If you find yourself in either an inpatient or outpatient treatment program, you might be pondering about the suitable questions to ask during your first therapy session. It’s crucial to recognize that the first impression we create in these sessions can significantly influence our client’s treatment expectations and their motivation to continue attending therapy. To discover the essential first therapy session questions for the initial session with a new client, read on.

Being mindful of our therapy session questions can allow us to facilitate an initial session while allowing ourselves to build therapeutic rapport. Both of which are necessary to engage in treatment.

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Things to Keep in Mind for Your First Therapy Session with a New Client

Counselors can encounter a range of emotions prior to their first meeting with a client. They may feel a mix of anxiety and excitement, or it could simply be a regular part of their clinical work routine. While the initial sessions often involve gathering information, it’s crucial to recognize the profound impact of the therapeutic relationship on treatment outcomes. It’s important to remember that building a strong therapeutic alliance plays a significant role in the effectiveness of therapy.

The therapeutic alliance we develop with our clients is impacted by our communication skills, behaviors, collaboration, time boundaries, and trust. Keeping these factors in the front of our minds can go a long way in helping clients. 

Body Language

The significance of body language in communication is often overlooked. Our clients gain valuable insights from observing how we navigate through the session, paying attention to our eye contact and other non-verbal cues. For instance, if we display signs of distress, anxiety, or discomfort, our clients may instinctively withdraw and reduce their level of engagement in the session. It’s crucial to be mindful of our non-verbal communication as it can greatly impact the client’s willingness to participate actively.

Collaboration

Active collaboration with clients regarding their treatment goals, objectives, and overall course of action is a vital element in many therapeutic approaches. While we can offer valuable suggestions, it is equally important to give clients a voice, enabling them to practice essential life skills and ensure that their treatment aligns with their personal aspirations. By actively involving clients in shaping their treatment goals, they are more likely to experience a heightened sense of intrinsic motivation towards their own healing process.

Communication Skills

Effective communication skills are crucial in assisting clients in comprehending what to anticipate during their sessions, as well as in navigating the necessary formal paperwork. Moreover, cultivating a genuine curiosity about your new client can aid in gathering the essential information required to determine the most suitable treatment approach for their individual requirements. By fostering open and clear communication, we can set appropriate expectations, streamline administrative processes, and gather valuable insights to tailor the treatment effectively.

Time Boundaries

Utilizing time effectively can serve as a healthy means to establish boundaries and promote consistency. Being punctual for sessions demonstrates respect for our clients’ time, as does concluding sessions at the designated time. While the temptation to extend a session may arise, it is advisable to reserve such instances for limited situations, particularly when safety concerns are present. Setting healthy boundaries regarding session duration not only respects your clients’ time but also ensures that you can maintain your own schedule and carry on with the rest of your day as planned.

Trust

Building trust in the therapeutic relationship often requires the most time and effort. This is particularly true for clients who struggle with trust, those who are mandated to treatment, and those who have had negative counseling experiences in the past. Honesty and authenticity in sessions play a vital role in cultivating trust with clients.

Before meeting new clients, it is beneficial to thoroughly review the information you have about them. Screenings, intake forms, and questionnaires completed by clients offer valuable insights into their motivations for treatment and potential goals. Take note of significant information and use it as a basis for relevant follow-up questions.

Working in a busy environment can be demanding, so it’s essential to allocate a few moments for self-care before each session. Checking in with ourselves throughout the day promotes mental well-being and job satisfaction. This can involve deep breathing exercises, brief moments of meditation, or listening to enjoyable music. While our work is fulfilling, it also comes with challenges, which is why it’s crucial to treat ourselves with kindness and compassion throughout the workday.

First Therapy Session Questions to Ask in the First Session

Drawing from your clinical experience, you may have established a set of key questions to ask during your initial therapy session with new clients. Another aspect to consider in this process is the paperwork expectations set by your facility. For instance, in an outpatient treatment program, you may be required to complete various consents and a biopsychosocial assessment, while inpatient treatment programs may have other professionals handle the intake assessment, allowing counselors to focus on different aspects of treatment.

For those who need to conduct a formal assessment, having a Biopsychosocial Assessment Template or an Intake Form can serve as a helpful guide for your questions. Additionally, if there are concerns about your client’s safety, such as suicidal ideation, a Mental Health Crisis Plan Form can be utilized.

The specific questions to ask during a therapy session will depend on the information covered. If you begin the session by reviewing treatment facility information forms, clinical consents, HIPAA consents, and other relevant documents, you can then ask questions to ensure that your client fully comprehends the shared information and its impact on them.

Here are some example questions and statements that can be used:

• I will provide you with a copy of these forms so that you can review them again at home, if you find yourself having questions you can reach out to me regarding your concerns
• I know this is a lot of information to take in, is there anything that you’re unsure about at this moment?
• What can we circle back to for you?
• What can I clarify for you?

Throughout the rest of your initial session, you will likely observe that clients tend to share more information when you pose open-ended questions. These types of questions encourage clients to provide detailed and thoughtful responses. Here are some examples of open-ended questions that can be asked during the first therapy session:

• 1 being low and 10 being high, how would you rate your overall level of distress?
• What would you say your top concern is regarding your mental health?
• Have you ever had thoughts of, or an intent to commit suicide?
• Have you ever attempted suicide? If no, What brought you in today?
• Do you have any goals for yourself while attending counseling?
• What changes  would you like to see in your life that we can work towards?
• Tell me about those who are important to you, what do those relationships look like?
• Can you tell me about what helps you through your toughest day?
• What does a good day look like for you?
• What does a typical day look like for you?
• On a scale of 1 to 10, what kept you from moving forward with your plan?
• What has your experience with mental health concerns looked like?
• Was there a time in the past where you sought help for your mental health?
• Can you tell me about your use of substances?
• Do you find yourself drinking or using drugs to cope with distress or uncomfortable emotions?
• Tell me a bit about your hobbies and interests
• Can you describe how you fit self-care into your routine?
• Who knows that you had this appointment today?
• Can you describe your career goals for me?
• Can you describe your overall physical health for me?

As you engage in your first therapy session, you will naturally discover that the questions you ask are specifically tailored to your area of expertise. For instance, a counselor specializing in substance abuse will have distinct areas of focus and exploration compared to a clinician who primarily works with individuals living with mood disorders. The unique nature of your niche will shape the specific questions you ask to address the needs and concerns of your clients effectively.

Asking the Right Questions with New Clients Final Thoughts

By utilizing open-ended questions in our initial therapy session, we empower our clients to steer the conversation and share information that they deem relevant to their own experiences. This approach facilitates a deeper understanding of our clients and helps establish a strong therapeutic alliance.

As you wrap up your first session, it may be important to consider signing additional consents of release if you become aware of other healthcare professionals involved in your client’s care or if your client desires the involvement of significant social supports in their treatment.

If you have concerns about your client’s safety, it might be appropriate to complete a mental health crisis plan. This plan can serve as a helpful tool for clients to navigate moments of heightened distress. By including specific details in the plan, clients have a step-by-step guide on how to address safety concerns.

Lastly, the information gathered in the initial session should enable you to begin formulating a treatment plan with your client. While some areas of their assessment may require further exploration in subsequent sessions, you should have a clearer understanding of their primary mental health concern. Involving your client in the development of their treatment plan exemplifies collaboration within the therapeutic relationship.

TherapyPatron.com helps mental health professionals better serve their clients. Our (editable, fillable, printable PDF) therapy worksheets can help you streamline your practice, effectively deliver different types of therapy, and support your clients be the best version of themselves.

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Resources:

Leach, Matthew J. (2005).Rapport: A key to treatment success. Complementary Therapies in Clinical Practice, 11, 262-265. https://d1wqtxts1xzle7.cloudfront.net/46583891/Rapport_a_key_to_treatment_success20160617-11064-1p7i6ps-libre.pdf?1466219229=&response-content-disposition=inline%3B+filename%3DRapport_A_key_to_treatment_success.pdf&Expires=1687915117&Signature=Egl8DfUUWAiLNDoyOfiZHOveF49COloPIo4LDmjE8fmrEZ1tfcnopwPu5yM3x24yPzP6lMEdRmeI4Jc-lSdbfEUx~LAu7aNukMT~b6aWCqB3vm0tQlfST-6zU0KHsMnAJ3r2iijK7WIPFjcrFL2kLmFuRB3XTAJ2NWPuDlnGeLxOTwJZZxmLQxMtLF-7HFm1FeGgyl3gt-kY~kZJ02aIgFnu6QZbwy2tTvHJK-UwL7yTszpzEKpbl26H4SiF6vsLkpDSl002R9lMtNili1P2fLWw1GbRO0O3IjKWyb1Z5kvJpvIdNY9vtXmVr0QHMybaOd9Yk3G5UlF1A6IyOR4GHw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

Author: Kayla VanGuilder, MA, LCMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.