How to get the most out of therapy.

Many people begin therapy hoping for meaningful change, but aren’t always sure how to make the most of the process. While a skilled therapist is important, what you do during and between sessions plays a critical role in your progress. The clients who get the most out of therapy do these things:

Find a therapist who has knowledge and experience in the areas you need. Therapists tend to have a few areas in which they specialize, which means they develop a lot of experience in those areas. Be honest with yourself about the issues you want to address and choose your therapist wisely.

Meet with your therapist regularly. You will benefit most by scheduling weekly at first. By meeting weekly, the two of you get to know each other quickly and can dig into the work. As you progress in therapy, you and your therapist could reduce the cadence of therapy to every other week and then monthly for maintenance.

Identify your goals. There might be several areas of your life that you would like to change. Talk with your therapist to determine which areas to focus on first. Goals can be large or small and can be broken down into smaller, achievable steps. As you make progress on a goal, you can start working on a new area of discomfort.

Be open, honest, and believe that you can change. Therapy works best when you are open, honest, and vulnerable with your therapist. Holding things back slows your progress. Therapy helps you to face some hard truths so that changes can be made. Commit to making small changes over time to become the person you want to be. Many of the thought patterns that helped you in the past may no longer serve you in the present. Being open to new perspectives can help guide you toward the person you want to become.

Do the homework between sessions. Make a plan at the end of each session of what you will do before the next session, and actually do it.

Educate yourself on your specific issue, disorder, or diagnosis. Read self-help books and listen to podcasts related to the issue. Become a life-long learner.

Use a journal. Your journal can serve as a place to reflect on the topics discussed in session and any thoughts or feelings that came up. It is also a great place to document your progress or struggles between sessions. Bring notes to therapy.

Practice the skills learned in therapy. Use the skills learned in therapy throughout your life at home, at work, and with friends. Journal about this practice and talk about it in therapy so you can see what worked and what didn’t so you can refine the practice and try again.

Reflect on the sessions. Take time after each session to reflect on the work you did. By reflecting on the work, you are solidifying it in your mind. Think of people and situations where you can use the new perspectives to make them work better for you.

Practice self-care. Self-care is personal to each person. Some basic categories of self-care include healthy eating, sufficient sleep, frequent movement, spending time in nature, connecting with others, engaging in hobbies, maintaining basic hygiene, and maintaining a tidy, organized home. By practicing self-care, you can lower your stress response and boost your energy and mood.

Set and maintain boundaries. Boundaries are a means of protecting your mental well-being, establishing mutual respect, and preventing burnout. Boundaries are not walls to keep people out; they are a means of clearly defining your personal limits and communicating to others how you want to be treated.

Be patient. Healing and personal growth take time. Healing requires identifying the areas that are no longer working for you, examining when and why you learned them, then choosing new ways of doing things. As you move along your healing journey, you can expect some successes and some setbacks. As you heal some areas, other areas of growth will likely surface.

Treat it as a partnership. Therapy is fundamentally a partnership—often called the "therapeutic alliance". You and your therapist are co-collaborators. While they bring clinical expertise, you are the leading expert on your own life. Together, you build trust, identify goals, and actively navigate your personal growth.

Therapy can be a transforming endeavor and a collaborative journey. Progress takes effort in and out of the therapy session. By being an active participant and making small changes over time, you will see your growth and transformation.

Think Therapy Is Expensive? Consider the Alternative

Many people say that therapy is expensive or a luxury; it costs money and time, and they don’t have enough of either. Want to know what is expensive? Ignoring your mental health.

Ignoring your mental health can, over time, lead to worsening conditions. Emotional distress can lead to burnout and decreased functional performance at work. Relationships can be affected by irritability, reduced patience, and even controlling behaviors. Under high stress, many people turn to maladaptive coping strategies such as substance use, overspending, and gambling, to name a few.

Chronic stress elevates cortisol, the stress hormone, which has been linked to higher risks of stroke, heart attack, diabetes, and suppressed immune function, which may contribute to an increased risk of chronic autoimmune diseases. Other common effects include chronic pain, headaches, and digestive issues.

Early intervention can lead to faster recovery, improved relationships, increased productivity, and the development of better coping skills for future challenges, often preventing the need for more intensive treatment later. The longer unhealthy coping mechanisms – such as avoidance, substance use, or poor communication – continue, the more deeply wired they become and the harder they are to treat.

Therapy is proactive; you learn tools to manage stress, improve emotional regulation, and handle future crises more confidently. Seeking help sooner improves communication and strengthens relationships, often resulting in quicker relief and allowing for faster personal growth, rather than just managing a crisis.

You do not need to be in a crisis to start or benefit from therapy-it is a proactive investment in yourself. Addressing your mental health early can lead to a better quality of life, less disruption to your daily routine, and far fewer costs down the road. Many people come to therapy wishing they had started sooner.

I am a transitional character in our current cultural revolution.

As a 61-year-old therapist with 23 years in the field, I find myself to be a transitional character in our current cultural revolution. Every generation has had its cultural revolutions, where the younger generation challenged the status quo. We are seeing this today with many people choosing to go “no or low contact” with their family members or to stay single rather than settle. Many people are calling it a trend and blaming therapists and social media. However, stepping away from unhealthy relationships is much bigger than that and has been brewing for a while.

We are at a time in history where many people are going to therapy, learning about themselves, and choosing to interact with the world differently. While people have sought psychological help throughout the ages, it has only been since the Mental Health Parity Act of 1996, in which mental health has been treated the same as physical health by insurance companies, that going to therapy has become the norm. With access to therapy, people have been examining their behavioral patterns and the traumas passed down through previous generations. The individuals who engage in this work often find that they improve their communication skills, boundaries, and self-care, which challenge the dynamics of their relationships and the status quo.

Research in the fields of psychology, mental health, and parenting has exploded since the 1980s. We have a much better understanding of how much of our behavior is rooted in how we were treated by others, particularly as children. We know much more about how children’s brains develop, what causes trauma, and what fosters resilience. Emerging research suggests that trauma lives in the body, affects the nervous system, re-wires the brain, and causes illnesses such as autoimmune diseases. People and organizations are using this research to inform practices, to enhance healthy social-emotional learning, and to protect children from harm.

So today, we are seeing adults examining their lives, how they were raised, and how they want to be now. They are calling out the ways they were harmed and are looking for some accountability from those who harmed them. They are not looking for perfection; they are looking for validation and changed behavior. This isn’t about one thing long ago; it is about ongoing behavior that continues to cause harm. A common pattern I am seeing is that grandparents are not respecting the boundaries of their adult children, who now have children of their own. Many young parents are struggling with the lack of support from their parents, despite remembering how involved their own grandparents were when they were young.

This article isn’t strictly about people going no contact with family members or choosing to stay single. It is about a change in expectations within our society. In my lifetime, things that we would say when I was a child and an adolescent are no longer acceptable. Slurs about race, gender, sexuality, intelligence, body size, and disabilities are not commonly accepted anymore. This shift in language reflects a deeper change; stigmatizing language is out, and compassionate language is in.

Alongside this, we are also seeing more people talking openly about their mental health and trauma histories. We are becoming a trauma-conscious society. This means that there is an increased awareness of the impact of trauma on the person’s nervous system. There is a shift in mindset from “what is wrong with you” to “what happened to you.” With this validation that harm was done to them, they are learning to self-advocate, create boundaries, and avoid re-traumatization.

They are recognizing that many of the old ways of communicating and doing things were harmful. There is a recognition of the difference between intention and impact. It is not enough that someone didn’t intend to cause harm; the impact also needs to be acknowledged. Those who are willing to see beneath the curtain of quirks and behavior see neurodivergence, trauma, neglect, and emotional immaturity. Choosing to perceive others through those lenses leads to more compassion and understanding rather than annoyance or rejection.

The younger generations are much more accepting of diversity, and they want us to get on board. They see the world with all its gradations of color and think that older generations have a limited palette to work with. They are challenging the status quo and inviting older generations to expand their knowledge, understanding, and compassion. They are pushing the world to mature socially and emotionally. In my practice, I see clients exploring all kinds of relationships. Many are more focused on a person’s essence rather than their anatomy. They are dressing however they want, regardless of gender norms. They are exploring other ways of making a life with nontraditional living arrangements and income streams. They are refusing to hide their lifestyles, needs, and accommodations.

When there is a change in how things are done, there tend to be those who lag behind, clinging to the old ways. We are seeing this in the male loneliness epidemic and parental estrangement. In many cases, a common thread is a gap in social-emotional maturity. Social-emotional maturity is having the ability to understand, express, and manage emotions while demonstrating empathy and building positive relationships with others. Social-emotional maturity requires self-regulation, accountability, empathy, openness, resilience, and the ability to build healthy relationships and maintain independence. Women are asking men to meet them where they are emotionally, to be an equal partner, to bring value to their lives, not be another mother to them. Adult children are asking their parents something similar. They want their parent to understand that the world has changed, that parenting has changed. They want their parents to respect them as adults who are forging a new path. Adult children don’t want to go no contact with their parents or other family members; they want them to step up, take responsibility, be accountable, and be open to new ways of seeing and interacting with the world generally and them specifically.

As a therapist, I help my clients to break long-standing patterns of unhealthy behavior, to learn to advocate for themselves, and to challenge toxic and abusive behaviors. I help them to improve their communication skills, identify boundaries, and engage in self-care. I help them to learn to love themselves. When people love themselves, like Frank’s Hot Sauce, they put that shit on everything, and what could be better than that?!

I am proud to be both a witness to and a bridge between generations in this cultural shift. As a therapist, I am poised to help people of all ages shift their perspective and make the changes in their lives to engage in relationships and to raise their children in a healthier way. This is how we begin to break the cycle of generational trauma, and I am here for it!