I can’t speak for all psychotherapists, so I’ll speak for myself. When I meet a new patient the first think I want to truly understand is why they are in my office. This goes far deeper than what they might have said on the phone or when they first sat down.
Perhaps they told me that they’ve been feeling more anxious recently. What does recently mean? Last week? Last month? Last year? Did they ever feel this way before? What do they think triggered this change? What do they attribute it to? What have they tried so far to help themselves? What made them wait until now before looking for help? Have they ever been in therapy before? How come they stopped? Was it helpful? What are they thinking and feeling when they are anxious? There are endless other questions I may have. I don’t necessarily ask these questions but I certainly look for the answers.
That said, I almost always allow and encourage patients to direct sessions, as I believe this is much more fruitful than if I do so. I
want to understand what they are looking for in treatment, and this goes far deeper than their words.
At the same time, I’m also trying to understand what kind of individuals they are, how insightful, introspective, empathetic, how strong their ego, how harsh their inner voice is, etc.