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18 Questions to Ask Your Therapist Before Your First Session

Setting up your first therapy appointment can be challenging. But, this is often the first step towards healing and growth. Licensed mental health professionals can assist you with anything from anxiety to depression to substance abuse. It's understandable if you're nervous about your first appointment. Here are some helpful questions to ask your therapist before your first sessions. Hopefully, the answers will put you at ease and help prepare you for your first therapy session.

1. Are you licensed to provide mental health treatment?

Licensing is extremely important, as this is proof that the provider has the education, training, and experience necessary to provide clinical services effectively. Furthermore, for a license to remain valid, the provider must maintain adherence to the code of ethics of the governing board. It is vital that your therapist has a license because it protects the public from receiving services that are damaging or unethical; therefore, it is crucial to verify this.

Due to the fact that there are multiple types of licensing for mental health professionals, being licensed can be confusing. Among the letters you may see are:

  • LP (licensed psychologist)

  • LCSW (licensed clinical social worker)

  • LPC (licensed professional counselor)

  • LMHC (licensed mental health counselor)

  • LMFT (licensed marriage and family therapist)

  • LCADAC (licensed clinical alcohol and drug abuse counselor)

Our recommendation is that you contact your provider if you come across letters that don't make sense.

2. Do you have any recommendations for me regarding therapy? How effective is this therapy for treating my problems?

Certain types of therapy are more effective than others for addressing specific issues, according to research. Among the effective treatments for a variety of concerns, cognitive behavioral therapy (CBT) is one that is effective for depression and anxiety, among others. Therapy should be recommended by your therapist, and the therapist should be able to explain how effective it is.

3. How often will we meet?

Your availability and commitment should be known in advance. You can expect to meet your therapist between three times a week and once a month, depending on your situation. If your therapist feels you should meet frequently, they will suggest it in your first session. As the weeks go on, this number may change, and it may go down or up, but it is important to have an idea of where you are starting.

4. How long will therapy last?

You can't always predict how long therapy will take. Therapists have, however, a general idea of what treatment often entails for most issues. Some therapies may only last six to twelve weeks, while others may last for months if not longer.

5. What I say to you is confidential. Can I trust you to keep it that way?

Generally, the answer is yes.

However, session information is confidential unless you pose an imminent danger to yourself, another person, or are unable to handle your own mental illness. When that happens, therapists can break the confidentiality agreement in order to safeguard you and others

It is important to emphasize the word "imminent." Suicidal thoughts, for instance, can exist without a plan or intent behind them. Knowing the difference can be extremely valuable. The fact of the matter is those suicidal thoughts aren't always emergencies. As such, this won’t involve breaking confidentiality. It would be impossible to maintain confidentiality, however, if you described a detailed plan to end your life.

In addition to being mandated reporters, mental health providers may also be reported for abuses of children and elderly people if they arise during the conversation. State-specific domestic violence reporting has a multitude of complications, and it's often not mandated.

6. What insurance providers do you accept?

There is no guarantee that your insurance company will accept a therapist just because they accept insurance. In addition, you may need to fulfill a deductible before your insurance plan will begin to cover you.

There may be providers that are not covered by all insurance companies, or who charge patients privately. It may still be possible to get some reimbursement for out-of-network appointments. You should ask your therapist if your insurance company can get statements from them.

Ask these questions upfront if you are concerned about pricing. Your insurance company should be able to inform you whether mental health appointments are covered.

7. What is the cost per session?

In addition to knowing how long a session will last, you should also know how much each session will cost. In some instances, therapy sessions can last 90 minutes, while in others they last only 45 minutes.

When you are paying for therapy out of pocket, this is especially important. Also, ask if you are eligible for any funding support or payment options.

8. Do I get charged for no-shows or cancellations?

Occasionally, the unexpected occurs, and it's useful to know if you have to pay more upfront. As such, it's important to find out how cancellation policies work in advance.

Also, often therapists require a deposit from their first-time clients in order to schedule an appointment.

9. What can therapy do for me?

The importance of explaining this concept to each individual must be emphasized by all therapists. It is easier to understand and believe in this process, which means better results for you.

Professionally trained therapists will use a wide range of techniques to work through a wide range of issues. Regardless of when certain techniques are used, clients should know how therapy works in general. As an example, during therapy, a therapist may explain to a client how gaining insights into interpersonal patterns will assist in changing behaviors or increasing the client's ability to recognize and alter negative thoughts.

It’s common for people to have a lack of understanding about what therapy will entail before they begin. Moreover, many people perceive therapy as similar to talking to a loved one or friend. For example, they believe the therapist is giving them advice. The question can provide some insight into their beliefs regarding the therapist.

Ask for clarification if your therapist gives you an answer that seems somewhat obscure or for examples of how this would work.

10. What will a typical therapy session be like?

Skills training and homework are part of some therapies. Supportive and flexible therapies are also available. There are some therapies that concentrate on the present, while others dig deeper into past family or relationship history. The amount of direct feedback and advice offered by different therapists also varies.

11. Can therapy be complemented by other resources?

While this question is specific to your condition, it's still important to ask. Are you able to contact your therapist if you have an emergency or a question outside of the usual therapy sessions? What hotlines should you keep at hand in case of an emergency?

12. What preparation should I do before a session?

The process of therapy requires work before, during, and after sessions. A cognitive-behavioral therapy session, for example, involves doing worksheets outside of the session. Additionally, a therapist might ask you to simply be aware of your more intense emotions during the week and observe any meaningful thoughts that come to mind.

There are several reasons why asking this question at the beginning of therapy can be helpful. The first benefit is that you will get a sense of what your therapist expects from you outside of sessions. There may be a way to modify these expectations if you feel they are unreasonable or make you feel stressed. Dialogue is the best way to resolve issues such as these. Moreover, this question may also help you gain a better understanding of how to maximize the therapeutic process and, ideally, lead to greater success.

13. Could medication be an option?

As well as psychotherapy, medication is often used as part of a treatment plan, since this can be very helpful. Medication can be prescribed by some therapists -- mostly psychiatrists and psychiatric nurse practitioners. Other therapists are likely to refer you to colleagues who can write prescriptions for you.

14. How does your office operate?

What happens if you're running late or need to reschedule or cancel your appointment? What are the hours of operation?

15. Is therapy offered in your office or online?

Many therapists now offer their services online through teletherapy since COVID-19. It is worthwhile to discuss this option with your potential therapist and find out if it is the right option for you.

Get details on the office location, parking, as well as other on-site aspects, such as mask mandates, if you are having in-person sessions.

16. How will I know if therapy is working?

This is an important question to ask as it helps individuals develop realistic expectations of therapy.

Depending on the presenting concern and the therapist's orientation, the answer will vary. Creating a cognitive-behavioral therapy program for anxiety is effective if you feel more control over anxiety symptoms and are able to cope effectively. In contrast, when using a motivational interviewing approach to help the individual quit smoking, the therapy is "working" when he or she feels more intrinsically motivated and confident about changing. Last but not least, if the therapist views therapy through a psychodynamic lens, the success of therapy may be determined by how much insight and understanding is gained.

17. Will you be available in case of a crisis after business hours?

If you are experiencing a crisis, some therapists will be available after hours. Other resources are available 24 hours a day such as local hotlines.

18. What do I do if I see you outside of the office, like at the grocery store?

Because of the stigma surrounding mental health, it’s alright if you prefer that the therapist doesn’t acknowledge you outside of sessions. But, if you feel comfortable saying “hi,” to them, that’s also perfectly acceptable.

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