Whether you are working in an inpatient or outpatient treatment program, you may find yourself wondering what some of your first therapy session questions should be. The first impressions that we make during sessions can impact our client’s expectations for treatment, and their desire to continue attending treatment with us. Keep reading to learn the first therapy session questions to ask a new client.
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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Getting Ready for Your First Therapy Session with a New Client
There are a variety of emotions that a Counselor can experience before meeting a client for the first time. You may feel anxious or excited, or this could be a routine experience for you in your clinical work that is a normal part of your day. While you may find yourself focusing on information gathering in your initial sessions, it is important to remember the significance of the therapeutic relationship for treatment outcomes.
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.
Our communication skills play an important role in helping our clients understand what to expect in their session, as well as in completing the formal paperwork that we complete. Additionally, having a healthy curiosity about your new client can help you gather the information needed to determine the best course of treatment for their unique needs.
Body language is often an underestimated aspect of communication. Our clients learn a lot from us by watching how we move through the session; including our eye contact and other non-verbal communication signs. As an example, if we appear distressed, anxious, or uncomfortable, our clients may pull back on their level of engagement in our session.
Collaborating with clients in regard to their treatment goals, objectives, and overall course of action is an important aspect of many therapeutic approaches. While we can make useful suggestions, allowing clients to be heard allows them to practice important life skills, and ensure that their treatment is working towards their personal goals. By having an impact on their treatment goals, clients may find themselves with an increased level of intrinsic motivation regarding their treatment.
The use of time can be a healthy way to demonstrate boundaries and work to facilitate consistency. Being on time for sessions is a way to respect our client’s time, as is ending sessions at the appropriate time. While you may find yourself tempted to extend your session, this should be reserved for limited situations, such as when there are concerns about safety. Establishing healthy boundaries regarding the length of a session is also respecting your time to ensure that you are able to continue your day as scheduled.
When we talk about the importance of trust in regard to the therapeutic relationship, this is often the component that takes the most amount of time to complete. This may be especially true for clients who have difficulty trusting others, individuals who are mandated to treatment, and those who have had a negative experience with counseling in the past. Being honest and genuine in your sessions can go a long way in terms of building trust with your clients.
Before meeting new clients, spend time reviewing the information that you have. Your clients may be asked to complete screenings, intake forms, or questionnaires before their session. These forms can provide you with some insight into their motivation for treatment and possible treatment goals. You can make note of information that stood out to you and follow up with appropriate questions.
If you work in a busy setting, it may be helpful to take a moment or two before your session to practice some self-care. Checking in with ourselves throughout the day can promote our mental health and workplace satisfaction. This can include a few moments of deep breathing, a short meditation, or listening to music you enjoy. While our work can be fulfilling and rewarding, it also comes with challenges which is why it is important to show ourselves kindness and compassion throughout our work day.
First Therapy Session Questions to Ask in the First Session
Based on your clinical experience, you may have some go-to questions to ask during your first therapy session with new clients. An additional factor to consider when conducting your first session with a new client is your facility’s expectation for paperwork. As an example, if you are completing intake assessments in an outpatient treatment program, you may be expected to complete an array of consents and a biopsychosocial assessment. Whereas some inpatient treatment programs have intake assessment completed by other professionals so Counselors can focus on other areas of treatment that they are responsible for.
For those who are expected to complete a formal assessment, it is often useful to have a Biopsychosocial Assessment Template or an Intake Form to guide your questions. Additionally, a Mental Health Crisis Plan Form can be used if you have concerns about your client’s safety, including suicidal ideation.
Specific questions to ask during a therapy session will be dependent on the information you cover in your session. If you begin your session by reviewing treatment facility information forms, clinical consents, HIPAA consents, and other documents, you can ask questions to ensure that your client fully understands the information you shared, and how it impacts them.
This can include questions and statements like:
What can I clarify for you?
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?
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
During the remainder of your first session, you will likely notice that clients share more information when they are asked open-ended questions. Examples of open-ended questions to ask during the first therapy session include:
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, 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 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?
Naturally, you will find that your questions in a first therapy session are tailored to your niche. A Counselor in a substance abuse program will have different focuses and areas of exploration compared to a clinician who works with individuals who are living with mood disorders.
Final Thoughts On Asking the Right Questions with New Clients
When we use open-ended questions in our first therapy session, we are allowing our clients to lead the conversation by including information that they feel is relevant to their experience. This allows us to gain a better understanding of our clients, and work to develop the therapeutic alliance.
At the conclusion of your first session, you may feel that it is important to sign additional consents of release if you learn of other healthcare professionals that your client is working with, or important social supports that your client would like involved in their treatment.
You may find it appropriate to complete a mental health crisis plan if you have concerns about your client’s safety. Crisis plans can be viewed as a tool that clients can use when they find themselves experiencing a significant level of distress. With specific details in the plan, your client can have a step-by-step guide of what to do if they are experiencing safety concerns.
Lastly, the information that you gather in your first session should allow you to begin formulating a treatment plan with your client. There may be areas of their assessment that need to be revisited in the following session, however, you should have a better understanding of their primary mental health concern. Including your client in the development of their treatment plan is an example of collaboration within the therapeutic relationship.
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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
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