Deciding to take an active step in your emotional and mental healing by going to therapy is a choice that requires a tremendous amount of bravery. Getting so far as to make an appointment is already an accomplishment. For this reason, feeling nervous or scared about your first session is natural.

Meeting a therapist can be a bit nerve-wracking, especially if it’s your first time going to therapy or your first time with a particular therapist. A common concern among those preparing for a session is wondering what to talk about in therapy. You might wonder: Do I have to talk about my feelings the entire time? Will they ask me about my childhood?

To help ease your worries, we’ve provided an overview of questions typically asked during a first therapy session. We’ll also share some of the subjects that often come up in therapy. However, keep in mind that you can talk to your therapist about anything that you feel you need guidance with or want to heal yourself from, so you don’t have to limit yourself to the topics in this article.

Your First Therapy Session: What to Expect

Before your first session, you will be asked to complete several forms. These may include questions about your medical history, your current medications and psychiatric or psychotherapy treatment you have had or are currently undergoing. 

If your provider accepts insurance, they might also ask you to provide details about your carrier and coverage. In addition, you will likely be asked to sign HIPPA forms, and a therapist-patient services agreement.

You may discuss your concerns with your therapist during your appointment if you want clarification about certain items in the forms.

The first appointment is called an intake session. It’s a bit like a meet-and-greet between you and your therapist, allowing you to get to know each other. There is no need to worry about what to talk about in therapy during this session, as your therapist will guide the conversation.

Your therapist may ask you questions to determine your needs and gauge how to best proceed with your treatment.

For example, they may ask:

• Why did you decide to go to therapy?

• What are your mental health symptoms?

• What are some current challenges you’re facing?

• What are you hoping to accomplish through therapy?

Your therapist may also request information about:

• If you have had any past treatment from a therapist or psychiatrist.

• The dynamics of your relationships with family members or friends.

• The state of your living situation or home life.

• Your education history and employment status.

• If you have a history of self-harm or suicidal ideation.

If you’re not comfortable answering a question, you must tell your therapist. Remember, therapy sessions are for you to feel comfortable and get what you need out of it, not for your therapist to make you feel uncomfortable. They will understand if you’re not quite ready to share certain details about your life.

During this session, your therapist will also review your answers to the form you were asked to fill out before the appointment. In addition, they will also ask you to review and sign an Informed Consent form. Feel free to ask your therapist questions about this or the other documents you are asked to sign.

Succeeding Sessions: What to Talk About in Therapy

The idea of telling a stranger, even if they’re a medical professional, about your thoughts, actions and feelings can seem overwhelming. However, remember that your therapist is there to help you, listen to you and guide you, not judge you. So, if you’re wondering what to talk about in therapy, the short answer is: anything you want.

However, we understand that it can be challenging to know where to start. To help you, here are some common topics discussed during therapy that can serve as a springboard for meaningful conversations with your therapist.

The Little Things

If there’s something that’s bothering you, you can definitely discuss it in therapy. It doesn’t have to be anything “serious,” either. Contrary to what you might have seen in movies or read in books, therapy isn’t just for helping treat mental health conditions such as depression and anxiety. It’s also not just for those who have been through traumatic experiences.

Therapy can be helpful for those who are going through a challenging period or having difficulties in any aspect of their lives, no matter how “minor” it might seem to themselves or others.

Thoughts, Behaviors and Emotions

Have you noticed recurring thoughts, emotions or behaviors that you feel uncomfortable with or believe may be problematic? For instance, a person having trouble controlling their anger can talk about this issue with their therapist to determine what motivates this behavior.

Together, they can try to determine where the emotion is coming from. Through several sessions, if needed, they can explore whether the individual’s anger is a manifestation of another emotion,  a response to feeling invalidated or something else.

You can feel safe talking to your therapist about any emotions that are troubling you. Working alongside your therapist, you can identify ways to process your feelings in a healthy manner.

Significant Life Events

Many people go to therapy after experiencing a stressful or painful life event, such as the death of a loved one, divorce or a difficult diagnosis. After events like these, it is common to feel a range of emotions, such as sadness and anger. If you are having trouble dealing with it, you can confide in your therapist.

A life event doesn’t have to be negative to be significant. Some positive or neutral major changes, like the birth of a child, a new job, moving to a different state or marriage, can trigger emotions and thoughts that you need help to process and manage.

Your therapist can help you understand what you’re feeling. With your therapist’s help, you can start learning healthy coping skills and strategies so you can adapt to life’s changes and maintain your emotional equilibrium.

Get Support and Guidance From a Therapist Who Understands

Park Slope Therapy in New York City offers individual, couples and children’s therapy services as well as parent coaching. Established to provide an alternative to conventional therapy, Park Slope Therapy has a modern approach that is geared toward guiding and empowering clients by providing them with the tools they need to heal and grow.

We offer a free, 20-minute phone consultation so you can learn more about us and see if we’re the right fit for you. We look forward to hearing from you!