Tips for Getting the Best Results from Your Therapy

Welcome to the world of therapy. It can seem mysterious at first - ‘what do you talk about? How do you know if you are getting better? How long will it take?’ All good questions, and you will get slightly different answers from different types of therapists. Psychotherapists can have many different certifications. Within our office alone there are: LMFTs (licensed marriage and family therapist), LCSWs (licensed clinical social worker), LPCs (licensed professional counselor), and additionally an RPT (registered play therapist). People might have one or more ‘main’ licenses, and specialized certifications in addition to this such as: addiction, trauma, and other topics.

What does a psychiatrist treat? Psychiatrists are medical doctors who have specialized in psychopharmacology and prescribe medicine for mental health conditions like depression, manic depression, and anxiety. Some GP’s also prescribe mood management medications depending on how long they’ve known you and what their specialties are.

Who should I go to? First and foremost the person should be a good fit personally. Read their biographies on their website, call and talk to them for a few minutes, and then try a session with the person. Due to confidentiality it’s less typical to find an online review. Ask friends or doctors for recommendations.

If it doesn’t feel right after the first session, you may need to try one or two others to find what you are looking for. The healing comes from a combination of the relationship with the therapist and the techniques the therapist has specialized in using. Some common specializations are:

• CBT (cognitive behavioral therapy focused on challenging common thought distortions)

• ACT (acceptance and commitment therapy) which shifts your thinking towards being more ‘mindful’ (in the present) and developing awareness about what your mind ‘fuses’ with, or gives energy to. We have approximately 6-7,000 thoughts a day, which ones do you choose to pay attention to? Are you responding with your reactive mind or your wise mind?

• DBT (dialectical behavior therapy) adds mindfulness and self soothing to the CBT tools of teaching us to challenge our thought distortions. It also adds considering our automatic interpretation of other points of view. This makes others’ actions seem less personally directed. People with strong emotions can benefit from growing the person’s ‘wise’ mind, detaching and choosing instead of reacting.

• EMDR is a trauma treatment (eye movement desensitization and reprocessing) and it is strongly evidenced-based. It evolved from work with veterans with PTSD and uses tools from ACT, somatic therapy, hypnosis, and CBT. There are general categories such as: marital therapy, family therapy, and play therapy, addiction recovery and more.

1. Identify what you hope to get out of therapy. Your therapist will invite your input to co-create a treatment plan.  It is important that you know this is a collaborative process. Express your needs, ask questions, read books, and do your homework assignments. Go to your first appointment with an open mind and understand the therapist will ask questions to help get the process started. This may stir up some strong feelings. Share any curiosity about specific approaches you’ve read about in your session. Ask any questions you may have including projected length of treatment.

2. Schedule sessions at a good time. Most therapists do 50 minute sessions once a week. This gives them a chance to process payments, book schedule changes, and take a bathroom break. Sometimes we recommend twice a week (for intense work or stabilization) or once every two weeks. Try and work with the therapist to find a routine time you can count on which will help remember your sessions, and to give your experience some predictability. Most therapists ask for a commitment and charge for missed appointments. Understand this is because they are holding a ‘spot’ and they do a lot of behind the scenes preparation for your appointment- research, treatment planning, and documentation. Additionally, therapists know that after the first 2-3 appointments, you’ll start feeling some relief and may feel less driven to do the hard work, but this is when lasting change happens. So the cancellation policy is to also help with your natural resistance by making it harder to cancel at the last minute. Most therapists are still workable around illness and occasional crises. Try and find a time you can give the session your full attention.. Know you may need time to settle any feelings that have come up.

3. Be honest about your symptoms. Some issues seem embarrassing but there is are many reason for confidentiality. Drinking, using drugs, they all add to whatever symptoms or distress brought you in for help. Therapists know suicidal feelings can be different than suicidal plans and you will not go straight to the hospital. Most of the time that is a last resort. Cheated on your partner? Again, a symptom of distress. Obsessional thoughts? Eating disorder issues? All of these point towards specific patterns we need to address. Marriage with no intimacy? Again, symptomatic of specific and general issues.

4. Talk about the therapy relationship. Therapy can be both a lecture and a laboratory. When the issues you have outside of therapy show up in sessions, it is a wonderful opportunity to experience being compassionately addressed, understood, and validated.  Afraid of seeming ‘needy’? Afraid of asking for too much? Worried about what your therapist thinks of you? All of that is information that helps the process. It’s a huge personal step in therapy to be able to talk about it.

5. Set expectations or markers to define successful changes. Establishing measurable markers or behaviors to watch for that indicate successful treatment will help you feel more motivated. Think about physical therapy - you are looking for better movement, less pain… In psychotherapy you may be looking for calmer/ less frequent fights in your relationship, using assertiveness tools, less episodes or shorter periods of anxiety or depression, practicing self- compassion - you get the idea!

6. Do the work outside of sessions. Are you supposed to practice something? Read something? Keep a journal? Go to 12 step meetings? You get out of it what you put into it. If you strongly dislike something that was suggested, give the therapist that information. We are very adaptable. It’s our job.

7. Set boundaries around therapy. Think about who you do and do not want to talk about your therapy with. Choose people who will be supportive.

A few other dos and don’ts:

1. Don’t obsess over being polite.

2. Don’t keep things to yourself.

3. Be your most authentic self.

4. Let your emotions show.

5. Try not to focus solely on symptom relief.

6. Don’t worry about the clock.

7. Establish a process for check ins. (Know how to reach your therapist after hours)

8. Expect to drag your feet sometimes.

9. Don’t expect your therapist to tell you what to do. Most of us don’t appreciate it.

10. Be Patient.

(above 10 tips from Kelton Wright, ‘Tips for Getting the Most Out of Therapy”, March 2, 2021)