What to Talk About in Therapy

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Psychotherapy can be a powerful tool for self-discovery, growth, and healing across several life challenges. Research has demonstrated that people who receive some form of psychotherapy (which is also referred to as ‘mental health counseling’, or simply ‘counseling’) are better able to function in their daily lives. Mental health counseling can help you to improve emotional and psychological well-being and is linked with positive changes in the brain and body as well, along with developing greater resilience and more neuroplasticity, which is the brain’s ability to adapt to new ways of thinking and being in the world. 

If you’re seeking therapeutic services to address specific challenges or simply to enhance your overall well-being, knowing what to talk about in therapy can significantly impact the effectiveness of your experience. Many people who attend counseling—particularly those who have never been before—can struggle with what to say and how to participate in order to realize the greatest possible benefit. 

In today’s guide, Clear Behavioral Health will explore the ways to make your therapeutic journey beneficial by discussing several aspects of the therapeutic process and how you can take part in beginning your own healing and improvement process. 

Understanding the Therapeutic Process

Many people primarily view therapy as merely a place to talk about their issues or complain about their current circumstances. While both these avenues can be a part of the therapeutic process it’s important to note that quality psychotherapy involves much more than this in order to be effective. It’s true that therapy offers a safe and confidential space to explore all your thoughts, emotions, and behaviors, along with how they impact your day-to-day life—but therapy is also a place where an individual can be challenged to develop new insights about themselves and the world around them, or to process through the impacts of traumatic or upsetting memories. 

While there are hundreds of therapeutic modalities which your therapist may utilize in your sessions, there are several near-universally-understood ideals of a quality therapeutic experience

Unconditional positive regard

Derived from the work of Carl Rogers, unconditional positive regard refers to the therapist’s acceptance of their client as they are, allowing for a more authentic relationship between therapist and client. Often, during a person’s first therapy session, they will worry about what their clinician thinks of them or their presenting problems, and unconditional positive regard can help to assure the client that their struggles are taken seriously and considered without undue judgment.

Issue exploration and treatment planning

A mental health professional will help you to clarify and better understand the issue(s) at hand, be they interpersonal, intrapersonal, or world-related. Working collaboratively to define the goals for therapy will help to give shape and direction to the therapeutic process as it unfurls, of which you and your therapist will also revisit to gauge your progress and update your goals together as necessary.

Skill building

Therapists will often introduce several practical and conceptual coping skills to help you cope with various challenges. These skills might include stress reduction techniques, communication strategies, mindfulness practices, and new methods to regulate your emotions or behavior. Learning and applying these skills can empower you to navigate your challenges more effectively.

Exploring patterns

Engagement in therapy can help to guide you in recognizing recurring patterns of behavior, thoughts, and emotions that may be contributing to your difficulties. Such insights help you gain a deeper understanding of the roots of your challenges and enables you to make conscious choices for change.

What do I talk about when I feel stuck or don’t know what to say?

When a person is first starting therapy, it can be easy to talk. Later on, however, many people will feel uncomfortable when they feel stuck or unsure of what to say next in therapy. However, these moments can also be the precipitator for true exploration and growth, so don’t be afraid to acknowledge your feelings and share them with the counselor. Being genuine and noting your internal process can benefit therapy sessions in several ways: 

  • To normalize how you’re feeling and make you more comfortable with the uncertainty
  • Allowing your counselor to help you become curious as to why you feel stuck
  • Increasing the therapeutic alliance and improving the therapeutic relationship you feel toward your therapist
  • To collaboratively consider new topics to explore

What about if I’m uncomfortable with my therapist?

Ultimately, if you’re feeling uncomfortable for any reason, you are always allowed to change the subject or even change therapists as you see fit. Talk therapy is not a one-size-fits-all proposition, and every mental health counselor has their own unique style and method of working. If you feel that your progress has stalled (and you feel comfortable doing so) then this can be an excellent topic of conversation in a psychotherapy session. A trained clinician will be able to help you examine the reasons why you feel this way and also provide any necessary referrals to other professionals that you may benefit from working with. 

What can I talk about in therapy, then?

It’s important to understand that there’s no right or wrong way to approach therapy on the client side. Your therapist is there to support you, guide you, and create a comfortable environment where you can openly express yourself. 

So what can you talk about during your therapy sessions? Let’s take a look at some common topics of conversation. 

Your concerns

Going to therapy is the perfect place to discuss any challenges you’ve experienced, be they in the past or the present day. Whether it’s anxiety, depression, relationship issues, addiction concerns, or general life stressors, your therapist can help you explore the root causes and develop strategies to cope and overcome these challenges.

The positive aspects of your life

Therapy isn’t just about addressing challenges; it’s also a platform to celebrate your successes and the positive aspects of your life. Share moments of happiness, personal growth, and achievements—all of which are important to acknowledge as therapy goes along. 

Emotions and feelings

Talking about your emotions and feelings is a common area of exploration in therapy. Be honest about how you’re feeling, even if it seems confusing or contradictory. Your therapist can help you untangle complex emotions and gain insights into their underlying causes.


Relationships give so much to our identity as humans, but they can also be challenging. Discussing your interactions with family members, friends, romantic partners, or colleagues can offer valuable insights into patterns of behavior and potential new areas for growth and exploration.


Exploring your self-identity, values, and self-esteem can lead to a deeper understanding of your values and potential new directions. Discussing how you perceive yourself and your struggles with identity can be a fruitful path toward personal growth.

Past experiences

Past experiences—including trauma—can have a profound impact on your emotional well-being. Your therapist can help you navigate these experiences, providing tools for you to process and heal from them.

Your Goals

Setting goals for therapy is an essential part of the process. Whether your goals are specific (like reducing anxiety symptoms) or broader (like improving self-confidence), discussing them with your therapist helps to create a road map for your therapeutic journey—one that will be revised as you meet your goals and create new ones along the way. 

Stress Management 

Discuss the current stressors in your life and learn healthier coping strategies to better manage them. Your therapist can offer techniques to reduce stress and improve your overall resilience in the face of adversity.

Communication Skills

Effective communication is vital in many aspects of life, from relationships to school and employment. Discussing communication challenges can lead to a better understanding of yourself and those around you. 

Life Transitions

Major life transitions, such as career changes, marriage, divorce, or becoming a parent, can bring about mixed and sometimes conflicting emotions. Discussing these transitions can help you navigate them with greater ease and remove the stigma and shame you may feel around them. 


Talking about your boundaries, both with yourself and with others, is often beneficial in mental health counseling. Setting healthy boundaries is crucial for maintaining positive relationships and your own sense of self and well-being.

Get the support you need

There’s no topic too big or too small to discuss in therapy. Every individual’s therapeutic journey is unique, and what you choose to talk about will depend on your personal experiences and goals. Clear Behavioral Health has many trained, experienced therapists on staff to help you gain new insights into your struggles and to work alongside you toward a better, more hopeful tomorrow.

Last Updated on September 12, 2023

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