What to Talk About in Therapy

Medically reviewed by Mark Hrymoc MD

If you’re considering therapy, you may be wondering what to talk about in therapy. Most therapists are good at helping you transition from one topic to the next. Because most people have lives that are busy and overloaded with obligations, you will likely find you have more issues to discuss in session than you have time.

Sometimes, you aren’t sure what to discuss in therapy, and that’s okay. It happens. To reduce the times that this occurs, list various life topics, and refer to them before or during your session. When listing topics, you can choose broad and narrow issues to discuss. Also, don’t feel obligated to engage in deep conversations until you and your therapist have established a trusting relationship.

In the first therapy session, your therapist will explain how therapy works and may ask questions to help them assess your mental health needs. 

What is Therapy?

You and your therapist need to be on the same page regarding the definition and expectations of the therapeutic process. Therapy is a form of talk therapy between you and a counselor. It is often combined with other therapies, such as medications, group therapy, family therapy, and psychoeducation.

Therapy may also combine traditional treatment methods with alternative ones.

Examples of alternative therapies include the following:

• Art and music therapy
• Play therapy
• Animal-assisted therapy
• Meditation
• Yoga
• Acupuncture

Ketamine-assisted therapy is available for those with treatment-resistant depression and anxiety. You may qualify for ketamine-assisted treatment if you have tried many other therapies without success.

The types of treatments available are a great conversation starter in therapy. 

Let’s take a closer look at what to talk about in therapy.

What to Talk About in Therapy

When considering what to talk about in therapy, one vital topic to explore is your emotional well-being. It is essential to discuss your emotions openly, as they can provide valuable insights into your overall mental health. Delve into your feelings, discuss the triggers behind them, and reflect on how they impact your daily life. Exploring emotions can be challenging, but with the guidance of a professional therapist, you can better understand and manage them, ultimately improving your emotional resilience and overall well-being.

Another important subject to tackle in therapy is your relationships with others. This could include your connections with family members, friends, or romantic partners. Talk about the various dynamics within these relationships, as well as how they affect your mental health. Address any conflicts, patterns of behavior, or unresolved issues that might have contributed to your present state. By gaining a better understanding of how your relationships impact you, you can learn to establish and maintain healthier connections.

Finally, discussing your personal goals and aspirations can be a valuable component of therapy. Reflect on the areas of your life where you would like to see improvement, such as career, education, or personal development. Consider the obstacles that have hindered your progress and brainstorm strategies for overcoming them. By setting clear goals and discussing them with your therapist, you can receive guidance and support to help you achieve the changes you desire, fostering a greater sense of accomplishment and self-worth.

Short-Term and Long-Term Goals

Setting goals is vital for every aspect of your life, including therapy. The goals you set in treatment can focus on what you want to achieve, including areas of improvement personally, professionally, academically, or socially. 

Short-term goals focus on what you want to improve in the first few months to a year of therapy. Long-term goals are the changes you want to happen in the next year or longer. Goals should be realistic and attainable and focus on you since you cannot change anyone else.

Thoughts

Fundamental theories in psychology suggest that your thoughts influence your feelings and emotions, which then influence your behaviors. You think about a situation and react rationally or irrationally when it arises.

Thoughts, especially negative thoughts, lead to a chain reaction that eventually affects your mental health. The more you repeat negative thoughts, the more significant the impact. Using cognitive-behavioral therapy, you can learn to recognize irrational negative thought patterns, stop them, and substitute them with positive thoughts. 

When struggling for something to talk about, tell your therapist about some of your thoughts, especially those that seem to repeat themselves daily. Are you having flashbacks, nightmares, or random worries? If so, discuss them in therapy.

Emotions

Consider your emotions and emotional responses if you have trouble deciding what to discuss in therapy. Emotions occur with each experience you have. The experience triggers a physiological reaction and then an emotional reaction. For example, you receive great news, your heart starts racing, and you feel happiness and joy.

Examples of other emotions include:

• Anger
• Fear
• Sadness
• Disgust
• Surprise 

Think about when you felt one of these emotions and process your reactions. If you have inappropriate reactions, such as becoming violent when angered, your therapist can teach you how to cope better.

Relationships

Relationships impact mental health and vice versa. In an abusive relationship, you may also experience depression, anxiety, and other mental health issues. If you have a mental health disorder, such as bipolar or obsessive-compulsive disorder, it will affect your relationships.

Healthy relationships are important at home, work, school, and socially. Working with a therapist, you can learn how to replace unhealthy relationships with healthy ones. Essential factors of good relationships include setting boundaries, building trust, communicating effectively, resolving conflicts, and having fun.

Think about all the relationships in your life and analyze them individually with your therapist. Together, find ways to improve each one.

The Good Stuff

Therapy does not require only discussing your faults or the things going wrong in your life. Talking about your strengths, awards, good times, and things that make you happy is just as crucial for your mental health. You must recognize that you have many great qualities, and talking about them builds self-esteem and gives you the confidence to strive towards success in all areas of life.

Celebrate the good stuff. Discuss whether the good things are related to the progress you are making in therapy. Be proud of the work you’ve done. If you have multiple sessions of talking about the good things and you’ve made measurable progress, it may be time to talk about transitioning to fewer therapy sessions.

Additional Topics to Discuss in Therapy

The list of things to talk about in therapy is extensive. Bring up any topic as long as it is relevant to your mental health. Below are examples of appropriate topics you can choose:

• Events in your past that had a major impact on you.
• Day-to-day life experiences.
• Medical conditions you have.
• Stress and stress management.
• Coping skills.
• Bad habits you’d like to change.
• Parenting issues.
• Communication styles.
• Personal fears or phobias.
• Substance abuse.
• Benefits of therapy

From gender identity to finances, no topic is off limits if they apply to your life. However, you don’t want to spend time on a topic that doesn’t help you somehow.

Finding the Right Therapist

Now that you know what to talk about in therapy, you can confidently begin your search for the right therapist for your needs. Finding the right therapist may involve meeting with multiple professionals to find the one you connect with the most. The search may be easier if you work with a treatment center that employs various therapists. They can match their therapists’ specialties with your needs during your initial assessment. 

Also, a treatment center, like the Mental Health Center, provides collaborative care on-site. They have a psychiatrist available if medication is needed, traditional and alternative therapies, treatment-resistant therapies, group support programs, and much more. Take the first step in seeking help and the rest will fall into place.