What Happens in a Senior Therapy Intake Session?

So, you’ve made the brave and important step of scheduling a therapy session — but what comes next? Your senior therapy intake session is when you get to know your therapist, discuss therapy goals, and gain a better understanding of how therapy might work for you. 

Key takeaways

• Senior therapy intake sessions involve mental health assessments, therapy goal setting, and gaining a better understanding of what happens in a therapy session
• This is an opportunity for you to get to know your therapist and for your therapist to get to know you.
• It can be helpful to come to a therapy intake session with a list of questions to ask your therapist.

What is a senior therapy intake session?

A senior therapy intake session consists of discussing your mental health and personal health history, conducting some mental health screenings, and expressing your current presenting concerns.

However, the main purpose of an intake appointment is for you and your therapist to get to know each other and for you to better understand what therapy involves.

During this meeting, your therapist will ask you questions about why you are seeking therapy and what life experiences you’ve had. They will discuss mental health challenges you live with. At times, intake safety screenings, including depression screenings and suicide risk assessments, may be used.

Finally, a senior therapy intake session is an opportunity for you to ask your therapist questions about their approach to therapy, what to expect during a typical therapy session, and how working with your therapist can help you meet your therapy goals.

Why it matters for older adults

According to the World Health Organization (WHO), about 14% of adults over the age of 70 live with a mental health condition. The most common conditions experienced by seniors are anxiety and depression. There are also some late-life issues that contribute to senior mental health challenges, including: 

• Elder isolation
• Medical comorbidities and chronic illness
• Financial uncertainty
• Loss and grieving
  

If you have taken the important first step of scheduling therapy for yourself or for your loved one, you deserve a giant pat on the back. This is the first step to feeling better and living a more balanced life.

Here’s what to know about why this first therapy intake session matters.

It helps build rapport between you and your therapist

Therapeutic rapport, AKA the therapeutic relationship, is essential. It’s important that you feel comfortable and understood by your therapist. During your intake session, take note of whether you feel understood and respected by your therapist. You can also get a sense of whether your therapist’s personality is a good match for yours.

Assess your mental health

This first session is also an opportunity for your therapist to do some mental health assessments. These assessments help your therapist understand what challenges you may be facing, so they can tailor their sessions to meet your needs. Assessments might include a depression screening and an anxiety assessment, for example.

It is a chance to ask your therapists questions

This first meeting is an opportunity for your therapist to get to know you, but it’s also a chance for you to get to know your therapist better. You can ask questions about their training and credentials, as well as their approach to support people through their mental health challenges. You’ll be able to gather information about what to expect in a typical therapy session, as well how long each session will be and how many sessions to expect.

Completing Sailor Health onboarding

The Sailor Health onboarding process happens separately, before your therapy intake session. All of your paperwork is taken care of during this process. 

Sailor Health onboarding may include:

• Signing informed consent forms
• Filling out and signing HIPAA forms
• Providing contact information and emergency contact information
• Sharing insurance information 
• Getting more information about Sailor Health therapy session duration, cancellation fees, and confidentiality policies

It can be helpful to ask for family involvement if you need help filling out some of these forms, especially as they need to be completed online.

If you are having trouble filling out intake paperwork or gathering the information your therapist is asking for, you can ask your therapist to assist you during your intake session. 

Insurance coverage is a common concern among seniors starting therapy. The good news is that Medicare does cover therapy for seniors. Before your first appointment, Sailor Health will ensure that your insurance coverage is in order. 

If you’ve had prior mental health treatment, Sailor Health may ask you to have your previous provider send over your therapy records, with your consent. They may also ask you to send over any relevant medical records. This will help your therapist get a comprehensive understanding of your overall health status.

Personal history questionnaire

Your therapist may also ask you to fill out a questionnaire about yourself. This may include:

• Personal and family history of medical conditions and mental health conditions
• Medications you currently take
• A history of your mental health struggles
• Your lifestyle habits
• Your support network
• Questions about what is bringing you to therapy
• Statement of what your therapy goals are

Setting up the environment for a session

Before your session, you may want to consider your needs and what therapy accommodations might be helpful for you. For example:

• Do you need lighting or sound accommodations because of vision or hearing issues?
• Do you need paperwork forms to be in large print type?
• Do you need your therapist to speak slowly and clearly?
• Do you have mobility issues and need to ensure that ramps or elevators are available to you?
• Do you need specialized support, such as bereavement support or life transitions therapy?
• Would a telephone or telehealth appointment work better for you, due to mobility or medical issues?
• If you’re doing a telehealth appointment, do you need help getting it set up? 

What to expect: A step-by-step walkthrough

The day has finally arrived. It’s your first therapy session. Here’s what to expect.

Information gathering

At first, it may feel like your therapist is asking you a million questions. This is simply because they’re trying to get to know you the best they can. This intake process will have many more questions than a typical therapy session, because this is their chance to gather information about your personal history, medical history, and mental health history.

Don’t worry: future sessions won’t contain quite so many questions, and your therapist will do much more active listening than questioning.

Cognitive and safety screening

In addition to a depression screening and an anxiety assessment, your therapist may do a cognitive screen. This will usually involve a brief memory check, similar to memory tests you may have taken at a doctor’s office during your annual check-ups. They may also do a suicide risk assessment that will consist of several short questions. These assessments are simple and effective ways for your therapist to understand where you are coming from and what your needs are.

Therapist fit

A key component of a senior therapy intake session is to get to know your therapist better. This is the time to discuss things like therapist qualifications, your therapist’s approach to geropsychology and geriatric counseling, and your therapist’s experience dealing with issues like yours.

This is also an opportunity for you to get more information about session frequency, fees, and how to communicate with your therapist in between sessions.

It’s a good idea to come to this first therapy session with a list of questions to ask your therapist. If desired, your loved one can help you put this list together.

Questions to consider asking your therapist include:

• How long have you been practicing?
• What kind of experience do you have in mental health for seniors?
• Is online therapy or phone therapy an option for me?
• Are there specific therapeutic approaches you use?
• What is your approach to helping seniors manage mental health issues?

Determining treatment goals

During this first session, you’ll have an opportunity to come up with some goals for therapy. Goal-setting is something you and your therapist will collaborate on. Therapy goals are unique to each individual. They can be symptom-specific, such as “I want to have fewer panic attacks” or “I want to feel less depressed.” They can also be more practical, such as “I want to learn how to communicate better with my spouse” or “I want to establish better boundaries with my extended family.” The goals you set with your therapist will help guide your therapy sessions going forward. 

Unique considerations for seniors

While seniors deal with many of the same mental health conditions that younger people do, such as depression and anxiety, they also have unique needs.

Here’s what to know about mental health for seniors:

• Often, seniors need a slower pace during therapy sessions and more time to answer questions.
• One third of senior adults have hearing loss, so questions need to be asked more slowly, and clear annunciation is important.
• Seniors who have hearing aids should wear them to their therapy sessions, and background noises should be minimized during the session.
• Visual deficits are also common among older people, which is why adequate lighting is necessary. 
• Seniors with vision issues should make sure to wear glasses to their therapy sessions.
• If printed materials are provided, it can be helpful to use large print and readable fonts.
• Audio instructions are an alternative for seniors with vision issues.
• With permission, a caregiver can accompany the senior to their therapy appointments to help with mobility or other issues.
• Caregivers can also help with telehealth issues like helping to set up online therapy sessions.

After the intake: next steps

Once you’ve had your first session with your therapist, you will have a better idea of what therapy might be like. However, keep in mind that the therapy intake session isn’t exactly the same as what a typical therapy session will be like, as much of it involves getting to know your therapist, discussing mental health history, and setting future goals. 

Still, you’ve now gotten a sense of what your therapist is like, how it feels to talk to them, and what their approach to therapy is. They’ve also likely answered questions for you like:

• What treatment planning will look like for you
• How long each session will be
• How you’ll be scheduling follow-ups
• How frequently you’ll meet
• What kind of family involvement might be helpful in and out of therapy sessions
• What you will cover in a typical session
• When you might expect to start to feel better

In the weeks that follow, you will probably develop a more detailed treatment plan. This will be done collaboratively between you and your therapist as you navigate your challenges and determine your treatment goals.

Sometimes therapists will provide you with some action items to accomplish before your next session, such as journaling, brainstorming, or considering a specific question. They may also suggest making an appointment with your healthcare provider, to rule out medical conditions that may be contributing to your mental health challenges, such as thyroid issues, urinary tract infections, or metabolic disorders..

Importantly, you should leave this intake appointment with a greater sense of purpose and some newfound hope that you will start to feel better soon.

Sailor Health: Therapy designed for older adults 

If you are a senior experiencing mental health challenges, Sailor Health is here for you as you embark on your therapeutic journey. We offer telehealth for seniors covered by Medicare, usually at 0 cost to you. 

During our intake sessions, we can help you devise a treatment plan to meet your needs. We focus on many of the concerns unique to seniors, such as mood disorders, anxiety, depression, and life transitions.

Ready to take that first step toward wellness? Connect with a Sailor Health therapist now.

Frequently asked questions

What is oversharing in therapy?

Oversharing is when you share excessively personal or irrelevant information with someone. In therapy, though, sharing personal information is helpful and necessary, and you can be assured that your therapist will keep this confidential. At times, people may go off on a tangent during therapy, but your therapist will help keep you on track so that you can meet your therapy goals.

How long does a therapy intake take?

Although typical therapy sessions last between 45 minutes and one hour, therapy intake sessions can take longer, usually between 60 and 90 minutes. This allows the therapist to get through assessments and new client questions without rushing.

What type of notes do therapists take notes during intake sessions? 

Your therapist might take progress notes during or after your therapy session. Examples of commonly used progress notes include SOAP notes and DAP notes, both of which are note-taking modalities used to document therapy client interactions and information.

References

1. American Psychological Association. (2023). Understanding psychotherapy and how it works. https://www.apa.org/topics/psychotherapy/understanding
2. McKee J, Brahm N. (2016). Medical mimics: Differential diagnostic considerations for psychiatric symptoms. Ment Health Clin. Nov 3;6(6):289-296. https://pmc.ncbi.nlm.nih.gov/articles/PMC6007536/
3. National Institute on Aging. (2023). Talking With Your Older Patients. https://www.nia.nih.gov/health/health-care-professionals-information/talking-your-older-patients
4. World Health Organization. (2025). Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
5. O’Neill, M. M., & Nakash, O. (2021). Uncovering the intricacies of the clinical intake assessment: How clinicians prioritize information in complex contexts. Journal of the Society for Social Work and Research, 12(4), 803-829. https://doi.org/10.1086/715439
6. U.S. Department of Health & Human Services. (n.d.). HIPAA Privacy Rule and sharing information related to mental health. https://www.hhs.gov/sites/default/files/hipaa-privacy-rule-and-sharing-info-related-to-mental-health.pdf