Going to therapy is always a good thing. It’s a place where you can sit with a trained professional and chat about whatever’s on your mind, all while receiving help and advice. But if you want to make the most of your therapy sessions, there are a few extra things you can do, including asking questions.
“Therapy is at its core a collaborative process — it takes two,” Lauren Freier, MA, LCPC, of Ignite Counseling, LLC, tells Bustle. “Much like with school, a job, or even a relationship, the more you invest yourself and your efforts, the more opportunity you have to gain and grow.” And while it may be difficult, it’s perfectly OK to do.
“You should absolutely feel comfortable asking your therapist questions and expressing your needs throughout the process,” Freier says. “For instance, if you do well with weekly ‘homework’ to help hold yourself accountable toward taking actionable steps toward your goals, make that known.”
Therapy is as much about what you want to do and say as it is about your therapist’s treatment plan, so feel free to make it your own. Here are some questions you may want to ask, according to experts, in order to get the most out of therapy.
1
“What Kind Of Therapy Do You Offer?”
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If you’re just getting to know your therapist, one of the first questions you’ll want to ask is what type of therapy they offer, as there are quite a few.
This will help you learn more about their areas of expertise, what specific treatment interventions they use, and also what their style and therapy background looks like, Freier says. This can help you get a sense of who they are, she says, and help you decide if their methods will be a good fit.
After all, you won’t get much out of therapy if you two don’t click, or if you aren’t comfortable with their therapy style. So don’t be afraid to ask.
2
“How Will I Know We’re A Good Fit?”
It might seem awkward, but it’s also OK to be straightforward and ask your therapist if they think you’re a good fit for each other, and whether they think they can help you.
This is something that can happen during an initial session, which your therapist will likely offer in order to do an assessment and talk about treatment goals, Jennifer M. Simpson, LISW-S, a clinical social worker with Thrive Therapy Inc., tells Bustle. “If your therapist refers [you to another therapist],” she says, “this isn’t a bad sign. In fact, they are likely ensuring you get to the right person to best serve you.”
3
“What Will My Treatment Plan Look Like?”
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Once you’ve talked and covered the basics of why you’re seeking therapy, you can ask your therapist about their treatment plan, as well as any goals they have for your visits.
“This is crucial to any therapy session as it provides direction,” Kristine Erskine, a therapist with Freedom Counseling, tells Bustle. “It helps you and your therapist to be on the same page regarding what you want out of therapy.”
And these goals are something you can come up with together. “Once one goal has been achieved, you can move on to the next one,” Erskine says. “Additionally, your goals can change if needed throughout the counseling process.”
4
“Can You Help Me Create Some Goals?”
It’s also OK if you don’t have any goals, or aren’t sure what needs to happen next. That’s where this question can come in handy.
“If you’re having trouble figuring out what your goals are — which can happen if you’re feeling overall crummy and know you just want to feel better — ask your therapist for guidance on how to articulate them,” Victoria Fisher, LMSW, psychotherapist and licensed clinical social worker, tells Bustle.
These can be goals you work on over time. Simply knowing you have them, and that you’re taking small steps in that direction, can be incredibly helpful.
5
“Can You Recap What We Talked About?”
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Since you and your therapist will probably cover a lot of topics during each session, it can help to ask for a quick recap before you leave so that you can remember the key points.
“Ask for reminder on a card or paper about what you discussed during the session or take your own notes in a notebook or on your phone,” Erskine says. “This will help you reflect during the week about what you discussed and remember to practice specific skills that your therapist and you decided upon for the week.”
6
“What Should I Work On This Week?”
Similarly, you might want to ask for homework or assignments to work on throughout the week, whether it’s “a book to read, or just some general introspection to engage in,” Nicole Miller, MS, LAPC, NCC, a licensed mental health counselor, tells Bustle. “Asking for homework outside of the office can help you to increase your knowledge […] as well as also be a catalyst to increasing the rate of change.”
After all, you can’t cover everything in one hour sessions. Success comes from what you do afterward, and the way you implement the things you learned each week. Homework can help keep you in the right head space, while giving you time to practice and reflect.
7
“How Do You Think I’m Doing?”
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After you’ve been to about three or four sessions, go ahead and ask your therapist how they think you’re doing. This will give you both the chance to reflect on what you’ve talked about so far and any progress you’ve gained, Dr. Jamie Long, licensed clinical psychologist at The Psychology Group, Fort Lauderdale, tells Bustle.
“It’s also a great way to spotlight any patterns that keep showing up,” Long says. “Knowing the repeat issues helps to initiate a course correction in therapy or a deeper dive into unresolved issues, which is important to get the most out of the sessions.”
8
“Can I Be Honest About How I’m Feeling?”
Therapists are humans, too, and might not always say the right thing. So if you feel like something’s off, let them know. “Don’t wait until you’re dreading going to therapy,” Fisher says. “A good therapist will appreciate your honesty and feedback.”
It might be difficult, but being honest in this way can even make for better therapy sessions. “Not only will this empower you, but it will propel the therapeutic relationship forward by building trust and understanding,” Fisher says. “Because the number one factor of any positive therapy outcome is just that — the connection with your therapist.”
9
“How Often Do I Need To Come?”
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How often you need to be visit your therapist — whether it’s once a week, more, or less — can depend on a lot of factors. And yet, it won’t hurt to ask for their opinion, in order to ensure you’re getting the most out of the treatment.
“It is always good to start out one time a week to assess, and then as time goes by you can reassess and change it to every other week or whatever you need,” Marnie Zigelman, LCSW, a licensed clinical social worker, tells Bustle. “There is no one-size-fits-all answer, but depending on your presenting problem, and the therapists approach, you might have a better idea.”
10
“Can I Talk To You Outside The Office?”
If you want to reach out to your therapist in between sessions, then you’ll need to know what their policy is in terms of calling them, texting, or sending emails.
“This is important to know what the boundaries are for the client and therapist outside of session,” Zigelman says. “Does the therapist charge a fee for contact outside of sessions? If so, what are the rules about that. It’s also good to know if [you] can reach out even if it isn’t deemed an emergency.”
11
“Can You Explain That To Me?”
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The stuff discussed in therapy can get confusing and messy at times, especially if your therapist is bringing up concepts you aren’t too familiar with, or making complex connections. So if you ever feel confused, Zigelman says, feel free to ask for clarification.
This is all part of creating a strong patient-therapist relationship, but will also help you get more out of therapy since you’ll be learning and digesting the information as you go. Don’t ever be afraid to speak up.
Therapy is, after all, largely what you make of it. Your therapist plays a big part in that, of course. But it can also be helpful to ask questions, and make sure you’re getting the most out of the experience.
If you don’t know what to talk about in therapy, some things to consider talking about include recent life events, relationships, traumas, and more.
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When I decided to go to therapy for the first time, I spent the whole car ride thinking about how ready I was to work on myself. But when I got there and actually sat down on my therapist’s couch, I clammed up. Suddenly, while sitting face-to-face with this stranger that I knew was there to help me, I had no idea what I actually wanted to say. My mind had simply gone blank.
Admittedly, I’ve always been shy, and talking to new people has always been a little overwhelming to me. But I thought it would be easy to open up to a therapist since it had been my choice to come there. It wasn’t easy. Instead, I felt so much pressure to make the most out of my session that I couldn’t think of a single thing to actually say.
What to expect
Whether you’re like me and had difficulty opening up at your first sessions, or you’ve been going for a while and feel like you’ve “run out” of things to say, know that you aren’t alone.
“It is not uncommon for people to come to session and be unsure about what they want to discuss,” says Jessica Small, licensed marriage and family therapist.
Opening up is tough, and it may not come easily, especially when just getting to know your therapist. In order to help assist you with opening up, some therapists may give you an assessment to take to better understand you and your needs as their patient and help create a plan for future sessions.
Other therapists might let you lead the conversation. If you’re unsure how to begin a conversation with your therapist or don’t know what to talk about, here are 12 things to consider.
1. “Small” issues
It’s easy to feel like you need to talk about “deep” or “serious” issues in therapy But remember, there’s no “correct” topic to discuss in therapy. You can talk about whatever you want.
True, some people come to therapy to address something specific, like anxiety or depression. But sometimes, people are just going through a life transition and want someone to talk with and help them cope with the change.
If you’re finding it tough to open up, Small advises remembering that nothing is off-limits.
“People talk about everything in therapy. They talk about their hopes, dreams, fears, disappointments, hurts, shame, conversations with their mom, interactions with their partner, perceived failures as a parent, sexuality, [or] their most recent date,” she says.
Not sure where to start the session? Begin by recapping what happened since you last saw your therapist — good and bad — and from there, see what you want to explore further together.
2. Patterns and behaviors
It may be a good idea to track your thoughts, patterns, and behaviors by keeping a journal between therapy sessions. This can be especially helpful if you’re shy or find it difficult to remember things on the spot.
Of course, you don’t have to bring your journal with you or read from it in session. But writing things down allows you to look for patterns in your feelings and behaviors that you might want to address with your therapist, Small says.
“For instance, a person may observe that they have been feeling inadequate or insecure and this would be a good thing to address with their therapist,” she says.
3. Present feelings
You might have felt sad, angry, or depressed during the week, but if you’re not feeling that way right now, you don’t have to start with that. Focus on how you’re feeling in the present, and just say how you feel — even if what you’re feeling is just, “I didn’t really want to take this hour for therapy today because I’m slammed at work.”
The truth is, what you need from therapy changes day to day. It’s OK if you went in thinking you’d talk about your relationship and instead spent the whole session venting about your boss.
“Therapy sessions really are meant to be as tailored as possible to what you’re needing at any given moment,” says Sol Rapoport, a marriage and family therapist working with UCLA’s Behavioral Wellness Center. “I actually tell my clients to think of their therapy time as the ‘Room of Requirement’ from Harry Potter — you get to get out of it whatever you are most needing that day.”
“And sometimes,” she continues,” what you need at the moment is someone to allow you the space to just vent.”
4. Rumination
Depression and anxiety can both involve rumination, or a tendency to go over the same thoughts repeatedly.
If you had a hard time falling asleep one night this week because your mind wouldn’t stop thinking about something you wish you’d done or you worried about something coming up, that’s often a great place to start your session.
5. Relationships
This doesn’t just mean your love life. Tell your therapist about all your relationships, whether that’s your partner, your family, or your friends.
Do you feel like you have support at home? Do you feel like you have other people to share your feelings with, or do you have difficulty opening up with others too, not just your therapist?
Relationships are important to your mental health, and they play an important role in affecting your mood and feelings on a day-to-day basis.
So, if you’ve been avoiding your mom’s calls, even though you love her, let your therapist know, and maybe you two can explore why you’re avoiding her.
Even if you feel like you have good relationships, talking about them might help you realize the things that are working in your life — and the resources you can lean on out of session.
6. Past traumas
This one might sound obvious — or conjure up stereotypical images of lying back on a chaise lounge a la Freud — but the truth is, if you’ve been focusing on your present in your last sessions, you might not have gotten around to filling in your therapist on your past.
For example, maybe you’ve spent your last month telling your therapist about your current relationship troubles, but you’ve never discussed your past relationships or your parent’s marriage.
Taking a moment to step back from your present and choosing to talk about your past could help you address some feelings you’ve been bottling up or left unresolved.
7. New life challenges
People in therapy tend to have something they want to address, says Nicholas Hardy, a psychotherapist in Houston, Texas. “However, it is not always a problem. Sometimes, it is a feeling or an emotion that is unfamiliar to them.”
“When clients experience new aspects of life, like childbirth, marriage, relocation, this can ignite untapped areas in their life that they need help understanding,” he continues. “While not always able to articulate what that feeling is, they are able to recognize that something is different.”
If something has changed in your life and it’s making you feel different in some way, bring it up. You don’t have to talk just about the “bad” stuff. Change can be good and yet still bring up new feelings you might want to explore in a safe, nonjudgmental space.
8. Avoided thoughts and conflicts
This could be something you’re ashamed of thinking, or something you think is “silly” to worry about. Maybe it’s something you think is “insignificant” or “stupid.”
We all censor ourselves and judge our feelings. But therapy is exactly the place to explore all our thoughts and feelings, even the ones we feel like we shouldn’t be having.
For example, lots of people think they’re not entitled to be upset about the pandemic because they haven’t experienced as many hardships, like job loss or the death of a loved one, and yet they’re still having a hard time coping with its impacts.
It’s OK to feel whatever you’re feeling, and it’s definitely OK to bring it up in therapy.
“Sometimes I ask clients to think about what they’d least like to talk about that day,” says Rapoport. “It’s usually a good sign of where the trouble is.”
That makes sense. We often avoid talking about things that are uncomfortable, painful, or difficult, and yet when we let them fester, they get worse. Consider therapy your safe place to talk through those things you’d otherwise avoid.
9. Trouble opening-up
If you’re having trouble opening up right now, and you’re not sure why, tell your therapist. There might be something to explore there.
“Even if a topic is not addressed immediately because of discomfort, it is valuable to understand what barriers are keeping [you] from opening up about a particular subject,” says Hardy.
For example, when you’re depressed, you often lose interest in things you once enjoyed and feel decreased energy levels. If coming to session today and last week felt exceptionally hard and you’re not sure why, your therapist might be able to help you unpack that and figure out if something else is going on.
10. Discomforts with therapy
Trust takes time to build, and sharing your thoughts and feelings with a stranger isn’t easy. If you’re having trouble trusting your therapist enough to open up, which is very normal, don’t be afraid to bring that up.
With that information, your therapist can work on building a foundation of trust that will allow you to open up more down the road.
“Therapy is about a relationship between the client and the therapist,” says Small. “If a client is having a hard time opening up, it may mean that there is still trust that needs to develop in the therapeutic relationship. I attempt to meet the client where they are at and build a rapport that will give them the safety and security they need to begin to be more vulnerable and open.”
11. If therapy is working for you
If you truly don’t feel comfortable with your therapist, there’s a chance they aren’t the therapist for you — and that’s OK.
Therapists have different professional backgrounds and specialties, and there are different types of psychotherapy.
“Think about how comfortable you feel asking for exactly what you need from them,” says Rapoport. “Some people prefer a more directive approach. Some people prefer concrete tools — for anxiety management, for instance. Others want to feel like they can talk about a specific subject with someone who is knowledgeable about that in particular.”
“Consider whether your needs are being met,” she continues,” and how open your therapist is to your specific requests and needs.”
If you aren’t getting what you need, if you don’t feel challenged in a good way or like your therapy is progressing, or if you prefer a therapist who shares your gender or racial identity, it might be worth exploring other therapist options.
12. When to end therapy
Psychotherapy isn’t meant to last forever. So, if you used to find it easy to think of things to talk about, and now you’re not, it might be a sign you’ve reached an end point.
It’s perfectly normal to feel like you don’t need therapy after a while. “As a therapist, we want to work ourselves out of a job,” says Small.
But before you quit, make sure you’re ending therapy because you truly got what you needed out of your sessions, and not just because you’re dissatisfied with your therapist.
A 2019 study of 99 adolescents ages 11 to 17, for example, found that people who ended therapy out of dissatisfaction had poorer outcomes than those who left because they felt they “got what they needed.”
To tell the difference, Rapoport recommends thinking back to your first session. “Does it feel like you accomplished what you set out to accomplish? If so, have you identified new goals along the way that you could shift to instead?”
“If you’re continuing to feel like you’re learning more about yourself, or you’re gathering new information and resources, it’s usually a sign that you’re still getting something out of therapy,” she continues. “If it feels like you’ve stalled, or that you’re not getting anything from your sessions that you wouldn’t be able to get from a conversation with someone else, it might be time to take a break.”
Keep in mind that you don’t need to stop abruptly. You can always talk with your therapist about putting more time between sessions and seeing how you feel.
If you currently see them for weekly sessions, for example, you could try doing a monthly check-in. If something comes up and you want to resume weekly sessions, you already have a foundation with a therapist you know and trust.
The bottom line
“No one has therapy all figured out, even the therapist,” says Hardy. If you’re finding it difficult to open up at first, don’t worry. It might take some time for you to really get in the swing of it. But with time, you should start to feel yourself becoming more comfortable and opening up more. If not, consider whether you might want to work with another therapist.
