If your therapist suggests an activity between sessions, ask what it involves, why it is being suggested and how you should respond if you become unsure or distressed. Leave with a shared understanding of the task, not just a worksheet whose instructions you hope to reconstruct later.
This guide is about discussing work assigned within an existing therapeutic relationship. It does not provide a treatment exercise or tell you to begin exposure, trauma processing or another intervention on your own. Different therapies use between-session work differently, and some do not use it at all.
Ask what the activity is intended to explore
Start with the purpose in ordinary language. You might ask, “What are we hoping to learn from this?” or “How does this connect to what we discussed today?” The answer helps distinguish the intended activity from a more ambitious task you might otherwise set yourself.
The NHS description of cognitive behavioural therapy explains that practice outside sessions can form part of CBT. That does not mean every worksheet found online is suitable for every person or that every therapy follows the same approach.
Ask which part of the activity matters most. If the therapist wants a brief observation, you may not need a lengthy written account. If a specific sequence is important, ask for it to be explained rather than replacing it with your own interpretation.
You do not have to agree that an activity sounds easy. Understanding its purpose and discussing concerns are legitimate parts of the conversation, especially when you are uncertain how it relates to your goals.
Define the task in words you can repeat back
Try summarising the instruction: “My understanding is that I will do this part, in this situation, and bring these notes back.” Ask the therapist to correct any misunderstanding. This is especially useful when several topics were covered near the end of a session.
Clarify whether the written material is the activity itself, background reading or an optional reference. A folder containing several handouts can be confusing if you do not know which one you are expected to use before the next appointment.
Ask about the intended amount and frequency rather than deciding that more practice must be better. Record the agreed scope in the therapist’s terms. Do not intensify an exercise to compensate for missing a day or to demonstrate commitment.
If instructions use unfamiliar language, request an example from the therapist that fits the agreed treatment plan. You should not need to infer the procedure from a search result that may describe a different intervention.
Explain practical barriers before leaving
Mention anything that may make the task difficult to carry out: lack of privacy, shift work, reading difficulties, limited internet access or a format you cannot use comfortably. These details can change how the plan needs to be communicated or organised.
For example, a paper worksheet may be impractical if others regularly inspect your belongings. An app may be unsuitable if you share a device. Tell the therapist the constraint and ask about an appropriate alternative rather than choosing a potentially exposing storage method.
Be honest about the time and attention you have available. A plan that assumes a quiet hour every evening may not fit your circumstances. Ask what a manageable version would involve without independently changing the therapeutic content.
Self-care when overwhelmed addresses broader daily support. A therapist-assigned activity has its own purpose and boundaries, so discuss how it fits rather than adding it to an already impossible list of obligations.
Agree what to do if the experience is difficult
Ask what difficulties the therapist expects, what should prompt you to pause and how to seek guidance. The answer should be specific to the activity and your care. A general article cannot decide how much distress you should tolerate or whether a particular response is safe.
Clarify between-session contact arrangements. Is there a message route for brief questions? When is it monitored? What should you do outside those hours? Do not assume a therapist’s inbox provides immediate support unless that has explicitly been arranged.
If you feel unsafe or need urgent help, use appropriate urgent local support rather than waiting for the next routine appointment or an ordinary email response. Keep any existing crisis or safety arrangements from your care team accessible and separate from the task worksheet.
An unclear instruction is a reason to ask, not a reason to improvise a more intense exercise. If you cannot safely resolve the uncertainty, avoid extending the task beyond what was clearly agreed and contact the appropriate care provider.
Use a fictional clarification note
Imagine a therapist has suggested a short written observation as part of an agreed plan. The following example records questions, not the content of a clinical exercise or instructions for readers to copy.
| Item | What to clarify with the therapist |
|---|---|
| Purpose | What are we hoping to understand? |
| Scope | Which part should I do, and how often? |
| Record | What information should I bring back? |
| Difficulty | When should I pause or seek guidance? |
| Contact | Which route is appropriate for a question? |
| Review | When will we discuss what happened? |
The note might end with: “I am unsure whether you want brief notes or a detailed account. Could we confirm that before I start?” That question is more useful than spending the week writing pages based on an assumption.
The therapist may alter the plan after hearing the concern. Record the revised agreement clearly so you are not left choosing between two versions of the instruction later.
Bring an honest account of what happened
At the next session, describe what you tried, what you understood and what prevented completion where relevant. You do not need to manufacture a successful result or reconstruct notes you did not make. An accurate account gives the therapist something real to discuss.
If the task was not attempted, explain the point at which it became difficult. “I could not find a private place” and “I did not understand the second instruction” describe different barriers. Neither is clarified by a general statement that you failed.
If you changed something yourself, say what changed. The therapist needs to know which activity you actually did rather than assuming it matched the original instruction. Do not hide the difference because the finished worksheet looks more complete.
Keep the review focused on information and next steps. A task record is not a moral score, and the purpose of discussing it is not to prove that you are a good or bad therapy client.
Revisit the agreement when needed
If activities repeatedly feel unclear, ask to reserve time at the end of sessions to summarise the next step. A brief shared written note or read-back may help more than accumulating additional handouts.
The NIMH overview of psychotherapy encourages questions about treatment and describes choosing care according to individual needs with professional guidance. Use that conversation to raise concerns about the approach, rather than assuming that difficulty with one task settles whether therapy can help at all.
Considering whether therapy could help and taking the step to seek support address broader decisions. Within ongoing care, the immediate goal is a task you understand, a clear way to raise problems and a planned opportunity to review the experience.
Keep the latest agreed instruction and retire confusing duplicates from your working notes. The useful outcome is shared understanding between you and your therapist, with enough clarity to avoid turning an assigned activity into an unsupported experiment.