Therapy FAQ

Not Sure What to Talk About in Therapy? Here Are 12 Things to Consider

Therapy can be intimidating, especially if you don’t know what to expect or are worried about being judged. But here’s the thing: there’s no judgment in therapy — anything on your mind is fair game. You’re not alone in feeling uncertain about what to talk about in therapy.  Remember, it’s a safe place to explore […]

By Alan Deibel, LCPC

Updated on Jan 12, 2024

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Therapy can be intimidating, especially if you don’t know what to expect or are worried about being judged. But here’s the thing: there’s no judgment in therapy — anything on your mind is fair game.

You’re not alone in feeling uncertain about what to talk about in therapy. 

Remember, it’s a safe place to explore various areas of your life, relationship issues, goals, past experiences, or anything else. No topic is too big or too small, and you can discuss whatever is on your mind.

Your therapist will support and guide you through your journey without criticism. Take a deep breath, be yourself, and trust that therapy offers you a path to self-discovery and growth in a confidential space.

Your Relationship With Your Therapist

The therapeutic relationship is the most important part of therapy. It’s the foundation for your progress toward emotional well-being and personal growth. The quality of this relationship can significantly influence the effectiveness of therapy.

Therapy, also known as psychotherapy, can be helpful if you struggle with mental health problems or need help dealing with the stresses of everyday life. It can provide you with the support and tools you need. For example, you might share with your therapist that you are struggling with an eating disorder. You may be afraid to tell anyone else about this, but you feel safe and supported by your therapist. They listen to you with compassion and understanding and never judge you. This helps you feel more comfortable opening up.

Cynthia Mobley, a licensed independent clinical social worker and certified clinical trauma professional (LICSW, CCTP) at Grow Therapy, noticed that many individuals come to therapy with a specific problem in mind. “Maybe they recently experienced a break-up or their anxiety/stress level is high and is affecting many areas of their life,” she says. “Or maybe they have been feeling down for a while and want their old self back, or they are having relationship issues they are hoping to resolve.”

Here are some important components of the therapeutic relationship that foster trust and create a safe space for open communication, which ultimately promotes meaningful therapeutic progress:

Trust and Confidentiality

You need to feel safe and comfortable with your therapist, knowing that they’ll keep your information confidential. Your therapist should be someone you can trust to listen to your thoughts and feelings without judgment.

Non-Judgmental Support

Your therapist is there to support you, not judge you. They should listen to your concerns and emotions without making you feel ashamed. They should also be able to offer you non-judgmental support, even when you are talking about things that are difficult or embarrassing.

Collaboration and Empowerment

Therapy is a partnership between you and your therapist. You should feel empowered to take an active role in your own healing. Your therapist should help you set goals and develop strategies to reach them. They should also be collaborative, working with you to create a treatment plan tailored to your needs.

Emotional Connection

You should feel a connection with your therapist. They should understand you and make you feel safe to open up. This emotional connection can help you feel more comfortable discussing and working through your problems.

Honest Communication

It’s important to be honest with your therapist. They can’t help you if you don’t tell them what’s really going on. Honest communication is essential for therapy to be effective. Your therapist needs to be able to understand your thoughts and feelings to help you.

Boundaries and Professionalism

Your therapist should also set clear boundaries. They shouldn’t cross the line into personal relationships with you. This is important to maintain the relationship’s professional nature and avoid potential conflicts of interest.

What Exactly Happens in Therapy?

Therapy sessions usually last about 45 to 50 minutes. The first session with a therapist is usually an assessment. The therapist will ask you about your life and what you hope to achieve in therapy. They might also give you some questionnaires to complete. This is a good time to ask questions and see if you feel comfortable with the therapist.

Here are some specific questions that your therapist might ask during your first session:

The therapist will also want to get to know you as a person. They’ll ask you about your interests, hobbies, and values. They’ll also want to know about your relationships with your family, friends, and significant others.

If you feel comfortable with the therapist after the first session and think they can help you, you can continue therapy. It’s important to remember that you are in control. If you don’t feel comfortable with the therapist, you can ask for a referral to someone else.

What to Expect

You may be hesitant to start therapy because you don’t know what to expect. That’s perfectly normal. It’s not always easy telling a stranger your deepest thoughts, but this will get easier over time. In therapy, you’ll talk to your therapist about your problems and what you want to change in your life. This could involve:

Talking about your thoughts and feelings: In therapy, you’ll have a safe place to talk about your thoughts and feelings without judgment. This can help you understand yourself better and figure out what you need to change. 

Learning coping skills: Therapy can teach you new coping skills to help you deal with stress, anxiety, and other problems. These skills can help you improve your mood and well-being. Your therapist will teach you different techniques for managing your emotions, such as relaxation exercises, mindfulness, and cognitive-behavioral therapy.

Setting goals: In therapy, you’ll work with your therapist to set goals for yourself. This will help you stay motivated and focused on your progress. Your therapist will help you to identify your goals and develop a plan to achieve them.

Exploring your past: Sometimes, it can be useful to explore your past in therapy. This can help you understand why you are the way you are and how your experiences are affecting your life today. Your therapist will help you to make sense of these experiences.

Building a strong relationship with your therapist: It’s important to build a strong relationship with your therapist from the beginning. This will help you feel comfortable sharing your thoughts and feelings, and it’ll make therapy more effective. Your therapist should be someone you trust and feel comfortable with. 

What you and your therapist discuss can also change over time depending on what’s going on in your life. For example, if you get a new job and find that you are having difficulty adjusting, your therapist can help you with ways to make the transition easier.

Helpful Topics for Therapy

According to the National Institute of Mental Health, 5.4% of adults in the United States experienced serious psychological distress in the past month. This statistic highlights the importance of seeking support and considering therapy if you are facing emotional challenges or mental health concerns.

Therapy can be a valuable resource in addressing these issues, guiding you towards a healthier and happier state of mind. It is a safe space for open talks, self-reflection, and teamwork to create transformative journeys. For example, if you struggle with anxiety, therapy can help you identify triggers and develop relaxation techniques like deep breathing or mindfulness to reduce stress.

If you’re not sure where to begin, here are 12 common topics people typically explore in therapy:

1. Mental Health Concerns

Therapy offers a nurturing environment to address your mental health concerns, whether it’s anxiety, depression, stress, or any other emotional challenge affecting you. Your therapist can help you understand your thought patterns and behaviors, equipping you with coping mechanisms to manage symptoms effectively.

2. Relationships

Exploring the complexities of your past and current relationships is a crucial part of therapy. Whether it’s family members, friends, romantic partners, or coworkers, therapy provides a safe space to understand challenges, learn effective communication, and establish healthy boundaries to foster fulfilling connections.

3. Life Transitions

Significant life changes, such as job losses, moves, or divorces, can be overwhelming. In therapy, you can navigate these stressful events, learn coping strategies, and discover a renewed sense of purpose and strength to move forward.

4. Healing From Past Traumas

Therapy allows you to process and heal from past traumas that continue to impact your life. By addressing experiences like abuse or neglect, you can develop coping mechanisms and rebuild trust in yourself and others.

5. Boosting Self-Esteem and Confidence

Therapy is a supportive space to work on building a positive self-image, boosting confidence, and embracing your strengths. Overcoming negative self-talk and setting realistic goals can empower you to feel good about yourself and your accomplishments.

6. Coping with Loss

Grief and loss are powerful emotions that therapy can help you navigate. Whether it’s the death of a loved one, the end of a relationship, or a job loss, therapy supports you in processing emotions, finding meaning in loss, and finding a path forward.

7. Mastering Stress Management

Therapy equips you with effective stress management techniques, helping you identify stressors and develop relaxation strategies. Learning to set boundaries, and prioritize self-care and wellness allows you to live a more balanced and fulfilling life.

8. Achieving Personal Goals

Setting and achieving personal goals becomes more attainable with the support of therapy. By breaking down aspirations into manageable steps, overcoming obstacles, and tracking progress, you can move closer to meeting new goals that are realistic.

9. Understanding Anger and Emotions

Through therapy, you can explore and manage intense emotions, including anger. Identifying triggers and developing healthy coping mechanisms empowers you to communicate your emotions constructively.

10. Improving Communication Skills

Effective communication is the bedrock of healthy relationships. In therapy, you can work on expressing yourself more clearly, listening actively, and resolving conflicts in a productive manner.

11. Unveiling Your True Self

Therapy becomes a canvas for reflection on questions surrounding your identity and life purpose. By exploring values, interests, and strengths, you can develop a deeper sense of purpose in your life.

12. Overcoming Addictions and Building Healthy Coping Strategies

Therapy offers support in overcoming addictions and developing healthier coping mechanisms. Understanding addiction triggers and formulating a plan for recovery allows you to manage emotions in a more positive way, ultimately building a life free from the constraints of addiction.

How Your Therapist Can Help

Mobley gives some insights into what a typical therapy session can involve: “I usually follow these steps in order to help my clients to know what to talk about when they come to therapy:

After the specific issue, called the presenting problem, is discussed, which usually occurs in the first session, the patient may not know what else to say. The therapist should explore with the patient the reason why they are affected. For example, we all know break-ups are difficult, even if we could see it coming and agree it was necessary. The break-up may give us a negative feeling that needs to be explored. This may also be the case for anxiety, stress and even depressive symptoms.

I usually begin with a discussion about childhood. We learn our first messages from childhood. If our caretaker(s) was/were happy, sad, anxious, etc. we learn what that looks like and how to deal with those feelings/emotions. In therapy, I may not uncover anything specific during the session; however, afterwards, something ‘magical’ happens! My patient may remember something about childhood that is worth noting.

What I like to do to help my clients to ‘know what to talk about in therapy’ is to ask them to take notes when they feel the symptoms that brought them to therapy, and we discuss it at our next session. Keeping a notebook, tablet, or phone handy has helped my patients to keep notes about things they want to address in therapy.”

Getting Support Through Grow Therapy

Feeling unsure about what to discuss in therapy is normal, and you’re not alone. There are many types of therapy; whether you go in-person or prefer online therapy, it can be a life-changing experience, empowering you to address challenges, improve relationships, and develop coping skills.

To make the most of your therapy sessions, honesty and openness with your therapist are crucial. Embrace feedback on your thoughts and behaviors, even if it challenges you — it can lead to meaningful growth. Remember, therapy requires effort, and being willing to engage in exercises and homework provided by your therapist can accelerate progress. Nothing is off limits; if you are patient, results will come, but it might take some time.

Ready to begin your therapy journey? Explore Grow Therapy — a valuable resource for finding the right therapist. With search options for location, specialty, insurance, and patient reviews, you can make an informed decision that aligns with your needs and preferences. Take this step towards a healthier and more fulfilling life with confidence.

Frequently Asked Questions

About the author
Alan Deibel, LCPC

Alan Deibel is a licensed clinical professional counselor with over 12 years of experience who specializes in ADHD, addiction, anxiety, trauma, and PTSD.

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.

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