When I look back at clients who have benefitted from therapy and those who haven’t, and read the literature and research on the subject, there are a number of things you can do to get the biggest return on your investment of time, energy, and at times suffering in therapy.

  1. It has to be goal-oriented. You can’t reach a goal you aren’t aiming at and you can’t aim at it if you don’t know what it is! Consequently, before you come in and before each session, have a very specific goal of how you want to be different at the end of that session or the end of therapy. It doesn’t matter if you change your goal every day, or even every few minutes, as long as you have a tangible goal of what you want to get.

  2. Therapy is about you. We can’t change the world, the past, or other people, so that leaves us! Even in couple’s therapy, you aren’t there to change your partner. All you can do is change yourself, and the things you do to which they respond. So in articulating your goal, what you want to get out of therapy, be sure the goal is about a change you want to make in yourself. This isn’t saying that everything that has ever happened to you, every circumstance, is your fault. Only that you are the only solution you can control.

  3. Attend regularly. It’s like working out at the gym. If you go erratically, or there are gaps in attendance, you never get the benefit of working out. You are always starting over. I understand that there may be reasons you can only come occasionally. But you need to know that, just like working out occasionally, you won’t get much out of it because you are starting over each time. I recommend to all my clients that they should come weekly until their goal is met, then taper off to alternate weeks, then monthly, and then as needed to support the change.

  4. Therapy is collaborative. It only works if we are a team, working together. Your ideas and input are just as valuable as mine and we need to be open to brainstorming, modifying the goals, modifying the plan, and working together. It’s my job to do the best that I can, and your job to do the best that you can.

  5. Therapy is like an antibiotic: take until the bottle is empty. We don’t take antibiotics until we feel better. We take them until the bottle is empty. This is because we can start to feel better when we still have the underlying illness. In therapy it isn’t uncommon to start to feel better after we get started, talk things over a bit, and see a little light at the end of the tunnel. If you stop treatment at that point, rather than when your goal is reached, you may not have made significant enough change to sustain the good feeling. That is why I emphasize having a very tangible goal of a change in yourself so you stay in therapy until the goal is met, not just until you feel better.

  6. Not all therapist/client combinations are a match. For therapy to work the therapist and client need to be a good match. Sometimes it doesn’t turn out that way and there is no shame in saying you’d like to see someone else. Better that than waste a lot of time and energy on a team that doesn’t work. Sometimes there are things that can be worked out, sometimes not. But, again, there is no shame in saying that it isn’t working and you’d like to work with someone else.