If you are new to counseling or even if you have been in therapy in the past, there are important counseling questions you need to answer for your therapist in your first sessions. The information you provide will help you and your counselor/therapist/psychiatrist (or whatever kind of mental healthcare provider you choose) to begin to develop a therapeutic relationship – a relationship of trust, openness, and honest communication. Because without trust, openness, and honesty, your sessions will be ineffective for you and your healing process.

During the first session, you will typically be asked for the reasons you are coming to therapy and your therapist will complete what is known as a bio/psycho/social/spiritual history. This is a way to gather information regarding a number of things including current problems requiring you to begin therapy, physical and mental health concerns, family, work, education, cultural/spiritual, and legal histories and a history of physical/emotional/sexual abuse.

You will also be asked about your alcohol and/or drug use, eating disorders, gambling problems, or other addictive behaviors.

Still other questions will be asked, depending on the therapy and therapist. Besides looking at this history and defining the problems, you should also be asked about your strengths, your supports, and your current coping skills.

10 Vital Counseling Questions Your Therapist/Counselor Needs To Know

What is your story

Be honest and open about your history and what is happening now. If you aren’t willing to discuss your story, then therapy will not be effective. However, you need to know that telling your story is your decision and the pace in which you discuss this is up to you and you will not be forced to talk about anything against your will.

Do you have concerns about therapy

Explain your concerns and fears about therapy in general, or if there have been problems with a previous therapist

Are you suicidal

Have you had thoughts or plans  with regard to suicide. Tell if you have had suicidal feelings in the past and what you did about them, or if you are feeling like you want to end your life now

Do you want to harm yourself

Tell your therapist if you harm yourself, and if so how. Let your therapist know if you have any guns or other weapons you can use to harm yourself or others

Do you want to hurt someone else

It’s important to let your therapist know if you are so angry at others in your life that you want to harm them, or have a plan to harm them, or have weapons to carry out harming others.

Are you being abused at home

Be honest about abuse. Let your therapist know if you and/or your children are in danger at home at this time and need protection so a plan can be made to keep you and your family safe

Do you have physical or mental health concerns

Difficult health/mental health issues due to your current life situation should be revealed right away as they may be of immediate concern and need attention. Let your therapist know what your health issues are

What is true extent of your drinking and/or drugging or other addictions

It’s hard to be open about how much substances are being used, but lying or minimizing your use will render therapy ineffective.

What are your concerns regarding confidentiality and what must be legally reported

Not everything you say is confidential and it is your right to know this. Being willing to sign a release of information to other treatment providers so that all your providers can work as a team (such as your physician, probation officer, etc.)

What will you do in case of an emergency

Explore what you can do if you need to talk to a therapist immediately (many therapists do not offer on-call services for nights and weekends. You need to know if  there is a back up, a hotline, what the nearest hospital or emergency room is. You can develop a safety plan including hospitalization if needed.

As you can see, being open about your issues is the only way you will be able to heal from your trauma or problems. It is important that you and your therapist develop a healthy rapport; studies reveal that the most important part of therapy is not the type of therapy or the type of therapist, but the relationship you have with your counselor.

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Carol Anderson
Carol Anderson, D.Min., ACSW, LMSW, is a licensed clinical social worker with over 25 years of experience in the fields of mental health, addictions, and co-occurring disorders. Her other specialties include grief and trauma, women’s issues, chronic pain management, holistic healing, GLBTQ concerns, and spirituality and transpersonal psychology. Dr. Anderson has been educated and trained in the fields of education, social work, and spirituality, and she holds a Doctor of Ministry degree (non-denominational/interfaith) specializing in spirituality.

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