You sit down, your therapist smiles and asks, "So, what would you like to talk about today?" And your mind goes blank. That's very common. Knowing what to talk about in therapy is not something anyone is taught. This post gives you a short answer, a list of prompts, tips for opening up, how to talk about therapy itself, what to do when nothing feels wrong and what stays private.
This post is general information, not a diagnosis. Only a qualified professional can assess what you're going through.
What to talk about in therapy, the short answer
You can talk about anything that is on your mind. There is no wrong topic. Big problems, small annoyances, a dream you had, a fight with your partner or a song that made you cry all count.
Your therapist's job is to help you make sense of it. You don't need to arrive with a neat plan or know why something matters. Often the most useful talks start with "This might be silly, but..."
If you're new to therapy, our post on what to expect in your first therapy session explains how the first meeting usually goes.
Things to talk about in therapy: a prompt list
If you're stuck, pick one of these prompts. You can even bring this list to your session.
About this week
What was the hardest moment this week?
When did I feel most like myself?
What did I keep thinking about?
What did I avoid?
About feelings
What feeling has been showing up most?
Where do I feel stress in my body?
What made me angry, sad or anxious, even a little?
About people
Who did I feel close to? Who did I feel far from?
Is there a talk I keep putting off?
Is there a pattern I keep repeating in relationships?
About the past
Is there a memory that keeps coming back?
What did I learn about feelings growing up?
About the future
What would I like to be different six months from now?
What is one small step I could take this week?
You don't have to answer them all. One good question can fill a whole session.
How to open up in therapy
Opening up can feel scary, especially if you've learned to keep things to yourself. A few tips:
Start small. You don't have to share your biggest secret in the first session. Trust grows over time.
Say what's hard to say. "I'm nervous to talk about this" is a great place to start.
Write it down. If speaking feels hard, bring a note or read from your phone.
Notice your body. If your chest tightens when a topic comes up, that may be worth exploring.
Let silence be okay. Pauses can give you time to find the words.
Research shows that the relationship between you and your therapist matters a lot. A strong working relationship, often called the alliance, is linked with better results in therapy (see Sources). That relationship is built by both people, over time.
Talking about therapy itself
One of the most helpful things you can talk about in therapy is therapy. That might sound odd, but it gives your therapist useful information. You might say:
"I didn't find last session very helpful."
"I felt judged when you said that."
"I'd like more practical tools."
"I'm not sure we're working on the right thing."
"I'm thinking about taking a break."
Good therapists want this feedback. They won't be offended. It helps them adjust to what you need. Saying it out loud can also be good practice for being honest in other relationships.
If you feel the fit is not right, it's okay to say so. You can also ask to try a different therapist.
When you feel you have nothing to talk about in therapy
Some weeks, nothing big happens. You might wonder if you even need to go. Having nothing to talk about in therapy is normal, and those sessions can still be useful.
Try these ideas:
Look at what's going well. What helped this week? How can you do more of it?
Check in on your goals. Are you closer to what you wanted when you started?
Go deeper on an old topic. Calm weeks are a good time to explore something you skipped before.
Talk about the "nothing." Feeling flat or numb can be worth exploring too.
Notice small things. A short moment of irritation or a passing worry can open up a bigger topic.
If you keep feeling you have nothing to say, it may be time to talk with your therapist about your goals. You might be ready to meet less often, or to shift focus.
It can also help to jot down a few notes during the week. When something bothers you, makes you laugh or sticks in your mind, write one line about it on your phone. Before your session, read the list. You'll often find more to talk about than you expected, and you won't have to rely on memory when you sit down.
Different kinds of therapy, different kinds of talk
Not every session sounds the same. Some types of therapy, like cognitive behavioural therapy (CBT), are more structured. You may set an agenda, look at thoughts and plan small tasks to try between sessions. Other approaches are more open, and you follow whatever comes up. Many therapists mix both (see Sources).
If you're not sure which style you'd like, that's fine. You can tell your therapist what feels useful, and you can change your mind along the way. Research suggests that across many types of therapy, shared factors like the relationship, agreeing on goals and feeling understood matter a great deal (see Sources).
What stays private in therapy
Many people hold back because they're not sure what stays private. At Transformation Counselling, what you share in counselling stays between you and your therapist. Even the fact that you attend counselling is confidential.
The only thing that comes before confidentiality is safety. There are four limits where a counsellor must report to the right authorities:
If you say you are going to kill yourself
If you say you are going to hurt someone else
If you say that a child is being abused
If you say you have been abused by a licensed professional, like a doctor or another counsellor
It is also possible that a therapist's notes could be subpoenaed if you are involved in a court case. You can read more on our confidentiality in counselling page.
If you have questions about privacy, ask your therapist at the start. Knowing the rules can make it easier to open up.
Finding a therapist who is easy to talk to
Feeling comfortable with your therapist makes all of this easier. Our individual counselling is available in Kitchener, Waterloo, Cambridge and Ottawa, or online from anywhere in Ontario. The free consultation can match you with a therapist who fits your needs and style.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers. Coverage depends on your plan, so check with your insurer before you start.
Book a free 15-minute consultation with our admin team. Let them know what's on your mind, even roughly, and whether you'd prefer in person or online.
If you're in crisis: if you or someone you love is in immediate danger, call 911. If you're thinking about suicide, call or text 9-8-8 any time, day or night.
Last reviewed: October 2026
Sources
Psychotherapies, National Institute of Mental Health
How important are the common factors in psychotherapy? An update, Wampold, World Psychiatry, 2015
Assessing the alliance-outcome association adjusted for patient characteristics and treatment processes: a meta-analytic summary of direct comparisons, Journal of Counseling Psychology, 2020