These are the questions you need to ask in your first therapy session

Not all therapists are created equal. I’ve worked with a few different mental health professionals over the past few years. To my surprise, the positive effects I’ve gotten from therapy has had little to do with a therapist’s diploma or years of experience, and everything to do with their philosophy, methods, and their communication style. A therapist’s credentials are merely a baseline; there are many other pieces to consider when deciding if they will be a good match.
The more quickly you can identify what feels right for you, the less time and money you waste in the process. 
I’ve worked with highly-qualified mental health professionals who were a complete mismatch for me, as well as less credentialed who have changed my life. Finding the right fit means going beyond the written bios and taking the time to ask the right questions up-front. This extra step can make the difference between you having a transformational experience or walking away feeling like therapy is a waste of time.

Some housekeeping before we begin:

  • There are many different kinds of mental health professionals, for simplicity’s sake, I will use the terms therapist and therapy. Know that this advice applies to any mental health professional that you are considering working with.
  • I’m not covering credentials here, you should be able to find education, license, and certification information during your initial search online.
  • If you are working through a clinic to find your therapist, you may not have the option to set up a phone consultation (or even select the person that you want to work with). That’s okay, you can still use these questions below to help gauge if the fit feels right during your first session. Often, clinics will give you the option to switch if the first match doesn’t work out. On a personal note, I’ve had incredibly good luck through clinics that assign therapists.
  • If you are looking for online therapy options, check out this guide I wrote to compare Talkspace vs. Betterhelp. 
what to ask your therapist
Once you have a shortlist of therapists, you’ll want to select your favourites and see if they offer a free phone consultation (most do).
The below list will help you determine if a therapist is a good fit, during your consultation of first session. The first section lists questions for you to ask the therapist, and the second is made up of things for you to reflect on throughout this process. It’s not a script. These are merely guideposts of how to interview a therapist and  get you thinking about what you need from them.

Questions to ask your therapist during your first session


What is their personal philosophy on therapy?

There are many types of therapy and types of mental health professionals. Asking them their personal philosophy on therapy will give you an idea of where they are coming from, and what it will be like to work with them. You may find that the way they approach their practice resonates with you, or not. Either way, it’s good information. A strong reaction to their philosophy, positive or negative, will help you know better what it is that you are looking for. Feel free to ask about any particular topics that you know might come up (i.e. trauma, racism, addiction, gender identity)

What about medication?

Only psychiatrists (or physicians) are able to prescribe medication, but some psychologists will work alongside a psychiatrist to prescribe medication to their patients. Wherever you stand on medication, it’s worth bringing up now. This way you know what’s on the table, and how their own personal thoughts on it. Just like any other doctor, some mental health professionals are going to be more prone to prescribing meds than others. I once saw a psychiatrist whose primary model was therapy in conjunction with medication. I wasn’t open to taking medication, therefore her approach and my goals weren’t a match. Through that experience, I found that practitioners who have an experience with a broader range of modals and work off of a holistic therapy model are a better fit for me. These decisions are very personal and there is no one-size-fits all approach. Make sure you have the knowledge you need to make informed decisions about your mental health.


What kinds of modals have they studied/trained in?

It’s common for therapists to train in a variety of modals and to continue to seek out training throughout their careers. Continued education is important in this field because what we understand about the human psyche is constantly evolving. The techniques that a mental health professional has studied are the puzzle pieces that make up their unique skillset. Asking about what a person has studied, specifically what training they sought out on their own, will give you a good idea of their approach.

How long do they typically work with clients?

Some therapists will aim to work with you for a limited number of sessions, others see clients for years. Asking will give you an idea of what to expect and if it’s in alignment with your goals.

How frequently will you meet?

Most people see their therapist weekly. Depending on the situation, it might make sense to start off with more or ween down to fewer sessions. See what they have in mind.


What can you expect the first few sessions to be like?

Clarity is your friend. Ask them what to expect.
LGBT affirming therapist

Special note for LGBTQ+ folx: It’s important that you find a therapist that is LGBTQ+ affirming. 

Here are a few great questions that I pulled from Advocate:

  • What is your training, knowledge and experience in working with the LGBTQ population?
  • What is your sexual orientation and gender identity? (Not all therapists will feel comfortable answering this question but most affirmative therapists will respond, as a matter of modeling.)
  • Do you provide “conversion therapy” or “reparative therapy” or “sexual orientation change efforts?” If not, what do you believe about this approach? 

Questions to ask yourself during your first therapy session


How did their answers line up with my expectations?

You may get answers you expect, answers that surprise you, answers that turn you off; all of this is good information.


How do I feel when speaking to this person?

Tune into your body. It’s normal to feel anxious. You are trying something new and you will likely meet resistance, internally. See if you can sense beyond these initial nerves. Do you feel any big “No”s? Any internal red flags popping up?

Do I feel like I could be comfortable enough to open up with this person?

Again, it’s natural to have some discomfort, so the question might be not “Am I comfortable now?”, but “Do I think I could be comfortable opening up with this person?”. Also, if you are sitting in the space where your sessions will take place, notice how the physical space feels to you.
Choosing a therapist is not just about determining if they are qualified to help you, but also gauging how their philosophy and presence resonates with you. Just like any other context in our lives, we will connect more with some people than others. Your therapist doesn’t need to be someone that you would want to hang out with, but they do need to be someone that you will feel comfortable enough with to build trust and share your personal thoughts and feelings.


Don’t be afraid to have calls with multiple therapists before setting up your first appointment. 

If you find that your first pick isn’t a good fit, don’t get discouraged. Now you have an even better idea of what you are looking for and what doesn’t work for you. Trust and have patience with yourself throughout the process.

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What to ask in your first therapy session
what to ask your therapist
What to ask in your first therapy session

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