Your Go-To Guide for What to Talk About in Therapy

You’re about to meet with your therapist and you have no idea what you want to talk about today. Maybe you’re new to therapy and still figuring out a rhythm or getting comfortable with your therapist. Or perhaps you have been in therapy a while and it’s just hard to come up with things to discuss in session. This is completely normal and happens to so many people! Therapy is a unique space in life where we have time to process things that we often don’t have the time to think about in our day to day life. When we finally get the time, we might not know where to start or life might be so busy, we can’t remember what we even wanted to talk about that day. Wherever you are in your therapy journey, this is your go-to guide for some tips to get your brain going on what to talk about in therapy!

1. Spend a few minutes reflecting on your week before your session. It can be helpful before your session to take a few minutes to reflect on what has happened in your life since your last session. Was there anything that brought a lot of stress? Were there any challenging interactions with others? Spending a few minutes thinking about these things before a session may give you some ideas for things to process or work on in your therapy session.
   

2. Take notes throughout your week of anything you might want to discuss in your session. If you’re someone who has difficulty remembering things that you might want to talk about in therapy during your session, it could be helpful to jot down some notes throughout the week as things come up. When you’re in session, you can pull your notes out and let your therapist know that these are the things you would like to focus on that day.
   

3. Go back to your goals. Whenever I start meeting with clients, we set goals in our first or second session. This is our guide map for what we are working on in our therapy sessions. If a client comes to session and there is nothing they have in mind they want to work on that day, I always bring it back to their goals and ask them to pick what they would like to focus on that day. It can be helpful to break goals down into smaller steps and brainstorm what action steps they might like to work on for the next week. You can always ask your therapist to remind you of what your goals are and pick one to work on with them that day. If you haven’t set goals with your therapist, ask them if you can set some goals for therapy together. 
   

4. Changes in symptoms. As you reflect on the time in between your sessions, have you noticed any major shifts in symptoms you experience? For example, if you are someone who experiences anxiety, was there any increase or decrease in the frequency or intensity of your symptoms? Did you experience any shifts in appetite or sleep over the past week? Your therapist will likely want to know how you are managing symptoms and if there are any changes so they can help support you with those things! You can always ask your therapist for a symptom tracker so you can keep track of your symptoms throughout the week.
   

5. Coping or grounding skills. We often go to therapy when we are struggling with something. Whether that is stress, anxiety, depression, relational issues, or something else, it can be helpful to work on coping skills and grounding skills. Coping skills are how we manage stress, anxiety, and challenging situations. Grounding skills help anchor us into the present moment. Your therapist can help you learn and practice healthy coping and grounding skills in session so that you can manage stress and anxiety in a healthy way. You likely already have some coping skills, so it might be helpful to focus on what is working for you and learn additional tools or change things up (as we grow and change, we may need different coping skills at different times!). 

In my sessions with clients, I aim to be very client centered and ask people if there are anything specific topics they would like to cover that day. Sometimes, life happens and there are things clients would like to process in session. Other times, clients don’t have anything specific they want to focus on that day. I usually check in with my clients about how their general mood has been since we last met and if they have noticed any changes in symptoms. This might bring some things to light that would be helpful for us to discuss - coping skills to manage increased anxiety, being present with any challenging emotions, communication skills for challenging interactions with others, etc. If things are going well with symptoms and no major changes, we’ll take a look at our goals for therapy. I’ll ask my client to pick which goal they would like to focus on that day. Clear goals give us a wonderful road map for what we might want to work on in session. 

Now that you have some tips to get your brain going on what to talk about in therapy, try one of these things out! Start with something you think you could have success with. If you’re someone who’s good at jotting down notes, you could start by taking notes in the notes app on your phone as things come up throughout the week. If you’re someone who does better with physical paper, ask your therapist for a symptom tracker so you can take some notes throughout the week. If you’re finding it hard to cope with stress, you could ask your therapist if you can work on some coping or grounding skills. If this resonates with you and you’d like to learn more, check out my profile here! I’d love to be able to support