Many years ago, when I was training to be a sleep therapist, I read a story from a psychotherapist about a client and how they worked with them to help them sleep better for about three years. They discussed how, for the first year of working with this client, they effectively provided them with the same advice in various ways. That advice was pretty straightforward, and one I have given to many clients. When you are going to bed, take your phone/tablet/computer, and make sure you cannot reach it from your bed. For an entire year, this client refused. How could this simple, straightforward advice that you can find on Google help him with his sleep?
Until he did it, and it dramatically changed his sleep. What was happening was that he was going to bed, but like many of us, he had a phone in his hand. Instead of placing the phone beside his bed, he would lie there, in bed, and scroll for hours. When he placed the phone on his desk, on the other side of the room, out of reach, then went to bed. There was no longer any phone in his hand, and the hours of scrolling stopped. Those hours turned into a good night's sleep.
It took the client a year to follow this simple advice. One of the biggest hurdles is habits; the client in question had, for many years, created a bedtime routine that effectively consisted of lying in bed, on his phone. It took a lot of effort from the client to even consider the advice. When he did, he got lucky, and things improved quickly and noticeably.
Much of what a therapist recommends will be given based on their experience, knowledge, and expertise. It's why they are so expensive. Ultimately, though, you get from therapy what you put into it. If you ignore all the therapist's recommendations, then little will change. If you take their advice and try sticking with it every single time as they recommend, then, like the described client, you might find a noticeable and immediate change.
What if it doesn't work? That is often the response that comes back: you tried something for a day or two, and didn't notice any difference. This information needs to be shared, and together you can explore why it didn't work and make changes over time, which will help you achieve your therapeutic goals.
What often happens is that most therapists spend most of their time trying to convince a client to try what they are recommending, to stick with it longer than a couple of days, and then to share with the therapist the details of what happened. The more information you can provide, the more accurate and effective the recommendations can become.
To get the most out of therapy, there are a few guidelines to follow.
First, be clear with your goals. What do you want to change and achieve with therapy, and then share them in the first session. Write them out in the intake form so the therapist can refer back to those original goals and check in with you on your progress.
Secondly, be honest. If you didn't try a piece of advice, be honest about it. Oftentimes, a therapist will follow up with what stopped you from following it. If you are not sincere, the therapist will base what they do next on false information. At which point will the therapy be less effective? A therapist is trained not to judge; they will not shame you, they are there for you, and if you cannot be honest with them about what's going on, then they are limited in their capacity to help. They are not mind readers.
Third, try. Try to follow the therapist's recommendations. The best test is to try what they recommend from the end of the session they suggested it, to the start of the next session, whether that be in a week, two weeks, a month, or more. A proper, motivated attempt will reveal a great deal about what you need and inform the therapist on how to help you move forward.
Fourth, it's a recommendation, not a requirement; you don't have to follow it. Just because the therapist gives it, does not mean you have to take it. If you don't plan to try it or like the advice, speak up. Tell the therapist why so they can adjust accordingly. Otherwise, it will be a waste of time.
Fifth, be patient. Yes, therapy is a lot of money, especially if you are not working or don't have benefits. You are seeking therapy for a reason, and you spent your entire life becoming who you are today, or creating the problem you are trying to correct. Becoming someone different, or trying to change, is a process that takes time. Therapy is about investing in your future self.
By Andre Stam, RP, CCC, OCT, is a psychotherapist who specializes in sleep, teacher support, burnout, anxiety, and depression. He has training in CBT. CBT-I, DBT, SE, and Narrative therapy.
