Questions to Ask Yourself Before Therapy
Questions to work through before booking a first session: what you want to change, what you can afford in money and time, what kind of therapist would suit you, and how you will know whether it is working.
The questions
Open any question for the note
What made me start looking for a therapist now rather than a year ago?
Why ask it
Most people can name a trigger: a break-up, a diagnosis, a comment from a friend, a week that did not pass. Saying it plainly helps, because the trigger is often not the same as the problem, and knowing the difference keeps the first session from being spent on the wrong thing.
If therapy worked, what would be different about an ordinary Tuesday?
Why ask it
Concrete answers give you something to measure: sleeping through the night, not rereading an email nine times, returning a call you have avoided. Answers like "feeling better" are hard to notice arriving, which makes it hard to tell whether the work is doing anything.
What problem would I name in the first session?
Why ask it
Write one or two sentences and keep them. Under pressure people default to the tidiest version of their situation, then spend several sessions circling the actual one. Having it written down means you can hand it over even if you cannot say it.
What have I already tried, and what happened?
Why ask it
Medication, books, exercise, a previous therapist, cutting back on drinking, telling a friend. A therapist will ask, and it saves time to have it ready. It also shows you whether you are looking for something new or a better version of something that partly helped.
Have I been in therapy before, and what worked or didn't about it?
Why ask it
Old experiences shape what you will tolerate. If a previous therapist felt cold, or pushed too hard, or you stopped going without explaining why, that is worth naming early rather than repeating. Stopping abruptly last time is useful information, not a mark against you.
What can I afford per session, and for how many months?
Why ask it
Work out the total, not the sitting fee. Therapy is more useful weekly than monthly, so an honest budget may point you toward a sliding-scale practice, a trainee under supervision, a group, or a service through work or a health plan rather than toward stopping after four sessions.
What are my practical constraints: time of day, online or in person, travel?
Why ask it
The commonest reason people stop going is that the appointment does not fit their week. Deciding in advance which slots you could keep for a year, including in a busy month, filters the list before you get attached to a particular therapist.
Do I want a therapist who shares part of my background?
Why ask it
Language, faith, culture, sexuality, disability, being a parent. There is no requirement either way, but if you would spend sessions explaining context, that is time and energy spent. Knowing your preference makes searching directories much faster.
What kind of style do I want: mostly listening, structured exercises, or being challenged?
Why ask it
Approaches differ in how directive they are, and a mismatch is often mistaken for the therapy failing. If you want practical tools and get open-ended reflection, or the reverse, you can ask about it before booking rather than after two months.
Am I expecting advice, and what happens if I don't get any?
Why ask it
Many therapists deliberately do not tell you what to do. If your hope is for someone to make a decision for you, that is worth knowing now, because the disappointment usually arrives around session three and gets read as the therapist being unhelpful.
How much time can I put in between sessions?
Why ask it
Some approaches involve reading, tracking, or practising something daily. An honest half hour a week is workable; pretending to more than you have leads to arriving with the homework undone and feeling like you have failed at recovery.
Who in my life knows I'm doing this, and does anyone need to?
Why ask it
You are not obliged to tell anyone. Still, worth thinking about who might notice the appointment in a shared calendar, and whether you want one person you can say "that was a hard session" to. Sessions can leave you unsettled for a few hours.
Am I going because I want to, or because someone else asked me to?
Why ask it
Both are common, and going at someone else's request can still help. But if the honest answer is that you are attending to prove something to a partner or an employer, say so in the first session. Therapists work with that; it just cannot be hidden.
Am I willing to say things I haven't said to anyone?
Why ask it
Not immediately, and not everything at once. But if the answer is a clear no, the useful step is to say that out loud early. A therapist can work with someone who is guarded; they cannot work with a version of your life that leaves out the part that matters.
What am I hoping the therapist won't ask about?
Why ask it
Whatever comes to mind is usually relevant. You do not have to raise it in week one. Knowing what it is means you will recognise the moment you steer away from it, which is the part that otherwise happens without you noticing.
How will I react if the therapist says something I don't want to hear?
Why ask it
Some people go quiet, some agree quickly to move on, some cancel the next appointment. Knowing your pattern lets you name it in the room. Leaving after an uncomfortable session is common and is often the point at which therapy would have started working.
Is there anything urgent that I should say in the first ten minutes?
Why ask it
Thoughts of harming yourself, a current risk at home, drinking or drug use at a level affecting your health, an eating problem. These change how a therapist works and whether they are the right service at all. Waiting until they ask can delay proper help by weeks.
What would tell me this particular therapist isn't right for me?
Why ask it
Deciding now, while calm, protects you from two errors: leaving because a session was hard, and staying for a year with someone who talks over you. Reasonable grounds include feeling judged, feeling unheard repeatedly, or a style you have raised once and seen no change in.
How long will I give it before I decide it isn't working?
Why ask it
A specific number of sessions, and a review with the therapist rather than a private verdict. Many approaches feel worse before they feel better, so a fixed checkpoint is more reliable than judging week by week on how you felt walking out.
What am I afraid I'll find out?
Why ask it
Common answers: that it is my fault, that nothing can be done, that I will have to leave someone. Naming the fear reduces how much it steers you. It is also worth saying to the therapist at some point, because it usually marks the thing you came for.
Practical notes on starting therapy
Practical guidance for the conversation itself
Before you book
- 1Check what is available to you at low or no cost first: a health service referral, an employee assistance programme, a student counselling service, a community or charitable clinic, a training clinic where trainees work under supervision.
- 2Write two or three sentences describing why you are getting in touch. You will reuse them in every enquiry email, and it makes the first contact much easier.
- 3Confirm the practical terms in writing: fee, cancellation policy, session length, how long appointments are usually held, and whether the therapist is registered with a professional body you can look up.
- 4Ask for a short introductory call. Most therapists offer one. Fifteen minutes tells you more about fit than any profile page.
- 5Contact more than one. Waiting lists are common, and the first person who replies is not automatically the right one.
Questions worth asking the therapist directly
- How do you usually work, and what does a typical session look like?
- Have you worked with this kind of problem before?
- Is there anything between sessions I would be expected to do?
- What are the limits of confidentiality in your practice?
- How will we know whether this is helping, and when would we review it?
- What happens if I need to pause, or if I want to stop?
What the first few sessions are usually like
Early sessions are mostly history
The first one or two often involve background questions rather than the work itself. This can feel like an interview and like nothing is happening. It is normal, and it is reasonable to ask when the pattern will change.
Feeling worse for a while is common
Talking about something you have avoided tends to raise its volume before it lowers it. Plan for a quiet hour after sessions where you can, especially early on, and avoid scheduling appointments immediately before something demanding.
Fit matters more than method
Whether you feel you can be honest with this person is the part most worth protecting. If you cannot, say so in the room. Therapists expect this conversation and it often improves the work; if it does not, changing therapist is not a failure.
If things are urgent
Therapy is not an emergency service and waiting lists can be long. If you are thinking about harming yourself, or you do not feel safe where you are living, contact a local crisis line, an urgent care or emergency service, or a doctor now rather than waiting for a first appointment. Tell whoever you speak to how immediate it feels, in plain terms. Getting seen sooner usually depends on saying the urgent part first.