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time posted
Dec 19, 2022

What Do I Talk About In My First Therapy Session?


So, you’ve made the choice to go to therapy – first of all congratulations for putting yourself first and doing something that will support and benefit you.

Now you begin to think and think and think and small nerves start to appear in your stomach. They all surround the idea of ‘what to talk about in therapy?’ Take a deep breath, this question is normal and having a few nerves before your first therapy session can be expected.

You are taking a big step in giving yourself the opportunity to heal, to be heard, and to find yourself. Therapy offers all of this and more, where you begin is completely up to you. There are no right or wrong ways to begin therapy, this is your journey, you chart the way.

All this control might be a bit scary, especially if you are not used to being able to control situations you are in. Keep breathing, you can do this. We are going to go through some ideas for topics you can bring up in your first, second, fiftieth therapy session!

What To Expect In Your First Session

The first session is all about getting to know each other – you are beginning to establish a therapeutic relationship or therapeutic alliance. This relationship is built on trust and complete acceptance. Finding the right therapist for you is important, if don’t feel that the therapist you see is the one for you, rather than giving up on therapy, find a different psychologist and try again.

After initial greetings some psychologists might ask you a few questions to help guide the conversation and to get information about you that they need to help them understand who you are and what brings you to their office.

Other therapists allow you to take the lead from the beginning and start where you would like to, and they will work from what you offer them. This allows you to start from where you are comfortable.

There may be some information that your therapist needs in the first session, this might include emergency contacts, basic family make up, your occupation, a medical history, etc. This information may be asked for on an intake form. This is to help the therapist construct a good understanding of who you are in the quickest time possible to ensure they begin supporting you from the beginning.

Other conversations that may occur in the first session are about insurance and billing information, exploring your expectations, explaining confidentiality, and sharing how the therapist works. These conversations will help you determine whether this is the therapist for you.

You may find that some of what you want to share goes over from the first session to the second, this is perfectly normal, and you shouldn’t worry. Rather feel confident that you have expressed everything that you need and want to than worry about the time you are taking. Remember – this time is yours!

Things You Can Talk About

You have got through the basic information, and you now need to have a starting point, but you still aren’t sure where to start. Continue with those deep breaths and think about some of these topics. You can discuss this difficulty or uncertainty with your therapist.

Any Reasons For Skepticism

Being honest with your therapist is key to building the therapeutic relationship. They will not judge you for uncertainties or thoughts that you have.  It is better to have them understand any skepticism or concerns about the process from the beginning.

You have every right to bring up these concerns, to hear what they have to say, or to have your point of view understood. 

You may be engaged in online therapy and have doubts about talk therapy in the virtual space, or you might not see how sitting and talking can be helpful, you may even feel that your therapist may not be able to understand how you feel because they have not lived your life.

All of these thoughts are valid and sharing them can help develop the trust and connection between both you and your therapist.

Your Past

Sometimes it is difficult to begin with the most recent experiences or you might feel that your therapist needs to understand elements of your past to understand what you are currently going through.

Taking your therapist through your past doesn’t mean you have to share every memory or event that you can remember. You have control as to what memories and reflections you share. You might think that there are some memories and experiences that will give your new therapist a better understanding of your family members or relationship patterns.

Sharing this can help you get the ball rolling and help you link to the more current thoughts and feelings. You might feel relieved after sharing old wounds and having them validated.

Your Current Feelings

You may wish to bring in what you are feeling in the present moment. It may be a reoccurring feeling that you have recently felt, or one that sticks in your mind. You may be feeling it in the therapy session and wish to talk about it.

These experiences can open a conversation that will explore the trigger or reason for this feeling and how to find coping mechanisms to handle the feeling in a helpful manner.

Speaking about your current feelings may help you to become comfortable with sharing more with your therapist and becoming more open and vulnerable. This will allow the process to deepen for you and you might gain valuable information about yourself.

You might wish to start each session by sharing what you are currently feeling and then expanding on that. It is a good starting point because it is about you and your personal experience.

Any Previous Therapy Experiences

Sharing any previous therapy experiences and how you found them is helpful for both you and your new therapist to understand what has come before in this safe space. It may be that you had a bad experience with therapy and are hesitant to try again.

It could be that you had the best experience, but your therapist retired and now you are nervous about starting the whole process again. You could also still be searching for the right therapist and might be feeling that you won’t find them.

Any of these experiences will assist a good therapist in sharing with you their preferred ways of working, exploring ways to meet your expectations or reassure your fears to allow for a possible connection to be made for a beneficial therapeutic process.

Talking about these moments gives you the opportunity to share your expectations and hopes for this process as well. You can express what you hope to gain from the space as well as what you expect from your therapist. Clarifying these expectations early in the relationship will ensure clear communication and understanding between the two of you. This will enhance the benefits of therapy.

Your Current Job

Often our jobs are topics of contention and stress. Whilst your therapist may not be able to change the circumstances, they are there to listen to whatever you need someone to listen to. Sometimes we need to vent and release the tension that has built up inside of us.

Therapy is a good place to express how you feel about your position, your daily interactions, your ambitions, etc. These expressions can help you release conflicted feelings or build a level of reflection and distance. Sometimes when we express these feelings to a partner or friend, they want to help us fix things. There are times when you just want to be heard, without the well-meaning suggestions.

Therapy offers you this opportunity. Talking about your job, colleagues, achievements, and conflicts at work can be a topic to speak about in therapy.

Your Relationships

Any relationship can be food for thought in a therapeutic space. This could be a friendship, a family member, a romantic partner, a colleague, anyone whom you interact with. Exploring relationship patterns, communication habits, conflict management can all stem from talking about your relationships.

You might want to focus on a positive relationship in your life. Remember, therapy is not always about the challenges or negative. You can recount the positives, the strengths in your life. Your therapist might call them assets – things that you can use to support yourself during more difficult times.

Any relationship you decide to bring up in therapy will be valuable to reflect upon and can provide you with greater insight. If you feel stuck and unsure about what to speak of in your first session, or even in a later session, choose a relationship that you are invested in and speak about it.

Any Goals You Have

Having goals is an important part of living a life that continuously moves forward. These goals may be personally related, or work related or even leisure related, like forming a new hobby. Your goals could also be therapy related and illuminate what you hope to achieve through therapy.

Any of these goals are worth speaking about. Being knowledgeable about your goals can assist your therapist in understanding the trajectory you are hoping to achieve. This helps them to align their support to your goals.

There are times when you are experiencing mental health struggles, such as depression or anxiety, where creating goals seems like an impossible task. You can talk about this as well. Explain how it feels when you are thinking about setting goals, what you find the most difficult part, what you think is keeping you from committing to these goals.

You could also talk about the achieving of your goals – do you often achieve the goals you set? Can you develop a plan that allows you to maintain working towards them? Or do you struggle to maintain enthusiasm and find that you often don’t achieve your goals?

These are all points that you can bring up in therapy and explore. You can even create goals together with your therapist. In this way you have a sounding board when you are creating your goals that can help you align your goals into small, achievable goals that will motivate you each time you achieve them.

Your therapist may also be able to help you create implementation plans and find ways to incorporate these new goals into your current life. These skills that you learn together with your therapist will then help you in the future for setting and achieving goals.

Roadblocks In Your Life

A roadblock could be anything that you feel is stopping you from moving forward or healing. It could be a person, an event, a thought pattern, a memory, a relationship, or even just a feeling that something is blocking you.

You can explore these roadblocks with your therapist. Sometimes they will be able to help you understand the block and find ways around it, other times they could help you reframe how you see the roadblock and shift how you approach it. This shift may negate the effect it has on you.

Roadblocks are not things to be avoided or viewed as impassable. These are normal occurrences that may need us to think out of the box or gain a different perspective in order to overcome them.

Therapy can offer you the space to explore these different perspectives safely and without judgement. Talking about your roadblocks allows you to feel in control of them and not under their control. When you feel in control, you feel more empowered and motivated to take these roadblocks on and conquer them.

Anything Causing You Anxiety

A therapeutic space offers you the opportunity to share any anxieties or worries within a containing place with an active listener who will not judge you. This environment can make you feel more comfortable sharing the things that are worrying you.

Anything that causes you anxiety or worry can be discussed whether you feel it is a big thing or not – there is no issue too small to talk about. Remember that this is your space and if you feel the need to talk about something then it is worth talking about.

Anxious feelings can become detrimental to how we are able to function if we have not been able to control and manage these feelings. Working with your therapist to unpack the situations or experiences that are creating anxiety will help you build your resilience and develop coping strategies.

Major Life Events

A major life event can be classified as anything that you feel was a pivotal or influential moment in your life. This may be an accident, a death, a divorce, a move to a new house, a work interaction, an illness, a self-discovery, etc. Any event that you feel had a deep impact on you or how you currently view yourself or the world is a good topic to bring into the therapy room. 

The reason you could discuss these events is the fact that they have shaped you and your world view in some manner. These could be recent events or from childhood. Your therapist will allow you to explore the event and its impact on your current wellbeing.

You might find that you need help to reframe the impact and find a different way of viewing the event or finding a way to develop the strengths the event offered you. Simply exploring the event in talk therapy can offer a release of emotions that you may have been too afraid to face.

To Wrap Up

There are many things that you can bring up in therapy. In fact, you are not able to bring up everything mentioned in this blog in your first three sessions! You may need to unpack all this information a little bit at a time.

Remember that the course that therapy takes is in your control. You are allowed to share what you feel is important at each session and work from there. Also, if one session you really don’t know what to say – you can let your therapist know this as well. 

You can decide on the information you are ready to share and explore together. If you are ready to look for a therapist to speak to, then contact One Life Counselling and Coaching. Take a step towards supporting yourself and get the ball rolling on understanding yourself better.

I am the founder of One Life Counselling and Coaching LTD and I am honored to lead a team of professional psychologists, psychotherapist’s and life coaches who dedicate their professional lives to helping people to elevate their mindsets, evolve their beliefs and learn to thrive in the present moment.
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