Imagine you're going to therapy for the first time. This first step is an important one. It's your opportunity to share your thoughts, feelings, and concerns with your therapist. At the same time, it's an opportunity for your therapist to get to know you better and understand what you're going through.

It's important to understand that therapy takes time. So, please don't expect your issues to be resolved immediately in the first session.

In the following sections, we'll take a closer look at the specific questions and processes you can expect both in a private practice, like my own online psychological counseling practice, and with therapists who bill through health insurance.

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Private Practice with a Psychologist (Self-Payment)

In this section, I'd like to not only introduce you to some questions that might be asked in a private practice but also provide some example answers. These answers are based on my own experience as an online psychologist in private practice. 

They are intended to help you gain a better understanding of what you can expect from the first session and how you can prepare for it. Please note that the actual questions and answers may vary depending on your individual situation.

1. What led you to consider therapy?

• “I feel like I can no longer cope with my stress, and I believe counseling could help me manage it better.”

2. What are the symptoms or problems you are currently experiencing?

• “I have trouble sleeping and often feel anxious and overwhelmed.”

3. How do these problems affect your daily life?

• “I have difficulty concentrating on my work, and I often withdraw from social activities.”

4. Have you ever sought therapy or counseling before?

• “Yes, I saw a therapist a few years ago, but I feel like I need help again now.”

5. Are there specific goals you hope to achieve through counseling?

• “I want to learn how to better manage my stress and cope with my anxieties.”

6. How would you describe your current mood?

• “I mostly feel anxious and stressed.”

7. What does a typical week in your life look like?

• “I work Monday through Friday and try to find time for myself on the weekends.”

8. How would you describe your relationships with family and friends?

• “I have a good relationship with my mother and sister, but I feel like I've drifted apart from my best friend.”

9. Are there any past events or experiences that have particularly shaped you?

• “Yes, my father’s death a few years ago deeply affected me, and I feel like I haven’t fully processed it yet.”

10. How do you normally cope with stress?

• “I try to distract myself with tennis, but sometimes I still feel overwhelmed.”

11. Are there any health issues I should be aware of?

• “I have high blood pressure and take medication for it.”

12. Are you currently taking any other medications?

• “No.”

13. What is your work situation like?

• “I work full-time in an office.”

14. How would you describe your sleep habits?

• “I have difficulty falling asleep and often wake up in the middle of the night. Then, because of all the overthinking, I can't fall back asleep and wake up completely exhausted.”

15. Are there things that worry or frighten you?

• “I worry about my health and am afraid I might lose my job.”

16. How is your diet?

• “I try to eat healthy, but sometimes under stress, I reach for unhealthy snacks.”

17. Do you exercise regularly or engage in other physical activities?

• “I play tennis a couple of times a week. I also usually go jogging on Wednesdays before work, but lately, I've found that increasingly difficult.”

18. What about your alcohol or drug consumption?

• “I occasionally drink a glass of wine, but I don't use drugs.”

19. Is there anything you would like to change in your life?

• “I want to learn how to better manage my stress and cope with my fear of the death of others or people close to me.”

20. Is there anything else you'd like to tell me that we haven't discussed yet?

• “I think we've covered most of my concerns. I'm looking forward to starting counseling.”

It's important to note that the way these questions are asked depends on the psychologist's attitude and approach.

Worth Reading: Nervous Before Your First Therapy Session? Top 10 Tips from a Psychologist

This list of 20 questions serves only as a general guide, and the actual questions may vary.

It is always best to answer the therapist's questions openly and honestly to get the most out of counseling.

Psychological Psychotherapists Who Bill Through Health Insurance

In this section, we'll look at the first therapy session conducted by a psychological psychotherapist who bills through your health insurance.

It's important to know that not all forms of therapy are covered by health insurance. According to “Psychologie Heute” (Psychology Today), currently, health insurance covers Behavioral Therapy, Psychodynamic Psychotherapy, and Psychoanalysis. Systemic Therapy will also be approved soon. Source

It's important to know that the questions asked during the first session may be similar, but each therapist has their own approach to screening their patients.

1. Have you ever experienced sudden anxiety, even when no real danger was present?
2. Do you feel uncomfortable in certain situations or places, such as department stores, while driving, in crowds, in elevators, or in enclosed spaces?
3. Are you afraid of situations where you might be observed or evaluated by other people, such as public speaking, gatherings, parties, or conversations?
4. Are you afraid of certain things, such as animals, heights, flying, or the sight of blood and injuries?
5. Do you often worry excessively, for example, about family, professional, or financial matters?
6. Have you ever experienced an extremely distressing, life-threatening, or traumatic event after which you felt very unwell, such as rape, other acts of violence, or natural disasters?
7. Are there actions you feel compelled to perform repeatedly?
8. Have there been times in your life when you felt consistently down, hopeless, or uninterested for a period of at least two weeks?
9. Have you ever experienced a period of at least two years during which you felt sad or depressed most of the time?
10. Have there been times when you felt extremely euphoric or irritable for at least one week?
11. Do you often fear that you suffer from a serious illness?
12. Before the age of 30, did you already struggle with numerous physical complaints?
13. Have there been times when you suffered from severe pain for at least six months, which almost constantly occupied your attention?
14. Have you ever experienced physical symptoms such as paralysis, loss of voice, visual disturbances, or difficulty walking?
15. Do you have strong fears of becoming overweight, or are you very concerned about your body shape and weight?
16. Have there been times when your weight was significantly below what others considered appropriate, or have you ever lost a substantial amount of weight?
17. Have you ever experienced periods of intense cravings or binge eating, during which you consumed large amounts of food in a very short time?
18. Do you take substances to influence your mood, such as alcohol, medication, or illicit drugs?
19. Have you ever had unusual experiences, such as hearing or seeing things or voices that others couldn't perceive or when no one else was around?
20. Have there been times when you felt strange things were happening around you, that people were doing things to test you or harm you, so you had to be constantly on guard?

These insights are intended to serve only as a guide for you. Every therapy is individual and tailored to the needs of the individual.

Why Private Psychological Counseling Might Be the Right Choice

There are various reasons why people might choose a private practice:

1. Confidentiality: In a private practice, counseling remains completely confidential. This means that employers, health insurance companies, and even partners generally won't be informed about the counseling unless the client chooses to share this information.
2. No Diagnosis Required: In a private practice, it's not necessary to provide a formal diagnosis to begin counseling. This can be appealing for individuals seeking help who have concerns about receiving a formal diagnosis.
3. No Long Waiting Times: Private practices often have shorter waiting times than therapists who bill through health insurance. This can be especially important for individuals who need immediate assistance.

These factors can help people feel more comfortable and willing to take the step towards therapy.

However, it's important to note that choosing a private practice is a personal decision and depends on many factors, including an individual's unique needs and circumstances.

In my opinion, it's always best to explore all available options and choose the one that best suits your own needs.

On my website, you'll find psychological self-tests to explore how much your symptoms are affecting you. Feel free to try them.

If you'd like to talk to someone about it – you know, I always welcome connections.

Warmly,

Patric Pförtner

Updated on: 11. Juli 2025

Magazine Psychological counseling

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