What Should You Talk About in Counselling?

Whatever's on your mind. That's the honest answer, even if it doesn't feel satisfying.

One of the most common things people say before a first session — and sometimes well into counselling — is that they're not sure they're talking about the right things. That they're somehow doing it wrong, or wasting time on something trivial, or that there's a more correct route they should be taking.

There isn't. There's no hidden syllabus.

What people actually talk about

To give you a sense of the range: work that's grinding them down. A relationship that's hit a wall. A bereavement they haven't really processed. The feeling that they've lost track of who they are. Anxiety that won't switch off. A decision they've been putting off for months. Something that happened a long time ago that keeps showing up. A general heaviness they can't quite name.

Some of it is big and obvious. A lot of it isn't. And the apparently smaller stuff often turns out to be more significant than it first appeared — or at least more worth looking at than the person assumed before they started talking.

What if you genuinely don't know where to start?

Then say that. "I don't really know where to start" is one of the more useful things you can say in a first session, because it's honest and it gives us somewhere to go. It's a lot more helpful than trying to construct a coherent opening statement when one doesn't naturally exist.

Some people arrive with a clear reason — a specific thing that happened, or a decision they need to make — and that's what we work with. Others arrive with something vaguer: a sense that things feel off, or that they've been struggling for a while and can't really say with, or that they just felt like they needed to talk to someone. That's entirely fine as a starting point. Often the most important thing emerges once we're actually in the conversation.

Can you change topic week to week?

Yes, completely. Some people follow a single thread across several sessions — returning to the same relationship, the same situation, the same piece of history — because that's where the work is. Others bring something different each week, and that's fine too. Counselling doesn't have to follow a fixed narrative.

It's also fine if what you brought last week feels less pressing by the time you're back. Life moves on between sessions. Something can feel urgent on a Tuesday and quite settled by the following Monday. That shift itself can be worth talking about — why it feels different now, what happened, what that tells you.

What if something feels too small to bring?

Bring it anyway. The things people dismiss as too minor are often the things that point to something more significant once you start looking at them. "I got really irritated by something stupid this week" can turn into a useful conversation about what's actually going on underneath. "I've been feeling a bit flat" might not sound like much, but it's worth following.

There's no hierarchy of what's worth talking about in a counselling session. If it's been on your mind, it's fair game.

What if you want to talk about something you find embarrassing?

That's often where the most useful conversations happen. The things people feel most awkward about bringing — the thoughts they've judged themselves for, the feelings they're a bit ashamed of, the behaviours they don't quite understand — are frequently the things worth looking at most carefully.

A counselling session is one of the few places where you can say the thing you've never said to anyone else, without worrying about how it lands. That's not something I take lightly, and I don't approach it lightly either.

If you want more of a sense of what the first session actually looks like in practice, have a read of what happens in the first counselling session. Or if you'd prefer to just have a quick conversation before committing to anything, that's what the free 20 minutes is for.