A Beginners Guide to Therapy. Part 2: What to ask in the consult

Jeff Guenther, MS, LPC on Sep 16, 2018

Illustration by Brandon Hrycyk

Part 1: How to find a therapist
Part 2: What to ask in the consult
Part 3: What to expect in the first few sessions
Part 4: How can you tell if therapy is working
Part 5: How to end therapy

Assuming you’ve done some research and found a therapist you think would be a good fit, you’re now ready for your initial consultation (for more one what to look for, check out Part 1 of this series). As I said in Part 1, you should shop around for a therapist before choosing one. I would recommend making a short list of at least three therapists to have a consultation with. The vast majority of therapists will be glad to set up an initial consult with you to determine if you’d be a good fit. The consult may be a phone call for 10 to 30 minutes. Or it could be in person for up to an hour. Many consults are free, but some therapists ask for payment for their time. Check with the therapists on your short list to find out what they offer.

What exactly is a consult?

A consult with a therapist is a short meeting to determine if the therapist would be a good fit for you. Consultations are generally pretty informal. It’s a chance to get to know each other. It’s also a chance for the therapist to get a sense of what your presenting problem is and make sure they feel they can competently treat you. A therapist has an ethical duty to refer you to other therapists that they think would be a better fit for you if they don’t feel able to treat you.

You should not expect any real therapy to take place in the consultation. Therapeutic work starts in the first full session after the consult. One of the most important parts of a consultation is that it gives the client a chance to ask the therapist some questions. As the client, you should feel empowered to ask the therapist any questions you have, especially if getting the answers will help you to feel more comfortable talking to the counselor. This article will focus on questions you may want to consider when speaking to a therapist for the first time.

How do you feel talking to the therapist?

Before we dive into all the questions you could ask your therapist during the initial consult (or whenever, really) you’ll want to check in with yourself during the meeting and right afterwards. It’s important to make sure you actually want to move forward with the therapist and there are some key things to consider before making that decision. 

  • Do you feel emotionally and physically safe? 
  • Does it seem like you could trust this person?
  • Do you like how they carry themselves?
  • Do you think they ask good questions?
  • Do they seem knowledgeable and competent?
  • Do you like them and enjoy spending time with them?
  • Are they setting the right tone?
  • Does the office feel comfortable?
  • Does it feel confidential?
  • Do you feel distracted and not engaged?
  • Do you want to stay and talk or are you counting down the minutes until you can leave?
  • Do you feel heard and understood?
  • Do you like the questions that are being asked of you?
  • Does the therapist seem empathetic to your situation?

If you don’t get a good feeling overall, talk to other counselors until you do. If you keep feeling uncomfortable after speaking with multiple therapists, then it may just be you. Which is incredibly common and nothing to be worried about or ashamed of. Therapy can be nerve wracking and cause a fair amount of anxiety. Especially if you’ve never been to a therapist before. While you’re anxiety about talking to someone may not completely go away in an initial consult, you’ll want to feel a bit of a relief at the end of a conversation. Or at the very least, you’ll feel like it’s safe to talk about anxiety inducing topics.

You need to ask questions 

It’s not just about the therapist figuring out if they can treat you. Can you sit in a room once a week and spill your guts to this person? You need to figure out if you think you’ll be able to tell them really vulnerable things. 

Before you come up with a list of questions, it’s important to figure out what you need or want to know. Below are some questions that you might ask, to help get you thinking. But realize that anything and everything is on the table. You’re about to be completely honest and open with them (hopefully). That means you can ask them whatever you want about their lives. It may feel weird asking the therapist questions about how they work or who they are. We aren’t used to asking healthcare providers personal questions. But counseling is different than other types of healthcare. Counseling gets super personal. And because of that, clients want to feel like the relationship is more balanced and that the therapist shares things about themselves as well. As a therapist myself, I am always prepared to field any and all questions from my clients. So don’t be afraid to ask me anything.

DISCLAIMER: You should know that if the therapist doesn’t want to answer a question, they won’t. And they will likely tell you why they won’t. But they won’t get offended. I promise. You should also know that therapists are trained to leave their personal biases and beliefs at the door. So even if you don't get the answer you were expecting they are still a highly trained professional that might be a great fit for you.

So while you can ask anything you want, the following are some questions that you might think are important to ask in a consult. You probably won’t ask all of them. But you may want to jot down the ones that you feel might be important to you.

  • Where did you go to school?
  • What did you study?
  • What makes you qualified to treat my problem?
  • Do you specialize in my problem?
  • What makes you a specialist?
  • Have you helped many people like me?
  • What is the typical outcome of those cases?
  • Am I good fit? Why?
  • What type of treatment styles will you use?
  • Can you explain those treatment styles to me?
  • Will we talk about my family and relationship history?
  • How important is it for you to know about my past?
  • How will I know therapy is working?
  • Will I feel worse before I feel better?
  • Who talks more? You or me?
  • Are you a confrontational therapist?
  • Do you give me homework?
  • Have you experienced my issue in your personal life?
  • Are you married?
  • Do you have kids?
  • Have you always been a therapist?
  • How long have you been in practice?
  • Are you from this city?
  • How often do I have to see you?
  • How much will it cost?
  • Do you accept my insurance?
  • Do I deal with my insurance or do you?
  • What’s your policy on canceling sessions?

Ask yourself what’s important for you to know in order to create trust. It could be anything. It could be about the therapist’s beliefs and values. Or it could be about their hobbies and interests. For example:

  • Do you see a therapist?
  • Are you politically progressive or conservative?
  • Are you religious? If so, how do you practice your religion?
  • Do you believe in God?
  • Who did you vote for?
  • What are your views on social justice?
  • What are you doing when you’re not a therapist?
  • Are you a sports fan? What’s your favorite team?
  • What kind of music are you into?
  • Are you a vegan, vegetarian or meat eater?
  • Are you pro-choice?
  • What are your feelings about our current president?

The mental health profession is predominantly made up of white people. If you’re a person of color and you are seeing a white therapist, you should ask as many questions as possible in order to feel like the therapist is culturally competent. You might consider asking:

  • Have you worked with a person of color before?
  • What makes you qualified to work with a person of color?
  • What have you done to learn about my specific culture?
  • How are you continuing to learn about my culture?
  • As a person of color, why should I trust you?
  • Do you believe that we live in a white supremacy culture?
  • Do you operate from a racial justice framework? How did you learn about that framework?
  • What are your thoughts on white privilege?
  • How do you experience and handle your own white fragility?
  • Do you believe that racism exists?
  • Would you feel uncomfortable if I talked about how white people have been racist to me?
  • How would you feel if I talked bout how much I can’t stand white people sometimes? Would you be offended?
  • Do you have supervisors or therapists of color that you consult with?
  • Do you speak any other languages?

Same goes for a queer person that is seeking therapy from a heterosexual cis gendered therapist. 

  • What is your gender identity?
  • What is your sexual identity?
  • Does your gender identity match your biological gender?
  • Have you ever treated a queer or trans person before?
  • What is your understanding of diverse sexualities and gender identities?
  • If gay, what was your coming out process like?
  • Do you think being gay is a choice?
  • Do you think homosexuality can be “cured?”
  • How do you feel talking about gay sex?
  • Are you trained in counseling people who want to go through gender reassignment surgery?
  • Do you support gay people getting married?
  • What makes you a LGBTQ specialist?
  • Do you understand the issues that are facing the LGBTQ community in this political environment?
  • Were you raised in an environment that was open to the queer community?
  • Where exactly were you raised?
  • Are you LGBTQ affirming and competent? (There is a difference and therapists understand the difference.)
  • Do you have LGBTQ friends and family members?
  • Do you have supervisors or therapists in the LGBTQ community that you consult with?

This is not an exhaustive list of questions. There are many more that you could ask and I’m sure you have ideas of your own. The important thing is that you come up with a list before you have your consult. And if you don’t have enough time to ask all your questions during the initial meeting, you can always email extra questions to the counselor afterwards. 

After the consultation

Once you’ve visited with a couple of therapists and asked them all the questions that are important to you, you’ll have a much clearer picture of which therapist to choose. You are ready to schedule your first full therapy session! Next week, I’ll be diving into what to expect from the first few sessions with your new therapist.

Jeff Guenther is a Licensed Professional Counselor in Portland, OR.
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