Best Therapy Intake Questions To Ask New Clients

When we meet with a client for the first time, we are not just checking boxes on an evaluation sheet; we are witnessing someone's courage in seeking treatment and sharing their story. Every question we ask serves two purposes: gathering vital clinical information while also creating connection and demonstrating genuine empathy. Through careful investigation and careful listening, we begin to understand not only the 'what' of their problems, but also the 'how' and 'why' they are essential to them.

Whether we are sitting with a worried parent of a young child, a teen struggling with their identity, or an adult facing life transitions, our approach must be as unique as each client’s story. The questions we ask and the way we ask them reflect our respect for their journey, our recognition of their experiences, and our commitment to supporting them on their healing journey.

For Young Children (such as 6-year-old Ankur)

When working with children, keep in mind that we are actually conducting two parallel assessments: one with the parents and one through observation of the child. Here's how I prefer to structure it.

Chatting with Parents

I typically begin with something like, "Tell me about your pregnancy journey with Ankur..." This begins a natural conversation about:

• Pregnancy

• Early Developmental Milestones

• The initial problems they noticed

• Family Dynamics and Interactions

• Daily Routines

• Understanding Development History

Then, I like to explore particular areas:

• "How does Ankur interact with other kids at the park?"

• "What makes him laugh the most?"

• "Who are his favourite people to spend time with?"

Communication Style

• "When Ankur wants something, how does he let you know?"

• "Tell me about a typical conversation with him"

Daily Life

• "Walk me through a typical day with Ankur"

• "What activities bring out the best in him?"

• "What situations seem to be challenging?"

For Adult Clients (such as 28-year-old Sneha)

With adult clients, I love starting with open-ended questions that help them tell their story:

Opening the Conversation

"What brings you here today?" might seem basic, but it's a powerful opener. I follow up with:

• "When did you first notice these feelings/concerns?"

• "What made you decide to reach out now?"

Understanding Client’s World

I find these questions particularly helpful:

• "Who are the important people in your life?"

• "What does a regular day look like for you?"

• "What brings you joy, and what drains you out?"

Exploring Support Systems

• "When life gets tough, who do you go to for help?"

• "What strategies have helped you so far?"

• "What kind of support are you hoping to find in therapy?"

Regardless of age or presenting concern, these questions often yield valuable insights:

1. "What would your best friend say about your strengths?"
2. "What makes you feel safe and supported?"
3. "What's the one thing you wish people understood about you?"
4. "How do you handle changes in your life?"

Remember that these questions are only beginning points. The idea is to attentively listen to your client and then follow their lead. Gentle follow-up questions such as

• "Can you tell me more about that?" or

• "How did that make you feel?"

Can often yield the most helpful details.

Non-Negotiable Questions to Ask

"What brings you here today, and what made you decide to seek help now?"

This probe indicates both the current problem and the tipping point that prompted action. Timing usually indicates crisis moments, preparedness for change, and the depth of anguish. Understanding why "now" is important for determining urgency and client motivation.

"Have you had thoughts of harming yourself or others, now or in the past?"

This direct risk assessment inquiry is critical to client safety and ethical conduct. It determines whether immediate intervention is required and directs treatment strategy. Despite its sensitivity, neglecting this issue may result in missing important safety problems.

"What are your current coping strategies when things get difficult?

This reveals current strengths and resources, potentially dangerous coping techniques (such as substance use), and areas requiring immediate action. Understanding how clients currently handle distress allows you to build on functional methods while correcting maladaptive ones.

"Are you currently taking any medications or receiving treatment for physical/mental health conditions?"

Understanding current medications and therapies is critical for planning care, avoiding incompatible approaches, and identifying potential side effects or interactions. It also demonstrates how medical issues may affect mental health, and vice versa.

Why are the Questions Different for Each Person?

Consider this: would you ask a 6-year-old the same questions as a teen suffering from anxiety? Or would you treat a senior citizen grieving over a loss in the same manner you would a new mother suffering from postpartum depression? Of course, not! Let me share some of my favourite intake questions, which I've found to be extremely successful across a variety of demographics.

Pro Tips I've Learned Along the Way

1. Pace yourself – not everything needs to be covered in the first session
2. Leave space for silence – sometimes the most important things are said after a pause
3. Watch for non-verbal cues that might signal discomfort or readiness to share more
4. Adapt your language and tone to match your client's style

A Guide to Areas That Must Be Covered in an Intake

1. Presenting Concerns

• Primary reason for seeking help

• Duration and intensity of concerns

• Impact on daily functioning

• Previous attempts to address issues

2. Personal History

• Family background

• Developmental milestones (especially for children)

• Educational/occupational history

• Significant life events/transitions

3. Mental Health Status

• Previous mental health experiences

• Family history of mental health conditions

• Current symptoms and their timeline

• Risk assessment (if applicable)

4. Support Systems

• Family dynamics

• Social relationships

• Current coping mechanisms

5. Physical Health

• Current medical conditions

• Sleep patterns

• Exercise and nutrition

6. Environmental Context

• Living situation

• Work/school environment

• Cultural/religious influences

• Socioeconomic factors

7. Strengths

• Personal strengths

• Interests and hobbies

• Successful coping strategies

• Available support networks

8. Treatment Goals

• Client's expectations

• Desired outcomes

• Timeline expectations

• Barriers to treatment

Keep in mind that the objective of intake is more than just gathering information -  it is also about starting to develop a therapeutic relationship that feels secure, supporting, and understanding. These questions help us get started on that journey together with the client.