What to Talk About in Therapy: 8 Conversation Starters

You may have heard that being open and honest in therapy is a key part of seeing change and feeling better. However, if you’re just starting therapy, you may have questions about what that looks like — how do you know what to talk about? What’s most important to talk about? What if you don’t have much to talk about in a given session?  

It’s normal to not always know what to talk about in therapy. In fact, it’s a common concern among many therapy goers. That’s why we’re sharing some guidance and therapy conversation starters to help you have productive sessions with your therapist. These tips are simply examples meant to help you get the conversation going — how you decide to start conversations with your therapist is entirely up to you. 

What to talk about in therapy: topics and conversation starters

Whether it’s your first session or fifteenth session, it’s normal to draw a blank on what to talk to your therapist about. If this happens, reviewing a list of general topics that are typically discussed in therapy may help you pinpoint something you want to make progress on or an issue you’d like to resolve. Consider thinking about the following topics the next time you aren’t sure what to talk about in therapy: 

1. Personal history and background

Talking about your background — whether it be about your upbringing and family dynamic, past mental health concerns and therapy experiences, or other life experiences that are significant to you — are important conversations to have with your therapist, especially when you’re first getting to know each other. Talking about your personal history and background can help you and your therapist determine if you’re the right fit for each other. This is important, as a strong relationship with your therapist is key to seeing success in therapy. 

Conversation starter tip: “An event in my life that has impacted me is ____."

2. Current challenges and stressors

At the beginning of your therapy journey, it’s important to let your therapist know what’s brought you to therapy, so they can ensure they’re the right fit for your needs. Perhaps you’re feeling symptoms of a mental health concern, experiencing a difficult life change such as divorce or job loss, or just feel like things could be better. Discussing these challenges with your therapist not only helps you decide if they’re right for your needs, but also helps you establish what you want to achieve in therapy.

The challenges and stressors that bring you to therapy in the first place may change throughout your journey, and new challenges may arise. New challenges provide important talking points for you to bring up in therapy. Share these with your therapist so you can discuss, set new goals, and learn skills to achieve them. 

Conversation starter tip: “I’m feeling down today. Recently, I went through ____.”

3. Your goals 

A topic of discussion throughout therapy should be your goals and what you ultimately want to achieve out of therapy. This helps you and your therapist create a treatment plan and ensures you have something to measure your progress against. Moreover, your goals can help remind you of why you started therapy in the first place when you’re facing challenges such as a decrease in motivation or lack of progress. 

Your mental health goals in therapy are unique to you, and can range from simply feeling more like yourself again, to resolving a conflict with a loved one, to better managing symptoms of a mental health condition such as anxiety or depression. Your goals can always change throughout therapy, too, so if you feel you want to shift your focus at any time, let your therapist know. 

Conversation starter tip: “Based on how I’m feeling now, I’d really like to achieve ____ through therapy.” 

4. Relationships and interpersonal issues

Did you know that relationships and interpersonal challenges are a common reason people seek therapy? In fact, 49% of married couples seek marriage counseling at some point, and research shows that couples therapy positively impacts 70% of those who get treatment.  Even if you’re in individual therapy, discussing relationship issues with your therapist can be beneficial to your mental health and overall well-being. 

Moreover, therapy can help you resolve relationship and social issues such as social isolation, involvement in unfulfilling relationships, and conflicts that arise from differing expectations between partners, family members, friends, or coworkers. So if you’re experiencing these types of issues, be sure to bring them up to your therapist. 

Conversation starter tip: “I’ve been having a hard time communicating with my partner…” 

5. Emotions and feelings

How you’re feeling may seem like an obvious topic to discuss in therapy, but it can be an easy one to forget, especially if you’re feeling better. That’s why, along with talking about negative feelings and emotions, it’s also important to talk about positive feelings, too. These can be a key indicator to yourself and your therapist of the progress you’re making in therapy and that the skills you’re learning to reach your goals are working. 

Conversation starter tip: “I’ve noticed I’ve been thinking about ____ a lot and feeling ____ about it.” 

6. Self-esteem and self-image

Low self-esteem and self-image can have a significant impact on your well-being and various aspects of your life. When you have low self-esteem you may feel less than others, value the opinions of others over your own, and focus on your perceived weaknesses and faults rather than your strengths. Self-image is important because how we think and feel about ourselves affects how we interact with others and the world around us. So if you’re feeling low self-esteem and self-image, including insecurities, poor body image, or general feelings of self-doubt, tell your therapist. Your therapist can help you identify the cause of your low self-esteem and work with you to develop skills to build a healthier, more accurate opinion of yourself. 

Conversation starter tip: “I notice I feel ____ about myself when ____ happens.” 

7. Coping mechanisms and problem-solving strategies

Sharing what you’d like to work on in therapy is one of the first steps towards feeling better. The steps that follow — setting goals and learning coping skills and problem-solving strategies to meet your goals — are equally important to your progress. As you continue on in therapy, you’ll work on building your skills both in therapy and outside of sessions. Your therapist may assign you homework to practice coping and problem-solving skills on your own based on the issues you want to resolve, and ask you how you did in your next session. It may be helpful to take notes while practicing these skills, so you can remember what to talk about with your therapist. 

Conversation starter tip: “When ____ happened a few days ago, I did ____ to help myself work through uncomfortable feelings.”  

8. Progress and setbacks 

The path toward reaching your goals in therapy isn’t a straight line — there are many twists and turns you’ll face along the way. And while making progress toward your goals is what you want to experience throughout therapy, know that setbacks are a normal part of the journey. There may be points where you feel like you’ve lost progress or feel past symptoms creeping up again. This is okay. Talk with your therapist about how you’re feeling so they can make changes as needed to your treatment plan to help you get back on track.

Some therapists may proactively request feedback from you through clinical questionnaires (CQs) before and after sessions to regularly check in on how you’re doing. At SonderMind, our therapists use CQs so you both can see the progress you’ve made and address any pain points along the way. What’s more? You can fill out CQs right in your SonderMind portal, so it’s easy to share and see how things are going throughout therapy. 

Conversation starter tip: “I’ve noticed I’ve started feeling ______ again.” 

Strong connection is key to successful therapy 

Sessions with your therapist won’t always result in epiphanies that drive fast progress or resolve big problems — therapy is truly a marathon and not a sprint. That being said, you should always be comfortable with your therapist and feel you can have open and honest communication with them. Having a strong therapeutic alliance with your therapist is vitally important to helping you achieve your goals. That‘s why it’s important to work with the right therapist from the get-go. 

If you’re looking to start therapy and want to make sure you connect with a therapist who’s right for you, or if your current therapist isn’t the right fit and you’d like to find a different one, SonderMind can help. Our therapists are trained in a variety of specialties and treatment approaches, and we can connect you with a therapist who’s right for you based on your needs and preferences. Just let us know a little bit more about yourself and what you’re looking for, and we’ll connect you with someone who’s the right fit for you.