Therapy works best as something you do, not something that happens to you
Turning up to a session each week matters, but it's only part of the picture. Therapy tends to work best when it's treated as an active, collaborative process rather than something done
to you by an expert. The therapeutic relationship itself, how safe, honest and understood you feel with your therapist, is one of the strongest predictors of good outcomes, regardless of the specific approach being used. That relationship is something you help build, session by session.
None of what follows is about trying harder or doing therapy ‘correctly’. It's simply a collection of things that tend to help, gathered from what tends to make the biggest difference for the people we see.
Be honest, especially when it's uncomfortable
It's completely normal to want to present a slightly tidier version of yourself, or to skip over something that feels embarrassing, shameful, or hard to say out loud. But the moments that feel hardest to bring up are often exactly where the useful work is. A good therapist isn't there to judge you, and won't be shocked by much. If something feels too difficult to say directly, it's also fine to say that out loud: ‘there's something I'm finding hard to talk about’ is itself a completely valid thing to bring to a session.
Bring the small stuff, not just the crises
It's easy to assume therapy is only for the big, obvious problems, and to arrive each week with nothing to say if nothing has gone dramatically wrong. In reality, some of the richest material comes from ordinary moments: an offhand comment that stung more than it should have, a pattern you noticed in an argument, a feeling that came up for no clear reason. These smaller threads often connect to the bigger patterns therapy is trying to help you understand and shift.
Give your therapist feedback
Therapy is meant to be collaborative, and that includes being honest with your therapist about what is and isn't working for you. If a particular approach doesn't feel helpful, if the pace feels too fast or too slow, or if something they said didn't sit right, saying so isn't a disruption to the process, it
is the process. Good therapists welcome this feedback, and research consistently shows that clients who feel able to speak up about the therapy itself tend to get more out of it.
Expect progress to feel uneven
Therapy rarely moves in a straight line. It's common to feel like things are shifting, then hit a difficult week, then wonder if you've gone backwards. This isn't usually a sign that therapy has stopped working. Processing difficult material, learning new patterns, or simply becoming more aware of things you'd previously pushed aside, can genuinely feel harder before it feels easier. Talking with your therapist about this uneven feeling, rather than assuming it means failure, is often part of the work itself.
Let the work continue between sessions
An hour a week is a small fraction of your life. What happens in that hour tends to matter more when there's some space, even five or ten minutes, to notice how it's settling with you afterwards. This doesn't need to be formal journalling or homework if that's not your style, though for many people it helps. It can simply be noticing, later that day or week, if something from the session comes back to mind, or if you handle a familiar situation slightly differently.
Consistency helps, even when you don't feel like it
There will be weeks you don't feel like going, or where you consider cancelling because things feel ‘fine’ or, conversely, too overwhelming to talk about. These are often exactly the sessions worth keeping. Building any kind of change takes a degree of consistency, and the relationship with your therapist, like any relationship, is strengthened by showing up reliably, not just when things are easy.
Fit matters, and it's okay to change course
Not every therapist is the right fit for every person, and that's not a reflection on you or on them. If after a genuine period of trying, you consistently feel unheard, dismissed, or like the approach simply isn't suited to what you need, it's entirely reasonable to raise this directly or to seek a different therapist. Good therapy depends on a real working relationship, and it's worth holding out for one that feels right.
A note for people doing EMDR specifically
If you're doing
EMDR therapy, a few of these points take on extra weight. EMDR's
phased structure means early sessions often focus on stabilisation and building coping resources before any reprocessing begins, and being open with your therapist about how grounded or overwhelmed you're feeling helps them pace this appropriately. It's also common to notice new memories, feelings or connections surfacing between sessions as reprocessing continues in the background. Bringing these back to your next session, even if they seem unrelated or minor, gives your therapist valuable information about how the process is unfolding for you.
You're already doing the hard part
Choosing to start therapy, and continuing to turn up, is itself significant work. The suggestions above aren't a checklist to get right, they're simply ways to lean further into a process you've already begun. If you're thinking about starting therapy, or wondering whether your current therapy is working as well as it could, we'd be glad to talk it through with you. Please
get in touch.
