What to Talk About in Therapy: Effective Topics for Healing

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Deciding what to talk about in therapy can be a daunting task, especially for individuals who are new to the therapeutic process. It’s natural to feel unsure about which topics to bring up and what to share with a mental health professional.

However, therapy is meant to be a safe space where individuals can explore their thoughts, feelings, and experiences, ultimately gaining insights and strategies for improved mental well-being.

Preparing for Your First Session

Things to discuss in therapy

During the first therapy session, it is essential for both you and your therapist to establish a clear understanding of the therapeutic process.

The initial meeting, often referred to as an interview, allows the therapist to gather information about your concerns, background, and goals for therapy. Whether it is an in-person session or via telehealth, it is crucial that you feel comfortable and supported.

The first session often involves discussing the reasons for seeking therapy and exploring expectations from the treatment.

The therapist will ask you about your historyexperiences, and any potential referral sources. Some crucial aspects to cover in the first session include:

  • Building rapport: The therapist will establish a connection with you, creating a foundation for trust and effective communication.
  • Assessing needs: The therapist will assess your concerns to better understand how you can benefit from therapy.
  • Establishing goals: You and the therapist will collaborate to determine achievable goals for the therapy process.
  • Discussing boundaries: Both parties will discuss and agree on confidentiality and the extent of the therapeutic relationship.
  • Planning treatment: The therapist will use their training and skills to develop a tailored treatment plan that addresses your unique needs and preferences.

You must approach the first therapy session with an open minda willingness to share your thoughts and feelings, and a readiness to engage in the therapeutic process.

By knowing what to expect, you can feel more at ease during the initial interview and get the most out of your therapy sessions.

Exploring the Areas for Discussion

Things to work on in therapy

Therapy is a journey of self-discovery, personal growth, and healing. One of the key elements of effective therapy is the open and honest discussion between the client and therapist.

These discussions often center around a wide range of areas, each uniquely important to the individual seeking therapeutic support.

1. Personal Experiences

Discussing personal experiences in a therapy session can help you gain insight and understanding of your past events.

This may include exploring past traumas, childhood memories, or past experiences that shaped your beliefs and personality.

By delving into these topics, the therapist can identify patterns of behavior and help you work on addressing and resolving any negative aspects of your past.

2. Psychological State

Therapy often involves discussing your current psychological state, including your emotions, thoughts, and feelings. It may entail assessing mood changes, life changes, and overall mental well-being.

These discussions offer you an opportunity to express yourself openly and gain feedback and guidance from the therapist, who can help you understand your emotional patterns and develop coping strategies for dealing with daily stressors.

3. Your Relationships

Other important areas for discussion in therapy are your relationships with your friends, family, and partner. This may involve examining conflicts, communication issues, or even life changes like divorce.

By exploring these topics, the therapist can help you develop healthier communication patterns and nurture your existing relationships.

Addressing relationship issues can also help uncover underlying emotional problems and contribute to improving your overall mental health.

4. Work Life

Things to work on in therapy

Therapy sessions may also address work-related matters, such as work stress, conflicts with colleagues, or career aspirations.

Exploring these topics can help you understand the impact of your work environment on your mental health and develop strategies to strike a balance between your personal and professional life.

By discussing and evaluating work experiences and goals, the therapist can support you in reaching your full potential professionally and emotionally.

5. Emotional Distress

In therapy, you are encouraged to explore and discuss your emotions openly. This process allows you to better understand the underlying causes of your emotional distress, potentially leading to more effective treatment strategies.

For example, discussing feelings of grief and loss can help you process your emotions and develop coping mechanisms to deal with the pain of losing a loved one.

6. Stress

Similarly, talking about stress and its sources can equip you with the tools for managing it, ultimately reducing its impact on your life.

A therapist may guide you in pinpointing specific stressors and work together to devise strategies to minimize or eliminate them.

7. Shame and Guilt

How to talk to a therapist

Addressing emotions like shame and guilt is also essential in therapy. These emotions can hold you back from living a fulfilling life, as you may feel undeserving of happiness or success.

By uncovering and exploring these emotions, you may begin to recognize the patterns that allow shame and guilt to dictate your choices and gain insight into how you can break free from these destructive patterns.

It is important to note that while discussing emotions in therapy can be challenging, it is a necessary aspect of the healing process.

By acknowledging and addressing emotions in therapy, you can work towards developing healthier emotional regulation and improved mental health.

Setting Goals in Therapy

In therapy, setting and achieving goals play a crucial role in ensuring successful outcomes for individuals.

Establishing clear, well-defined goals helps therapists and clients alike understand the primary focus and desired outcomes of the treatment plan.

When you actively participate in defining your goals, you often feel more invested in the therapeutic process and motivated to attain them.

SMARTER Goal-setting Model

One critical aspect to consider in the goal-setting process is to create achievable and realistic targets.

The SMARTER goal-setting model recommends that goals be:

  • Specific
  • Measurable
  • Achievable
  • Relevant
  • Time-bound
  • Evaluated
  • Re-adjusted

This model ensures that goals are attainable within a specified timeframe and can be easily monitored and adjusted as needed.

Personal Values and Interests

Talking to therapist

Incorporating your personal values and interests into your goals is essential for promoting engagement and motivation.

For example, if you are passionate about art, therapy may include objectives relating to creative expression.

This approach increases the likelihood of being committed to achieving your goals and experiencing a sense of accomplishment.

Communication and Collaboration

Throughout the course of therapy, ongoing communication and collaboration between you and your therapist are crucial for tracking progress, evaluating goal attainment, and adjusting goals as needed.

This process ensures that the treatment plan remains relevant and aligned with your changing needs, fostering a strong sense of purpose and direction in the therapeutic relationship.

Journaling as a Therapeutic Practice

Journaling is a powerful tool that can help you process your thoughts and emotions. This practice enables individuals to express and explore their feelings, as well as identify patterns in their thoughts and behaviors.

Journaling can be especially helpful for individuals who may find it difficult to articulate their thoughts verbally during therapy sessions.


Journaling as a Therapeutic Practice

One of the primary benefits of journaling in therapy is the ability for individuals to have a safe and private space for self-expression.

Through writing, you can freely explore your inner thoughts and feelings without the fear of judgment.

This process can lead to greater self-awareness, helping you to better understand your emotions and identify the root causes of your issues.

Enhancing Communication

Journaling can also be an effective tool for enhancing communication between you and your therapist.

By sharing your written thoughts, you can provide insight and context into your emotions and experiences, making it easier for therapists to tailor their approach to your needs.

Additionally, journaling can reinforce the therapeutic relationship, as you may feel more connected to your therapist when you share your written reflections.

Final Thoughts

In therapy, it is essential to maintain open and honest communication. Discussing feelings, thoughts, and experiences can enable individuals to gain insight into their emotions and learn coping strategies.

Remember that therapy is a personalized process, and the content of sessions should be tailored to meet the unique needs of each individual.

Frequently Asked Questions

What should I ask my therapist?

When starting therapy, it’s normal to have questions about the process. It’s important to ask your therapist about their approachconfidentiality, or any other concerns you might have.

Inquire about their experience and qualifications to ensure they are the right fit for your needs. Be open to discussing your goals and expectations to create a suitable plan for your therapy journey together.

Remember, asking questions helps build trust and rapport between you and your therapist.

What should I share in my first session?

During your first therapy session, you should share information about yourself, your background, and your reasons for attending therapy.

Be honest about your feelings, thoughts, and challenges, allowing your therapist to better understand your needs.

You may discuss any relevant personal or medical history, past traumas, current life situations, or future aspirations.

Don’t worry about revealing everything in the first session, as therapy is a process where you will gradually unfold and address various aspects of your life.

How can I talk about difficult topics?

Discussing difficult topics in therapy may feel overwhelming or uncomfortable, but it’s essential for personal growth and healing. Be patient with yourself and trust your therapist to support you through these conversations.

You can start by mentioning that you want to discuss a sensitive issue and express any concerns or fears you may have.

It might be helpful to write down your thoughts or practice talking about the topic with a trusted friend before the session.

Your therapist can help you navigate through these discussions by asking gentle, open-ended questions and creating a safe, non-judgmental space for you to explore your emotions.

What can I discuss when I’m out of ideas?

There might be times in therapy when you feel unsure about what to discuss or feel like you’ve run out of ideas.

In these situations, try focusing on the present moment – any recent experiences or emotions that have arisen or new challenges you’re facing.

It’s also helpful to revisit your therapy goals and assess the progress you’ve made, as well as explore any lingering concerns or unaddressed issues.

Your therapist can guide you through this process by using therapeutic questioning techniques that encourage reflection and self-exploration.


Hodgetts, A., & Wright, J. (2007). Researching clients’ experiences: A review of qualitative studies. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice14(3), 157-163. Link.

Viklund, E. (2013). Therapy talk and talk about therapy: Client-identified important events in psychotherapy (Doctoral dissertation, Linköping University Electronic Press). Link.

Additional Resources

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About the author

Eliana Galindo
Eliana is a dedicated psychologist from Colombia who has gained extensive experience and made significant contributions in child development, clinical psychology, and rehabilitation psychology.Her work as a rehabilitation psychologist with disabled children has been transformative and compassionate. In the child development field, she creates nurturing environments through assessments, interventions, and collaboration with families.In clinical psychology, she supports individuals overcoming mental health challenges with empathy and evidence-based approaches. Inspired by her experiences, Eliana is motivated to write about mental health, aiming to raise awareness and advocate for a compassionate and inclusive approach to well-being.

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