How to Make Your Intake Assessments More Impactful (Without Getting Stuck in Paperwork)

The first therapy session is a delicate dance. It's your opportunity to establish trust, build a strong connection, and set the tone for the therapeutic relationship. But for many mental health counselors, the first session gets bogged down with paperwork and standardized questions, leaving little room for genuine connection. If this sounds familiar, you're not alone.

That's the struggle Dr. Maelisa McCaffrey addresses in her latest video review of The First Kiss by Dr. Daryl Chow. This invaluable resource flips the traditional approach to intake assessments, encouraging therapists to focus less on rigid structure and more on creating meaningful connections with clients. Here, I’ll share top strategies inspired by Dr. Chow's work (and Dr. Maelisa’s insightful review) to help you reimagine your intake process.

By the end of this post, you’ll have actionable tips and resources for conducting more effective, engaging, and client-focused intake sessions.

What Is an Intake Assessment?

For mental health professionals, an intake assessment is often the first step in the therapeutic process. It’s your chance to gain a deeper understanding of your client's background, challenges, and goals. Traditionally, intake assessments involve completing forms, collecting developmental histories, and discussing consent and confidentiality policies.

While these steps are crucial, there’s a growing consensus that they shouldn’t dominate the first session. Instead, the focus should shift to building rapport and addressing what’s most pressing for the client from the outset.

Why Rethink Your Intake Assessments?

If the conventional structure of intake assessments leaves little room for meaningful dialogue, it may unintentionally create barriers between you and your client. Dr. Chow's approach prioritizes connection, which can:

• Encourage clients to return: Research shows the most common number of therapy sessions attended is just one. A more engaging first session increases the likelihood your client will continue therapy.
• Build trust early: A strong client-therapist bond is foundational to successful therapy outcomes.
• Provide clearer insights: A conversational and client-focused format can uncover personal insights that structured questions might miss.

The Core Philosophy of Dr. Daryl Chow’s The First Kiss

The title The First Kiss serves as a metaphor for the importance of the first therapy session. Dr. Chow challenges the notion of rigidly structured intake assessments, advocating instead for an approach that fosters immediate connection and relevance. His strategies focus on four essential principles:

1. Turn Questions into Connections: Use questions not just to gather information but as tools to deepen your relationship with the client.
2. Focus on the Present Moment: Address what feels most timely and relevant to the client during the session.
3. Collaborate on Priorities: Instead of sticking to a preset checklist, co-create the session’s agenda with the client.
4. Elicit Feedback: Wrap up the session by asking the client what worked and what could improve, reinforcing collaboration and trust.

5 Game-Changing Strategies for Impactful Intake Sessions

Reimagining your intake process doesn’t mean throwing out the essentials—it means weaving in techniques that make the session feel less like an interview and more like a genuine dialogue.

1. Have Clients Complete Paperwork Beforehand

Don’t waste valuable first-session time filling out forms together. Instead, send intake paperwork to your clients ahead of time. This allows you to review their responses before the session and spend more time addressing what’s truly important to them.

Pro Tip: Include a comprehensive biopsychosocial assessment form and ensure clients complete it prior to their first session. This reduces administrative tasks while ensuring you have the information needed for diagnosis and treatment planning.

2. Start with Open-Ended, Salient Questions

Kick off the session by asking something like, "What’s most important for us to focus on today?" or "What feels most pressing to you right now?" This allows the client to steer the conversation toward what matters most to them.

For example:

• If a client shares a recent significant life change, such as a breakup, spend time exploring the emotional and practical impact rather than rushing through a checklist of generic questions.
• If the client seems hesitant, ask about their feelings about being in therapy or what motivated them to seek help.

3. Don’t Be Afraid to Deep-Dive Early

It’s a common misconception that the first session should only skim the surface. Dr. Chow encourages clinicians to dig deeper into one or two areas if it feels relevant to the client.

For instance:

• If a client mentions ongoing workplace stress, you might explore how it’s affecting their sleep, relationships, and mental health, instead of waiting to address these topics in later sessions.

This approach not only demonstrates genuine interest but also creates an immediate sense of progress.

4. Address “Paperwork Panic” Strategically

Many clinicians feel torn between forming a connection and ensuring all essential paperwork is completed. Here’s a trick to balance both:

• Utilize digital solutions or admin staff to collect forms beforehand.
• Prioritize discussing consent, confidentiality, and key logistics for a few minutes at the start of the session.
• Save less time-sensitive paperwork, such as detailed developmental history, for a follow-up session.

Remember, intake assessments don’t need to be completed in one session. Even for insurance purposes, multiple sessions can be used to gather the necessary information.

5. Conclude with Client Feedback

End each intake session by asking:

• "What should we do more of in future sessions?"
• "What should we do less of?"

This feedback creates an immediate sense of collaboration and shows clients that their voice matters. It empowers them while giving you valuable insights to tailor future sessions.

Reaping the Benefits of a Strong First Session

Not only does this client-focused approach foster greater engagement, but it also simplifies your documentation process. Through meaningful dialogue, you’ll naturally uncover critical insights that inform:

• Treatment planning
• Clinical formulations
• Provisional diagnoses

By recalibrating your intake process, sessions become more about the client’s lived experience and less about ticking boxes.

Expand Your Resources for Better Intake Assessments

The strategies shared here are just the beginning. If you’d like more guidance on revamping your intake process and other documentation challenges, explore these resources:

Check out The First Kiss by Dr. Daryl Chow 

• This invaluable guide dives deeper into creating impactful first therapy sessions.
• Order here (affiliate link)

Stress-Free Documentation Courses 

•  Join Dr. McCaffrey’s online course, Stress-Free Documentation for Mental Health Clinicians. 
• Sign up here

Invest in Stress-Free Documentation for Mental Health Therapists by Dr. Maelisa McCaffrey

• Access proven systems and strategies for all your private practice paperwork needs.
• Amazon link
• Bookshop.org link

Revamping your intake process isn’t about abandoning protocol—it’s about adapting to connect with clients more authentically. Use these strategies to create sessions that spark trust and set the stage for meaningful change.