What to Do Between Therapy Sessions

Therapy is one hour a week, sometimes less. What happens in the other 167 hours determines whether that hour actually changes anything.

A lot of people think about therapy as a place you go where the work happens, and then the rest of the week you’re waiting for the next session. But that’s backwards. The session plants seeds. Everything between sessions is the growing.

What the Between-Session Space Is Actually For

The purpose of between-session time isn’t to summarize your week for your next appointment. It’s to keep the therapeutic process alive when you’re not in the room. That might mean practicing a skill your therapist introduced. It might mean noticing a pattern in real time instead of reconstructing it from memory. It might mean sitting with a question that came up in session rather than letting it fade the moment you walk out the door.

Therapy works through repetition and application. An insight you have in a session but never apply is interesting but not transformative. An insight you sit with, test out, come back to, and slowly integrate — that’s what actually changes things.

Keeping a Between-Session Journal

You don’t need to be a writer for this to be useful. The journal doesn’t need to be elaborate or literary. It just needs to capture what’s actually happening in your mind and life.

After a session, write down the main thing that came up. Not a transcript — just the thread you want to stay connected to. What was the insight or question you left with? What did your therapist say that landed? What came up that you didn’t fully get to?

During the week, note moments that feel relevant. A situation that triggered something familiar. A feeling you couldn’t quite name. A moment where you responded differently than you usually would and want to understand why. A recurring thought that keeps surfacing.

When you come back to your next session, you have raw material rather than a vague sense that something happened that felt important but you can’t quite remember now.

Actually Practicing What You’re Learning

If your therapy involves skills — CBT thought records, DBT emotion regulation tools, mindfulness practices, communication techniques — they don’t work unless you practice them. Not just in crisis moments, but when things are calm enough that you can actually do it intentionally.

Think of it like physical therapy. A physical therapist gives you exercises to do at home. If you only show up for the session and never do the exercises, recovery is slow or doesn’t happen. Psychological skills are the same. They need repetition in the conditions of your actual life to become automatic.

Some people find it helpful to schedule practice. Ten minutes in the morning for a mindfulness exercise. A thought record at the end of a difficult day. A brief review of what you’re working on before an anticipated challenging situation. The scheduling makes it more likely to actually happen, especially early in the process when the habits aren’t built yet.

Sitting With Rather Than Solving

Therapy often surfaces things that feel unresolved, and the instinct is to either immediately analyze your way to an answer or push the discomfort aside until the next session. Neither tends to be the most useful response.

There’s a third option: sitting with it. Staying curious about what came up without rushing to conclude. Letting the question breathe.

Some of the most important shifts in therapy happen not during sessions but in the days after, when an idea is slowly integrating, when your unconscious is working on something in the background. If you immediately distract yourself from anything uncomfortable that comes up in therapy, you short-circuit that process.

Sitting with something uncomfortable is a skill in itself. You’re building the capacity to tolerate uncertainty and difficult feelings without immediately escaping them. That capacity is part of what therapy is trying to develop.

Noticing Your Patterns in Real Time

One of the things that differentiates people who grow in therapy quickly from people who stay stuck is the habit of self-observation. Noticing your patterns in real time rather than only recognizing them in retrospect.

During the week, when you find yourself in a charged situation — getting defensive, withdrawing, overreacting to something small, people-pleasing when you don’t want to — try to catch it as it’s happening. Not to stop it immediately (that’s advanced), but just to notice it. “There’s that thing.” “I’m doing the avoidance thing again.” “I’m angry in a way that feels bigger than the situation.”

The noticing creates a gap. That gap is where change is possible. Even if you go ahead and do the old behavior anyway, you did it with awareness, and awareness is where all therapeutic change eventually starts.

Connecting to Your Reasons for Being in Therapy

It’s easy to lose touch with why you started therapy, especially during stretches when things feel relatively stable. Sessions can drift into processing whatever came up that week without sustaining direction.

Between sessions, return to your original reasons. What are you trying to change? What do you want your life to look like that it doesn’t look like now? What relationships, experiences, or ways of being matter enough to you that you’re spending time and money on this?

Having that direction in mind helps you notice relevant material during the week. It also helps you come to sessions with intention rather than just filling time.

Movement and Physical Wellbeing

It’s not a substitute for therapy, but the physical dimension of wellbeing is genuinely relevant to mental health work. Sleep deprivation makes emotional regulation harder. Chronic sedentary behavior affects mood and energy. Exercise has real anxiolytic and antidepressant effects.

Between sessions, basic self-care — getting enough sleep, moving your body, spending some time outside, limiting substances that destabilize your mood — creates better conditions for the work. You can’t do deep emotional work well when you’re chronically exhausted and never leave the house.

None of this has to be extreme or Instagram-worthy. A thirty-minute walk, a reasonable bedtime, one meal a day that doesn’t come from a drive-through. Small consistency matters more than dramatic overhaul.

What to Do When You Have a Hard Week

Sometimes between sessions, things fall apart. A relationship crisis, a work collapse, a depression that descends out of nowhere. What do you do?

First, write it down if you can. Not to process it completely on your own, but to capture it while it’s fresh so you can bring it to your therapist.

Second, use whatever skills you have. Even imperfectly. Even if it only takes the edge off.

Third, remind yourself that the session is coming. You don’t have to resolve this today. You’re not alone in it.

And if things are genuinely dire — if you’re in crisis, thinking about hurting yourself, or in danger — reach out beyond waiting for your appointment. Your therapist’s practice may have emergency contact procedures. Crisis lines are available 24/7. Crisis care is not a sign of failure; it’s using the appropriate level of support for the situation you’re in.

The between-session work isn’t dramatic. It’s consistency, attention, and the quiet daily commitment to the growth you’re in therapy to find.

This article is for educational purposes only and is not a substitute for professional mental health treatment. If you are experiencing a mental health crisis, please reach out to a qualified mental health provider or call 988.