What To Ask A Therapist In Your First Session, According To Mental Health Pros

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Like the initial decision to go to therapy, finding the right mental health professional can be complicated. The emotional quickly becomes practical, as insurance coverage, budget, appointment availability, commute, and consultation appointments come into play.

Then, there’s the patient-doctor connection, which licensed clinical counselor Allison Kranich says is “the most important aspect of treatment." Counselor Christine Montana echoes this sentiment, adding that “good rapport creates a close and harmonious relationship with patients — it allows you to understand your patient's feelings and communicate effectively.”

In fact, finding a therapist is not unlike dating — it’s imperative to shop around, trust your gut, and ask the right questions to effectively narrow your search. It's also important to consider the type of therapy you're interested in or need for whatever you're working through. Maybe you want to explore cognitive behavioral therapy to help shift some unhealthy thinking patterns, or maybe you need a counselor to listen and help you cope with tragedy. Either way, there are plenty of options to choose from when it comes to mental health professionals, and it is important to choose wisely to get the correct care you need. Once you've determined that, you can move on to picking the therapist for the job.

To further break down this process, we spoke with Kranich, Montana, and a current patient about where to start, what to ask, and how it feels when you’ve found “the one.”

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Finding A Therapist: Where To Start

According to Montana and Kranich, searches typically start with an insurance provider, a referral from a trusted source, personal research, or a professional organization like the American Psychological Association and the American Counseling Association. “A primary care medical provider is always a great place to start — oftentimes, they have therapists they refer to regularly,” says Kranich. You can also ask your insurance company for a list of in-network therapists to rule out the coverage issue, which is how Whitney Cook, a Washington D.C.-based teacher, began her search. “I’m very fortunate to have good insurance — I was able to go onto their website, enter my location, and print off a long list of therapists that were covered,” she explains.

Cook then moved onto the research phase, checking out each therapist’s website and eliminating providers that didn’t seem like a good fit. “Once I found the office I liked most based on their mission statement and history, I read through each therapist's biography and chose from there,” she explains. “I was specifically looking for ones that dealt with addiction, family trauma, and codependency.” All in all, it took Cook about two months to find her current therapist, who she’s been seeing for four years now. “After finding the right therapist for me, I truly believe there’s a perfect fit for everyone.”

Understanding the different types of mental health certifications and their capabilities can also guide your search. Find a general breakdown below:

  • Psychiatrist: A medical provider, often an M.D./D.O., who can prescribe medication.
  • Psychiatric nurse practitioner (NP): A mental health professional who often practices with psychiatrists and can prescribe psychiatric medications.
  • Doctoral-level Psychologist (Ph.D. or Psy.D.): A mental health professional with the highest level of training in behavioral health and psychotherapy. They’ve often completed many years of coursework and post-doctoral training within their field. Some provide psychological testing, but do not prescribe medication unless they specifically completed additional training in the area. They often work with providers that do prescribe medication.
  • Counselors/therapists: A mental health professional who completed graduate-level training, often at the master’s level, in behavioral health and psychotherapy. They do not prescribe medication, but often work with providers that do.
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Finding A Therapist: What To Ask

Once you have a provider or two you're interested in meeting with, some email or phone correspondence in which you are able to ask some initial questions can help narrow things down even more. That said, keep in mind that the interview-style format doesn’t work for everyone — intuition is also important to take into account. “It was more about feeling for me,” reflects Cook. “I’m a very guarded person, and right away, I was able to be vulnerable with my therapist. I was shocked by the things I shared with him.”

The below questions, recommended by Kranich and Montana, can help you find a therapist that checks all of your boxes.

  • What is your area of expertise?
  • How long have you been practicing? Are you licensed to practice in the state? (State licensure is evidence the therapist has met specific guidelines and requirements to practice psychotherapy, including supervised experience.)
  • What treatments do you use? Are these treatments successful in treating (area in which you are seeking help)?
  • Do you accept my insurance? What are your fees?
  • What is your therapy style? (For example, do you want a therapist who listens, or is more direct?)
  • What exercises would you expect me to do between sessions, if any? (This will help you understand what the therapist expects from you.)
  • Do you have an understanding of my perspective and lifestyle? (This could be based on gender, cultural, race, ethnicity, and the like.)
  • What are your policies regarding cancellations, in-between appointment contact, emergencies, etc.?
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How to Know You’ve Found the Right Therapist

Kranich and Montana both agree that a successful patient-therapist relationship is marked by the complete and total absence of judgement. “It’s OK, and sometimes unavoidable, to feel uncomfortable in therapeutic sessions, given the intimate nature and difficult topics often addressed,” notes Kranich. “However, you shouldn’t feel unsupported or fearful of discussing your emotions — you should feel the therapist is able to provide constructive, useful feedback in a warm and supportive environment.”

Competency is also important in Montana’s eyes. “You need to feel confident that this is an individual with enough smarts, qualifications, and skills to provide the care you deserve,” she explains. “This person should challenge you to look at things that are uncomfortable, while walking the journey with you.”

These characterizations aptly describe Cook’s chosen mental health professional. “My therapist doesn’t try to make me anything other than who I am at my core,” she explains. “For example, I have codependent tendencies, and he helps me navigate this quality so I can live with it in a healthy way, as opposed to trying to eradicate it. When sessions are really hard for me, I can actually see the hurt in his eyes. He always remembers everything I say; I know he cares.”

At the very least, therapy should serve as a consistent emotional outlet. “It’s a safe space I can go to every three weeks, and just feel all the feels,” she explains. “I don't like anyone to feel sorry for me or see me as vulnerable or weak, and during that hour, I’m able to be all those things. I can leave it all there and power through my day, week, and month being the woman everyone needs me to be.”

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