If it’s your first time in therapy – or you’re not sure what therapy is supposed to look like – it can be an intimidating process: Within a few hours of meeting your therapist, you’re supposed to open up about your problems and deepest fears…lots of talking and tears, and somehow you come out on the other side a changed person?! 

It’s a lot to wrap your head around. 

The reality is that therapy is most successful when you go in with intention. There are clear steps you should take to make the most out of it, each one critical to a successful journey and necessary to take in the right order. 

1. Establish Trust Between You and Your Therapist 

This may be the most important step in your journey, because if you don’t have a safe and trusting relationship with your therapist, you’re less likely to open up, accept feedback, and try new things. The strength of this relationship – known as the therapeutic alliance – has a profound effect on the success of therapy. 

If there are specific topics you know you want to explore or will be a large part of your journey, bring those up early on to get an understanding of a therapist's comfort level with them. For example, if you know your relationship with your family is struggling, ask questions related to their experience in that area. 

These questions do a great job of determining client-therapist fit: 

• Do you have experience working with clients like me? 

• How do you like to work with clients? Do you prefer free-flowing conversation, or structured questions?

• What should be my focus between sessions? 

• How will we know if I’m making progress? What should I do if I don’t feel better?

2. Articulate Clear Goals 

Whether you want to have better coping skills to manage anxiety symptoms, build or increase self-compassion, or discuss and process past trauma, establishing goals can help make sure you stay on track.

Sometimes clients can have a hard time articulating goals, in which case it can be helpful to  turn struggles into questions you would like answered. Phrasing observations as questions naturally lends itself to setting a goal.

A parent who says, “My children don’t listen to me,” will shift to “I wonder if there might be another way for me to communicate with my children?” From here, that question can become the basis for the goal. In this scenario, maybe the goal turns into “Have a better relationship with my children.” To achieve that goal, learning to effectively communicate is essential. 

Sometimes clients come to therapy with a clear idea of what they want to accomplish. Whether you come with goals, or you spend time defining your goals, setting these from the outset will help guide the treatment plan. 

3. Address the Distress

Often clients are starting therapy because they’ve reached a point in their lives where they’re really struggling to cope with a stressor or trauma. A crucial step is identifying and reducing distress. 

Our brains are incredibly talented at surviving crises. When we’re under a great deal of stress or feeling burned out, our brains conserve themselves by limiting access to higher-order problem-solving and decision-making, focusing instead on in-the-moment survival.

This can become a vicious cycle: Being in constant crisis mode limits our ability to function in our daily lives. Then, as our ability to manage routine tasks becomes more difficult, stress naturally increases, rinse and repeat until we begin to gradually – or not so gradually – shut down. 

Before you can start exploring the issues identified in your goals, you should calm down your physical symptoms, so you can think more clearly. By practicing diaphragmatic deep breathing exercises, grounding or mindfulness practices, or a body scan exercise you can calm the body’s stress system in the moment.

When you're juggling multiple stressors that are outside your control, it can seem counterintuitive to set those stressors aside and focus on yourself, but that’s exactly what your brain and body need you to do to get back to a state of healthy regulation. 

4. Do ‘The Work’

In a more relaxed state, learning can take place. This is the part of therapy that many people envision as “the work.” During this phase, you and your therapist should talk about your goals and any internal or external barriers that stand in your way of reaching those goals. 

Here it can be helpful to remember that learning can be uncomfortable. Whenever we’re learning a new skill, we also elect to put down our strengths and use our less-practiced qualities and abilities. We become beginners again.

In this step, you’re on the right track during this phase when you’re making progress toward the goals that you set. 

5. Track Your Progress

Just like you wouldn’t keep healing a broken arm without X-rays, or train for a race without timing yourself, it’s important to regularly check on how you’re progressing toward your goals. Otherwise, you could go months, or even years, without truly knowing if all this therapy is making a difference.

At Octave, our therapists do this by giving quick assessments each month to track your anxiety and depression levels. This provides crucial data to let your therapist know if they need to try a different approach or see if there’s something that’s being missed in sessions. While you are hopefully also just feeling better over time, this kind of “measurement-based care” ensures that you can see real results, some that may not even be fully noticeable.

6. Graduate With New Skills

There comes a time in every therapeutic relationship when treatment should end, which can be a bittersweet moment, but most of us are not meant to be in therapy indefinitely. 

You’re ready to graduate from therapy when you achieve your goals, you’re able to reduce your distress, and you can practice skills effectively on your own. During this time, it’s helpful to reflect on the progress that you’ve made and what you’ve learned. Therapy is a tool in your toolbox that you might not always need, but can return to when your existing coping strategies stop working.

Understanding that there can and should be an endpoint should feel empowering. It helps to know that starting therapy isn’t some lifelong commitment, or a crutch; instead, it’s a period of emotional training to make you better qualified for coping with life’s challenges and a resource you can come back to when you need it.

Ready to get started? Octave has over 1,000 therapists who have been carefully selected to meet your mental health needs.