What gets discussed at a therapy intake?

If you contact a mental health professional about getting your child or teen into therapy, they’re likely to mention wanting to do an intake session first. Perhaps you already have an intake scheduled, and you’re curious about what it’ll entail. I thought that outlining how I structure my intakes might give you a better idea of what to expect; however, every therapist operates differently, so be sure to take my outline with a grain of salt 🙂

Who attends the intake

The vast majority of time in my practice, I ask that parents attend the intake session alone, without their child. This is because parents are often feeling frustrated and exhausted by their child’s behavior, and I don’t want them to have to censor themselves – nor do I want the kiddo to spend 50 minutes listening to all their “crimes.” A parent-only meeting allows the adults (including me) to speak candidly so that my first meeting with the child can just focus on building rapport with them.

The only exception to this rule is when the client is an older child or teen who has requested therapy for themselves! In that situation, I want to honor their role in advocating for themselves, plus they can often articulate the problem more accurately than their parents, who may be in the dark about why their teen wants therapy.

What gets discussed

Here are the typical questions I ask:

• What brings you to therapy? What are your concerns?
• How long has the problem been going on?
• Is your child complaining of head or stomachaches? How is their sleep?
• Is this problem affecting them in other situations outside the home? (School, at the baby-sitter’s, soccer practice, etc)
• Is there anything else relevant to your child’s history or family that I should know about?

The first two bullet points are probably self-explanatory and not much of a surprise, but I’ll delve a little deeper into the other questions.

Stomachaches and sleep?
Often, when children are experiencing high stress or anxiety, they’ll complain of head or stomachaches more often than usual. Sleep patterns are another area that can quickly get out of whack – in fact, I’ll say that very few children on my caseload are sleeping soundly at night. Physical health issues very often indicate psychological ones. Now, if this is something your child is struggling with, I’ll always ask that you check in with the pediatrician first to rule out any medical problems.

Even if all is well in a biological sense, it doesn’t mean the aches and pains aren’t real. Stress gets stored in the body and revealed in confusing ways – just as you might notice yourself getting a headache or neck strain or eye twitch when you’re stressed.

Problems happening in other situations?
Asking about how the problem affects the child at home, school, and other situations helps me to start isolating what I think could be the core issue in need of addressing. For example, if Kayden seems to do okay at home but shows extreme behavior at school and soccer practice, I might be wondering if there’s something about the structure or sensory experiences in those situations that are particularly triggering for him.

On the other hand, if Claire has separation anxiety from her mother at home and all other situations, I’ll feel more confident that the challenge isn’t specific to location and instead exists within Claire and her relationship with her mother. These things can’t be fully determined in an intake session alone – it will require more sessions with both kiddo and parents – but it helps me start to piece the puzzle together so that I can figure out how to help.

Anything else in the child’s history?
Background may not always seem relevant, but it can affect the presenting problem more than you think! To use the example above, if I discover that Kayden experienced a traumatic event at school three years ago, I’m going to look at his behavior very differently than if this knowledge were left out. Healing trauma comes first before addressing behavior.

Note: in my practice, I send intake paperwork to parents to complete before the meeting takes place, so you’ll have plenty of time to think about these things rather than trying to remember everything on the spot!

Opportunity for questions

In my intakes, I always make sure there’s time at the end for parents to ask whatever questions they may have about me specifically. Most commonly, people ask if I have experience working with a particular problem, as well as what strategies I typically take to address it. There are also often questions about the play therapy process.

However, sometimes the intake can be heavy and parents may feel at a loss for questions when the time comes to an end. Or, they may already be familiar with the therapy process and don’t feel a need to ask much. That’s okay too! Parents are always welcome to email me questions that pop up for them later.

In sum, the intake session is very much an information-gathering session for me, as well as an opportunity for us both to get to know each other. After all, feeling comfortable with and confident about your child’s therapist is an important aspect of your child’s treatment.