What to Do Between Therapy Sessions: Five Practices to Help You Grow
Learn simple Tools for Reflection and Mindfulness to deepen your progress between Appointments
Reframing the Path, by licensed therapist Melissa Rolfes, is your guide to making the most of your therapeutic journey, helping you feel more confident and effective every step of the way. The information provided here is for educational purposes only, and is not a substitute for professional mental health or medical care, nor does it establish a therapist-client relationship. If you're experiencing distress and feel unable to keep yourself safe, please access these resources.
Therapy Doesn’t Have to Stop When the Session Ends
The work you do in your counseling sessions is only one part of the therapeutic process. Real change takes shape in the days between, when insight meets daily life. The conversations we have together start the process, but growth continues as you move through your routines, relationships, and moments of awareness. What happens between sessions often shapes how deeply the work takes root. It’s where you start to notice your thoughts, emotions, and patterns in real time, and practice new ways of responding.
The time between sessions isn’t about doing more work or filling every quiet moment with self-improvement. It’s about integration, letting insights settle and experimenting with what feels different. In this post, we’ll look at five simple practices that can help you stay connected to your growth between sessions, no matter where you are in your therapy journey.
A Note About Self-Reflection
Self-reflection is at the heart of therapy. It’s the practice of turning your attention inward with curiosity instead of judgment, noticing what you think, feel, and need in real time. Reflection isn’t about analyzing every detail or trying to fix yourself; it’s simply awareness. When you pause to observe what’s happening within you, even briefly, you create space for something new to take shape.
It’s important to remember that reflection and rumination aren’t the same thing. Reflection is grounded in curiosity, and the more curious we are, the less judgmental we become. Rumination, on the other hand, tends to spiral into worry or self-criticism. If you find yourself looping or feeling stuck in your thoughts, take a slow breath and bring your awareness back to your body. Think of your attention like a puppy in training; when it wanders off the pad, gently pick it up and place it back. That small redirection can reconnect you to the present moment, where insight has room to grow.
Five Simple Tools to Stay Connected to Your Growth Between Sessions
The tools below are gentle ways to stay connected to your process and support continued growth outside of appointments.
1. Journaling
Journaling gives shape to your inner world. Putting thoughts to paste can help you see patterns, name emotions, and track progress over time. It doesn’t have to be a perfect production of daily entries. It’s just about pausing long enough to listen to yourself.
Sometimes it can be daunting to stare at a blank page, so it helps to start small. Try writing a few sentences about moments that stood out this week. If you experienced a strong emotional response, jot down the “who, what, when, where, and why,” and reflect on how you got through it. Notice what helped you regulate or what you might want to try next time.
You can also use prompts to get your journaling process flowing:
What am I learning about myself right now?
When did I feel most grounded or at ease this week?
What thought or story has been on repeat lately? Is it true, or is it just familiar?
What mental habit am I noticing, and is it helpful or not helpful?
What felt like progress, even if it was small?
How did I care for myself (or avoid caring for myself) this week?
What’s something I want to remember from this week’s therapy session?
Keep your journal simple and consistent. It can be a notebook (who doesn’t love buying new stationary?), a notes app, or even a voice memo on your phone. What matters most is making space to notice and name what’s unfolding . This way your awareness becomes something more tangible, something you can bring back to therapy.
2. Tracking Symptoms
Tracking your symptoms can be one of the most useful tools for enhancing your progress in therapy. It not only helps you identify contributing factors to why you feel the way you do, but it also gives your therapist valuable insight to better understand what’s happening between sessions.
You can track whatever feels most relevant to your goals, such as mood, anxiety level, sleep quality, physical tension, or energy. Simple rating scales can work well (for example, “anxiety 6/10” or “sleep 8/10”). It doesn’t matter what your scale is, as long as its the same scale every time.
If you prefer structure, I recommend creating a spreadsheet, where each row is a different date, and each column is a different item to track. Below I have shared all the items/columns from the spreadsheet I share with clients. Take what you need and leave the rest:
Menstrual Cycle: Note Day 1 (the start of your period) and premenstrual days (roughly Days 21–28). Hormonal shifts can impact mood, anxiety, and energy, so tracking your cycle helps connect physical changes to emotional patterns.
Medications: Record whether you took medications as prescribed and note any PRN (“as needed”) medications used. Consistency and changes can both affect mood and cognition.
Sleep: Track hours slept and quality of rest. Include whether you had difficulty falling or staying asleep and how rested you felt upon waking.
Physical Activity: Log any movement or exercise, including rest days. Activity often influences energy and overall mood stability.
Appetite: Observe eating patterns — overeating, undereating, or loss of appetite can all indicate shifts in emotional or physiological state.
Substance Use: Note use of caffeine, alcohol, or other substances, as they can influence anxiety, sleep, and overall wellbeing.
Stress and Triggers: Identify key stressors or situations that increased symptoms (work, social, family, finances, etc.).
Pain and Physical Symptoms: Record chronic or acute pain (like headaches or muscle tension) that may be connected to stress or anxiety.
Mood and Emotions: Choose a daily mood rating (😊🙂😐🙁😞) and jot down any strong emotions or themes that stood out.
Thoughts and Self-Talk: Track common thought patterns — whether they’re self-critical, anxious, or balanced — to identify cognitive habits over time.
Energy and Motivation: Use a simple 1–5 scale to capture your daily energy level and task initiation or follow-through.
Coping and Self-Care: Note any strategies or activities that helped you manage stress (e.g., mindfulness, social connection, creative outlets) and how effective they felt.
Patterns often tell a story: maybe anxiety spikes before certain meetings, sleep quality drops after drinking caffeine late in the day, or your premenstrual phase heightens irritability. Over time, these small data points build a clearer picture of your inner landscape and make your therapy sessions more targeted and productive.
Remember, this practice isn’t about grading yourself. It’s about gathering information; noticing what’s changing, what’s consistent, and what needs more care or attention as you continue your work in therapy.
3. Values assessment
Therapy often helps clarify what truly matters to you… the people, priorities, and principles that give your life direction. A values assessment is a way to step back and evaluate whether your current actions, habits, and boundaries align with what’s most important to you, which can create a stronger sense of integrity and ease in daily life.
You can begin by identifying a few core values that resonate with you. These may shift over time, but common examples include authenticity, compassion, balance, connection, creativity, independence, and growth. Once you’ve named your values, reflect on how they show up (or don’t) in your daily life.
Here are a few prompts to guide your own values assessment:
Which of my current actions or routines feel aligned with my values?
Where do I notice tension between what I believe in and how I spend my time or energy?
What situations bring out the best in me — and what values are at play when that happens?
What boundaries or habits might help me live more in line with what matters most?
How do my values influence the way I care for myself and relate to others?
You don’t have to get it perfect. The goal is to increase awareness, not judgment. Values assessments can help you reconnect with what steadies and guides you, especially when you’re feeling overwhelmed or unsure of your next step.
4. Mindful Pauses
Mindful pauses are short moments of awareness woven into your day. They don’t have to look like formal meditation or long breathing exercises. Instead, they’re small interruptions to your autopilot. brief check-ins with yourself that invite you to notice how you’re feeling, what you need, or what’s happening around you.
You can start by pausing for a few seconds between tasks, before a meeting, or while waiting in line. Notice your breath, your posture, or the way your body feels against the chair. Ask yourself, What’s my body telling me right now? What am I feeling or needing in this moment?
These moments can be complemented by also taking a few diaphragmatic breaths, also called belly breathing, where you inhale slowly through your nose and your belly rises on the inhale, as if its filling with air. Then you pause, and exhale even slower through your nose, and feel the belly fall. This gets the diaphragm moving, which activates the “rest and digest” part of your nervous system (the counterpart to “fight or flight”).
Mindful pauses can help you recognize early signs of stress, overwhelm, or disconnection before they build. Over time, they strengthen self-awareness and make it easier to apply what you’re learning in therapy to real life.
5. Creating micro-habits
Lasting change doesn’t usually happen through big, sweeping shifts. More often, it builds through small, consistent actions that reinforce new ways of thinking, feeling, and behaving. Micro-habits are small, simple, repeatable behaviors that can lead to big changes and can support the growth you’re working toward in therapy.
If you’ve read my post about the connection between thoughts, feelings, and behaviors (and how to break those cycles), you already know that change in one area can influence the whole pattern. Micro-habits are one of the most effective ways to begin that process. By changing a single behavior, you start to shift both your emotional and cognitive patterns over time.
When creating a new habit, keep it small and realistic. Using the SMART framework can help:
Specific: Choose one clear behavior.
Measurable: Decide how you’ll know you’ve done it.
Achievable: Make it something you can actually follow through on right now.
Relevant: Connect it to your therapy goals or values.
Time-bound: Give it a window, such as “I’ll try this for one week.”
A few examples of micro-habits might be:
Writing one line of gratitude in your journal before bed.
Taking two slow, intentional breaths before responding in a tense conversation.
Spending five minutes tidying your space or stepping outside between work tasks.
Balancing one self-critical thought with a compassionate one.
Choose one small way you can care for your body differently, such as washing your face before bed, or dry brushing daily before showering.
Micro-habits work because they’re manageable. They’re small enough to practice even on difficult days, but powerful enough to create momentum. Over time, these tiny shifts can rewire your behavioral patterns and reinforce the insights you’re developing in therapy. And you can even work with your therapist to better identify which micro-habits are best for you.
Do you Want to create a micro-habit of less screen time? Check out my post about starting a Digital Detox.
Bringing It All Together
Therapy is most effective when it continues to unfold beyond the hour we spend together. The time between sessions is where insight, awareness and small actions become lived experience and begin to shape new patterns.
Whether you’re journaling, tracking symptoms, checking in with your values, practicing mindful pauses, or building micro-habits, each of these tools helps you stay engaged in your process. They don’t replace therapy, they extend it. This helps you integrate what you’re learning into the rhythm of your daily life.
Growth rarely happens all at once. It happens in the small choices, honest reflections, and steady attention to yourself. Over time, these practices help you build a deeper sense of awareness and agency, both in and beyond therapy.
Growth is easier with support.
I work with adults across Virginia through online therapy, guiding clients in session and empowering them to grow outside of our time together. Therapy is a space to deepen awareness, gain clarity, and build tools that support real change. This work can take place between appointments as well. If you’re a Virginia resident who is ready to continue your growth both in and between sessions, I hope to hear from you.
