Guide for When Clients Say, “I Don’t Know What to Talk About”

About:

Many first-time (or even long-term) clients struggle with where to begin in therapy. Below are structured yet flexible responses to help them engage without feeling pressured.

1. Normalize and validate the Feeling

"That’s totally okay—a lot of people feel that way, especially early on. Therapy can feel like standing in front of a big bookshelf and not knowing which book to pick up first. We can figure it out together."

"It’s completely normal to draw a blank sometimes—therapy doesn’t always have to be about ‘problems.’ We can talk about anything that feels meaningful to you, even small wins or random thoughts."

2. Draw from Previous Sessions

Option A: Revisit a Past Topic
"Last time, you mentioned [X]. Would you like to explore that further, or has something new come up since then?"

Option B: Reconnect with Goals
"One of your goals was [Y]. Would it help to check in on how that’s going, or would you rather focus on something else today?"

Option C: Expand on a Brief Mention
"A few sessions ago, you briefly brought up [Z]. I’d love to hear more about that if you’re open to it."

3. Offer Gentle Prompts (Pick 1-2 Per Session)

Option A: Recent Experiences
*"No pressure to dig deep right away. Could we start with something small from this week? Like:

What was a highlight or challenge for you?
Did anything leave you feeling stuck, annoyed, or proud?"*

Option B: Body & Emotions Scan
*"Sometimes our bodies know before our brains do. If you check in right now…

Is there an emotion you’re feeling most today? (Even ‘numb’ or ‘meh’ counts!)
Where do you feel it in your body? (e.g., tight chest, tired legs?)"*

Option C: Meta-Question (For resistant clients)
"If you did know what to talk about, what might it be?" (Often reveals hidden hesitations.)

4. Psychoeducation + Collaboration

*"Therapy doesn’t always need a ‘topic.’ Sometimes we can:

Explore patterns (e.g., ‘I noticed you often say ___. Want to unpack that?’)
Practice a skill (e.g., breathing for anxiety, assertiveness role-play)
Look at relationships (e.g., ‘Who drained or supported you this week?’)
What feels least intimidating to start with?"*

5. Create Space for Wins & Positives

Option A: Highlight Progress
"Before we start, I’d love to hear—has anything gone well since we last met? Even small wins count!"

Option B: Shift Focus to Strengths
"Therapy isn’t just about what’s wrong. What’s something you’re proud of lately? A challenge you handled well?"

Option C: Celebrate Stability (If everything is going well)
"It’s great to hear things are going smoothly! Should we take time to reflect on what’s working so you can keep it up? Or would you like to explore something completely different today?"

6. Offer Flexible Session Options

If the client is doing well and struggles to find a topic:
*"We have a few options today:

Celebrate the progress—we can reflect on what’s helped and how to maintain it.
Explore something light—maybe a hobby, relationship, or future goal.
End early—if you’re feeling good and don’t need the full session, that’s okay too!
What feels best to you?"*

7. If They Still Feel Stuck…

Use a Structured Prompt
*"Let’s try this: Tell me about one moment this week where you felt…

Frustrated? → (Could reveal stressors)
Proud/relieved? → (Highlights strengths)
Neutral? → (Might uncover emotional numbness)"*

Or, Use a Scaling Question
"On a scale of 1-10, how ‘full’ is your emotional cup right now? (1 = totally drained, 10 = overflowing). What’s making it that number?"

8. For Chronic “I Don’t Know” Responses

Reframe resistance as a clue:
"I hear you’re feeling stuck. That’s useful info! Maybe ‘not knowing’ is protecting you from something. Could we explore that?"

Use scaling questions:
"On a scale of 1-10, how much do you want to figure out what to talk about? If it’s low, what’s getting in the way?"

9. Script for Silence or Shutdown

*"It’s okay to take a minute. I won’t push you, but I also don’t want you to feel alone in this. Would it help if I…

Ask very specific questions? (e.g., ‘What did you eat for breakfast?’ → can lead to energy/mood talk)
Suggest a theme (e.g., sleep, family, work stress)?
Sit quietly together until something comes up?"*

10. Closing the Session

If they explored a win or positive:
"I love that we got to focus on what’s going well today. Let’s keep noticing these moments—they’re just as important as the tough ones."

If they chose a shorter session:
"It’s okay to take the space you need. We’ll pick up next time, whether there’s something to process or just more good stuff to share!"

End with agency:
"Today we talked about ___. For next time, you could notice when you feel ___, or we can pick up where we left off. Either way, we’ll go at your pace."

Key Principles:

Avoid interrogation. If they freeze after 2-3 prompts, switch to "It’s okay—we can pause here."
Silence is data. "Not knowing" may signal avoidance, dissociation, or underdeveloped self-reflection.
Humor disarms (when appropriate): "Therapists have a secret manual with 200 questions. Want me to flip to a random page?"
Therapy isn’t just for crises—stability and wins deserve attention too.
Use past material—intake notes, goals, or passing comments can spark discussion.
Give clients control—offering options (even ending early) builds trust.
Celebrate neutrality—if a client says "Nothing’s wrong," that’s a win worth honoring!

Adapt for teens: "If your friend was in therapy, what would they need to talk about?" (Projection helps.) or "If your life were a movie right now, what’s the best scene? The most boring one?"