What to Talk About in Therapy

Embarking on a journey to better mental health can stir up a mix of emotions. Whether you’re weighing your options or preparing for your first session, the uncertainty of what to talk about in therapy might linger in your mind.

But here’s the reassuring truth: therapy is a judgment-free zone, and there’s no predefined script that dictates what to talk about in therapy sessions. Your sessions are as unique as you are, tailored to your individual needs.

As Krista Lacroix, CPC, LPC, CLC, CQIA, a Lyra Care Therapist says, finding a therapist gives you “at least one person in your life who will let you say anything you want to say. You will not be judged for it. You will be met where you’re at.”

The safety to say anything is part of what makes therapy effective. A trusting rapport with your mental health care provider helps you unpack things that may feel too vulnerable or embarrassing in other contexts. Mental health providers have assisted clients with many types of problems, so they won’t be shocked by what you have to say.

“If we don’t create that trusting connection between client and therapist, therapy cannot be effective,” Lacroix says. “When we do create it, people feel welcomed and heard, and able to share their deep thoughts.”

It can help to know what to expect in your first therapy session. Most sessions last about an hour, though it may depend on your therapist or program. Your provider will spend time getting to know you and reviewing any mental health symptoms you’re experiencing. They’ll explain how therapy works and help you develop goals for therapy.

Ideas for what to talk about in therapy

The therapist’s job is to help you explore whatever you want to explore. Some people enter therapy knowing exactly what they want to talk about in therapy, while others aren’t sure why they feel unwell or what they should focus on. If you don’t know what to talk to your therapist about, bring that up early in the therapy process. They can help you sort through your feelings if you aren’t sure where to start.

“I tell clients, ‘This is your space. This is your therapy. You have the right to bring anything you want to bring, and your counselor has the responsibility to make space for that,” Lacroix says.

Need some ideas for what to talk about in therapy? Here are a few common topics people broach with their mental health care provider.

Relationships

Navigating relationships—with a spouse, other family members, friends, and co-workers—can be challenging. Therapy is an excellent space to sort through conflicts, disappointments, and other tricky relationship dynamics. It can also help you navigate toxic relationships.

Current feelings

People sometimes come to therapy to deal with uncomfortable emotions. Unpleasant feelings aren’t “bad” in and of themselves. In fact, they can help signal unaddressed problems, which makes them very useful.

“Some people honestly don’t know why they’re in therapy. They just know that they don’t feel good, and they’re looking for help anywhere they can get it,” says Lacroix. Therapists are an ideal partner to investigate the roots of your distress. 

Past trauma

It’s not true that “time heals all wounds.” Past trauma can continue for years, even decades. Therapy can help you come to terms with events that were traumatic or extremely difficult, such as death, broken relationships, assault, life-threatening experiences, and abuse, among others.

Self-esteem

Comparisons, disappointment, and shame can cloud your self-perception. Our interconnected world makes it easier than ever to compare yourself to others. This can lead to counterproductive feelings such as imposter syndrome and self-consciousness. Therapy is a good space to build your sense of self-worth and confidence.

Job or career worries

Work stress is a common driver of mental health struggles. You may be at a loss for how to manage a difficult boss or co-worker, or how to cope with feeling stuck in a job you dislike. High expectations at work can leave you feeling drained without knowing how to relax and care for yourself. Concerns about job security and your financial future can also cause great anxiety. A therapist can help you cope with these concerns.

Stress

Therapy is often used to help people address various sources of stress, such as:

• Work
• Caregiving
• Finances
• School
• Managing a household
• Relationships
• Disturbing current events
• Social media
• Financial uncertainty
• Health concerns

A therapist can help you not only name your stressors, but manage them, whether by removing sources of stress or learning self-care strategies.

Personal identity

Many clients come to therapy to explore their sexual or gender identity. Sorting through the challenges of being in a minority group or culture is another common identity-related therapy goal. Therapy can also be helpful for friends and loved ones who want to learn how to support someone in understanding their identity.

Life transitions

Major life changes such as graduating from school or moving to a new city can leave you feeling lonely and unsure where you fit in. Transitioning to parenthood often brings overwhelm as you struggle to balance a whole new set of demands. A new job or promotion may trigger feelings of uncertainty about your abilities. And aging is an ongoing transition that requires adjustment to changes in your abilities. A trained mental health professional can help you face these and other tough transitions with resilience.

Mental health diagnoses or suspected conditions

If you suspect you have a mental health condition, it’s important to speak to a therapist about being evaluated and getting an official diagnosis if needed. Likewise, if you’ve already been diagnosed and are experiencing bothersome symptoms, therapy is the best place to make a plan for managing your condition. In some cases, therapists may refer you to a psychiatrist or other physician who can help you manage the condition with medication.

When to end therapy

Ending your therapy journey is often referred to as “graduating” from therapy. A few specific signs may indicate that it’s time.

• You’ve met all the therapy goals you set for yourself.
• You’ve run out of things to talk about with your provider.
• The problems you started therapy to address have all been resolved.
• You notice a major decrease in bothersome mental health symptoms.
• You feel confident in your ability to use the tools your therapist has given you.

Only you and your therapist can decide when you’re ready to graduate from therapy.

Take the first step

If you think you’d benefit from therapy, take the first step and find a mental health care provider. You can seek referrals from a mental health benefit or insurance provider through work, as well as your doctor, friends, and family who have tried therapy.