How to Get the Most Out of Therapy - man and woman in therapy session

How to Get the Most Out of Therapy

Haeli Harris
May 18, 2021
October 9, 2022

It's an hour before your therapy appointment, and you still don't know what you want to talk about. Maybe you just started therapy, and you're not sure how to make the most out of it. You may feel lost in the process.

Hey, it's normal.

There are a few things you can keep in mind to help you through the journey.  

How to Get the Most Out of Therapy

Everything is on the table

You can talk about anything in therapy, and nothing is too small to talk about. Even very small problems or struggles can shed light on your personality that will be helpful for your therapist to know as they work with you. Therapy at its best is honest.

Therapy is all about real-life problems—and real-life has its big and small challenges!

Talking about your past is important, too. This can help you work through past trauma and the source of negative thought patterns and habits.

Just be you

This can be very hard for those of us with social anxiety or depression. Know that your therapist gets it, they aren't judging you, and they are there to help you. Therapy is a safe space to talk about your struggles. It isn't a place to obsess over what you say or how you act.

Therapy is low-risk. You're not going to damage a relationship or lose a friend by speaking up to your therapist and being your authentic self. Go with your gut.

You're expected to talk about yourself in therapy. Don't judge yourself for being the way you are.

Document it

Write down questions you have for your therapist, coping skills you've learned, your thoughts, and more. It can be easy to forget the progress you've made. Keeping a therapy journal can help you remember how far you've come and keep track of what you want to tackle next. It will also help you identify patterns in your thoughts, behaviors, and challenges.

A journal can also be a great place to refer to when you are experiencing panic, anxiety, or low mood. Have a page or two dedicated to coping skills and/or a list of things you enjoy that you can do whenever you need a mood boost or stress reliever.

This will also help you do your homework outside of therapy sessions. Therapy is way more than sessions—it is what you do when you're living your everyday life. Therapy is what you make it.

Ride it out

There will be ups and downs in your mental health journey. Emotional wounds will surface and be addressed. It can be very painful to open those doors again—but it is a necessary part of the process.

Don't give up on therapy if it's been especially hard the past few sessions. Healing takes time. You may be on the cusp of a breakthrough. Don't give up!

And if you don't feel like going to a therapy appointment, do your best to show up. You can reduce the friction by asking your therapist to do a virtual session with you if you usually meet in person. You may want to consider changing your therapy appointment time as well. Go at a time that is best for you. If therapy has been especially challenging lately, tell your therapist so you can work it out together.

Know your goals

Your therapist will likely ask you what your goals are right off the bat. Make sure you keep those goals in mind throughout your therapy experience.

It's totally okay if your goals change throughout your journey. That is normal and expected. Voice those goal changes to your therapist so they can help you reach them.

Talk about the client-therapist relationship

If you feel that some conversations with your therapist didn't help uncover what you were hoping for, let them know.

Tell your therapist if you aren't happy with how things are going. Tell them what has been helpful and what hasn't been.  

What to Talk About in Therapy

Therapy can address depression, anxiety, PTSD, work issues, relationship challenges, substance abuse, trauma, and many other things. What you talk about depends on what your challenges and goals are.

Here are some ideas for what to talk about in therapy, especially if you're just getting started:

  • The negative thoughts do you tell yourself most often
  • Things that have upset you or gotten under your skin lately
  • How to manage stress and anxiety
  • Healthy habits you can build to help support your mental health
  • Things that are challenging for your relationally
  • A big project you have at work
  • Unresolved trauma
  • Your childhood and how it has shaped you as an adult

What if I have nothing to talk about?

Stumped about what to talk about at your next appointment? That may be a good sign! It may mean that you are healing. It doesn't mean that there's something wrong with you, your therapist, or therapy in general.

Just because you don't have something in mind to talk about doesn't mean there's nothing to dig deeper into. Sessions that start without a particular topic in mind can open the door to deep conversations into topics previously discussed.

Just because you don't have anything in mind to discuss doesn't mean that therapy isn't helpful. Therapy isn't just for when you're in a crisis—it is also great for preventative care. Similar to taking your vitamins or going to your annual appointment with your primary physician.

There is no shame in not knowing what to talk about, either—your therapist may have something in mind. You may be surprised at what bubbles to the surface. Sometimes, these are the best conversations. Oftentimes, things will surface that you didn't think were bothering you but actually are.

Here are some general topics to bring up in therapy when you just don't know what to talk about:

  • Thoughts that you've been telling yourself lately
  • Things that you still are struggling with
  • Things that have really helped you on your mental health journey
  • Your relationship with your therapist and how you feel during therapy sessions

Worst comes to worst, you can talk about the progress you've made and what you can do next to heal even more.

How do I get started with therapy?

Starting therapy can be daunting.

You can start by seeing if your employer provides therapy through an EAP. If not, you can find therapists through your insurance provider or through local organizations like your place of worship. You can also rely on word of mouth.

If your company doesn't have an EAP, tell them about Nivati. We provide easy and simple access to therapy—it only takes 3 clicks to set an appointment!  


By participating in/reading the service/website/blog/email series on this website, you acknowledge that this is a personal website/blog and is for informational purposes and should not be seen as mental health care advice. You should consult with a licensed professional before you rely on this website/blog’s information. All things written on this website should not be seen as therapy treatment and should not take place of therapy or any other health care or mental health advice. Always seek the advice of a mental health care professional or physician. The content on this blog is not meant to and does not substitute for professional medical advice, diagnosis, or treatment.

Haeli Harris
Haeli Harris
Haeli Harris, LMFT is the Director of Clinical Operations at Nivati. She has been practicing as a Marriage and Family Therapist since 2014. Haeli has experience working as a therapist in private practice settings, residential facilities, outpatient treatment care, schools, and telehealth.