Starting therapy can bring relief, uncertainty, and plenty of questions. What will the therapist ask? Do you need to prepare? What if you don’t know how to explain what’s been happening? If you’re seeking care for your child, you may also wonder whether you’ll attend sessions together and how involved you’ll be.
You don’t need to arrive with a polished explanation or a clear treatment goal. Part of your therapist’s job is to help you understand what’s been difficult and identify a path forward.
Although the process varies depending on age, concerns, and treatment approach, the first few sessions typically involve getting to know one another, gathering information, and developing a treatment plan.
The First Few Appointments
Early appointments often include more questions and background information than ongoing therapy sessions. Your therapist needs to understand both the concerns bringing you in and the broader context of your life.
They may also review practical matters, such as scheduling, fees, communication between appointments, and confidentiality. This is an opportunity to ask questions about how treatment works and what you can expect.
For children and teens, ask ahead of time who should attend the initial appointment. Depending on the provider and the child’s needs, early meetings may include caregivers, the child, or a combination.
What kinds of questions might you be asked?
Your therapist will guide the conversation. You don’t need to prepare answers to every possible question, but knowing the kinds of topics that may come up can make the process feel more familiar.
The questions below are examples, rather than a checklist every therapist follows.
1. What brought you to therapy?
Your therapist will likely start by asking what prompted you to seek support and why you’re reaching out now. Questions might include:
- “What has been feeling difficult lately?”
- “When did you first notice this?”
- “Has anything changed recently?”
- “What would you most like help with?”
It’s okay if your answer is broad: “Everything feels harder than it used to,” or “We’re having a lot of conflict at home.” Your therapist can ask follow-up questions to help clarify the concerns.
2. How are these concerns affecting daily life?
A therapist may ask about sleep, appetite, relationships, and functioning at home, school, or work. Concrete examples can help them understand what you’re experiencing.
For a child, a caregiver might describe what happens before school or during bedtime. A teen might talk about avoiding assignments or feeling disconnected from friends. A young adult might describe difficulty managing responsibilities or getting through the workday.
Questions could include:
- “Can you walk me through a recent difficult moment?”
- “What happens before, during, and afterward?”
- “What do you find yourself avoiding?”
- “Are there situations where this feels easier?”
You don’t have to know why a pattern is happening to describe what you’ve noticed.
3. What else should your therapist understand about you?
Therapy also involves understanding your history, relationships, strengths, and supports. Your therapist may ask about previous treatment and relevant health information.
Depending on your situation, examples might include:
- “Have you tried therapy before? What was helpful or unhelpful?”
- “Who do you turn to for support?”
- “What activities do you enjoy doing?”
- “Are there family, cultural, or identity-related experiences you want me to understand?”
- “How do you currently handle difficult moments in your life?”
Sharing what has worked matters just as much as describing what hasn’t.
4. What would you like to change?
Your therapist will work with you to identify goals. These can start with everyday changes you would like to see, such as:
- Getting to school more consistently.
- Spending less time caught in worries or compulsions.
- Having fewer conflicts around homework.
- Speaking up in relationships.
- Participating in activities that anxiety has made difficult.
You don’t need to know which therapy approach will help you get there. You can ask your therapist to explain their recommendation and how it connects to your goals.
What if you’re asked something difficult?
Some questions may feel personal or uncomfortable. You can say that you’re unsure how to answer, ask why a question is relevant, or explain that a topic is difficult to discuss.
For example: “There’s something related to this that I’m not ready to explain in detail. Can we talk about how to approach it?”
Your therapist can help you discuss the pace and purpose of that conversation. Being honest about discomfort gives them useful information, too.
What should caregivers expect?
If your child or teen is starting treatment, it can help to bring a few specific observations. Instead of only saying, “They’re anxious,” you might describe repeated questions before an activity, difficulty separating, or missed school days.
Also make room for your child’s perspective. You and your child may have different ideas about what’s difficult or what needs to change. Those differences are worth discussing.
Questions to ask the provider include:
- “How will caregivers participate?”
- “Will there be separate caregiver meetings?”
- “How will we learn what to practice at home?”
- “How will you balance my child’s privacy with keeping us informed?”
Clarifying these expectations early can help everyone understand their role.
What happens after the initial sessions?
As your therapist develops an understanding of your concerns, they should discuss a recommended plan. Depending on the approach, treatment may involve learning skills, tracking patterns, practicing new behaviors, or completing exercises between sessions.
You can ask:
- “Why do you recommend this treatment?”
- “What will a typical session look like?”
- “How will we track progress?”
- “When will we review whether the plan is helping?”
The first few sessions are the beginning of an ongoing conversation. You can bring questions, correct something you feel was misunderstood, and give feedback about what is or isn’t helpful. You don’t need to know how to “do therapy” before you begin.
The Boston Child Study Center is an evidence-based treatment, training, and research center dedicated to improving the lives of children, adolescents, young adults, and families through innovative evidence-based cognitive behavioral treatments. For more information, please reach out to our team.