Written and reviewed by
Antonia Moosmann
Licensed psychologist in Germany, M.Sc. Clinical Psychology. These are the questions I'd want a new client to ask me before we started — including the ones a platform's onboarding won't suggest.
Read more about how I reviewKey facts
In a hurry? Here's the short version.
- Ask before you book: licensing jurisdiction, training in your specific problem, primary modality, fees + cancellation policy, insurance/reimbursement, typical length of work.
- Ask in the first session: how we'll know it's working, what happens if it isn't, how the therapist handles disagreement, what's outside their scope, what homework they'd ask of you.
- If you're going online, ask four extras: licence in your jurisdiction, between-session crisis policy, therapist continuity, privacy and recording.
- Listen for the answers, not the words. Defensive, vague, or grandiose responses are the most useful data the first session can give you.
- Next step: if you're picking a platform, the one I get asked about most is in the BetterHelp review. If you're still weighing therapy vs. self-help, start with do you actually need a therapist?
The first session is a two-way interview. You're not auditioning for the therapist — you're both deciding whether this is going to work. Asking better questions is how you make that decision well.
Why these questions
Why this checklist exists
Most readers booking a first therapy session feel like they're on the back foot — nervous, not sure what's allowed to ask, half afraid the therapist will judge the question. The truth is the opposite. The clients who ask the most direct questions in the first session almost always do the best work over time. They're already practising the thing therapy is mostly for: noticing what they actually need and saying it out loud.
The checklist below is what I'd want a new client to ask me — and the questions I wish more readers would put to any therapist before booking. Some of them are obvious. The underrated ones are at the bottom of each section.
Step one
Six questions to ask before you book
These are the questions a 15-minute free consultation should comfortably cover — and most therapists offer that consultation precisely so you can ask them. If a therapist won't do a brief intro call, that's worth noticing.
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Are you licensed, and in which jurisdiction?
Why it matters: Sounds obvious; it's the one some readers skip. A psychologist licensed in California can't legally see you in Texas. For online platforms, ask which states or countries the therapist is actually licensed to practise in — not just where the company operates.
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What's your training in the specific problem I'm bringing?
Why it matters: "I see anxiety" is different from "I'm trained in CBT with exposure for panic." A therapist who can name the specific protocol they'd use is a green flag. A vague "I take an integrative approach" might be fine — or might mean no protocol at all.
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What modality do you primarily work in?
Why it matters: If you've read the modalities guide, you already know the rough fit. CBT for anxiety and OCD. DBT for emotion-regulation and self-harm patterns. EMDR or trauma-focused CBT for single-event trauma. If their modality doesn't match what you're bringing, ask why they'd take you on anyway.
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What's the fee per session, and what do you do if I can't make a session?
Why it matters: Get this in writing before the first session. Common ranges: $100–$250 in the US, more in major cities, less in many other countries. Cancellation policies vary — some charge full fee for less than 24 hours' notice. None of this is rude to ask.
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What insurance do you take, or what receipts can I submit for reimbursement?
Why it matters: If they're in-network, copays are usually $20–$60. If they're out-of-network, ask whether they provide a superbill (the receipt format insurance reimburses). Outside the US, ask about Kassen acceptance in Germany, NHS routes in the UK, Medicare in Australia.
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How long do you typically work with clients on this kind of problem?
Why it matters: Useful expectation-setting. CBT for a specific phobia: 8–12 sessions is normal. Recurrent depression with relational patterns: a year or more is normal. If the answer is wildly different from what the evidence suggests, ask why.
Step two
Five questions for the first session itself
These are the questions you carry into the room (or the video call). Two or three of them is plenty for the first 50 minutes — save the rest for sessions two and three.
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How will we know if therapy is working?
Why it matters: Good therapists welcome this. They'll usually name specific markers — reduced panic-attack frequency, sleeping through the night three times a week, the inner critic getting quieter — and a rough timeline. Vague "you'll feel better" answers are softer.
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What happens if I'm not feeling better in 6–8 weeks?
Why it matters: Every good therapist has an answer for this. "We'd review what's working, what isn't, and adjust" is the answer you want. If the response is defensive or vague, that's data.
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How do you handle disagreement in session?
Why it matters: This is the most underrated question. A therapist who flinches when you push back can't help with the parts of yourself that need pushing back. A good one welcomes it — and might even say "please do."
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What's outside your scope?
Why it matters: Honest answer: most therapists have a few presentations they don't take on. A clear "I'd refer out for [X]" is a maturity signal. "I can work with anything" is rarely true.
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What homework or between-session work would you ask of me?
Why it matters: If you're going to do this seriously, the between-session work matters more than the session itself. CBT-flavoured therapists usually have an answer. Psychodynamic therapists might say less homework, more reflection — also fine, but ask.
Step three (if online)
Four extra questions for online therapy
Online platforms add their own questions on top of the standard ones. These four are the ones most onboarding flows don't surface — but you'll want the answers in writing.
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Are you licensed in the state or country where I'll be sitting during sessions?
Why it matters: Online therapy doesn't dissolve licensing law. If you're in Texas and they're licensed in California only, the work isn't legal. Platforms like BetterHelp and Talkspace handle this automatically; if you're booking direct, double-check.
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What's your policy if I have a crisis between sessions?
Why it matters: Some platforms route crisis to local hotlines (which is fine — that's what hotlines are for). Some individual online therapists offer between-session messaging; others don't. Knowing the boundaries in advance is more useful than learning them in the moment.
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Will I have the same therapist every session, or could I be reassigned?
Why it matters: On some commercial platforms, therapists leave and clients get reassigned. On others, the relationship is stable. Ask. If continuity matters to you, it's a non-trivial filter.
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How do you handle privacy and recording?
Why it matters: Whether sessions are recorded, where any session notes live, and who has access varies a lot. The FTC's 2023 BetterHelp settlement made this a live question — covered in the BetterHelp review. Worth asking on any platform.
A therapist who flinches when you push back can't help with the parts of yourself that need pushing back. The first-session version of that question is one of the most useful you'll ever ask.
Listen for these
Eight red flags worth taking seriously
You're listening for the answer, not the words. These are the patterns where I'd encourage a reader to pause and consider another therapist — even if the first session "felt fine."
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They guarantee outcomes. (Good therapy doesn't promise; it works at probabilities and effort.)
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They tell you what's wrong with you in the first session. (That's a hypothesis to revisit, not a diagnosis to deliver.)
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They steer every conversation back to one of their own preoccupations.
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They flinch, deflect, or get defensive when you push back on something they said.
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They're vague about credentials, licensing, or modality — even when you ask directly.
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They make you feel small after sessions more often than understood.
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They suggest you stop other treatment (medication, your GP's care, another therapist) without coordinating with the other clinicians.
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They cross professional lines — over-sharing, social media follow requests, after-hours non-emergency contact.
If you've decided
If you're picking a platform, start here.
The platform I get asked about most is BetterHelp. I wrote a full review covering what they do well, where I wouldn't recommend them, the questions in this checklist they handle automatically, the ones they don't, and the FTC privacy settlement readers should know about.
Read the BetterHelp review →Still not sure which modality fits? See which type of therapy fits which problem — a clinician's map of CBT, DBT, ACT, psychodynamic, and EMDR.
A note on sources
The checklist above is a working clinician's distillation of the consensus on therapist-selection (American Psychological Association guidance for choosing a therapist, NICE patient materials on what to expect from psychological therapy), the published outcome research on the therapeutic relationship (common-factors literature on rupture, repair, and disagreement in session), and the regulatory specifics relevant to online therapy — including the FTC's 2023 settlement with BetterHelp over privacy practices, which is what made some of the online extras above worth flagging.
Where I've named specific red flags, I'm following the same patterns major guidelines flag as concerning therapist behaviour. Where I've left a question soft ("ask, then listen for the answer"), the evidence doesn't justify a sharper line.
Common questions
Is it rude to ask these questions in a first session?
No — and any good therapist will tell you the same. Asking is a sign that you're taking the work seriously, and the answers help both of you decide whether the fit is right. If a therapist gets defensive when asked basic questions about credentials, modality, or fees, that's the most useful data the first session can give you.
How many of these do I need to ask in the first 50 minutes?
Most of them can be answered in a 15-minute consultation call before the first session — and many therapists offer that for free specifically to handle this. If you're booking a paid first session directly, three to five of the most important questions for your situation is plenty. Save the rest for sessions two and three.
What if I don't know what modality I want?
That's fine — most readers don't. The modalities guide at which type of therapy fits which problem? maps common problems to the approach I'd start with. You can use it as a rough filter when you read therapist bios.
What if I find a therapist who feels off after a few sessions?
Give a new therapist three to five sessions to settle. After that, if the fit is wrong, name it directly — most therapists would rather you switched than quietly disengaged. "This format isn't working for me" or "I'd like to try someone with a different style" is a complete sentence. Online platforms generally make switching easier than in-person referrals; that's one real advantage they have.
Where should I actually start if I haven't picked a platform yet?
If online therapy is what you're considering, the one I get asked about most is BetterHelp — strengths, limits, and the FTC privacy settlement are all in the BetterHelp review. If you're still weighing whether online is right for you at all, the online therapy effectiveness guide covers what the research really says.
What if I can't afford private therapy?
Three real options: public mental-health systems (NHS Talking Therapies in the UK, gesetzliche Krankenkassen in Germany, community mental health centres in the US), training clinics (graduate students supervised by licensed clinicians, often at reduced rates), and structured workbook self-help — covered in detail at do you actually need a therapist?