Therapy Questions: What To Talk About in Therapy

You’ve just made an appointment for your first ever therapy session. First of all, congrats! Going to therapy is a big step, whether you’re doing it to treat depression or an anxiety disorder or to get a deeper understanding of yourself.

 Psychotherapy, or talk therapy, is all about having meaningful conversations that help you learn about the problems that affect you and how you can develop coping strategies to deal with them.

Whether you meet a local licensed therapist or take part in online therapy, the time you spend with your therapist is an opportunity to talk about anything that’s bothering you, as well as an opportunity to make meaningful progress toward your goals for therapy.

While therapy is a positive process, it’s very common to feel nervous and unsure of what to talk about before your first session.

So any uncomfortable feeling you’re having ahead of your meeting is totally valid — after all, you’re going to spend 40 to 60 minutes talking to someone you haven’t ever met before.

The good news is that most therapists are absolutely aware of this. They’ll typically go out of their way to create a safe space and develop a therapeutic relationship, or therapeutic alliance, with you.

To start working toward that goal, your first therapy session typically involves your therapist learning more about you and helping you become comfortable in a therapeutic environment.

To make the process easier, we’ve shared 10 things to talk about in therapy. These include questions to ask your therapist and also things your therapist may ask you about.

By reviewing these ahead of time, you’ll be able to walk into your first session feeling prepared, comfortable, and ready to make progress.

If you’ve never met with your therapist before, your first therapy session will usually be an intake session. The therapist will want to know the main reason you decided to come into therapy, how your issues have evolved over time, your past experience with mental health problems and any treatments you’ve received, as well as a brief summary of the important milestones in your life.

Also, after you check in and begin your therapy session, you’ll cover topics such as your therapist’s professional information, policies and fees, as well as key topics such as client confidentiality, your rights as a patient, and how the process of therapy will typically work.

As part of this process, you’ll need to sign an informed consent document. This is a type of legal document that confirms that you consent to take part in therapy.

Your therapist will work with you to make sure that everything is clear before you begin your first session.

Depending on your symptoms and personal needs, you may need to complete a range of other documents to provide your therapist with more information.

As part of this process, you may need to provide information about your physical health, use of certain types of medication, and family history of certain conditions.

This information helps your therapist learn more about your specific needs, as well as the most effective treatment options for you.

Don’t worry — not all sessions will be like this. Once your therapist has this information, you’ll be able to spend more of your time focusing on talking, learning, and making meaningful progress.

Your first time in a therapy session is all about laying the groundwork for the future. You’re free to talk to your therapist about a variety of therapy topics, whether it’s a specific issue that’s bothering you or an aspect of therapy you’d like to learn more about.

When it comes to what to talk to your therapist about, there’s no such thing as a “bad” question or topic. During your first session, you should feel free to ask any questions you’d like answered.

Below, we’ve listed 10 common questions that you may be asked, or may want to ask to your therapist, during your intake session.

1. Why did you decide to seek therapy?

Perhaps the most important question in therapy, asking what led you to seek therapy in the first place can help your therapist learn more about what’s going on in your life that’s affecting your thoughts, feelings or general mental health.

There are countless reasons to seek therapy. Some people might take part in therapy to treat a specific mental health issue, such as depression or anxiety.

Others are prompted to try therapy if they’re having a hard time after big life changes, such as relationship issues, a stressful experience, or the loss of a loved one.

There’s no “right” or “wrong” answer to this question. Instead, it’s designed to help you open up to your therapist about the reasons you’re seeking therapy.

It’s important to answer this question openly, honestly, and in as much detail as possible. Based on your answer, your therapist may choose to move your conversation in a specific direction to learn more about what’s troubling you, and how you can solve it.

2. What do you expect from therapy?

Just like people often take part in therapy for very different reasons, people often have different expectations about what they’ll get from therapy.

Your therapist will work with you to help you learn more about yourself, establish and work toward your new goals, and make informed, effective decisions. In order to help make these positive changes, it’s important that they’re fully aware of what you expect from them.

As always, try to answer this question as openly and honestly as possible. Remember that your therapist is there to listen to you.

The more information you can give, the more the therapist can do to help you have a positive, constructive experience.

3. Have you ever seen a therapist or counselor before?

Your therapist might ask if you’ve ever seen a therapist, counselor, psychiatrist, or other mental health professional before. If this isn’t your first time seeking therapy, make sure to let them know.

Your therapist might ask about your past experiences with therapy, such as the type of therapy that you received. There are many types of therapy. Cognitive behavioral therapy (CBT) is an example of a common therapy modality.

Another therapy topic that they may cover is related to the specific aspects of past therapy that you found helpful and rewarding or difficult and uncomfortable. This helps them to get a better read on approaches that did and did not work for you in the past.

If you’ve never seen a therapist before, your therapist may spend more time making a safe space and helping you to feel comfortable and familiar with the therapeutic process.

4. What is the biggest problem you’re currently facing?

Problems can vary in scale, and what seems like one large problem may be a variety of smaller stressors that are affecting your thoughts, feelings and behavior.

Your therapist might ask you to define the major problems you’re facing. Identifying the specific problems that are troubling you can help you to prepare a treatment plan that includes developing new coping skills as well as methods for learning and making positive changes.

5. How do you cope with your problems?

Everyone has a coping strategy for dealing with problems. Whether you’re troubled by anxiety, stress, depression or a certain situation or individual, you likely have behaviors that you turn to in order to cope.

Some coping skills are productive and healthy, such as making notes in a diary, meditating, or setting new goals for yourself to work toward.

Others are unhealthy, such as using alcohol, drugs or other destructive behaviors to cope with stressful situations and other challenges.

Your therapist might ask you this question to learn more about how you cope with difficulties in your life, as well as positive changes that you may be able to employ to prevent your unhelpful coping strategies from interfering with your progress.

6. What are your strengths and weaknesses?

From creativity to being a loyal friend to the ability to focus intensely on a certain goal until it’s accomplished, everyone has unique strengths.

Your therapist may ask you to describe your strengths. Don’t worry, this isn’t the type of question you’d get in a job interview. Instead, it’s designed to help your therapist get a good read on the unique and specific skills that you have to deal with problems and challenges.

During therapy, your therapist may help you to learn about how you can use these strengths to cope with things like stress, anxiety or depression and make progress in your life.

Similarly, your therapist may ask you to talk about your weaknesses. By being honest and open in your answer, you’ll be able to identify points that you can work on together to help you better deal with tough situations and take control over your thoughts and behaviors.

7. Have you ever had thoughts of self-harm or suicide?

Many people with depression, anxiety, and other mental health conditions have suicidal thoughts or engage in self-harm.

These issues occur in people with moderate or severe forms of mental illness, such as severe depression or bipolar disorder.

If you’ve been diagnosed with a mental health condition that’s associated with self-harm, your therapist may ask you this question.

While a question like this may seem alarming, it’s important to keep in mind that your therapist wants to make sure you’re safe. If you have self-harmed, or if you have suicidal thoughts, your therapist needs to make sure that you receive the necessary care and attention.

As always, it’s important to be totally honest with your therapist. Don’t feel afraid or ashamed to let them know if you have self-harmed or considered hurting yourself.

Your therapist’s job is to help you, and they’ll make sure to take all necessary steps to keep you safe, comfortable, and free from harm.

8. What do you want to accomplish?

Therapy is all about learning and making progress, whether this means gaining more control of your moods and emotions, changing your thinking, adapting your behavior, or making progress in specific areas of your life.

In order to identify these new goals and monitor your progress, your therapist may ask you about the specific things you want to accomplish.

Not everyone has a clear idea of what they want to accomplish from therapy, so don’t feel bad or disappointed if you can’t provide a specific goal.

Instead, focus on communicating with your therapist about what you hope to do together. The more information you can give, the better your therapist will be able to prepare a personalized treatment plan to help you move forward through your therapeutic journey.

9. How would you describe your partner, friends, or family?

If someone else plays a significant role in your life, it’s important to let your therapist know about how they treat you and how you feel around them.

Your therapist may ask you certain questions about your relationships with other people, such as your family members, friends, and coworkers. This can include questions about your family dynamics, how you interact with friends, and more.

These can offer insight into how you connect with others, identify the people that are there for you, and show you how strong your support network is.

While talking about your relationships with other people may feel unusual, remember that your therapist isn’t there to judge you.

10. What can you do to make progress?

This is one of the questions to ask your therapist, especially toward the end of your first session.

Not all therapy sessions are about making measurable progress toward a goal. Sometimes, a simple conversation about what’s going on in your life and how you’re feeling can have a major impact on your wellness, even if it doesn’t feel actionable.

However, if you’re going into therapy with specific goals, you may want to discuss how you can work towards them with your therapist.

Your therapist may help you to set concrete, objective markers that you can use to monitor your progress and stay focused on making meaningful changes in your life.

Starting therapy can seem daunting, especially if you’ve never talked to a psychotherapist, psychologist, or other mental health professional before. If you feel nervous or have a hard time opening up during your first session, that’s totally normal. You can even say so to your therapist.

Talking about your feelings, struggles, and current or past experiences with someone you’ve only just met can be challenging. However, you’re absolutely not alone.

Researchers have investigated this very topic and found four common concerns people have about opening up during their first therapy session. These include:

• A fear of expressing any negative emotions

• Not feeling like you have the right words to express how you feel

• Having low self-esteem or being insecure about sharing personal experiences

• Feeling like you’re being disloyal to loved ones by talking about relationship issues or dynamics

Just know that your therapist is not here to judge you. They’re invested in your well-being and in helping you to feel comfortable and at ease in order to establish a trusting therapeutic relationship.

When you’re beginning therapy, know that you’re always in control of the process. It’s up to you to decide what to talk about and what’s off-limits.

If your therapist asks a question that you don’t feel comfortable answering, you can freely tell them that you’d prefer to talk about something else.

Over time, you may start to feel more comfortable with the therapeutic process, which will allow you to open up to your therapist and talk about the specific issues that are troubling you, and help you make progress in your daily life.

These are just a few sample therapy topics that you might discuss with your therapist. 

Some of them are more direct, and some of them are open-ended questions designed to help you explore how you’re feeling and open up about your current and past experiences.

And these are just a few of an endless number of things you’re free to talk to your therapist about. You may have follow-up questions or you may want to know something we haven’t touched on here. All of it is part of the counseling process.

To get started with therapy, you can reach out to a mental health provider in your area or talk to your primary care provider about getting a mental health referral for a licensed therapist.

Alternatively, you can connect with licensed mental health providers online using our online psychiatry services, individual therapy, and online anonymous therapy.