What to Expect in an Initial Therapy Consultation Call
You’ve decided you’re ready for therapy. You’ve asked for recommendations, scoured online directories, and found a therapist who seems like they might be what you’re looking for. You reached out, and they responded to set up a consultation call.
The next big step is that first call.
If you're feeling nervous or uncertain, you are not alone. Many of my prospective clients share this exact feeling before we first speak. They report not knowing where to start or how to explain what’s bringing them to therapy. After all, it’s just a 15-minute call. It’s hard enough to tell your story in a full session, let alone a brief chat.
Because this uncertainty can feel overwhelming, I like to start my calls by sharing what to expect. For most people, simply knowing what’s next can help settle those nerves. This post will walk you through exactly what to expect in a therapy consultation – from what the therapist will ask to what you can ask to find the right fit.
What is a Therapy Consultation, Anyway?
First, let's clarify what this call is – and what it isn't. An initial consultation for therapy is not a therapy session. It’s a brief, 15-20 minute conversation to help you and the therapist decide if you're a good match.
Think of it as a mutual "getting to know you" call. The therapist's goal is to understand what you're looking for and to determine if their skills and approach match your needs. Your goal is to get a feel for their style and learn about their practice to see if you feel comfortable.
And to answer a very common question: are therapy consultations free? At many private practices, including ours, this initial 15-minute call is free. It's always a good idea to confirm this when scheduling.
What to Expect in a Therapy Consultation: What Your Therapist Will Ask
While every therapist is different, the conversation generally follows a basic structure. To make it feel more concrete, here is what a consultation call at my practice often looks like. A therapist will likely want to get a brief snapshot of you and your needs.
1. Your Reasons for Seeking Therapy
This is the "what’s bringing you in?" part of the call. You don't need to have a perfect, pre-written speech. You can simply share what's been on your mind.
"What’s bringing you into therapy?" I want to understand what led you to seek help now and what you hope to focus on.
"How is this problem affecting your day-to-day life?" We'll touch on how your sleep, eating, work, school, and social life are being impacted. This helps me understand the bigger picture of your stress or anxiety levels.
2. Your Personal Background and History
A therapist wants to get to know you as a whole person, not just as a set of symptoms.
"Tell me a bit about yourself." This might include what you do for work, who you live with, or what your support system looks like.
"Have you been to therapy before?" If so, what was that experience like? Sometimes people come to therapy with negative past experiences. I want to know and understand that. I also want to know if you had a great experience and what was beneficial to you.
3. Assessing Safety and Clinical Fit
This part of the conversation is about making sure the therapist has the right expertise to support you safely and effectively.
"Do you have any history of trauma?" This can be a tough question to answer when you've just met someone. I always tell prospective clients that I don’t need to know any details, but I do need to know if trauma is a part of their history. Building safety and trust comes first, so this just lets me know if that’s something we will get to in sessions to come.
"Do you have any current or past suicidal thoughts or self-harm behaviors?" Many people with anxiety, depression, and trauma experience these thoughts, and there is no shame in that. It’s also important for me to make sure my practice is the right fit. In some cases, I may recommend a comprehensive DBT (Dialectical Behavior Therapy) program, as this is the most effective therapy for these specific challenges. I want prospective clients to get the right therapy, even if that means I refer them to a trusted colleague.
"Do you take any medications or have any medical issues?" We know how connected mental and physical health are. I believe in understanding the whole person, and that includes your physical health.
What Happens Next? Logistics and Finding the Right Fit
Towards the end of the call, the therapist will likely shift to logistics and next steps.
At my practice, I share what modality of therapy I think would be a good fit for you based on your needs. We offer a range of services for anxiety, depression, trauma, and more. We also identify who in our practice might be the best match from our team of therapists.
We also discuss session rates and how you may be able to get reimbursed by insurance. Therapy is a big investment of your time and resources. I want to make sure you can get any reimbursement you're entitled to.
Finally, I always stress the importance of the "therapeutic match." While a consultation call is a good indicator, sometimes after the first full session, you or the therapist may realize it’s not the best fit. That is completely okay. I always encourage open communication. I know that I am not the right therapist for every client, and I want clients to have the best match possible.
At the end of our chat, I'll ask if you want to set up a first intake session or if you'd like to think about it. You may want to interview other therapists, in fact, I encourage it!
What to Ask in a Therapy Consultation: Your Turn to Interview
This call is just as much for you as it is for the therapist. You are interviewing them! You have every right to ask questions to see if they feel like the right person to help you.
Here are some great questions to ask in a therapy consultation if the information hasn’t already been covered:
What therapeutic modalities do you use? (e.g., CBT, psychodynamic, EMDR)
What is your experience working with people who are struggling with [your specific concern, e.g., anxiety, new parenthood, life transitions]?
What would our first few sessions look like?
What are your session rates? Do you provide superbills for out-of-network reimbursement?
How often would we meet, and how long are your sessions?
What is your policy on cancellations or rescheduling?
Frequently Asked Questions
Are therapy consultations free?
In many private practices, yes. At our practice, we offer a free 15-minute phone consultation for this purpose. However, some therapists do charge for their time, so it is always best to ask when you first schedule the call.
What's the difference between a consultation and a first therapy session (intake)?
A consultation is a 15-20 minute "fit check" to see if you and the therapist are a good match. A first therapy session, often called an "intake," is a full-length session (usually 60-75 minutes) where you dive deeper into your history, review completed paperwork, and begin setting goals for your work together.
What if I’m nervous and don’t know what to say?
This is completely normal and something therapists expect. A good therapist will lead the conversation and ask questions to help guide you. You don't need to prepare a speech; just be yourself. It's perfectly fine to say, "I'm not sure where to start."
What if I realize the therapist isn't a good fit?
That is 100% okay and a normal part of the process. The goal of the consultation is to find the right fit. You can simply say, "Thank you for your time, I'm going to continue my search," or "I don't think this is the right fit for me." A professional therapist will understand and respect your decision.
How to Prepare for Your Therapy Consultation Call
Knowing how to prepare for a therapy consultation can make the process feel much smoother.
Find a Private Space: You'll be discussing personal information, so try to be somewhere you won't be overheard.
Jot Down Your "Why": Think about what prompted you to reach out. It's okay if it's just a feeling. You can write down a few bullet points to reference.
Write Down Your Questions: Have your list of questions (like the ones above) ready so you don't forget.
Breathe: Remember, it's just a conversation. It's your job to just show up and answer as honestly as you can. The therapist will guide the call.
Taking the Next Step
I hope this overview of what to expect in a therapy consultation takes some of the pressure off.
Just maybe, it will even encourage you to pick up your phone or open your computer to reach out to that referral name you’ve been sitting on.
Ready to find balance? If you need help integrating coping and emotional processing, finding a qualified mental health professional is your best next step toward effective emotional regulation.
About the Author: Jordyn Levine, LCSW
Jordyn Levine, LCSW (CA #101755), is a therapist and founder of a group practice based in West LA. She takes a collaborative, trauma-informed approach that is warm, relational, and evidence-based, with specialties in trauma, anxiety (including OCD/health anxiety and panic), grief, life transitions, and parenting.