How to Get the Most Out of Therapy: 7 Things to Do Between Sessions

Written by Stephanie Underwood, MSW, RSW

Counselling works best when the growth continues outside the session. Here are seven evidence-informed strategies to help you process deeper, build momentum, and get more out of every appointment.

KEY POINTS

• The fifty minutes you spend in a counselling session are only part of the process. What you do in the days between sessions shapes how much of that work actually takes root.

• Healing is not a passive process. It requires practice, reflection, and a willingness to stay engaged with the work even when your therapist is not in the room with you.

• You do not need to overhaul your life between appointments. Small, consistent actions compound into significant change over time.

The Work Does Not End When the Session Does

There is a common misconception about counselling that is worth addressing directly.

Many people assume that healing happens primarily inside the session. That the conversation with their therapist is the medicine, and everything outside of it is just waiting for the next dose. That as long as they show up consistently and engage honestly in the room, the work is being done.

The session is important. It is the place where patterns are named, where insights emerge, where the relational experience of being genuinely seen and heard begins to do its own corrective work. But fifty minutes, once a week or once every two weeks, is a fraction of your life. The rest of it, the actual living, is where the real integration happens.

What you do between sessions determines how much of what was discovered in the room actually becomes part of how you move through the world.

The strategies below are not about adding more pressure to an already demanding process. They are about helping the work land more deeply, so that each session builds on the last rather than starting over.

1. Write It Down: Why Capturing Insights Between Sessions Matters

Counselling sessions can produce moments of genuine clarity that feel vivid and significant in the room, and then begin to fade within hours of leaving. This is not a failure of attention. It is simply how the brain processes emotionally significant material. The insight happened. The nervous system has not yet had time to consolidate it.

Creating a dedicated note, whether in a journal, a notes app, or wherever is most accessible to you, gives those insights somewhere to live before they dissolve back into the noise of daily life.

What is worth tracking between sessions includes the key takeaways from each appointment, the moments during the week where you noticed yourself reacting in a familiar pattern, the wins, however small, where you did something differently, and the questions or topics that felt unfinished and deserve to be brought back into the next session.

You do not need to write extensively. A few sentences is enough. The act of writing is itself a form of processing.

2. Track Your Thoughts, Beliefs, and Schemas: Becoming a Student of Your Own Patterns

One of the most valuable things you can do between counselling sessions is begin to notice, and record, the thoughts and beliefs that show up repeatedly in your daily life.

This is particularly significant if you are doing schema-informed work, where the goal is to identify the deeply held beliefs that developed in childhood and are now running in the background of your adult relationships and behaviors. Those beliefs do not announce themselves. They show up as automatic thoughts, emotional reactions, and behavioural impulses that feel like facts rather than patterns.

Keeping a simple log changes that. When you write down the thought that fired when your partner seemed distant, or the belief that showed up when you made a mistake at work, you are catching the pattern in real time, across real situations, with real emotional stakes. Over time, that log becomes a map.

3. Notice Patterns Without Judging Them: The Practice of Compassionate Observation

Between sessions, one of the most powerful things you can do requires no journaling, no logging, and no active effort. It simply requires paying attention.

Observation is the first step toward change, and it is a step that most people skip because they are too busy judging what they notice to actually see it clearly. When a familiar reaction shows up, the instinct is often to criticize it, to use it as evidence that something is wrong or that the healing is not working.

Between sessions, pay attention to the thoughts that keep returning, the emotional triggers that show up across different situations, the relationship dynamics that feel uncomfortably familiar, and the behaviours you find yourself repeating even when you do not want to. Not to fix them yet. Simply to see them. What you are willing to observe without judgment, you can eventually understand. And what you can understand, you can begin to change.

4. Practice One Small Skill: Why Consistency Beats Intensity Every Time

Counselling sessions often introduce skills. Boundary-setting, cognitive reframing, grounding techniques, communication strategies, distress tolerance tools. And it is tempting, particularly early in the process, to try to implement all of them at once. That approach rarely works. Not because the skills are not valuable, but because the nervous system does not change through intensity. It changes through repetition.

Between sessions, choose one thing to practice. Just one. It might be pausing before you react in a conflict and asking yourself what schema is being activated. It might be setting one small boundary that your usual pattern would have you avoid. It might be challenging a negative thought about yourself that shows up regularly, or asking for support from someone in your life rather than handling something alone.

The skill does not need to go perfectly. Small actions, practiced consistently over time, create changes that no single session, however powerful, can produce on its own.

5. Be Curious About Setbacks: What a Difficult Week Can Actually Teach You

At some point in the counselling process, most people have a week that feels like regression. A week where the old patterns came back in full force, where the skills did not work, where something happened that seemed to undo progress that felt real.

A difficult week does not mean counselling is not working. It means you are a human being in the middle of a non-linear process, encountering the natural resistance that comes with genuine growth. The question most people ask in these moments is: why am I back here again? The more useful question is: what can I learn from this? Setbacks, examined with curiosity rather than judgment, are some of the most useful data points in the entire healing process. Growth is rarely linear.

6. Prioritize the Basics: Your Nervous System Cannot Heal in a Depleted Body

Mental health work is harder, slower, and less effective when the body's basic needs are not being met. The nervous system does not operate in isolation from the physical systems it lives inside. When sleep is consistently poor, when the body is dehydrated or undernourished, when there is no movement and no time outside, the nervous system's capacity for regulation, learning, and integration is genuinely compromised.

Between counselling sessions, tending to the basics is not a distraction from the healing work. It is part of it. Consistent sleep. Adequate hydration. Nourishing food. Some form of movement. Time outdoors, even briefly. These are not luxuries. They are the physiological foundation that makes everything else possible.

7. Give Yourself Time to Process: The Space After a Session Is Part of the Work

Counselling sessions frequently bring up material that does not resolve neatly within fifty minutes. Memories, emotions, new perspectives, and uncomfortable recognitions do not always finish processing the moment the session ends. Sometimes the most significant integration happens in the hours immediately afterward, if you give it the conditions it needs.

Wherever possible, try to schedule counselling at a time that allows you some unstructured space afterward. Not back-to-back with a demanding meeting or a long commute in heavy traffic. Enough breathing room to let what was stirred up begin to settle.

In that window, consider journaling about what stood out during the session while it is still fresh. Take a walk. Rest if you need to. Some sessions are genuinely tiring in ways that deserve to be acknowledged rather than pushed through. Practice a grounding exercise if the material brought up was activating. Counselling asks a great deal of the nervous system. The time immediately after a session is not downtime. It is integration time.

A Final Note

If you are currently in counselling, the fact that you are there matters. Seeking support is not a small thing. For many people it is an act of genuine courage, particularly for those whose earliest relational experiences taught them that their needs were not worth addressing.

What happens inside the session is important. And what you bring to the time between sessions is equally so. You do not need to do this perfectly. You just need to stay engaged with your own process. To stay curious about yourself. To keep showing up, inside the session and outside of it, with as much honesty and compassion as you can access. The healing is happening even when it does not feel like it. Especially, sometimes, when it does not feel like it.