Starting therapy is a significant decision, and choosing who to work with is part of that. You search, you get a list of names, and then you’re supposed to pick someone you’ll be sharing your most private thoughts with. That’s not an easy call to make from a name and a short bio.
Asking a few direct questions before your first session can tell you a lot about whether someone is actually a good match. This article goes through six of them, what each one is trying to get at, and what a useful answer looks like.
Why the Right Fit Matters
There’s a fair amount of research showing that the relationship between a therapist and client is one of the strongest predictors of how well therapy goes. If you don’t feel comfortable being honest with your therapist, the sessions tend not to go very far, regardless of what technique they’re using.
That said, comfort doesn’t mean easy. Therapy involves going over things that are genuinely hard to talk about, so some discomfort comes with it. What you’re trying to avoid is a different kind of discomfort, where you feel unheard, misunderstood, or like you can’t be straight with the person you’re working with. The questions below are meant to help you sort that out before committing to someone.
Question 1: What Is Your Experience With What I’m Dealing With?
This is the most practical question you can ask. Therapists vary a lot in what they’ve actually worked with, and having general clinical training isn’t the same as having worked through specific conditions or situations with real clients.
If you’re dealing with trauma, ask directly whether they’ve worked with trauma and what approach they take with it. If you’re going through grief and loss, ask how often they’ve worked with clients in that situation. If your child needs therapy, ask about the age range they typically see and what that work looks like. You’re not putting the therapist on trial. You’re just checking whether their background lines up with what you’re bringing in.
Question 2: What Therapeutic Approaches Do You Use?
Therapy is not one thing. Different approaches work in different ways, and knowing which ones a therapist uses gives you a better idea of what sessions will actually involve.
A few you’re likely to come across:
- CBT (Cognitive Behavioral Therapy): Focuses on identifying thought patterns that contribute to distress and changing them. Tends to be structured and time limited.
- ACT (Acceptance and Commitment Therapy): Instead of changing thoughts, it focuses on changing your relationship to them and acting in line with your values despite difficulty.
- EMDR (Eye Movement Desensitization and Reprocessing): Used primarily for trauma. Works by processing distressing memories using bilateral stimulation.
- IFS (Internal Family Systems): Addresses different “parts” of a person’s inner experience to work through internal conflict and past wounds.
- DBT (Dialectical Behavior Therapy): Centers on emotional regulation, distress tolerance, and interpersonal skills.
You don’t need to know these in detail. What you’re checking for is whether the therapist can explain what they use in plain language, whether it makes sense for your situation, and whether they can work with more than one approach if needed.
Question 3: What Does a Typical Session Look Like?
People often go into therapy expecting one kind of conversation and find themselves in something completely different. A therapist who works in children’s play therapy runs sessions that look nothing like someone doing couples therapy or standard individual talk therapy. Even within the same general type, there’s real variation in how structured or open-ended a session is.
Some therapists follow a set format each week. Others leave a lot of room for wherever you are that day. Some give assignments or ask you to journal between sessions. Others don’t. There’s no universal right answer, but knowing the format ahead of time helps you figure out whether it suits how you tend to work.
Question 4: What Are Your Fees, and Do You Accept Insurance?
A lot of people feel awkward asking about money, but it’s one of the more important questions on this list. If sessions aren’t affordable to keep up, therapy won’t have much chance to work.
Ask what the per-session fee is and whether they take your insurance. At Palisades Counseling, accepted plans include AETNA, Blue Cross/Blue Shield, Select Health, EMI, PHP, DMBA, UofU Health, Medicaid, and TriCare. It’s also worth asking whether telehealth is an option, especially if getting to an in-person appointment is hard to manage around your schedule. Palisades Counseling offers telehealth alongside in-person sessions in Provo. Getting these details sorted early saves a lot of hassle later.
Question 5: How Will We Know If Therapy Is Working?
Most people skip this question. It’s worth asking because a therapist who can answer it clearly is usually one who keeps track of whether sessions are actually doing anything useful.
The answer doesn’t need to be elaborate. Something like: “We check in on your goals regularly and I ask how you feel things are going” or “After the first few sessions we decide together what we want to change, and we use that as a reference going forward.” What you want to hear is that progress is something both of you pay attention to, not just something that’s supposed to happen on its own over time.
Question 6: What Happens If I Don’t Feel Like This Is Working?
This question surprises some people because it can feel like you’re already planning for things to go badly. But it’s a reasonable thing to ask, and how a therapist responds to it is telling.
Therapy doesn’t always work with the first person you try. Sometimes the approach doesn’t suit the problem, or the fit just isn’t there. A therapist who handles this question directly, by saying they’d want to talk about it, think about adjusting the approach, or refer you elsewhere if needed, is someone who’s focused on whether you’re getting help rather than on keeping you as a client. A vague or defensive response is useful information too.
What to Pay Attention to Across All Six Questions
The answers themselves matter, but so does how the conversation feels. A few things worth noticing:
- Does the therapist answer in plain language, or mostly in clinical terms?
- Do they ask about your situation, or do they mostly talk about themselves?
- Can you ask follow-up questions without it getting awkward?
- Are they upfront about what they don’t work with or haven’t had much experience with?
No single exchange tells you everything. You’re putting together a picture from all of it.
Quick Reference: What Each Question Is Really After
| Question | What It’s Checking |
|---|---|
| Experience with your concern | Whether their background fits your situation |
| Therapeutic approach | What sessions will focus on and how they run |
| Typical session format | Whether the structure suits how you work |
| Fees and insurance | Whether it’s affordable to continue |
| How to measure progress | Whether the therapist tracks outcomes |
| What if it isn’t working | Whether they’re focused on your results |
Specialist vs. Generalist: When It Matters
Most therapists are trained across a range of issues. But if you’re dealing with something specific like addiction, eating disorders, or ADHD, it’s worth asking whether they have specific training there rather than just broad experience. Targeted experience usually means a clearer grasp of the condition and more familiarity with what approaches tend to help.
For conditions like anxiety, depression, or stress, a skilled generalist who’s a good fit for you will often do more than a specialist who isn’t. Both the experience and the working relationship factor in.
These Questions Give You a Starting Point, Not a Guarantee
Going through these questions will give you useful information. It won’t guarantee a perfect match. Some people ask thorough questions and still end up with someone who isn’t right for them. Others go in with less research and find a therapist who works well almost immediately. The questions help narrow it down, but you’re also relying on your read of the person and how the conversation feels.
If you’re not sure where to start, the Find Your Counselor page at Palisades Counseling shows therapists with their specialties, approaches, and the age groups they work with. That can help you figure out who to reach out to before you even get to asking any of this.
Six Questions Are a Starting Point, Not a Barrier
It’s possible to spend so much time researching a therapist that you put off actually booking anything. These questions are useful, but they don’t all need perfect answers before you make a first appointment. A lot of what you’re trying to figure out will become clearer once you’re actually in a session.
If you’re thinking about starting therapy in the Provo area or through telehealth, contact Palisades Counseling to talk through who might be a reasonable fit for your situation.