Going to therapy can be anxiety provoking. You may not know what to talk about from week to week. You may have some ideas, but once you get there, you forget it all. This can make progress slow and difficult.

Want some guidance?

Here are some suggestions about what to talk about in therapy that can make your time with your therapist productive.

What’s Working

The more we talk about what’s positive, the more we see the positives. Talking about what is working can help your therapist reinforce healthy strategies and keep you motivated. This can also help you to feel that you’re competent and capable of handling your issues.

What’s Not Working

Therapy is not intended to be a bitch session, yet without a broad view of the issues, it’s hard to know how to improve your situation. Talking about what’s not working, what you did to correct that, and what happened next is a great place to start any therapy session.

What’s New

Sometimes something shifts in our lives and it throws everything else out of balance. The opposite can be true too. This is important information to share with your therapist.

Your Feelings

Life’s holistic. In order to be a healthy, whole person, we don’t just focus on thoughts or behaviors. We also incorporate our feelings. This might lead to cultivating mind/body awareness, emotional intelligence, or just having a good cry. All this is beneficial!


If you are worrying, can’t sleep, are engaging in harmful behaviors, are depressed, or are using alcohol in excess, these are symptoms that your therapist needs to know about. Talking about them also can make them more present so that you can choose to cope with them.


Human life revolves around relationships. We all have families, friends, coworkers, neighbors, and lovers. Our relationships can make our lives miserable or delightful. Letting your therapist know about how they are unfolding gives her a clue into how you are doing and how she can help.

what to talk about in therapy

Past Trauma

Many present day problems have their roots in childhood or past relationships. Working with someone who knows how to use this information to get to the root of the problems is invaluable to healing completely. Be sure to share any memories that come up- even if they seem insignificant.


Sometimes sexuality is a factor in what brings you to therapy, sometimes it isn’t. If something has happened or is happening now that impacts your functioning, share it with your therapist. Together you can decide whether it seems important today.

Medical Issues

The mind, body, and spirit aren’t separate. Although your therapist isn’t a doctor, she knows that medical issues can manifest emotionally and vice versa. Sometimes this is an important part of your recovery.


If you “always” get depressed in October, your relationships go super fast and then tank after about three months, or you are enthusiastic about new project and then drop out before they are finished, those are patterns. Patterns can point to stuck places or unhealthy habits that are better

What You Want Out of Therapy

Be clear about your expectations from therapy. If you are not getting what you expect or want, let your therapist know. Therapy isn’t something that happens to you. It’s a relationship. You participate. You and your therapist co-create the session, so you have to show up honestly to get the best results.


If you have any questions about the skills that you are learning, homework, or anything that is talked about in therapy, ask. If you are curious about what’s normal for people, ask. As long as you are practicing healthy boundaries, no question is off limits.

The Things You Don’t Want to Talk About

I love transparency. I love when my clients say something like, “There is something I need to talk about, but I am not ready.” This tells me that it’s on their radar and we will get to it when they feel safe and comfortable. Sometimes we focus on how to get them ready to talk about it, and sometimes we work on other things and circle back.


Therapy is not intended to be a forever relationship. You are there to meet specifics goals and then go do life on your own until you need help again. It pays to know what the goal posts are and how close you are to meeting them. As you get closer, it’s time to talk about termination.

In the beginning, you and your new therapist may spend some time getting to know each other. This happens to build trust. If you want to jump into things, take the lead. Remember, therapy is collaborative.

Take notes in between sessions so you don’t forget what you want to say or run out of topics.

If the conversation still isn’t flowing, maybe you will mesh better with someone else. Perhaps you and the therapist aren’t the best match and you could have better luck with someone else.