Intake Questions

A handy little cheat sheet of sample questions related to the intake – by no means is this list exhaustive, nor will every question necessarily apply. This is meant to be a jumping-off point and give you an idea of what you’re looking for!

2.1.2 FAMILY OF ORIGIN

Who grew up with you in your house?
Are your parents still together?
Tell me a little bit about what the experience of growing up in your house was like for you.
- Religion?
- Moved around a lot?
If you had roles in the family what would yours be and then what would your other family members be?
Can you tell me a little bit about what your mom was like as a mom, and what her personality was/is like?
- How did that translate for you? What did that feel like?
- Why don’t you tell me some of the best things about her?
- Was your mom emotionally present, or more like the physically present and not emotionally engaged type?
- If yes: Who did you go to in childhood for that emotional engagement?
- What’s your relationship with your mom like now?
- How do you feel about your adult relationship with your mom?
Can you tell me now about what your dad was like?
- What was your emotional response to your dad?
- Was he as involved as your mom?
How did the two of your parents get along?
Did your parents get along when you were a kid?
If resentful towards each other, would that resentment go towards each other or to you and your siblings?
How do your parents get along now?
Can you tell me a little bit about your siblings?
What do your parents/siblings do now?
What is your relationship with your parents/siblings like now?
What are your siblings up to? Do they have a partner or any kids or anything?

2.1.3 CHILDHOOD SCHOOL EXPERIENCE

What were you like in school?
How were your grades?
How was it socially for you in school?
- Did you have a good group of friends?
What did you go to post-secondary school for?
- What was that like for you?
Any moving around?

2.1.4 ROMANTIC RELATIONSHIP HISTORY

What was your first romantic relationship like?
- When was it?
- Was your partner your same age?
Why did you guys break up?
- How was that?
- Did they break up with you or did you break up with them?
- How did things end?
- What was that like?
Talk to me about the first year of your relationship.
- What was their personality like?
- What were they up to?
- What were you up to?
- Did you ever live together?
- What ended that relationship?

2.1.5 MEDICAL HISTORY & HEALTH

MOOD ACROSS THE WEEK

What is your mood like across the week?
Have you had any surgeries or anything like that?
How was your pregnancy?
- How was the birth for you?
- How has the postpartum experience been?

SLEEP

Can you tell me a little bit about the quality of your sleep, on average?
How many hours would you say you get?
Do you know if what your body’s ideal amount is?
What number is that for you?

EATING

Can you tell me also now about what your eating is like? What I mean is:
- a) any dieting lifestyle stuff
- b) any major weight loss or weight gain
- c) body image stuff
How do you feel about food?
What is your body image like?

EXERCISE/MOVEMENT

What do you do for movement and exercise?

DIAGNOSES (SELF/FAMILY)

Have you ever been diagnosed with anything related to stress or mental health?
How severe is this for you and what kind of impact does it have?

COPING SKILLS (HEALTHY AND/OR UNHEALTHY)

What do you do when you are not feeling great, or when you are in a stressed or sad mood?
What do you do to cope with difficult situations?

2.1.6 SOCIAL SUPPORT & FRIENDS

Who are your friends?
What’s your social life like?
Who is the first person you reach out to with good news/bad news?

PERSONALITY

Can you tell me what your personality is like?
How would most of your friends describe your personality?
Would you say you are more of an introvert or more extrovert?
What is your conflict style?

2.1.7 TRAUMA HISTORY

Aside from the topics we’ve already discussed, what other traumatic or noteworthy events still feel important to mention?

2.1.8 HOBBIES & FUN

What do you do for hobbies and fun?
What do you do for yourself for fun? Relaxation?

2.1.9 SCREEN TIME

How many hours of screen time do you have per day?

2.1.10 CURRENT IMMEDIATE FAMILY/LIVING SITUATION

What was your current partner like when you first met them?
- What is their personality like?
- What do they do?
- How long have you guys been dating/been together?
- Do you live together?
- When did you move in together?
- What were those first few years like?
What were things like after you had your child?
How did your romantic relationship change?
What does intimacy look like in your relationship – either emotional or sexual?
How are the domestic responsibilities shared in your household?
- How do you feel about that?
What would you say is the biggest challenge with your relationship?
What would you say is the best thing about your relationship?
Would you say that you make decisions together?
What does your decision-making process look like?
- For example, if you guys are going on a vacation, who picks the destination and handles most of the planning?

PARENTING STYLE

How would you describe your views on parenting?
Would you say you and your partner have similar views on parenting?
- If no: What are some of the major differences that come up?
Tell me about your child; what are they like?
Is there anything especially challenging about parenting your child for you?
How do you feel about disciplining your child?
Do you guys have any pets?
- If no: Any plans to adopt a pet in the future?

2.1.11 FINANCES

What kind of socio-economic challenges come up and what does that look like?
Do you have similar views on money?
Is money a stressor in your relationship?
How would you describe your parents’ views on money?
Did your parents have the same mentality when it came to finances?
What is your perspective on money like?
Is money a stressor for you?

WORK

What do you do for work?
Can you tell me a little bit about what is really fun and awesome about the job?
What is maybe not so fun and awesome?
Any personalities at work that are difficult for you?

April 13, 2021