How to Get the Most Out of Therapy: A Guide to Staying Consistent and Making Real Progress
You’ve taken the hardest step – you booked your first therapy session. Maybe you’ve even gone to a few appointments. But now you’re wondering: “Am I doing this right? How do I actually make therapy work?“
If you’ve ever left a session thinking “that was helpful” but then struggled to apply anything by the following week, or if you’re not sure whether therapy is really making a difference, you’re asking the right questions.
Therapy isn’t magic. It’s work – and like any work worth doing, there are ways to approach it that set you up for success and ways that leave you spinning your wheels.
Why Some People Get Amazing Results While Others Don’t
Here’s what most people don’t realize: the quality of your therapy outcome depends less on finding the “perfect” therapist and more on how you show up to the process.
Research consistently shows that clients who actively engage in therapy – who do the between-session work, communicate openly, and stay consistent – see significantly better outcomes than those who show up passively expecting the therapist to “fix” them.
You’re not broken. You don’t need fixing. But you do need to understand what makes therapy actually work.
The Real Reason Therapy Fails (And It’s Not What You Think)
Most people assume therapy fails because they chose the wrong therapist or because “therapy just doesn’t work for them.“
The reality? Therapy most often fails because of inconsistency. Not inconsistency in attending sessions, though that matters. I’m talking about inconsistency in applying what you learn between sessions.
Think about it this way: if you went to a personal trainer once a week but never exercised between sessions, would you get results? Therapy works the same way. Your 50-minute session is important, but it’s a tiny fraction of your week – roughly 0.5% of your waking hours.
The real transformation happens in the other 99.5% of your time.
What Consistency Actually Means in Therapy
Let’s talk about what being consistent in therapy really looks like.
Session Frequency Matters More Than You Think
When you first start therapy, weekly sessions aren’t a suggestion – they’re essential for building momentum. Here’s why:
Your brain needs repetition to create new patterns. When you meet weekly, the previous session is still fresh. You can build on insights, notice patterns, and maintain the therapeutic momentum.
When sessions are spread three or four weeks apart, you lose continuity. Too much happens between appointments. You forget what you discussed. You lose the thread of connection with your therapist. Each session feels like starting over.
I get it – weekly therapy is a commitment. It costs money. It takes time. But if you’re going to invest in therapy at all, investing in frequency – especially at the beginning – dramatically increases your chances of actually getting results.
If budget is tight: Ask about sliding scale options, use your insurance benefits if available, or consider doing intensive weekly work for 2-3 months and then spacing out as you improve. But don’t start with monthly sessions and wonder why nothing changes.
Showing Up Consistently Means More Than Just Attendance
Consistency also means:
Being on time. Starting sessions late eats into your therapeutic time and disrupts the flow.
Not canceling unless absolutely necessary. Last-minute cancellations break momentum and often signal avoidance – which is worth exploring with your therapist.
Coming prepared. Take a few minutes before each session to think about what you want to discuss or what happened since last time.
If you find yourself frequently canceling, showing up late, or struggling to commit to weekly sessions, that’s information. It might mean you’re not ready for therapy right now – and that’s okay. But be honest with yourself and your therapist about it.
The Between-Session Work Nobody Talks About
This is where real change happens, and it’s the part most people skip.
Understanding “Therapy Homework”
Not all therapists assign formal homework, but all good therapists expect you to be thinking about and applying what you discuss between sessions.
This might look like:
Self-reflection exercises. Noticing patterns in your thoughts, emotions, or behaviors based on what you explored in session.
Trying new behaviors. If you and your therapist identified communication patterns that aren’t working, you actually try the new approach with your partner.
Practicing skills. Whether it’s breathing techniques for anxiety, boundary-setting scripts, or challenging negative thoughts – you have to practice when it matters, not just in the therapy room.
Journaling or tracking. Writing down insights, tracking your mood patterns, or noting triggers helps you bring concrete information to your next session.
Why Most People Don’t Do the Work
Let’s be honest about why the between-session work doesn’t happen:
You forget what you discussed by the next day. You mean to practice that communication technique, but when the moment comes, you default to old patterns. The worksheet feels awkward or pointless. You’re busy and therapy feels like one more thing on your to-do list.
All of this is normal. Here’s how to actually make it happen:
Take notes during or immediately after your session. Write down key insights, specific things you want to remember, or actions you want to try. Your therapist won’t be offended – they’ll appreciate it.
Set reminders on your phone. “Practice deep breathing at 2pm.” “Check in with partner about weekend plans (using I-statements).” Make it specific and time-bound.
Start incredibly small. If journaling every day feels overwhelming, commit to one sentence each night. If practicing a new communication style with your partner feels scary, try it in a low-stakes situation first.
Expect imperfection. You won’t do everything perfectly. You’ll forget sometimes. You’ll slip back into old patterns. That’s part of the process. What matters is that you’re trying and bringing your experiences back to therapy to discuss.
Being Honest (Even When It’s Uncomfortable)
Therapy only works if you’re willing to be real about what’s actually happening in your life and in your head.
The Things People Hide From Their Therapists
You’d be surprised how often clients hold back information that’s directly relevant to why they’re in therapy:
The fight you had with your partner that you’re embarrassed about. The thought you had that feels too dark or shameful to say out loud. The fact that you disagree with something your therapist suggested. The substance use that’s increased lately. The suicidal thoughts that pop up sometimes.
Here’s what I need you to understand: your therapist has heard it before. Whatever you’re worried about sharing – the shame, the embarrassing behavior, the “terrible” thought – your therapist has worked with people experiencing the same thing.
Creating Safety to Be Honest
If being open feels impossible, that’s worth discussing with your therapist. Say something like:
“I’m having trouble being fully honest because I’m worried you’ll judge me.“
“There’s something I want to talk about but I’m scared to bring it up.“
“I tried the technique you suggested and it didn’t work, but I feel bad saying that.“
A good therapist will appreciate this transparency and work with you to create more safety. If your therapist responds defensively or dismissively to vulnerability, that’s valuable information about whether they’re the right fit.
The Confidentiality Shield
Everything you say in therapy is confidential (with very few exceptions: imminent risk of harm to yourself or others, child abuse, court orders). That confidentiality exists precisely so you can be honest.
Use it. Take advantage of having a space where you can say the things you can’t say anywhere else.
When Things Aren’t Working: Speaking Up
One of the most important things you can do in therapy is give feedback when something isn’t helping.
Signs You Should Speak Up
Your therapist keeps focusing on something that doesn’t feel relevant to you. The homework they’re assigning doesn’t make sense or feels pointless. You tried a technique and it made things worse. You don’t feel heard or understood. Sessions feel like they’re going in circles without progress. You’re not sure what you’re working toward.
How to Give Feedback
You don’t have to be confrontational. Try something like:
“I’ve noticed we spend a lot of time talking about my childhood, but I’m really hoping to focus more on my current relationship. Can we shift our focus?“
“I tried that breathing exercise when I was anxious and it actually made me more anxious. Can we explore other options?“
“I’m not sure what our goal is right now. Can we talk about what we’re working toward?“
A competent therapist will welcome this feedback. They want therapy to be effective for you, and your input helps them adjust their approach.
If your therapist becomes defensive, dismissive, or makes you feel bad for giving feedback, that’s a red flag about the therapeutic relationship.
Setting Yourself Up for Success: Practical Strategies
Here’s how to create conditions that make therapy actually work:
Before Your First Session
Write down why you’re seeking therapy. What do you hope will be different in three months? Six months? Be specific.
Think about your commitment level. Can you realistically attend weekly sessions for at least 2-3 months? If not, when could you?
Consider logistics. What time of day works best? Do you need virtual sessions for flexibility? What do you need to make attendance consistent?
After Each Session
Spend 5 minutes reviewing. What stood out? What do you want to remember? What are you going to try this week?
Schedule your next appointment before you leave. Don’t wait. Get it on the calendar.
Set one small intention. Not ten things. One. What’s the single thing you’re going to practice or pay attention to before next session?
Between Sessions
Notice patterns. You don’t need to do anything differently yet – just start paying attention to the things you’re discussing in therapy as they show up in real life.
Be curious, not critical. When you notice yourself doing the thing you’re working on in therapy, approach it with interest rather than judgment. “Huh, there’s that pattern again” instead of “Why do I keep doing this?”
Bring your real experiences back to therapy. Did you try something new? How did it go? Did something happen that relates to what you’re working on? Share it.
When to Stick With It (And When to Move On)
Not every therapy relationship is meant to last forever, and that’s okay.
Give It a Fair Shot
You should see some signs of progress within 8-12 sessions if:
You’re attending consistently. You’re being honest and open. You’re doing the between-session work. You and your therapist have clear goals.
Progress doesn’t always mean feeling better – sometimes it means understanding yourself better, having more awareness of patterns, or feeling more equipped to handle challenges even when they’re still hard.
Signs It Might Be Time to Switch Therapists
You consistently don’t feel heard or understood. Your therapist isn’t specialized in what you need (e.g., you need trauma therapy and they don’t have that training). You’ve voiced concerns multiple times and nothing changes. You dread sessions or find yourself making excuses to cancel. There’s been no noticeable change or insight after several months of consistent work.
Switching therapists doesn’t mean therapy doesn’t work for you. It means you need a better fit – and that’s completely reasonable.
The Bottom Line
Therapy works when you work at it. Not perfectly. Not flawlessly. But consistently and honestly.
You don’t need to be the “perfect” client. You just need to:
Show up regularly (especially at the beginning – weekly is ideal). Be as honest as you can, even when it’s uncomfortable. Do something – anything – with what you discuss between sessions. Give feedback when things aren’t working. Trust the process while also advocating for yourself.
The clients who get the most out of therapy aren’t the ones with the easiest problems or the most insight. They’re the ones who commit to showing up and doing the work, even when it’s hard.
Ready to Start (or Restart) Your Therapy Journey?
If you’re in Ottawa and looking for a therapist who will be direct with you about what works, who values your active participation, and who won’t waste your time – I’d love to talk.
Book a free consultation to discuss what you’re hoping to work on and whether we’re a good fit. Therapy is an investment – let’s make sure you get real results from it.