What to Talk About in Therapy: A Comprehensive Guide to Therapy Sessions

Attending therapy is a confidential space to discuss experiences, thoughts, issues, overwhelming feelings and the things you have gone through and are going through in your life. Counselling can be a place to work through stuff long in the past, or to sort out some confusions about your present situation and the goals you want to achieve going forward.

People come to therapy for an array of reasons, such as issues in a relationship, struggles with friends or family, challenges parenting, working on social problems, going through depression, and experiencing anxiety. Whatever the situation, your therapist will tailor the situation to meet your needs.

This article will discuss the question, “What do I talk about in therapy?” to learn the benefits of therapy. Counselling can help you overcome life obstacles as you invest in your well-being.

What Would the First Appointment with your Therapist Look Like?

The first meeting or two with your therapist will be based on an assessment, including a questionnaire on your general background, personal details, and the reasons that brought you to the office.

Some therapists do it by structuring the session to act as a guide as they learn more about you and your situation. Other counsellors may prefer to learn about the client by allowing them to freely speak about why they came to therapy in the first place. The therapist may offer a few questions of curiosity for the client to share more about themselves.

Either way, a good therapist will be listening to your responses in a way that helps you feel heard. This naturally causes your mind to want to share more. So don’t worry that you may not have much to talk about, or you may struggle to open up. With a good therapist, talking will happen naturally as you feel cared for through compassion and curiosity.

To read about the signs of a good therapist, click here.

What to Discuss with the Therapist

The short answer is, everything that you would like to talk about. The time is yours; it is your session, and you can decide what you want to discuss with the therapist. It is common to think about things you want to share and then show up at the office, and your mind goes blank. You could have something specific on your mind.

It is also common to go to therapy with not much on your mind but openness to how the session will unfold. Again, the therapist is there to support your needs. Your psychotherapist might ask you what you’d like to talk about. Either way, a good therapist will create a setting that fosters natural sharing.

If you do not know what to speak about, spend a minute or two thinking about what brought you to therapy. What do you want to focus on? What’s on your mind? Is there anything that just stays with you? Sometimes, pondering on where life has taken you can be encouraging. The good thing is that you can start the discussion anywhere you want.

You can start where you are and share whatever you like. If you’re still not sure how to start with your first appointment with your therapist, then here are some ideas for things you can talk about when you’re not sure where to start:


Thoroughly Discuss Your Core Issues

We all face challenges and changes in our lives. We welcome some of them. The fear of some is unbearable. There are also minor bumps along the way. In some way, they all affect our lives.

Any change in your life, such as a marriage, divorce, birth, death, major move, job change, or illness, can be a rock to your world. What have been your biggest challenges and changes? What have they done to you?

The State of Your Mood

Feelings are reflected in your mood. It can also change over time. It’s important to let your therapist know if you are experiencing mood changes, especially between sessions.

In this way, they can keep track of your symptoms, how they change over time, and how best to guide you.

Any bothersome changes can be discussed. It’s also okay to talk about the positive changes you’re noticing!

Discussing Trauma & How Therapy Can Help

Trauma can be hard to address, even in therapy. Initially, you may not be able to reveal your trauma. Trauma is painful for many people, so they don’t want to go into detail about it. It’s okay not to do it.

Share information little by little as you’re ready. You might be afraid to share something with your therapist. An experienced therapist can help you deal with difficult situations, especially an experienced trauma therapist. You will be guided to work through your trauma in a safe, comfortable way.


Behavioral patterns

Certain situations may have triggered ways for you to cope. Some patterns may be helpful to you. Some may not.

If you share your insights with your therapist, they will be able to understand your experience better and help you find healthy ways of dealing with those situations that you find troublesome.

Conversely, not sharing with your therapist is not a bad thing. A good therapist will know how to guide the session in the way that suits your needs, including the right amount of talking for you.

The Pain of Grief and Loss

We aren’t usually prepared to deal with grief and loss. Mental health can be adversely affected when it becomes complicated. Do you find it difficult to move on after a recent loss? Did you suffer a significant loss in the past that remains unresolved?

Sometimes, the effects of a loss don’t become apparent for a long time after the event. Loss can be an important part of your session, and your session can provide a safe space for you to talk about it.

What many people do not consider is that loss is for more than just a loved one. We grieve any significant change that removes something we love, person, place or thing. Talking freely helps your counsellor to identify areas of need you may not have considered. So don’t worry about rambling. That is how the counsellor hears your story.

Past Medical History

A brief medical record always helps. It would help your therapist to know whether there is any impact of your physical health on your mental state.

Mental well-being has been found to improve physical health, reducing the risk of strokes and heart attacks. There is a connection between poor mental health and a variety of health problems. A number of chronic illnesses, such as stroke, heart disease, chronic pain, and diabetes, have been linked with depression.

The opposite is also true; physical illnesses can cause mental health issues such as increased stress and anxiety, poor sleep, and depression.

Goals? What are they, and Why Are they Important?

Many patients are uninformed about the whole therapy process, and even with successful therapy sessions, a lot of patients miss out on their goals, what they are going to achieve, and whether the fruits of therapy will remain in the future.

A good therapist always works on their client’s goals and helps them achieve the best results in the therapy sessions that will help them stay positive and enjoy their life like never before.


Unspoken Topics About Therapy – Ending it!

There are things you guard and protect besides the things you can discuss. It’s just that you don’t talk about them. Perhaps they are the most important things to discuss. Blurting these topics out isn’t likely to happen. The deepest secrets are rarely revealed right away to a therapist.

Talk to your therapist about some of the things you’d like to be able to discuss but have yet to be quite ready to discuss. Don’t hesitate to ask your therapist what you need to support your sharing.

They can help you move forward and discuss those deeper issues with you.

These therapy topics might just open a dialogue that brings you to a new level of insight and growth when you don’t have anything to talk about in therapy.

Most importantly, you need to find the right therapist. The right counsellor is the one that you feel comfortable talking to. It is hard to open up to someone that you do not feel comfortable talking to. Doing an initial free consultation is one way to determine if a counsellor is the right person for you.

At Boomerang Counselling Centre, we have a wonderful team of caring listeners who are skilled therapists. You can read their bios and book a consultation directly through the website. That way, you can meet the counsellor first to see if you feel comfortable with them. Then, you will be comfortable when you come to counselling and not be concerned about what you are going to say.

If you’re not quite ready, you can read more blogs, and do more research until the time is right for you to invest in yourself and see how talking in therapy can be helpful for you.


We specialize in a variety of neurodiversity, behavioural, anxiety, attention, learning, social, and emotional problems. We also provide family support through parent coaching, counselling, and reunification.