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How to Get the Most Out of Therapy (With Me)


Choose someone you like.  Choosing a therapist is a bit like dating. You can go on a date with someone who is perfectly lovely and still not click with them. Similarly, you can go to a therapist who your friend loves and not feel like you can work well with them. It’s not because the therapist is a bad person or a bad therapist, the relationship just doesn’t click for you.  That’s OK. Different therapists have different strengths and styles. You don’t want to become a serial therapist-shopper, but I encourage you to take our first few sessions to evaluate how you feel. If it’s not a good fit, I’ll understand- and I’ll even help refer you. Just let me know.


You have responsibilities. Sometimes I wish that I could reach into my clients’ minds, push a button, and instantly solve whatever problems they have. Similarly, I know some clients wish things were that easy. Unfortunately (and fortunately) personal change often takes time and energy on both of our parts. I encourage you to take some time during the week to reflect on what we talked about in session. What was helpful? Was there anything that was confusing or feels unaddressed? What would you like to focus on in the next session? Some clients will even have a therapy journal where they write down reflections or take notes. If we’ve practiced an exercise in therapy, try it during the week.  If I give you homework, try your best to do it. Different people have different needs in therapy and in life. But, as a general rule, the people who get the most out of therapy are people who put the most into it. You are worth the work!


Have goals. They don’t have to be super-specific, but it helps to come into therapy with some ideas about the goals we’ll be working on. From there, we can evaluate your treatment based on if you’re moving towards or away from what you want to accomplish.


Tell me your strengths. We spend a lot of time talking about problems in therapy. But what are your strengths? Do you have a hobby you enjoy? People you care for? Personal qualities you appreciate? A lot of the time, we find a key to solving our problems in the strengths and resources we already have. Tell me about them!


Ask questions/Give feedback. Therapy is a partnership. Thus, it’s really important for me to know what’s helping and what’s not helping in our sessions. You can always ask why- why I asked a certain question, why I’m recommending a certain strategy, why I made a certain statement, etc. You can say why you think a strategy won’t work for you- and help design something different or more tailored to your needs. My goal is ultimately to be helpful to you- and the best judge of that is ultimately you. Keep me in the loop with your reactions.


Stop worrying about me. I promise you that you’re not too “weird” or “crazy” or “hopeless” or any other negative trait for me.  Because therapy is a relationship, it makes sense that you would have concerns about what I’m thinking, if I’m judging you*, if you’re hurting me by talking about traumatic information, etc. That’s all really normal. If and when these concerns come up, I encourage you to remember I’m here as a helper and that our relationship is focused on you and your needs.  I do my own self-care to make sure I’m okay for our session. Let’s focus on you.


Lean into discomfort. This doesn’t mean you have to give me, say, your full trauma history during our first session. I want to get into difficult things at a pace that works for you and is not overwhelming.  I know that it takes some time to trust a new therapist. However, if we’re doing good work, we’ll likely eventually run across a topic or idea that makes you a bit uncomfortable. You can absolutely set a boundary about what you are and are not comfortable with discussing, and I will respect it. However, I want you to consider that some of the most therapeutic work for you might involve the thing that you initially feel uncomfortable discussing. Similarly, at some point you may notice an issue comes up in therapy that comes up in your other relationships- you feel judged, you feel smothered, you feel unappreciated, etc.  You’ll want to repeat problematic behavior patterns from other relationships- blame yourself, act out, leave, etc. I encourage you to talk to me about what’s going on instead. One of the healthiest things we can do together in therapy is to work together to resolve a conflict in a way that feels good and empowering for you.


You can experiment. Is there something new you’re trying out? Try it in therapy! Maybe you want to set more boundaries. Maybe you want to express emotions more openly. Maybe you want to talk about a part of you that you’re nervous discussing with others. I’m a safe place and a good sounding board. Let me be your guinea pig.


Be honest about your safety.  As a therapist, I have a moral and legal obligation to prevent and report certain forms of harm. This includes current child abuse and neglect, abuse of the profoundly disabled, and abuse of the elderly. This also includes reporting if a client is actively suicidal or homicidal. I want to call your attention to the word “actively”. I know, for example, that people can experience a range of suicidal thoughts without being in immediate danger to themselves.  I want to be a safe place where you can talk about these if they’re happening- in fact, I’m honored when clients are willing to talk about their darker thoughts with me. If I feel you are at immediate risk, I do want to get you to a hospital or somewhere you’ll be safe. However, if not, my default is usually to work with you and help you create a plan to keep yourself safe and well.


You are worth the work.  I said it above but I’ll say it again: You are worth the work. Some people think they are too sick for therapy- that their problems are too great to be fixed. Others think they are too well- that because they’re not in crisis they don’t “deserve” the help. A lucky few will simultaneously convince themselves that both of the previous statements are true. Therapy can be different for different people- my sessions with a patient in crisis are probably going to look different than my sessions with someone who is working to access greater personal creativity. But I think wellness, actualization, and personal development are always worth the work. I would be honored to do that work with you.


*A (partial) list of the jobs I could have chosen if I wanted to judge you: Music critic. Elocution teacher. Sound Editor.  Actual judge.


Written by: Rebecca Thompson, LCSW

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