Try to be open and honest. This is true, simple, and not easy. The more honest you can be, the more you will benefit from therapy.
Do your homework. Cognitive-behavioral therapy often involves reading, self-monitoring, and other “homework” assignments. Studies (and personal experience) have shown that doing homework leads to better outcomes in therapy. Still, homework only helps if you actually do it!
Remember that anxiety and discomfort are normal. Attending therapy involves saying things that you would not normally say to a stranger, and requires you to talk about uncomfortable aspects of your life--the things that make you anxious. Feeling anxious at therapy is like sweating at the gym. If you’re not doing it at all, you’re probably missing out.
Talk about whatever seems important. Sometimes, when people seek treatment for one particular problem (say, sleep difficulties), they assume they should not bring up something else (say, an argument with their partner). But, our lives are not compartmentalized. What happens in one place affects what happens over there. When in doubt, bring it up!
Consider taking notes or recording sessions. In therapy, you’ll probably discuss things that are anxiety-provoking or emotionally overwhelming. When you are in this state, processing and retaining information can be difficult. For that reason, taking notes and recording sessions can be beneficial. This is especially true if you experience severe anxiety or difficulty concentrating. Some people have told me that they did not really “get” something we discussed until they went back later and listened to it again.
Give your therapist feedback. Chances are, your therapist is like most people: Well-intended but imperfect. It is perfectly appropriate and helpful to offer feedback.
If you are considering stopping therapy, let your therapist know. People sometimes find this difficult. If you are considering ending therapy because you have made some real improvements, it can be useful to discuss strategies for maintaining those improvements after therapy ends. If, on the other hand, you are not seeing the results you would like, it is worth discussing whether a change of approach or an outside referral is in order. And, if practical or financial considerations present an obstacle, those can usually be worked out.