WHAT TO SAY IN THERAPY

A Guide for Those Unsure About What to Talk About in Therapy

If you’ve been struggling with stress, anxiety, depression, or other mental health challenges, you may have thought about seeing a therapist. But maybe you’re hesitant or ambivalent about actually taking that step. What would you even talk about? What if the therapist judges you? Is therapy really worth the time, money, and emotional energy?

If you can relate to those concerns, you’re not alone. Many people are unsure about starting therapy, even when they’re really struggling. The good news is that hundreds of studies have shown that therapy can help improve symptoms of mental illness, enhance coping skills, and increase well-being and life satisfaction.

This article aims to demystify the therapy process so you know what to expect. We’ll cover what therapists wish every new client knew, how to prepare for your first session, what to talk about, and how to get the most out of therapy. Whether you decide to try therapy or not, we hope this information helps you feel more informed and empowered to make the right choice.

WHAT THERAPISTS WISH YOU KNEW

Starting therapy can feel vulnerable, but it doesn’t have to be scary. Here are a few key things therapists want every new client to know:

1. Therapy is a collaboration, not a quick fix. Your therapist is there to listen, guide, and support you, but you’re in the driver’s seat. Don’t expect them to magically solve all your problems. Instead, therapy is a process where you work together to gain new insights and coping skills.
2. Fit matters, so shop around. Just like dating, finding a therapist you click with and trust is important. If you don’t feel comfortable with the first therapist you see, it’s okay to try someone else.
3. You don’t need a diagnosis to benefit. While therapists do diagnose mental health conditions when appropriate, you don’t need a label to justify getting help. Anyone can benefit from having an objective, caring person to talk to. Therapists work with people dealing with a wide range of life challenges, not just mental illness.
4. Your therapist won’t judge or manipulate you. Opening up to a stranger can be scary, but therapists are trained to listen without judgment. They’re not there to criticize you, tell you what to do, or psychoanalyze you. And you’re in control of what you share – your therapist will never force you to discuss anything you’re not ready to discuss.
5. All emotions are welcome, even the messy ones. Society often pressures us to put on a happy face, but therapy is a place where you can take the mask off. It’s okay to cry, get angry, or admit to thoughts and feelings you’ve been ashamed of. Therapists are used to seeing people at their most vulnerable, and they don’t think less of you for it.
6. Change takes time, so be patient with yourself. Many people come to therapy hoping for a quick solution to issues they’ve been dealing with for years. In reality, change is a gradual process that requires commitment. It’s normal to have setbacks and moments of discouragement. Therapy is not always easy, but it is worth it.

HOW TO PREPARE FOR YOUR FIRST THERAPY SESSION

So you’ve scheduled your first therapy appointment – now what? Here are some tips to help you feel more prepared and get the most out of that initial session:

1. Reflect on your reasons for seeking therapy. Take some time to think about what prompted you to seek help now. Are you dealing with a specific problem or stressor? Are there certain thoughts, emotions, or behaviors you want to change? Writing this down can help you articulate your situation to the therapist.
2. Describe your symptoms and their impact. If you’ve been struggling with symptoms like persistent sadness, anxiety, sleep issues, or low self-esteem, note how often you experience them and how much they interfere with your daily life and relationships. This helps the therapist understand the severity of your distress.
3. Set goals, but be flexible. Think about what you hope to get out of therapy. What would “getting better” look like for you? Your goals might include reducing specific symptoms, processing a trauma, improving a relationship, or getting “unstuck” in some area of life. Share these with your therapist, but be open to modifying them as you go.
4. Prepare questions about the therapist’s approach. Therapists have different styles and specialties, so feel free to ask about theirs. You might inquire how they typically work with clients, their therapy modalities, and whether they have experience treating your particular concerns. Jot down any other questions you have so you don’t forget.
5. Get practical details squared away. When you make the appointment, ask about office policies, fees, accepted insurance, and paperwork you must complete. Knowing these logistics ahead of time can put your mind at ease and allow you to focus on the actual session.
6. Keep an open mind. If you’re feeling anxious about starting therapy, that’s understandable. Try to set aside specific expectations and focus on being as open and honest as you can. Remember, your therapist is there to help and support you, not to judge or criticize. Trust that you’re doing something good for yourself by being there.

WHAT TO TALK ABOUT IN THERAPY

Now that you’re prepared for that first session, what will you actually talk about? The beauty of therapy is that you can discuss anything that’s on your mind, but here are some common topics and questions to consider:

1. Your reasons for seeking therapy and what you hope to gain from it
2. An update on your symptoms, mood, and any recent changes or stressors
3. Key relationships in your life, both current and past
4. Significant life changes, challenges, or transitions you’re navigating
5. Any traumas, losses, or grief experiences that still impact you
6. Your family dynamics and important childhood experiences
7. Unhelpful thought patterns, intense emotions, or behaviors you want to shift
8. Your hopes, fears, dreams, and goals for the future
9. Personal qualities, strengths, and values you want to develop further
10. Anything else that’s been on your mind, even if it seems small or unimportant

Remember, you don’t have to have it all figured out or even know exactly what to say. Starting therapy can feel like a relief because you finally have a safe, non-judgmental space to sort through your thoughts and feelings out loud. Your therapist will likely ask questions to better understand your experience and guide the conversation, but you’re always in control of what you disclose.

HOW TO GET THE MOST OUT OF THERAPY

Starting therapy is a big step, but following through is how you’ll see the most benefits. Here are some tips to stay engaged in the process:

1. Prioritize honesty, even when it’s hard. You’ll get the most out of therapy by being as truthful as possible about your thoughts, feelings, and experiences. If you’re embarrassed or ashamed of something, tell your therapist. Chances are they’ve heard it before and won’t judge you. Hiding things only keeps you stuck.
2. Do the work outside of sessions. Therapy isn’t just the 50 minutes you spend with your therapist each week. You’ll need to take the insights and skills you’re learning and apply them to your daily life to see real change. Your therapist may assign “homework,” like tracking your moods or practicing a new coping strategy. Following through shows you’re committed to the process.
3. Give your therapist feedback. Your therapist wants to know what is and isn’t working for you in therapy. If something they said rubbed you the wrong way, tell them. Bring it up if you’d like to spend more time on a certain topic. Therapy is a collaborative process; your input helps your therapist tailor treatment to your needs.
4. Keep going, even when it gets tough. Sometimes, you feel like you’re not making progress or you’d rather avoid difficult emotions that come up in therapy. This is when many people drop out, but it’s also when real growth can happen. Stick with it, and lean on your therapist for support during the hard parts.
5. Celebrate your wins, big and small. Therapy can be challenging, so it’s important to acknowledge your progress along the way. Did you have a vulnerable conversation with your partner? Did you use healthy coping skills instead of turning to an old vice? Did an insight in the session give you a new perspective? These are all worthy of celebration. Recognizing small victories can give you the momentum to keep going.

If you’ve been considering therapy but are feeling unsure, we hope this article has given you a clearer picture of what to expect and shown you that your concerns are valid and normal. Therapy is a deeply personal experience; it takes courage to be vulnerable with another person. But it can also be incredibly rewarding and healing.

You don’t have to be in crisis or have everything figured out to benefit from therapy. You have to be willing to show up and do the work. And you don’t have to do it alone – a skilled therapist will be there to guide and support you every step of the way.

If you’re struggling and think you could benefit from professional help, we encourage you to take that first step. Call my office at 844-802-6512 and find out what is possible. It may feel scary, but it could be the start of a journey toward greater self-awareness, emotional resilience, and a more fulfilling life. You are worthy of healing and happiness – and therapy could be the key to unlocking both.