April 25, 2019

A Therapist’s First 4 Questions

Mental Health & Wellbeing

The first counseling session with a client looks different for everyone. Each person comes in with their own story, their own struggles, their own goals. There’s a lot of information to gather in that first session to try to get a sense for where this person is coming from and how you can be most helpful moving forward. The conversations might be different, but when I begin therapy with someone, there are a few things I’m always listening for from the start. There are some key lifestyle choices that are a part of every persons’ life which can affect our physical and mental health dramatically. Regardless of what brings someone in to therapy, here are four areas that I will listen for or ask about, to insure that he or she is doing what can be done outside of the therapy room to cultivate mental well-being.

Sleep Hygiene

Sleep hygiene is just a fancy phrase referring to one’s sleeping habits and patterns, and is one of the first things I’ll ask about when I meet with a new client. Sleep improves learning, concentration, mood, emotion regulation, hormone production, immune system functioning… The list goes on and on! If you aren’t sleeping well, you’re likely not functioning to your highest potential. A lack of sleep not only doesn’t help your overall health, it can actually harm it. Our sleep hygiene requires more attention than we think! Exploring more restful sleep options can be a good start to feeling your emotional wellness leading to restoration.

Eating Habits

It’s no secret that eating well is crucial for your physical health and is often the first line of defense against various diseases or deficiencies. I’m always curious about client’s eating habits because in addition to affecting physical health, our eating can significantly affect our mood, our concentration, and overall happiness. This correlation can work the opposite way as well- our moods can affect our appetites and eating habits. For example, one potential symptom of depression is a significant change in appetite (a big increase or a big decrease). If you’ve noticed a change in your eating habits, that might be indicative of your your physical or mental well-being.


Again, we know exercise is important physically, but it too plays a role in our mental well-being. Exercise is associated with lower rates of depression and anxiety and with improved memory and mental flexibility. If starting to exercise feels overwhelming, I’ve got great news. The exercise doesn’t have to be super intense! You don’t have to do cross fit or run 5k’s for these benefits to kick in; even small amounts of exercise are helpful in cultivating wellness. If you want to implement exercise but aren’t sure how to start, consider some simpler options like taking your dog for a walk, try your hand at gardening, jump rope for a bit or spend some extra time walking around the mall or grocery store. Start simple and get your heart rate up; then start thinking about what you might want to implement regularly. 

Social Supports

One thing I consistently say to my clients is that humankind is wired for connection. That’s why this is the final area that I will always ask about in a session with a new client (and will probably continue asking about as we continue meeting). Our brains thrive when we are connected with other people, and our general well-being can suffer when we aren’t. It is helpful for me to know when we begin sessions what kind of support networks are available outside of therapy and how we can improve or build on that. If your social support is robust, that’s fantastic! And if there seems to be a lack of connection or few relationship building opportunities, we can always navigate how to add small and approachable things to help build this up and create a sense of both being known and knowing those around you.

In Conclusion

There are lots of other things I’ll ask about in a first session, like context questions about families, jobs, and daily life activities. Regardless of what else we cover, I do always go back to these four, since they are a helpful starting point. If you are considering seeking counseling these could be topics to be thinking about. Of course, every therapist is different- these might not be areas of focus for other counselors. Even if they aren’t priorities in sessions, though, they are likely to come up at some point and are worth taking a closer look at. So whether you are preparing to meet with a therapist or just wanting to get a head start on taking care of your mental health, I think spending some time evaluating your sleeping, eating, and exercise habits as well as your social support network could be a great place to start. If you feel like you need support in any of these areas, that’s okay! A therapist could be that partner or patient listener you’ve always wanted to help you plan out taking one step at a time. Please know that therapy is for everyone! Maybe even you.

Written by therapist Clair Miller

More Optimum Joy Articles

We can help you get started

Ready to set up your first appointment?

If you haven’t been in touch with us yet, you can get started by filling out our intake form.