First-Time Therapy Questions: What You’ll Be Asked At Your First Therapy Appointment

Last week, I shared 8 factors to consider when you’re choosing a therapist.  Today, let’s talk about those first-time therapy jitters. 

If it’s your first time going to therapy, there are certain questions your therapist will likely ask you.  Being prepared for these questions can make you feel more confident going into the first appointment.  Today, let’s dive into the questions you should be prepared to answer at your first therapy appointment.

What Happens at the First Therapy Appointment

The agenda for the first appointment is to

1. discuss what therapy looks like,
2. review confidentiality and other policy/procedure stuff, and then
3. begin diving into the concerns that bring you to therapy. 

What You’ll Be Asked at Your First Therapy Appointment

Most therapists ask similar questions at the first appointment. 

These are the questions I typically ask at a first appointment, and you’ll likely find that many providers ask similar questions (though keep in mind that every therapist is different, so expect some variability).  

1. What brings you in?

Here, I’ll ask openly about your main concerns…stressors, symptoms, recent life events, etc. that are bothering you.  I’ll ask follow-up questions, as well, like 

1. How long have you been experiencing…?
2. What life events or recent stressors have contributed to the way you’re feeling?
3. What makes it better/worse?  
4. Have you ever experienced this type of thing before?

2. What’s your typical alcohol use like?  

I always ask about substance use, even for people who’ve never used any substances at all and even for people who used in the past but have been clean or sober for a really long time. 

It’s important to know both what you’re using now and what you might have used in the past because that helps us determine what might have been going on in your brain at certain key points of development, which could affect past mental health struggles or even current ones years later.  

3. Do you have any physical health problems you deal with?

Included in this category, prepare to talk about how you’re sleeping and eating, any head injuries you’ve had, and any medications you take.  I also ask about family medical history to determine whether there might be a heritable condition impacting your mental health experience.

4. Tell me about your relationship with your family.

Here, I’m asking for the briefest possible description of what your childhood was like and what your relationships are like with your parents and siblings now.  We’ll dive deeper into this in subsequent appointments if it’s relevant, but there’s never enough time in the first appointment to do justice to every topic, so my goal is to get a little bit of info about a lot of different things.  I’ll also ask about mental health conditions or substance use in your family.  

5. Have you ever experienced a traumatic event?  

I specifically ask new clients not to provide details about any traumatic experiences at the first appointment.  Instead, I’m asking for broad headlines that might be important to follow up on later (e.g., “My dad abused me,” “I was in an abusive relationship,” etc.).  Again, no details…just headlines. We’re not trying to re-traumatize anyone at the first meeting, so the simplest headline possible will do.

6. Are you having any suicidal thoughts or urges?  

Be prepared to answer some questions about suicide, including questions about whether you’ve had suicidal thoughts or urges in the past, whether you’ve ever attempted suicide, whether you’ve ever harmed yourself on purpose, or whether you’ve had thoughts or harming someone else.  

7. How are you functioning in your daily life?  

Here, I’ll ask you about how work is going, how you’re doing with taking care of yourself and your home, what kinds of hobbies you have, and any other areas of your life that might be impacted by your mental health symptoms.  

8. Do you have any questions for me?

I always give clients an open invitation to ask any questions they might have — questions about me, my life, my training, my experience, what therapy looks like, what to expect, etc.  Next week, I’ll give you a list of questions you might want to ask when your therapist opens the floor for questions.  Don’t miss it.  

9. Are you feeling comfortable with the fit between us?

At the end of the first appointment, I always ask new clients if they’re feeling reasonably comfortable together.  We talk about how important the fit is between a therapist and a client, and I promise to help connect them with another provider if something feels uncomfortable about our first appointment.  

The End of the First Appointment

The first appointment tends to whiz by because there’s so much to discuss in a short amount of time.  When you have a general sense of the types of questions you’ll be asked, it can feel a bit more comfortable going to the first appointment.  It gets easier after the first appointment — you know where to park and how to get in the building, you’ve met the therapist, you’ve seen the office, you know his or her mannerisms, and you have a general sense of how comfortable or uncomfortable the experience is. 

How to Maximize Your Therapy Appointments

Once you’ve made it to your first appointment, be sure to take along my worksheets to maximize your therapy sessions — squeeze every ounce of success you can out of those sessions!

Up Next…

Next week, stay tuned for a list of questions you should ask at your first appointment.  When your therapist asks, “Do you have any questions for me?” — that’s your opening.  I’ll tell you what to ask.  Don’t miss it.

Talk to you soon,

Dr. Finch

P.S.    Remember, this is education, not treatment.  Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you.  See the disclaimer for more details.