Sitting down with a therapist and not knowing where to start is very common, especially at first. The good news: there’s no wrong topic, and part of a therapist’s job is helping you find the thread. Still, a little preparation helps you get more from each session. Here are ideas for your first session, regular sessions and those days when you feel you have nothing to say.
See how it works, step by step
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For your first session
- What made you decide to seek therapy now.
- What you’re struggling with and how long it’s been going on.
- How it affects work, relationships, sleep or health.
- What you’ve tried so far.
- What you’d like to be different in a few months.
- Questions about how therapy works, confidentiality, and the therapist’s approach.
Ideas for any session
- Something that bothered you this week, even if it seems small.
- A strong emotion you noticed and what triggered it.
- Patterns you see repeating in relationships or at work.
- Thoughts you keep returning to (see overthinking).
- How the homework or skills practice went.
- Your childhood or family, if it feels relevant.
- Goals, values and decisions you’re facing.
- How you feel about therapy itself, including what isn’t working.
When you have “nothing to talk about”
- Say so: “I’m not sure what to talk about today” is a perfectly good opener.
- Review the week: high and low points.
- Talk about what you’re avoiding talking about.
- Discuss progress toward your goals.
- Bring notes or journal entries.
See how it works, step by step
Online-Therapy.com walks you through a short questionnaire, matches you with a licensed therapist, and gives you a structured CBT program. Use code THERAPY20 for 20% off your first month.
See how Online-Therapy.com works →Sponsored link · Cancel anytime · Not an emergency service — in crisis, call or text 988
Tips to get more from therapy
- Jot down topics during the week in your phone.
- Be honest, even about embarrassing things; therapists have heard it before.
- Ask for feedback and practical tools if you want them.
- Practice between sessions; that’s where much of the change happens.
- Speak up if the fit isn’t right; switching therapists is normal.
If you’re new to therapy, read how to start online therapy and how to choose an online therapist.
Frequently asked questions
What should I say in my first therapy session?
Why you’re there, what’s been hard, how long it’s been going on, and what you’d like to change. Your therapist will guide you.
Is it normal to not know what to talk about in therapy?
Very normal. Saying so is a fine way to start.
Can I talk about anything in therapy?
Yes. Confidentiality has limited exceptions (such as serious risk of harm), which your therapist will explain.
Should I prepare for therapy?
A few notes help, but there’s no need to over-prepare.
See how it works, step by step
Online-Therapy.com walks you through a short questionnaire, matches you with a licensed therapist, and gives you a structured CBT program. Use code THERAPY20 for 20% off your first month.
See how Online-Therapy.com works →Sponsored link · Cancel anytime · Not an emergency service — in crisis, call or text 988
Sources
- American Psychological Association: Understanding psychotherapy and how it works
- NIMH: Psychotherapies
- NIMH: Tips for Talking With a Health Care Provider About Your Mental Health
- SAMHSA: 988 Suicide & Crisis Lifeline