Don't Know What to Talk About in Therapy?

Don't know what to talk about in therapy? Check out these tips from FOLX Health to help guide you.

February 7, 2023
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Starting therapy is a gigantic step towards bettering your mental health and overall wellbeing. For many, it can be an incredibly healing and life-changing experience.

Whether you’re contemplating therapy, looking for a therapist, or are already currently in talk therapy, it’s important to think ahead about what conversations you want to initiate in each session. Here are some tips for starting your next therapy session on the right foot.

Think about your therapeutic goals

If you’re in therapy, or just thinking about trying it, it’s important to consider what you want to take away from therapy. Perhaps, you might be struggling through a rough time in your life and you need a professional to talk to. Maybe you know you struggle to hold space for your own feelings. Whatever your situation is, think about what goals you want to set for yourself. Here are some questions to get you started:

  • What topics or issues do you want to conquer in this safe space? For instance, do you want to tackle specific relationship issues?
  • Are you looking to develop new coping skills like how to practice better self-care day to day?
  • Do you have any childhood trauma you want to better understand and heal from?
  • What breakthroughs are you hoping to make?
  • Do you also want to work with a psychiatrist?

When you've identified some goals, bring these with you to therapy and share them with your therapist. Think of your work as a partnership or teamwork. The more your therapist knows about what you're hoping to get out of therapy, the better!

If you’ve been in therapy for a while already, it might be helpful to make new goals or revisit old goals if you’ve made any in the past. Ask yourself if it’s worthwhile to take a different approach.

Learn about the different types of therapy

Therapists typically have different kinds of specialties. They may practice different therapeutic approaches like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing therapy (EMDR) to name a few, according to Medical News Today. Many of these specialties involve advanced or additional training. If you're interested in a specific type of therapy, looking for a therapist specifically trained or certified in a certain type of therapy is important.

Since therapists are also licensed clinicians, they’re required to be accredited in order to legally offer and conduct therapeutic services. For instance, a therapist may be an LCSW or licensed social worker. The right therapist for you, however, will use an approach that aligns with your therapy and wellness goals. CBT, for instance, is often recommended for those new to therapy with anxiety and depression. However, if you’ve been previously diagnosed with borderline personality disorder, for example, a structured DBT program may be more catered for your specific diagnosis and therapeutic goals.

A FOLX Health illustrated graphic of someone deep in thought and working on their mental health

Set intentions before your therapy sessions

Take some time to pause before your therapy sessions, especially before your first session. Even if you’re continuing a conversation from your last session, pause anyway. 

This could look like meditating, journaling, or even recording a voice note. No matter how you do it, know that thinking ahead can be extremely beneficial. Use the opportunity to center yourself and pick one to three points to bring up during the upcoming session.

If you do happen to write down your intentions before therapy, it can be a helpful place to return to after your session. Afterward, reflect on whether your intentions were articulated during the therapy session. Do you feel accomplished in bringing specific topics to the conversation?

If you’re still struggling to prioritize certain topics over others, you can consider bringing it up in your session and being more transparent. Name it and hear what your therapist says. Sometimes, naming you don’t know which direction to go can be a skill in itself. Your therapist may be able to help guide you.

Notice what comes up in between sessions

If you’re having a hard time dealing with complicated and/or uncomfortable feelings, document how you’re feeling in between sessions. Even if you’re unsure of what bothers you when these feelings arise, it’s helpful to know what is going on in between sessions. This can help guide what to bring up in your next session.

Many people find breakthroughs happen in between sessions. Incorporating self-work and reflection between sessions can be just as important as the actual sessions. If you're unsure of how to incorporate this step, talk with your therapist for their suggestions.

We recommend you keep a journal to write down your thoughts and feelings. A journal can be a safe, private place to help you reflect independently before and after sessions. Freewriting can also be a meditative practice that helps you externalize the noise inside your mind. Additionally, consider bringing your journal to therapy sessions with you, so you can discuss anything important that comes up.

Garner your support

Your therapist should help you feel supported in the therapeutic relationship. However, your therapist is only one of your cheerleaders. Check in with trusted family members, friends, and other loved ones. Fill them in on your journey with therapy. It’s likely you won’t be the only one on such a journey! Ask if they’d be willing to be part of your care team. If you ever have a particularly difficult session or just need a pep talk, you can ask for their support and foster a connection, even if it’s over a simple phone call.

Whether you're seeking in-person or online therapy, look out for a clinical psychologist or other mental health providers specializing in LGBTQ-competent care. Learn more about the process in our article, How to Find an LGBTQ-Friendly Therapist.

Embrace queer joy and flourish with help from a dedicated team who are experts in mental health care, so you can keep your mind as healthy as your body. To learn more about our mental health services, visit here.


FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!