Therapy conversations depend on each person’s experiences and emotions, but common topics include personal growth, past trauma, and relationship problems.
A successful client-therapist discussion is based on honesty, openness, and a willingness to learn and grow.
To get the most out of therapy, it’s important to find a therapist who has experience working with your concerns, is a good cultural match, and can help you set and reach your personal goals.
Whether you’re trying therapy for the first time or starting treatment with a new therapist, you may be wondering what exactly you should talk about during therapy sessions. You might worry about choosing the “right” topic, saying the “right” thing, or filling the silence. Many people feel this way, so you’re not alone.
It’s true that therapy time is yours to use, but that doesn’t mean you have to carry the whole conversation by yourself. A good therapist will help guide the session, ask questions, and work with you to explore what feels important. You don’t have to show up with a perfect plan or a list of topics prepared.
It may help to remember the main goals of talk therapy: to help people find relief from mental health symptoms, support daily functioning, and improve their overall quality of life. Anything that affects your well-being — big or small — is worth bringing up with your therapist.
Five things to talk to your therapist about
Conversations with your therapist will depend on your personal experiences, current challenges, and well-being goals. If you’re not sure what to talk about first, try asking yourself: “What event or emotion prompted me to seek support, and how do I want to feel after speaking with my therapist?” Remember that your therapist is there to ask questions and help you figure out where it makes sense to get started.
Here are several other common topics that people discuss in therapy:
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1. Emotional challenges
Talk therapy is an effective tool for learning to identify and understand emotions, like stress, sadness, and anxiety. With the support of your therapist, you’ll discover techniques to effectively manage your emotions. You’ll also learn how your emotions impact your mental health and overall well-being. To start, consider any ways your mood has changed lately.
2. Relationship and family dynamics
Relationship problems are another common reason that people seek therapy. Exploring your connections with family, friends, romantic partners, and co-workers can help you identify patterns, conflicts, or communication issues that may be impacting your mental health.
3. Personal growth and self-reflection
Many people use therapy sessions to reflect on personal growth, self-discovery, and goals. For example, maybe you’ve been feeling stagnant at work and you’d like help figuring out your next career move. Therapy can also help you navigate major life events, like marriage, starting a family, or relocating for a new job.
4. Past traumas
A traumatic event is anything that causes mental, physical, emotional, or spiritual harm. And even if the trauma occurred during childhood, it can have long-lasting effects on your attitude, behavior, and overall ability to function. Therapy helps people understand how past trauma influences their current well-being. It also teaches you coping mechanisms to reduce associated mental health symptoms.
5. Daily life
Sometimes, you just want a safe space to reflect on what is and isn’t going well in your life. Working with a therapist can help you discover how to create healthier habits and avoid ones that are interfering with your goals.
How to get the most out of therapy
A successful client-therapist relationship is based on honest, open communication and a willingness to learn, grow, and improve. Here are some additional tips to help you get the most out of your therapy sessions.
Be open and honest
Being open and honest with your therapist (and yourself) is essential to the process. Therapy is a safe and confidential space to discuss whatever is on your mind, including your fears, feelings, and private concerns. The conversation may feel awkward or embarrassing at first, but honesty is necessary for personal growth and creating sustainable change in your life.
Implement therapeutic strategies in your daily life
During therapy, you’ll learn different skills and coping techniques to help you manage your mental health symptoms and overcome emotional challenges. Using these new tools during everyday life can help you experiment with new ways of thinking, feeling, and behaving, even when you’re not with your therapist.
Be an active participant
To really benefit from your therapy sessions, it’s important to be emotionally present and engaged. Although your therapist will guide you through the healing journey, it’s your responsibility to make decisions that will help you achieve your goals. During your next session, try asking questions and taking a more active role in setting the agenda.
Regularly assess progress with your therapist
Therapy is a collaborative process between you and your therapist. To help monitor your growth, encourage open communication so you can regularly review goals and discuss any challenges or setbacks. Plus, this will help your therapist assess your progress and make any necessary adjustments.
Simple prompts to help you know what to talk about
If you still feel unsure about where to start, it can help to think about your week and check in with a few key areas. You can use the prompts below to choose what feels most important to talk about.
You might start with your emotions. For example:
I felt really anxious when I was late to work today.
I keep feeling angry or irritable, and I’m not sure why.
I’ve been feeling numb or checked out lately.
You could also talk about your wins. These are moments that went well, no matter how small. You might share:
I handled a stressful moment better than I usually do.
I set a boundary that I’m proud of.
I noticed a small improvement in my mood, sleep, or habits.
You might bring up any slips or setbacks. These are moments that were hard or didn’t go the way you hoped. For example:
I fell back into a pattern I’m trying to change.
I shut down or withdrew during a conflict.
I avoided something important because it felt overwhelming.
Or you might talk about questions you have. These can help your therapist understand what you want to explore. You could ask:
Is it normal to feel irritable all the time?
Why do I react so strongly when I experience stress?
How can I cope better the next time I feel this way?
Bringing even one of these into the session can help your therapist understand what you’re experiencing and guide the conversation.
What to talk about when things are going well
Some people worry that they won’t have anything to talk about in therapy when life feels calm or when symptoms improve. You might even feel guilty for not having a problem to bring up. But therapy is still useful during these times, and you don’t need to be experiencing difficulties to benefit from your sessions.
When things are going well, you and your therapist can talk about:
What has been helping you feel more stable or balanced
Routines or habits that are supporting your mental health
Skills you want to keep practicing so you don’t lose progress
Goals you’d like to work toward, even if they feel small
Any early signs that stress might be building, so you can address it sooner
How relationships, work, school, or family life are shifting as you feel better
Talking about positive changes can help you understand what’s working and how to keep it going. It also gives you space to strengthen coping skills and prepare for challenges that may come up later. Even when you feel like you have nothing to say, your growth is still worth talking about.
When to start therapy
Starting therapy can help you manage a wide range of mental, emotional, and behavioral concerns. Some people seek therapy to help with a current problem in their life, while others eventually start treatment after living with symptoms for months or years. Regardless of what brings you to therapy, it’s important to make sure that you’re ready and willing to begin treatment.
Here are a few signs that you may benefit from starting therapy:
You have an ongoing, overwhelming feeling of sadness or helplessness.
Your problems aren’t getting better, despite your best efforts.
You find it difficult to concentrate on everyday activities.
You’re always worried, on edge, or expecting the worst.
Your actions are harming yourself or others.
How to start therapy
Once you’re ready to start therapy, it’s important to find a therapist who makes you feel seen, heard, and supported. Here are a few questions to keep in mind when choosing a therapist:
Do they have experience with the conditions or concerns that brought you to therapy? For example, if you’re feeling anxious, you’ll want a therapist who has experience treating anxiety.
Do they have experience working with clients with a similar background to yours? Choosing a therapist who understands your cultural identity is important.
Will this therapist assign therapy homework? With some types of therapy, like cognitive behavioral therapy (CBT), therapists will assign homework to reinforce coping skills between sessions.
Preparing for your first therapy session is another way to help you make the most of the experience. Even if you’re still not sure what to talk about, the following tips can help you feel confident and empowered when meeting your therapist.
Reflect on your thoughts and feelings. Are there specific emotions or experiences that you’d like to discuss during therapy?
Set personal goals. Your therapist will help you create specific treatment goals, but it can be helpful to reflect on the reasons you’re seeking therapy and what you’d like to achieve.
Create a list of questions. Preparing a list of questions for your therapist can help make sure that you get all the information you’re looking for during your first session.
Therapy is for everyone, whether you’re sorting through something heavy or just trying to understand yourself a little better. You don’t need the perfect words — just a place where you can be honest and supported.
Brandy Chalmers, LPC
Clinical reviewer
Find a therapist with Rula
Whether you’re trying therapy for the first time or clocking in your 100th session, it can be tough to figure out what to talk about. Rula can help you find the right therapist to get the conversation started.
At Rula, we’re here to make it easier to connect with a therapist who takes your insurance and offers the specialized care you deserve. Rula helps people find a therapist who offers individual, couples, or family counseling to help you discuss your unique needs and concerns.
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Adrienne Duhon, LCSW
Adrienne has worked in the mental health field for over 10 years across a variety of settings including hospitals, nursing homes, and telehealth. In her current role as a Clinical Quality Specialist at Rula, she supports therapists by providing clinical guidance, documentation support, and peer consultation, with a focus on improving quality of care. She is trained in CBT and specializes in working with people experiencing anxiety, depression, and ADHD.
Adrienne is passionate about mental health because she believes everyone deserves access to compassionate, evidence-based care that helps them thrive and feel supported. Outside of work, she enjoys spending time with her family and taking long walks with her dog.
Rula’s editorial process
Rula’s editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
