5 Questions You Should Always Ask a Therapist Before Your First Session

Photo: Stocksy / Ivan Gener
You ever scroll down your timeline on Twitter and notice all these tweets from folks about things their therapist told them? Sometimes the convos make you want to laugh, but sometimes these remarks from strangers on the internet feel like they were meant directly for you. (Or is that just me?) Those kinds of moments, however, can help you realize that perhaps you could benefit from therapy yourself.

Unfortunately, finding a therapist and going to sessions isn't as simple as the Twitter-verse makes it seem. Therapy is a deeply personal journey, and you don't want to embark on it with someone you don't like or who doesn't understand where you're coming from. As a licensed therapist myself, I always recommend that people ask their potential mental health provider these important questions before setting up their first appointment:

1. Do you offer a consultation session?

Most therapists offer some kind of consultation—a short, informal conversation in person or over the phone—so that you can get to know each other and decide whether that person is a fit for your needs before going through with a full session. (It's also a great time to ask a lot of the below questions.) Consultation is often free, which can help you avoid paying the full cost of a session before you know that this is the therapist you want to work with. If this is your first go at therapy, it's best you seek one who is willing to consult with you prior to setting up your first session.

2. How much does each session cost, and do you accept insurance?

According to mental health directory GoodTherapy, a therapy session can cost between $65 per hour to $250 per hour or more, depending on where you live, the therapist's training and credentials, and other factors. While the Affordable Care Act requires most insurance companies to cover some form of mental health care services, it's common for therapists in private practices to not accept health insurance.

That's why it’s important to have a conversation up-front about the cost per session and the forms of payment they accept, so you're not surprised by your bill later on. If the out-of-pocket cost is too high for your budget, ask if they offer a sliding scale form of payment, which will reduce the cost of an average session based on your income. If you are receiving services from a clinic, you are more likely to be dealing with insurance—so be sure to ask to make sure your plan is accepted there.

3. What is your therapeutic style?

There are a variety of treatment modalities, from traditional talk therapy to more specific forms of treatment like eye movement desensitization reprocessing (EMDR) for trauma. Every therapist has their own style when it comes to how they practice. It is important to know which modality they use so that you can have an understanding of how this style of treatment will benefit you and help you achieve your goals. You can even go a step further and ask about the effectiveness of this treatment for the issues that you plan to bring to therapy so that you can be better aware of how your needs will be met.

4. What licenses and certifications do you hold?

Most therapists have a college degree plus an additional secondary degree (such as a doctorate in psychology), and are licensed by their state. The amount of training a therapist has can affect what kind of services they provide—and what they charge for them. But all can be great options for therapy, depending on your comfort level.

When I was an intern training for my Master's in social work, I remember the struggle of building rapport and trust with clients because they thought I was inexperienced. It sucked, but I understood it. Everyone has different preference levels of what type of certification their therapist has. Maybe you’re okay with working with an intern who’s not fully certified or licensed yet, and maybe you’re not. Finding out their level of expertise is critical so that you can feel the most comfortable during this experience. You can also ask what supports your therapist receives to help guide their work. Every counselor, whether certified or not, is expected to have regular supervision to discuss client cases and receive feedback. No one is above learning, not even your therapist.

5. Can you explain your level of cultural competence?

We may not realize it, but race, ethnicity, and sexuality can impact the therapeutic relationship. With so many different forms of discrimination and oppression affecting marginalized groups, people from those oppressed backgrounds often feel safer, understood, and validated when they can talk to someone who shares the same cultural background or identity.

Of course, finding a therapist who has the same background as you can be challenging, which is why it's important to ask a potential therapist about their views on societal issues that impact you and your mental health. (For example, if you are a member of the LGBTQ community, you'll likely want to know if they are gender-affirming.) A well-informed therapist should have the knowledge to understand that problems are often rooted in systemic issues, and in order to provide quality care in therapy, they cannot overlook these critical issues that impact our well-being.

Here's how to know when it's time to stop therapy. And here's why so many of us straight-up lie to our therapists.

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