How to set yourself up for success in therapy

Starting or restarting therapy takes a lot of courage. Over the next week I want to share with you some of my reflections of clients who have done really well in therapy. It is my hope that you might be able to adopt some of these things if you are in therapy or considering therapy and in so doing, get results that lead to lasting change.

Knowing your “why” for coming to therapy

Undoubtedly, something has led to you reaching out for help at this time. Over time, the sense of urgency in addressing this can reduce and with it, the importance you place on therapy. Being able to come back to the reason you came to therapy in the first place (e.g., what wasn’t working in your life) can help you stick at it and get the results you are hoping for. 

Prioritising your therapy sessions and coming consistently

I have found that those people who attend regularly (at least once a fortnight) do better than those who come more infrequently. Being able to prioritise the time you have set aside for coming to therapy is important. Cancelling and/or rescheduling sessions will slow your progress and can lead to despondency, resignation and giving up.

Preparation and reflection

Those that do well in therapy often spend time mentally preparing before each session about the things they wish to talk about (even if it’s just a few minutes). These topics are often linked to the difficulties that brought them to therapy and the goals they have set for themself. Similarly, spending time at the end of each session reflecting on the key take-home messages, what you have learnt about yourself and how you can apply that in a way that takes your life forward in a meaningful direction. Some people like to dialogue this with a friend or partner, others like to journal and others just spend some time mentally reflecting. Find what works best for you. 

Don’t count your chickens before they’ve hatched

A significant number of people leave therapy prematurely. They might have experienced an initial reduction in symptoms and believe that things have improved and that they no longer need help. If the underlying causes have not been addressed, symptom improvement rarely lasts. Given enough time and/or stressful life experiences, the symptoms often return or are replaced by new symptoms. A client I once treated had a history of significant abuse as a child, as a teenager she received treatment for an eating disorder, and then in her adult years, OCD and panic attacks. She had seen a number of psychologists, but hadn’t seen any long enough to get to the bottom of her difficulties, so she had some initial improvement only to experience new difficulties down the track. It’s important that before finishing up our work together, we have a discussion to make sure we have sufficiently addressed the root cause of your difficulties. 

Unchartered territory

Any effective therapy includes facing difficult thoughts, feelings, images, situations etc. This understandably can be uncomfortable and make you feel anxious. Experiencing anxiety in session is a good thing – as it means what we are looking at is meaningful and important. If you are feeling calm and relaxed the whole time we have missed something. It will be important for us to get to know your threshold for tolerating anxiety. Too much anxiety can lead to worsening of symptoms and too little anxiety can mean that things don’t change. Noticing where your threshold for anxiety tolerance is leads to reduced anxiety outside of session and greater capacity to deal with difficult feelings. These two things are crucial for psychological wellness. 

Change is not linear

Some therapy sessions you will leave feeling on top of the world, other sessions you may be feeling flat, overwhelmed, hopeless or confused. People sometimes comment after a few sessions that their problem is deeper than they first suspected. This is often the case if they are accustomed to avoiding their inner life (thoughts, feelings). Please don’t be discouraged if you feel as though progress is slower than what you had hoped for. Please do talk to me as regularly as you need about how you are finding therapy and how you feel we are tracking along. If something isn’t working it’s important that we come up with a solution that works for you. It may be that there is an aspect of the problem that we have missed or it could even be that the fit between us is not right. 

I hope you found these thoughts useful, and that you might be able to come back to them from time to time if it’s helpful

Dr Jamie Barnier

About Dr Jamie

I’m a Clinical Psychologist based in Melbourne who helps adolescents and adults cope with overwhelming emotions and remove the need to numb negative feelings through food, alcohol, sex or drugs. I focus on addressing the root cause of the problem with the goal of creating happiness, peace and lasting change.

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