To Boost Therapy’s Benefits, Rethink One “Incredibly Important” but Overlooked Aspect
The time between therapy sessions is "incredibly important.”
People call therapy a journey for a reason. It can be daunting just to make the leap and select a therapist, make an appointment, and go to your first session. But one session doesn’t mean you reached your final destination — it’s a stop on the way. And as you travel from stop to stop, you will encounter stretches of time when you can test out the tools you learn in therapy to help you get to your station, wherever that may be.
In fact, the time between therapy sessions can be “incredibly important for progress toward goals,” says Karthik Gunnia, a psychologist and a clinical assistant professor at New York University. And your therapist can help you make it through to the next session.
Gunnia suggests people talk to their therapists about what to do between sessions so that your extracurricular activities align with the style of therapy and your individual treatment plan.
Another way to think of therapy is to think about learning to play a musical instrument, explains psychologist Melanie Badali. You work with an instructor once a week, say, but practicing between lessons builds your skill faster. To capitalize on your therapeutic journey, there are specific things you can do as soon as you end a session and in the days or weeks between appointments that might make it more effective.
What to do right after therapy
When a therapy session ends, the rest of your life comes flooding in and your responsibilities clamor for your attention. But if you can, take ten minutes to write down some of the key takeaways of the session as well as your general feelings, Gunnia says.
Journaling helps you retain the information and insight gained in therapy, says therapist Alyssa Mancao. If you had a particularly overwhelming session, the time immediately after is also an opportunity to test out your new coping skills, Mancao says. She recommends blocking off between 10 and 30 minutes after a session to process your feelings.
Your therapist might also recommend some self-care, especially “if [the client] had a session where they were particularly vulnerable,” says Badali.
What to do in between therapy sessions
What happens between sessions can depend on your goals and your chosen form of therapy, explains Badali. Some therapists offer between-session tasks —“homework” — but because that term can have negative connotations for some, others prefer to call this work “skills practice” or “home action.” Ultimately, this work should be a collaboration between you and your therapist.
Therapists who practice cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), or dialectical behavior therapy (DBT) are more likely to recommend at-home practices between sessions.
Badali says she recommends between-session work to clients depending on their goals, their readiness to change, and their resources, as well as their safety and personal circumstances.
For example, Badali explains, “practicing assertive communication may not be safe for a client to try with a family member who is aggressive.”
What is therapy “homework?”
There are different skills you can practice between therapy sessions. For example, a therapist might suggest to their client that they write down triggering events and associated thoughts, feelings, and behaviors, says Gunnia. This can reveal patterns of thought and behavior, which can then form the basis of your next therapy session.
Your therapist might recommend mindfulness practices, like meditation or breathing exercises. Other work may be more targeted: You might practice asking for help or try to maintain a consistent bedtime routine. It can be helpful to write down your emotional goals for the week, and identify the small actions that can help meet those goals, says Mancao. “Holding themselves accountable is a small way someone can move forward in the therapy process,” she explains.
Research suggests that people who put in this type of work outside therapy sessions are likely to have better outcomes than those who do not, Badali says. She recommends asking your therapist for suggestions on home action if they don’t mention it in your session.
But, Badali cautions, “if you are not at least 90 percent confident that you can complete the home action suggested by your therapist, let your therapist know.”
“This way, you and your therapist can come up with ways to overcome barriers or obstacles that prevent you from practicing your new skill or come up with a plan that you are feeling more ready to tackle at this time,” she says.
Importantly, one of the most helpful things you can do between sessions is practice self-compassion, says Mancao.
“It’s important for people to see therapy as a process, with each session building up on the other,” she says. “Sometimes the progress may not be all too obvious to see at one point. Healing isn’t an upward linear line. Rather, it is an ebb and flowing of knowing and unknowing.”