Therapist

What questions are asked in first therapy session

Prepping for therapy? While every therapist has their own approach, there are common questions you may be asked at your first appointment.

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So, you made your first therapy appointment. It might be your first therapy session ever, or you’re just switching to a new therapist.

Either way, going to a therapist for the first time can feel overwhelming to some. You might go back and forth on whether to even go. Many schedule, cancel, and reschedule that first appointment.

Not knowing what to expect can make you even more reluctant to keep your appointment. It’s OK to be nervous. It’s natural to feel this way when meeting someone for the first time — even a therapist.

To ease those first-appointment jitters, we share the most common questions a therapist may ask during that initial meeting.

What to expect

Before your first appointment, you might be asked to complete a written or online form. You can choose to answer the questions on this form, or decline to answer them at that time.

The first appointment is usually called an intake session. During an intake session, the therapist will introduce themselves and review the online form and any other intake forms with you.

One of those forms is an Informed Consent — a document you sign agreeing to enter into therapy. This document also typically includes:

  • your therapist’s information — name, credentials, and license number
  • policies, including a cancellation and no show policy
  • fees
  • limits of confidentiality
  • patient rights
  • risks and benefits

You may also be given additional questionnaires, depending on your needs and symptoms.

The questionnaire may include questions about your medical and mental health history and your family history. Try to be as open and honest as possible, as this will help your therapist tailor your treatment in a way that’s most beneficial for you.

Questions you may be asked

During your first appointment, you’ll be asked a number of questions. These will help the therapist understand your background, along with your present and future goals.

Questions may vary based on the type of therapy and type of therapist you’re seeing.

Why are you seeking therapy at this time?

People go to therapy for a variety of reasons. You’ll be asked to explain why you’re seeking therapy to give the therapist an idea of your goals.

This also allows your therapist to find appropriate referrals if they’re not well-trained in your specific issues, or allows them to consult with other therapists or professionals with knowledge in that area.

What do you expect from therapy?

There’s a common misconception about the role of therapists. Therapists aren’t there to give you advice and tell you how to feel or behave. You can get that type of advice talking with friends or family.

Therapists are there to help you become more self-aware, meet your goals, and reflect on the best choices for you.

They’re also trained to help you determine if your symptoms are caused by a mental health condition, and they can recommend treatment, if needed.

Have you been in therapy before? What was that experience like?

This question can help your therapist understand what you expect from therapy. It will also tell them if you’ve had a bad experience before so they can figure out if something heightens your symptoms.

Some people who go to therapy want tangible coping skills, while others might just be looking for a safe place with someone to listen and support them.

Whatever your reasons for seeking therapy, you don’t have to feel ashamed.

Are you having suicidal thoughts right now, or have you had suicidal thoughts within the past month?

There are only a few exceptions to confidentiality in therapy, and harm to yourself or others is one of those exceptions.

If you’re having suicidal thoughts, being honest about them is the best way to get help. The therapist will work with you on a safety plan and try to find out if additional measures are needed.

Are you having homicidal thoughts, or have you had homicidal thoughts in the past month?

This is another exception to the confidentiality rule that a therapist might ask to ensure your safety and the safety of those around you.

Remember that the therapist has a legal duty to warn and protect individuals if there’s a threat of harm.

Do you have supportive people in your life? If so, who?

Therapists ask this question because support systems increase positive mental health and well-being.

In fact, research suggests that having supportive people in your life is also linked with a lower chance of suicide and a quicker recovery.

How is your relationship with your family?

This allows therapists to learn a lot of information about you and your background. It can clue them in to whether you have healthy relationships with those in your life.

This question may unearth painful memories or trauma. But you don’t have to address these issues if you don’t want to do so at this time.

How do you cope with stress?

The way you handle stress will help your therapist determine treatment and coping strategies that might work for you.

If you’re having trouble coping, providing you with skills and strategies to try may be a part of your treatment plan. If you have good coping methods, they may encourage and advise you how to use these skills during times of distress.

What are some of your strengths?

If you’re open about your strengths, your therapist can help you learn to use your strengths when things feel overwhelming.

What are the goals you want to accomplish in therapy?

You may be bringing a lot to the therapy session regarding goals and what you want to work on.

This question helps you focus on what’s truly important and allows the therapist to create a plan of treatment based on your response.

Types of therapists

According to the National Alliance on Mental Illness (NAMI), there are many types of mental health professionals who can provide therapy, including:

Counselors, clinicians, and therapists

These professionals have attained a master’s in therapy or a related field such as psychology, marriage or family therapy, or counseling psychology. These pros are trained to use therapeutic techniques and assess a person’s mental health.

Common licenses in this group include:

  • licensed professional counselor (LPC)
  • licensed marriage and family therapists (LMFT)
  • licensed clinical alcohol and drug abuse counselor

Social worker

Social workers are very similar to LPCs, as they also have precise training in assessing and treating a person’s mental health. In addition, they hold a master’s degree in social work.

Common licenses and certifications in this group are:

  • licensed clinical social worker (LCSW)
  • licensed independent social worker (LICSW)
  • certified social worker (ACSW)

Psychologists

These professionals hold a doctorate degree in psychology (PsyD), philosophy (PhD), or another type of specialty such as counseling. Psychologists usually have longer and more supervised training programs than professionals who hold a master’s degree.

While they can provide therapy, they’re also trained to do assessments and psychological testing.

Psychiatrists

Psychiatrists are licensed medical doctors who have studied psychiatric conditions and completed psychiatric training. They can provide therapy, prescribe and monitor medications, and diagnose mental health conditions.

Psychiatrists typically hold one of these doctoral degrees:

  • doctor of medicine (MD)
  • doctor of osteopathic medicine (DO)

Psychiatric or mental health nurse practitioners

These professionals hold either a master of science (MS) or a doctorate degree (PhD) in nursing, focusing on psychiatry. Together with other mental health professionals, they help monitor your condition and track your progress.

They can consult with you on medications and help determine which medication is best to help manage your symptoms. Practitioners might also provide physical and psychiatric assessments, emergency care, and evaluate treatment.

Though they can be helpful with medications and monitoring your progress, they’re not typically the first choice for psychotherapy.

After the first session

Your first session can be exhausting. Sharing your emotions and bringing up painful memories and feelings can be emotionally draining.

It’s natural to feel overwhelmed and tired.

But don’t give up! You’ve started the work — and that’s the first step to finding some relief and improving your well-being.

After that first session, consider how you and the therapist relate to each other. If it’s not a good fit, that’s OK. Finding a good therapist that best fits you and your needs might take some time.

So, now what?

Now that you know the types of questions to expect, it might ease some of your worries and make you feel more relaxed and confident as you prepare for your first appointment.

Remember that just because a therapist asks a question doesn’t mean you have to answer it.

Ultimately, the answers to these questions are helpful, but you can also let the therapist know when you’re not comfortable sharing certain information.

It’s OK to hit pause on certain issues or put it to the side for now. The key is to find a therapist and build a safe space where difficult or painful issues can unfold naturally and at your pace.

If you have an appointment with a counselor for your first therapy session, you might not know what to expect. Or perhaps you’re considering starting therapy but don’t know where to begin. Knowing where to start and what to expect during your first session can help you feel more comfortable and informed.

Learn more about the different types of therapy, what to expect from your first appointment, what questions to ask your therapist, and more.

How to Choose a Therapist

No two therapists are the same. Asking the right questions will help you choose the best therapist for you. Questions to ask before you make an appointment:

  • Affiliations: “What professional associations do you belong to?” Knowing more about a therapist’s professional affiliations can give you a better idea of their credentials, background, and current focus.
  • Background: “What is your academic background, and what has your training been to prepare you to practice as a therapist?” Making sure your a potential therapist has training and experience in treating your condition or concerns means you will be more likely to get the appropriate treatment you need.
  • Cost: “What are your fees? How will my insurance claim be handled?” Not all therapists accept insurance, so it is important to consider the cost and payment before starting treatment. Rates may also vary considerably.
  • Experience: “What specialized training and/or experience have you had working with the issue I am dealing with?” An experienced therapist can recognize the problems you are facing, which can give them greater insight into the treatments and techniques that can most help you.
  • Rules: “What are your office protocols?” (e.g., booking appointments, payment for missed appointments, emergencies, building access after hours, etc.) Understanding how such situations or handled can help protect your working relationship and ensure that your sessions proceed with fewer issues.
  • Specialties: “What type of therapy do you do?” It can be helpful to know whether the therapist does mostly talk therapy or if they include opportunities for role-playing, visualizing, hypnosis, artwork, ‘bodywork,’ and other techniques. You may prefer a specific approach, but some techniques may be more helpful for certain types of problems.

Before Your First Therapy Session

When you get to the therapist’s office, expect your initial experience to be similar to a doctor’s appointment. You will sign in when you get there, sit in the waiting room, and wait for someone to call your name. If your therapist has a home practice, the scene might be a bit more casual.

While waiting, you will likely fill out some paperwork, including:

  • HIPPA forms
  • Insurance information
  • Medical history, including your current medications
  • A questionnaire about your symptoms
  • Record release form
  • Therapist-patient services agreement

If you feel uncomfortable answering any of the questions on paper, you can wait until you are with the therapist and answer the questions orally. You might also have the option to complete this paperwork at home prior to your first visit.

Your First Therapy Session

Your first session with the therapist will be different from future visits. The initial visit is a period for you and your therapist to get to know each other and get an idea of how to proceed. Future visits will be more therapeutic in nature. For example, in your second session, you may explore a specific symptom, problem, or past trauma you mentioned in the first session.

Keep in mind that psychotherapy usually requires multiple visits, so don’t expect any instant solutions to your problems the first day. Therapy is about equipping you with life-long solutions and not a quick fix.

During the first session, your therapist may ask you:

  • What are your symptoms?
  • What brought you to therapy?
  • What do you feel is wrong in your life?
  • Some questions about your history, including your childhood, education, relationships (family, romantic, friends), your current living situation, and your career

You and your therapist should also come to an agreement about the length of your treatment, methods to be employed, and ins and outs of patient confidentiality.

Length of Treatment

Depending on your issue and therapy goals, therapy can last a few sessions or several weeks or years. While you likely want to know how long it’s going to take to “feel better,” there’s no simple answer. It’s very individualized.

In addition, some insurance plans only cover a set number of sessions in a given year, so you may need to factor in those limitations and/or work with your therapist to come up with a payment plan.

Therapy Methods

Therapists have training in a variety of techniques that can help you better cope with mental illness, resolve personal issues, and create personal changes in your life. Finding out what technique or combination of techniques your therapist will use can give you a better idea of what will happen during your sessions. Some common types of therapy include:

  • Client-centered therapy (person-centered therapy): A non-directive form of talk therapy that emphasizes positive unconditional regard
  • Cognitive or cognitive-behavioral therapy: Focuses on making connections between thoughts, behavior, and feelings
  • Existential therapy: Focuses on you (free will, self-determination) rather than the symptom
  • Gestalt therapy: Focuses on the “here and now” experience of the client
  • Psychoanalytic or psychodynamic therapy: Focuses on getting in touch with and working through painful feelings in the unconscious mind

Patient Confidentiality

In most cases, a therapist is required to keep information discussed during therapy private. However, according to the American Psychological Association’s “Ethical Principles of Psychologists and Code of Conduct,” confidential information can be disclosed with the permission of the individual or as permitted by the law.

While the specifics of a legal duty to warn vary by state, in most cases, a therapist is required to breach confidentiality if a client poses an imminent threat to themselves, the therapist, or a third party. The information must be divulged to a person capable of taking action to reduce the threat, for example, a police officer.

What to Ask Your Therapist

When the therapist finishes, they should ask you if you have any questions. You can use this opportunity to get to know your therapist a little better by asking more about their training, experience, approaches, and goals for therapy.

Questions to Ask During Your First Therapy Session

  • How can you assure my confidentiality?
  • How long will each session last?
  • How many sessions will it take to resolve my issue?
  • Will you briefly explain what I can expect to happen in my sessions?

Is Your Therapist Right for You?

A big part of successful therapy is feeling comfortable with your therapist, which may come over time. However, if after a few meetings, you’re just not clicking, you do have the choice to seek out another therapist.

To determine if you’re receiving the best care from your therapist, the National Alliance on Mental Illnesses recommends asking yourself the following questions:

  • Do they challenge you?
  • Do they check-in with you?
  • Do they guide you to your goals?
  • Do they help you learn?
  • Do they show acceptance and compassion?
  • Do they treat you as an equal?

If your answer to any of these questions is “No,” then it’s likely time to consider changing therapists. At the end of your session, just tell your therapist that you will not be returning. Don’t be surprised if your therapist asks why.

You can answer honestly (you just feel like you’re not clicking) or just say that you prefer not to say. In most cases, your therapist will be professional and can recommend another therapist who will be a better fit. 

A Word From Verywell

Knowing what to expect during your first therapy session can help you feel more prepared. Your first session is often about you and your therapist getting to know one another, determining if the therapist is a good fit for your needs, and going over what you want to accomplish in therapy.

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