Top 12 Therapy Conversation Starters in 2025: How to Maximize Your Sessions

Unsure about what to bring up during therapy? Consider discussing recent experiences, your relationships, past traumas, and more to unlock meaningful conversations.

Starting therapy can be intimidating. Many people, including myself, find it challenging to open up during initial sessions despite being eager to begin. Your mind might go blank when facing a supportive stranger ready to help.

Opening up takes time, especially if you're shy or new to therapy. Remember, it's okay to feel uncertain about what to say—you're not alone.

What to Expect in Therapy Sessions

Whether you’re new or have been attending sessions for a while but feel stuck, uncertainty about topics is common. Jessica Small, a licensed marriage and family therapist, notes that many clients come unsure about what to discuss.

Therapists may guide conversations or let you take the lead. Assessments might be used to tailor future sessions to your unique needs.

12 Engaging Topics to Discuss in Therapy

1. Everyday Concerns

Therapy isn’t only for major issues. You can talk about everyday moments, hopes, fears, or minor stresses. There’s no “wrong” topic.

Start by sharing what has happened since your last session—both highs and lows—and explore from there.

2. Behavior Patterns

Keeping a journal between sessions can help identify recurring thoughts and behaviors. You don’t need to share the journal but noting patterns like feelings of insecurity can be valuable for discussion.

3. Current Emotions

Focus on how you feel in the moment, whether it’s frustration, stress, or even reluctance to attend therapy. Your needs can change day by day, and therapy adapts to support you.

4. Overthinking and Rumination

If your mind replays worries or regrets, especially when trying to sleep, this is a powerful conversation starter to unpack anxious thoughts.

5. Relationships

Discuss all your relationships—family, friends, romantic partners. Sharing how you connect or distance yourself from others can reveal important insights.

6. Past Experiences and Trauma

Addressing unresolved past events can help explain current feelings and behaviors. It’s okay to revisit these at your own pace.

7. Life Changes and New Challenges

Major transitions like moving, marriage, or parenthood can stir unexpected emotions. Therapy provides a safe space to explore these feelings.

8. Avoided Thoughts

Anything you feel ashamed or hesitant to say belongs in therapy. Sharing uncomfortable or “silly” worries can lead to breakthroughs.

9. Difficulties Opening Up

If you find it hard to share, discuss this challenge itself. It might reveal barriers that therapy can help dismantle.

10. Trust Issues with Therapy

Building trust takes time. Express doubts or discomfort with your therapist to foster a stronger, more open connection.

11. Evaluating Therapy Progress

Check in on whether therapy meets your needs. If not, consider discussing changes or exploring new therapists better aligned with your goals.

12. Knowing When to End Therapy

Therapy isn’t permanent. If you feel you’ve achieved your goals and no longer have topics to explore, it may be time to pause or end sessions thoughtfully.

Frequently Asked Questions

What am I supposed to talk about in therapy?You can discuss your feelings, recent life events, relationships, challenges, and personal goals.What if I have nothing to talk about?Try sharing what’s happened since your last session or explore your relationships and emotions. If you feel therapy has fulfilled your needs, consider pausing.Are there topics I can’t discuss?Therapy is a safe space for all thoughts and feelings, including difficult or ‘small’ concerns.What should I share with my therapist?Be open about your emotions, thoughts, challenges, and what you hope to achieve through therapy.

Final Thoughts

“No one has therapy all figured out, not even therapists,” says psychotherapist Nicholas Hardy. Opening up may take time, but patience and the right therapist can make it easier. If you feel stuck, don’t hesitate to explore different therapists or approaches that better suit your needs.

Written by Simone M. Scully, health and science writer. Connect with Simone on her website, Facebook, and Twitter.

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