It can be useful to look at a client’s history to see where problems developed and where decisions about life were made - however, some clients have very few memories about their childhood and this is not a problem. Looking at the present - how a client thinks, feels and behaves in relation to certain situations or relationships is helpful. Exploring what lies underneath these thoughts, feelings and behaviours can be challenging but enlightening and ultimately rewarding. It is then useful to explore other options available to the client, many of which may be options previously discounted and/or not even considered.
Many clients come along to sessions with a particular issue that they want to explore but very often a client will come along with no set agenda - and just see what happens in the session. Therapists talk about both content and process in psychotherapy, content being what is talked about in the session and the process being more to do with the ‘how’ - how it proceeds and how the relationship is. Many therapists - myself included - like to work in the ‘here and now’. This means exploring the process and what is going on for the client in that exact moment in the therapy room. Clues to this can also be in body language, tone of voice or thoughts and feelings experienced by the client. Also this is where the client/therapist relationship comes in - how does a client feel in relation to the therapist in that moment? Exploring this can be invaluable in helping the therapist to get to know the client and in helping them in their relationships outside of therapy.
Overall there are no rules as to what to talk about or how to do therapy and ultimately it will be different for everyone.