What’s the First Thing You Ask a Client as You Begin Psychotherapy?

By Katelyn Baxter-Musser, LCSW, C-DBT

When clients first attend therapy, they often feel a range of emotions: worry, uncertainty, and hopefulness, to name a few. They might be unsure of where to begin, uncertain of which concerns to address first, and feel apprehensive about sharing their intimate life details with a complete stranger. We can help clients work through this uncertainty and apprehension by opening our session with this simple question: “What brings you here today?”

This seemingly simple question truly holds a lot of power. By beginning with this open-ended question, we allow clients to guide their session, inviting them to begin their narrative wherever they feel most comfortable, emphasizing that they are in the driver’s seat of their therapy. By asking, “What brings you here today?” we learn about the context of the client’s struggles, their readiness for change, their hopes and desires, and their goals for therapy.

This simple five-word question sets the foundation for healing and recovery, allowing us to build a clinical relationship based on nonjudgment, validation, and trust. This question sets the stage for a client-centered therapeutic relationship, where we can begin to help clients achieve their therapy goals by:

· Creating a safe environment

· Validating their experiences

· Fostering the development of self-compassion

· Meeting their therapy goals by setting achievable steps

· Developing healthy coping skills and strategies to manage the challenges they face

· Promoting personal growth through encouraging clients to take an active role in their therapy

The one question you ask when first meeting a client holds a power that extends far beyond that initial session. This question opens the door to a collaborative and empowering therapeutic relationship where clients feel heard, understood, and supported—extending far beyond the first session throughout the course of their therapeutic journey.

Katelyn Baxter-Musser, LCSW, C-DBT, is a licensed clinical social worker, an eye movement desensitization and reprocessing (EMDR) consultant, and is dialectical behavior therapy (DBT)-certified through Evergreen Certifications. In addition to her private practice, she is a national presenter for PESI, having trained thousands of mental health professionals on DBT, trauma, intimate partner violence, and mindfulness.