8 Things I Wish Every Client Knew Before Starting Therapy
Therapy is a big commitment and a significant investment of time and money. I recognize what a huge step it can be for some to prioritize their mental health in such a way. Everyone brings with them their own ideas and understandings of the therapy process when they begin treatment. Aligning with clients around their goals and expectations for the therapy process is one of the first tasks of building our working relationship.
In all of my experience working with people, I have found that some get more out of working with me than others. I hope that by sharing what I have noticed, you can use this perspective to get the greatest benefit from your experience in therapy.
1. Consistency is crucial.
This might be the most predictive factor for how beneficial your therapy process becomes (and it is entirely within your control!). You will get the most out of your therapy when you arrive on time and attend therapy every week. Period.
With all due respect and recognition for the complexity of our lives and schedules, prioritizing your therapy time will pay dividends on your investment. Consistency allows us to reach greater depth and continuity in our work together. Furthermore, the simple act of holding this space with such importance will influence how you engage in the process.
When therapy is something you schedule around – rather than something you reschedule when other needs arise – you allow this process to have a greater stake in your life. You open the door to the fullest experience possible.
2. Our sessions are merely a starting point.
Like the first item above, the way you decide to engage with the therapy process is one of the most impactful factors within your control to maximize your progress on goals. Don’t get me wrong, attending therapy sessions weekly with consistency provides an enormous opportunity for growth all by itself.
However, the more you strive to carry what we discuss in session into your daily life, the more you will get out of our process together. People often tend to regard therapy as a process that happens for one hour a week. They do not consider this work as extending beyond our session time. They will say things like: “You know, I’ve had so much going on in the last week I haven’t really thought about our last session. Can you remind me what we talked about?”
Let me pause to say that it is so understandable why this happens. Your life is busy! There is so much to occupy your attention without therapy. In addition, the uniquely focused and vulnerable space of your therapy session makes it very easy to hold separately from the rest of your life. I offer this perspective without judgment of what is “right” or “wrong.”
In my experience, however, I have noticed that the clients who hold what happens in session in mind throughout their week tend to make progress at a quicker pace. Making a point to notice how parts of your therapy sessions show up in your daily life provides you more perspective to take this exploration deeper in the next session.
3. You do not need to come prepared.
There comes the point in every therapy – typically after your first several sessions – when we have finished setting the landscape of your life, history, and goals. At this next stage, people commonly experience some form of anxiety about "what do I talk about now?”
Many people spend the hour before therapy reflecting in search of their “problem-of-the-week” to be the focus of this week’s session. Some people make a practice of noting moments that come up throughout their week so they can remember them as a potential topic to share in therapy.
There is nothing "wrong" with either of these approaches. If you take away nothing else from this section, I hope it’s that there is no “right” or “wrong” way to do therapy. Period. The only measuring stick is whether you are finding value from the process.
However, my experience has shown me that “coming prepared” often serves a protective function for clients. This is most evident on days when, despite their best efforts, clients start the session saying some version of "I don't know what to talk about this week." Clients often share feelings of anxiety or fear about “wasting time,” discomfort in the “awkwardness” of silence, worry that they are doing therapy “wrong,” or a variety of other big emotions that arise in the empty space left without a prepared topic.
Though it may sometimes feel uncomfortable, these moments offer some of the richest opportunities for growth. We all use strategies to distract from what feels bad. Allowing therapy to have this space helps you discover comfort and familiarity with the deeper emotions that surface without distractions. For this reason, I encourage you to normalize the practice of "just arriving" at therapy without a plan. Sometimes the most powerful sessions come from what spontaneously bubbles up in that space.
4. Take off your filter.
It is quite common for people to hide parts of themselves from others. We all have a filter. We protect ourselves from judgment, ridicule, rejection, or other negative social consequences when we hide what feels "wrong" or vulnerable. Therapy, however, is a space to let your inner world live externally and be witnessed in a safe place. I strongly encourage you to prioritize being completely open and honest with your therapist as much as possible.
This openness can be incredibly hard for some. However, there is no benefit to lying or bending the truth in therapy. Quite the contrary, keeping things hidden from your therapist deprives you of some of the most meaningful growth opportunities.
One of the hallmarks of therapy that makes this relationship different from any others in your life is that everything you share with your therapist is confidential*. I am not a part of your social network and community; therefore, nothing you share in therapy can negatively impact your outside life or relationships. Nothing is off-limits!
Furthermore, another unique quality of your therapeutic relationship is that it is one-sided. It’s all about you! Therefore, you need not be concerned about hurting or offending me. In fact, if this worry comes up, let’s talk about it! (More on this below.)
*There are exceptions to confidentiality in therapy, mandated by state laws. These exceptions include clients who demonstrate a danger to themselves or others and any disclosures of child abuse or elder/dependent adult abuse.
5. Let’s talk about us.
Though this relationship is unique, you will still experience your therapist in similar ways you experience other people in your life. You will react to them just as you do in any other relationship. The difference here is that in therapy, you can talk about it as it is happening and try out different ways of relating to them.
I might say something that touches you in a vulnerable way. You might feel inspired by new insight. Or, I might do something that disappoints you or feels hurtful in some way. Talk about this when it happens!
Allowing your inner thoughts and interpretations within your therapeutic relationship to live out loud will enable you to experience something new and be seen more deeply. Sometimes the feelings evoked in your therapeutic relationship will echo sentiments in other meaningful relationships in your life. Working through emotions that arise about your therapist can be a tremendous source of healing and help you find new ways of relating to other people in your life.
6. Use therapy to try on something new.
We generally go to therapy because we want something to change in our lives. Yet, when confronted with opportunities to change, we feel reluctant to do anything differently. You will get the most out of your therapy if you bring a willingness to experiment with new ideas or behaviors in sessions.
Perhaps there are patterns you have in relationships that have been difficult to change. Try showing up differently with your therapist! Let therapy be a practice ground for changes you want to bring to the real world.
7. Try to keep a “big picture” perspective.
Personal growth happens slowly and is not a linear process. Sometimes change is happening in ways that are not always visible on the surface. For these reasons, one cannot evaluate therapy based on a single session. The value gained in treatment is something that the entire process must measure, not session by session.
Maintaining this perspective will take much of the burden of “getting something” from each session off your back. It simply doesn’t work that way and places a lot of pressure on you to change quickly or find big revelations every week. Some sessions will not feel profound. Some days you will not feel up for therapy. No matter the case, every session carries its own value as part of the big picture of your treatment process.
8. Say ‘goodbye’ at the end.
I’ve said a lot about how a therapeutic relationship is unique, and this is a big part of it. The end of therapy has so much potential to offer if you allow yourself to end treatment thoughtfully.
Provided that the circumstances leading to ending therapy allow for it, discuss your decision to end treatment with your therapist and create a plan to end therapy over the course of a few sessions (I would recommend at least 4). Saying goodbye with intentionality allows you to reflect together on your work and relationship from the point of view that sees the end in sight.
In my experience, so much can come from these sessions. How often have you said goodbye to someone important and really taken the time to talk about what this relationship meant to you or what hopes were left unfulfilled? Saying goodbye can be challenging, and this is yet another place to try on a new experience in a safe place.