises, and practice self-care.

Is therapy once a month enough?

Most therapy courses are done on a weekly schedule, which allows for quicker progress and more rapport building between therapist and patient. For serious issues, even more frequent appointments may be recommended. However, if you need therapy but monthly sessions are all you can afford or fit into your schedule, go for it; they’re far better than no sessions at all. Be extra vigilant about keeping up with the homework exercises to maintain the sessions’ benefits.

Can You Do Too Much Therapy?

It is possible to become emotionally dependent on therapy. Some patients find themselves going over and over the same issues or not digging to the root of a problem. Focusing too strongly on a problem can make it worse. To prevent this, take your therapist’s advice. Try keeping a journal of changes you notice in your mood and behaviours, and when they improve, discuss ending the course of therapy. Try tapering it off to sessions once a fortnight instead of once a week to make the change less sudden.

How Long is Too Long for a Therapy Session?

Typical sessions run for about 60 minutes, while group or couple counselling sessions can be ninety minutes. Too much longer than that might be more information and emotion than can be comfortably processed at once.

Can therapy sessions be thirty minutes?

In my experience shorter sessions can be useful for people with limited time, for intense focus on one topic, or for maintaining improvement at the tail end of a course of therapy.

Why are therapy sessions one hour?

Usually, the actual therapy portion of the session will be forty-five to fifty-five minutes long, allowing the therapist time to make notes and decompress. Over the years I’ve seen this allows for covering a reasonable amount of information without being overwhelming and has been found to be the most effective time for most people.

What to Say in your First Therapy Session

First, you’ll need to establish a rapport with the therapist. It’s okay to chat for a while and see how you get on. If you don’t feel a connection, you can look for another therapist. Most therapists offer a free or low-cost tester/consultation sessions, and if it’s clear you won’t work out together they may refer you to a colleague.

Next, the therapist needs to know why you came. Explain what you’d like to address, any symptoms, goals, etc. Different therapists will ask different questions at this point, but many will ask if you’ve attended therapy before, if you’re on medication, and some details about your home life and family history. Ask them any relevant questions you want to ask.

How to talk to a therapist about depression and anxiety

Don’t worry about going into depth immediately; start with small issues and work up. Bring up any life circumstances or medications which might be causing the problems. If you have recurring fears, hurtful thoughts, or urges to harm yourself, tell the therapist, no matter how insignificant you think the thoughts are.

What to tell your therapist if things are going well

In my experience it’s useful for the therapist to know when things are improving. You still have things to talk about when they are. Discuss exactly what’s improved, why it has, and how to make sure it stays that way. Check how much progress you’ve made towards your goals. Think of what could go wrong in future and how to prevent or prepare for it.

Can you tell a therapist too much?

Ideally, you can tell your therapist anything. It’s their job to listen to everything you have to say, and they will have heard more upsetting or embarrassing things from other people before.

What if I Run Out of Things to Talk About with my Therapist?

That can be a good thing; therapy courses are supposed to end eventually. Having no more to say about an issue may mean it’s resolved. If that’s not the case and you have a mental block, say so, and the therapist might have some questions to prompt you.

How to Tell your Therapist you Need More

If you’re still struggling or if therapy isn’t going as well as you hoped, tell your therapist. It might help to write down what you need to say beforehand. Opening up is hard, but necessary, and will ultimately help you.

[1] Bergin and Garfield’s Handbook of Psychotherapy and Behaviour