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Private Practice Kickstart
with Miranda Palmer, LMFT
& Kelly Higdon, LMFT

The #1 Question Therapists Forget to Ask

Private Practice ConsultationThere is a simple question I ask of any person that is interested in working with me, regardless if it is life coaching, business coaching or psychotherapy.

While we as mental health professionals are well versed in assessment, the initial phone consultation is a crucial part of beginning a relationship with a client.

When I work with clients, I am not only assessing if my services are what they need and if they are a good fit, I also want to understand their expectation and their motivation. Before I enter into a therapeutic or coaching relationship, I want to be clear about where they are at with their expectations of the process and the results they will be achieving. Informed consent is crucial. However, informed consent isn’t given until the person sets up the appointment and that is why I address expectations from the beginning. This is why I always ask this question before I work with someone.

I also want my clients to be motivated and clear about why they are going to therapy or enrolling in a business school bootcamp. Empowerment is important in this process, so I always ask….

“Let’s imagine we are done working together, you look back and say ‘this was the best investment of my time, energy and money,’ what needs to happen in order for you to be able to say that?”

I didn’t invent this question at all. Dan Sullivan writes about this question in his book and says it much more eloquently than I. His phrasing is “If we were having this discussion 3 years from today, and you were looking back over those 3 years, what has to have happened in your life both personally and professionally, for you to feel happy with your progress?” Of course this is aptly named the Dan Sullivan Question.

But why apply a coaching question in a clinical setting? What does this question actually do?

From the initial consultation you are providing an opportunity for clarity. You are getting to understand their motivations for reaching out to you and their expectations as far as what your services will provide. You will discover from this answer if you are willing to work with the client and you will be able to address the expectations before they schedule an appointment.

I have heard stories of clients booking their first appointment and then finding out that therapist works long term, on a weekly basis. They weren’t expecting that and thus they felt like they wasted their time and money on a session to merely have their expectations clarified.

This question also empowers the potential client to clarify their own desires and help them make a decision about whether or not working with you is a good for their needs. You want to ask questions that prompt the client to make a decision and take action.

What has most amazed me is the responses when I ask the question. Most people are grateful and appreciate the opportunity to think about their decision in a new way. I also have seen results from this question. Clients are more decisive about working with me, they are clear about their goals and intentions and this lends to a more impactful working relationship.

I encourage you to reflect on your initial phone consultations and explore what you are asking and it’s impact. Try out the question and see what happens. If you want more information click here to get a recent article on the Intial Consultation: 6 Lessons Learned.


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The #1 Question Therapists Forget to Ask

Kelly Higdon, LMFT

Kelly Higdon, LMFT is a private practice expert that believes therapists are some of the most important healers in the world. She teaches therapists how to grow successful businesses from scratch and to move beyond the couch with multiple streams of income. Get to know Kelly better through her free private practice marketing trainings, the Business School Bootcamp for therapists, or through private practice consultation.


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APA Reference
Higdon, K. (2019). The #1 Question Therapists Forget to Ask. Psych Central. Retrieved on January 28, 2020, from