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How to Get the Most out of Therapy: Tips from Therapists

Branded Illustration of Kristin FitzGerald, CCO and Co-Founder of WebTribes Inc.
By Kristin FitzGerald, CCO and Co-Founder, specializing in practice marketing and brand
Updated November 3, 2026 · 12 min read
Getting the most out of therapy comes down to a few habits: finding a therapist you trust, being honest, taking an active part in the work, speaking up when something feels off, and giving the process enough time. That is the short version of what therapists told me when I interviewed them for TherapyTribe.
Illustration of a woman kneeling to water a large, growing plant
Like any growth, therapy works best when you tend to it.

Over the years, I’ve interviewed professionals who were members of the TherapyTribe directory, and asked each the same three questions: What should a person look for in a therapist? What is one mistake most clients make? What is one myth about therapy you would like to bust? This article pulls out the points they made most often, in their own words. If you are still deciding whether to go at all, start with Do I Need Therapy?, and if you are new to therapy, What Is Psychotherapy? explains how it works.

What Most Therapists Agreed On

Key takeaways from the mental health professionals I interviewed

The Relationship Matters Most

Every therapist made this point. Credentials matter, but what they kept coming back to was whether you feel safe, heard and not judged with that person. Several said to talk with more than one therapist, and not to give up on therapy after one or two poor matches. Research backs them up: a large meta-analysis of 295 studies covering more than 30,000 clients found the strength of the client-therapist relationship (the therapeutic alliance) is one of the most consistent predictors of how well therapy goes (Flückiger et al., 2018). For help weighing credentials, approaches and cost, see How to Choose the Right Therapist.

“…if you don’t feel comfortable, safe and supported, I recommend that you keep looking.” (Shellee Moore, MFT)

“Some people prefer to meet several therapists before they settle on the one that feels the best.” (Damon Constantinides, PhD, LCSW)

Be an Active Partner in Your Therapy

Showing up is not the same as taking part. Therapists described themselves as guides who help you find your own answers, and several said most of the change happens between sessions: trying a suggested skill, noticing a pattern, or jotting down what you want to remember. In cognitive behavioral therapy (CBT), clients who completed more of their between-session assignments, and did them well, tended to have better outcomes (Kazantzis et al., 2016).

“Think of the therapist as a guide and not a magician who can magically give you solutions to your problems.” (Tina D’Amico, LCSW)

“You actually have to be fully engaged in the process, ready and willing to take a deep look at yourself and your relationships, and decide that you WANT to make changes.” (Lori Freson, MA, LMFT)

“I think you’ll get the most out of therapy if you take responsibility for keeping a journal of what goes on in the sessions.” (Aline Zoldbrod, PhD, psychologist and AASECT-certified sex therapist)

“The therapist is more like a guide sitting beside you and is going on a journey with you. Ultimately you are the one in the driver’s seat … The therapist can guide you by giving you the tools you need to make these changes happen but in the end, you are the one who has to do all the work.” (Ellie Zarrabian, PhD, life coach)

How Do I Prepare for Therapy?

You do not need a polished story, but think about what has been bothering you, how long, and what you want to be different. One psychologist suggested describing what is happening to you rather than arriving with a self-diagnosis. And ask about the therapist’s experience with your concerns; a good therapist expects questions.

“It is very important that clients underline what the problems are, how long they have been occurring and have some understanding about the way the therapy process works.” (Cliff Koblin, MA, LPC, LCADC)

“Much better is to go in … and talk about your symptoms.” (Bennett Pologe, PhD, psychologist)

“Make sure to ask a lot of questions. A good therapist will be happy to answer them, either on the phone, or during the initial consultation.” (Lori Freson, MA, LMFT)

What Should I Talk About in Therapy? Be Honest, Even When It Is Hard

Talk about what is actually on your mind, especially the parts you are tempted to skip. Clients often save the most important topic for the last few minutes, when there is no time left to work on it. And not knowing what to talk about is normal; figuring it out is part of therapy. Holding back is common: in one survey of 547 therapy clients, 93% said they had lied to their therapist at least once, and the most common thing they downplayed was how bad they really felt (Blanchard & Farber, 2016).

“…a lot of patients will wait until the last 5-10 minutes of the session to talk about a substantive matter or issue.” (Bridget Levy, LCPC)

“You should be able to talk about your deepest secrets without being judged.” (Michael Giordano, LICSW, CST)

“…concerned they’re not doing it right or they don’t know what to talk about. That’s why you’re here, to get help figuring out how to do things differently.” (Damon Constantinides, PhD, LCSW)

Speak Up When Something Feels Off

If something your therapist said stung or confused you, say so. Several therapists called this one of the most useful things a client can do, because it often leads straight to the issues that brought you in. Research on “ruptures” in the therapy relationship supports this: when a strain is noticed and worked through together, outcomes tend to be better (Eubanks et al., 2018).

“I think the biggest mistake you can make is not to talk to the therapist when there are things you find uncomfortable about the interaction.” (Jeffery Smith, MD, psychiatrist)

“As a therapist one thing I hope patients are able to do is to tell me when something I said made their heart drop, made them feel disheartened, misunderstood.” (Lynn E. O’Connor, PhD, psychologist)

“Any therapist who views your work together as a partnership will welcome your questions and concerns about your “treatment.”” (Michael Giordano, LICSW, CST)

Give It Time, but Trust Your Gut

Change can feel uncomfortable before it feels better, and many clients leave just as the deeper work begins or as soon as the first relief arrives. Others warned about the opposite mistake: staying for months with a therapist who is clearly not a fit. The balance is to ride out normal ups and downs and talk about doubts instead of quietly dropping out. Leaving early is common; across 669 studies, about one in five clients ended therapy prematurely (Swift & Greenberg, 2012).

“Many clients are terrified of change of any kind and often “quit before the miracle happens”.” (Cliff Koblin, MA, LPC, LCADC)

“…other times this dip down is a necessary part of healing – the same way that cleaning out an infected wound hurts before it feels better.” (Ann Marie Dobosz, MA, MFT)

“I think some people stay too long with a therapist who is not a good fit. Always trust your instincts!” (Shellee Moore, MFT)

“They are hesitant to move on when not seeing results or uncomfortable with the therapist, and remain mired in an untenable situation.” (Charles di Cagno, MS, public speaking anxiety specialist)

How Do I Know If Therapy Is Working?

Early signs include leaving the first session with some hope and, within a few sessions, finding the conversations interesting rather than repetitive. Ask how you are doing against your goals; some therapists track progress with short questionnaires, a practice that improved results in two-thirds of the studies in one review (Lambert et al., 2018). For more on what progress looks like, see What Is Psychotherapy?, and if it is time to switch, How to Choose the Right Therapist covers red flags.

“…you should leave the first session with a sense of hope that this therapist can help you, and that things will get better.” (Lori Freson, MA, LMFT)

“…by the third or so you should be having some sense that the conversations are interesting, not repetitive, that you are heading into new territory.” (Bennett Pologe, PhD, psychologist)

“But if you don’t come out of a session with at least one new idea or insight about what’s going on with you, then there is something wrong with the therapy.” (Aline Zoldbrod, PhD, psychologist)

Therapy Myths Therapists Want to Bust

Seventeen of the professionals named a myth. No single myth dominated, but a few came up more than once:

  • “Someone else will fix it.” Five therapists pushed back on the idea that the therapist, or a pill, will solve the problem for you. “Behavioral therapy takes motivation, effort, and willfulness.” (Eda Gorbis, PhD, LMFT)
  • “Therapy means something is wrong with you.” Three said seeking help is a sign of strength. “…it takes courage to explore oneself. It is a strength rather than a limitation.” (Lana M. Ackaway, LCSW-R, CASAC)
  • “It is like the movies.” Three described the couch-and-years-of-analysis image as outdated; one added that longer therapy is not a sign of being sicker. “People don’t lie on couches and go to therapy four times a week anymore like they do on these shows.” (Joe Bavonese, PhD, psychologist)
  • “Your therapist must be just like you.” “One myth I’d like to bust is that you need a therapist who is like you (same age, gender, race, sexual orientation, etc.) in order to feel understood.” (Ann Marie Dobosz, MA, MFT)
  • “Your therapist is reading your mind.” “…people often think psychologists are trained to read your mind or that they are always analyzing you … many of us are trained to listen intently to our clients without passing judgments, drawing quick conclusions or putting them in categories.” (Ellie Zarrabian, PhD, life coach)

Frequently Asked Questions

Is there anything I shouldn’t say in therapy?

No. You can talk about anything, including embarrassing thoughts and feelings about your therapist. The bigger problem is holding back. Your therapist will explain the few legal limits to confidentiality, such as a serious risk of harm, at the start.

What should I talk about if I have nothing to talk about?

Say exactly that. Quiet weeks are good for looking at patterns, goals, what went well and why, or how therapy itself is going.

What are signs that therapy isn’t working?

Warning signs include feeling judged or unheard, weeks of repetitive sessions, no sense of direction, or dreading appointments. Raise it with your therapist first. If nothing changes, How to Choose the Right Therapist explains when and how to switch.

When is it time to stop therapy?

When you have met your goals, feel able to handle setbacks, and have talked it through with your therapist. Therapists cautioned against stopping the moment you feel better, because first relief often comes before the root problem is addressed.

Ready to find a therapist who fits? Answer a few questions and TherapyTribe will match you with licensed therapists who work with your concerns. Get matched

This article is for general information only and is not a substitute for advice from a licensed mental health professional. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline, US) or see our crisis helplines.

Professionals Who Contributed

Thank you to the professionals who shared their advice. All were TherapyTribe members at the time of the interviews, and credentials are listed as of then.

  • Lana M. Ackaway, LCSW-R, CASAC
  • David Amarel, PhD, psychologist
  • Joe Bavonese, PhD, psychologist
  • Tom Caplan, MSW, clinical social worker
  • Joseph Cilona, PsyD, psychologist
  • Damon Constantinides, PhD, LCSW
  • Tina D’Amico, LCSW
  • Charles di Cagno, MS, public speaking anxiety specialist
  • Ann Marie Dobosz, MA, MFT
  • Lori Freson, MA, LMFT
  • Michael Giordano, LICSW, CST
  • Eda Gorbis, PhD, LMFT
  • Cliff Koblin, MA, LPC, LCADC
  • Bridget Levy, LCPC
  • Shellee Moore, MFT
  • Lynn E. O’Connor, PhD, psychologist
  • Bennett Pologe, PhD, psychologist
  • Jeffery Smith, MD, psychiatrist
  • Ellie Zarrabian, PhD, life coach
  • Aline Zoldbrod, PhD, psychologist

References

Blanchard, M., & Farber, B. A. (2016). Lying in psychotherapy: Why and what clients don’t tell their therapist about therapy and their relationship. Counselling Psychology Quarterly, 29(1), 90–112. https://doi.org/10.1080/09515070.2015.1085365

Eubanks, C. F., Muran, J. C., & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55(4), 508–519. https://doi.org/10.1037/pst0000185

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. https://doi.org/10.1037/pst0000172

Kazantzis, N., Whittington, C., Zelencich, L., Kyrios, M., Norton, P. J., & Hofmann, S. G. (2016). Quantity and quality of homework compliance: A meta-analysis of relations with outcome in cognitive behavior therapy. Behavior Therapy, 47(5), 755–772. https://doi.org/10.1016/j.beth.2016.05.002

Lambert, M. J., Whipple, J. L., & Kleinstäuber, M. (2018). Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring. Psychotherapy, 55(4), 520–537. https://doi.org/10.1037/pst0000167

Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547–559. https://doi.org/10.1037/a0028226