One of the biggest challenges facing therapists, whether it be for in-person or online therapy, is getting their clients to open up. Despite their years of training, sometimes a mental health professional can have a hard time coming up with enough unique questions to keep the conversation flowing. If your patients have been reluctant to speak openly, consider posing some of these questions during your next therapy session in order to help them feel more at ease and talk more freely about whatever’s on their mind or heart. You might be surprised by what you learn!
Before we dive into the questions, there are a few guidelines to keep in mind. The first is to stick with open-ended questions whenever possible. As you’re talking with your patients, it’s important to avoid asking questions that can only be answered with yes or no. Simple yes or no questions lead to superficial answers with little depth or reflection required. Instead, ask open-ended questions that require a longer, more thoughtful response.
You should also try using follow-up questions and statements to further prompt your patients. For example, you could say, “Can you tell me more about that?” or “That's interesting, tell me more.” Using these kinds of phrases will encourage your patients to speak openly and honestly, which is important for addressing concerns in therapy.
Also, avoid coming across as confrontational when asking your patients questions. Repeated questioning may make them feel threatened or have anxiety about how you'll react if they share something personal—and then they might clam up and stop sharing anything at all. It can take time before a patient opens up during a session, so give people time to warm up before hitting them with big questions.
Before you begin your first session, it is important to note that if a patient is concerned about payments, you should consider starting sliding scale fee therapy. You must be aware of the negative effects this could cause though because it could lead to therapist burnout. Also, if you are wondering how much therapists make in sliding scale therapy work, the average cost per session will vary.
Below, you’ll find a list of questions therapists ask their patients during their first session along with explanations about why they’re effective. Beyond asking questions you should also learn more about what to talk about in therapy with your patient.
1. What prompted you to seek therapy?
This question is a great way to start your first therapy session with a client. The patient’s answer to the question, “Do I need therapy,” can provide you with insight into the major issues the patient is facing and help you start formulating a treatment option. Other variations of this question include, “What brings you here today?”, “Why are you seeking therapy at this time?”, and “What caused you to seek therapy now?”
2. How have you been coping with the issue that brought you here?
After determining the primary driver that caused them to seek therapy, you should then ask what they’ve already done to address the issue. This question serves multiple purposes. For starters, you gain insight into your patient’s coping skills (or lack thereof.) You also have a better idea of what they’ve already tried so you don’t make similar suggestions when recommending a treatment option or medication.
3. Have you ever seen a therapist before?
Another question you should ask in the first session is whether your client has ever been to weekly sessions with a therapist before. If they’re new to therapy, this gives you a chance to introduce them to the structure of therapy plus how it works. Also, it’s not uncommon for a person to switch therapists mid-treatment; they may be visiting you because they aren’t satisfied with the progress being made with another practitioner. It helps to know if your client has tried therapy before so you can avoid making the same mistakes that a previous mental health professional may have made.
4. How is your relationship with your family?
This is a great question to ask in order to give you insight into how your patient's relationships function in his or her day-to-day life. Knowing how family members treat one another can give you important information about how your patient deals with conflict and what their role is within their family system. Is your patient aware of his or her role? Do they feel as though they have equal power in their relationships? How do they view their parents, siblings, children, extended family members, friends, spouse, or partner—and themselves for that matter? Asking about their family will provide you with insight so you can better understand who they are and how they’ve developed.
5. Are you having any suicidal or homicidal thoughts?
Though your patient may be reluctant to reveal this information because it brings up turbulent emotions, it’s an important question to ask. There are a couple of reasons why you should pose this question. For one, it helps ensure the safety of your patient and the people in their life. It also allows you to gauge the seriousness of their problem so you can offer an appropriate solution.
6. How connected do you feel to the people in your life?
This is a vital question for two reasons. One, finding out how connected your patient is with those around them will let you know whether they feel isolated or not. Feelings of loneliness or isolation can have serious detrimental effects on a person’s mental and physical health. Asking this question will also let you know if the client has a strong support system in place, which has been proven to lead to a quicker recovery.
7. What do you expect to gain from therapy?
This question will give you better insight into what your patient hopes to accomplish in therapy. When you ask this question, try to get your patient to be as specific as possible. An answer like “I want less conflict in my life” is a bit too vague; see if you can have them provide details about the type of conflict they want to avoid and what their life would look like if this changed. Once you know what their goals are, you’re better able to create a treatment plan that will help them reach their aim.
What do you think the problem is from your perspective?
How does the problem make you feel?
In your opinion, what will make the problem better?
How is the problem affecting your life?
How would you describe the relationships between you and your friends/peers?
What’s more important: having many friends or deeper relationships with just a few friends? Why?
What do you bring most to your friendships?
How often do you get to meet your friends?
How much time do you spend with your partner?
Who do you trust the most in your family?
What’s the most memorable moment from your childhood?
What type of student were you in high school?
What role do you take in groups: leader or follower? Why?
If you could change anything about your life, what would it be?
What three steps could you take to change your situation for the better?
What aspects of life do you feel are easy to manage?
What things do you find difficult to manage?
What do you think is a good life?
What kind of a person do you want to be?
What are you connected to that is bigger than you are?
What is your primary goal in life?
If you could spend your time any way you wish, what would you focus your attention on?
What do you spend your time thinking about?
What issues keep you up at night?
What negative thought patterns have you noticed?
What do you think is the first next step toward a better life?
Are your behaviors actively creating the life you want to live?
How would you describe your ideal self?
How far do you think you are from your ideal self?
What would make you more content in life?
How do you define a happy life?
What are the things that please you in life?
What is the toughest decision that you ever made?
How do you think that decision affected your life?
What dreams have you experienced repeatedly?
What feelings do you experience most often in the course of your day?
What do you think are your core strengths?
Who in your life understands you the best?
What insecurities do you have in your life?
What causes you the most anxiety in life?
What are the greatest areas for improvement in your life?
What events in life are you most grateful for?
What causes you to become envious of people?
What is the primary source of motivation for you in life?
Who is your inspiration in life?
How would you rate your confidence on a scale of 10? Why?
What is your greatest fear?
What kinds of situations make you uncomfortable?
How difficult is it for you to apologize to people?
What is the most difficult thing for you to forgive in others?
What is the thing that you regret the most in life?
What unfinished businesses do you have in life?
How do you react to unpredictable situations?
How do you react to unpleasant events?
Which of your behaviors make you feel guilty?
Are you satisfied with the direction that your life has taken?
How do you make decisions?
Are you prone to impulsive reactions?
Who has been the biggest influence in your life?
How difficult is it for you to manage time?
How important is discipline in your life?
What are our daily life stressors?
What are your priorities in life?
What is the one habit you want to get rid of?
How would you help someone with a similar problem?
Suppose a miracle happened to solve all your problems, how do you think your life would be better?
Have you ever taken any impulsive decisions in life that you later regretted?
Do you follow your heart or your head? Why?
What events do you find triggering?
How do you think your triggers affect you in life?
What coping mechanisms do you use to overcome your problems?
What methods have you tried to break the chain of negative thinking?
Have you ever gained any productive outcomes by focusing on positive aspects of life?
Are there any negative automatic thoughts that keep bugging you?
What is the one thing that you would like to change about yourself?
What is the one thing that you would like to change about your family?
What do you do to relax?
What are your long-term goals in life?
Why are these goals important?
What are your short-term goals?
How will your life change if you accomplish these goals?
What obstacles are keeping you from your goals?
What are you looking for in a potential therapist?
Asking questions is an essential part of therapy; they help build trust with your patient and improve communication. If you ever find yourself stuck, not knowing what to ask your client, just choose one of the questions provided above to get the conversation going.