Clinical Intake Interview Guide
A Structured Framework for the First Client Session
Compiled & expanded from a clinician's intake template
This guide takes your intake structure — introduction, presenting complaint, and history of present illness — and rounds it out
with the additional sections a complete first-session intake typically needs: background history, risk screening, mental status
exam, and closing. Use it as a flexible prompt sheet, not a rigid script — let the client's pace guide how much of it you cover in
one sitting.
1 | Introduction & Consent (~2 min)
“Hello, I'm [Name], the Clinical Psychologist. Thank you for coming in today. Everything we discuss is confidential, except in
situations where there is a risk of harm to yourself or someone else. Is it okay if we begin?”
Tip: State the limits of confidentiality clearly and early — this builds trust and sets expectations for the rest of the interview.
Pause here for the client's consent before proceeding.
2 | Presenting Complaint
? What brings you here today?
? What difficulties are you experiencing?
? When did these problems begin?
? What made you seek help now?
? Which symptom troubles you the most?
3 | History of Present Illness (HOPI)
Onset
? When did it start?
? Was the onset sudden or gradual?
Duration
? How long has this been happening?
Course
? Has it been improving, worsening, or staying the same?
Frequency
? How often does it occur?
Severity
? On a scale of 0–10, how distressing is it?
Triggers
? What usually brings it on?
? What makes it better?
? What makes it worse?
Functional Impairment
Has it affected:
◆ Work?
◆ Studies?
◆ Family?
◆ Social life?
◆ Sleep?
◆ Appetite?
4 | Past Psychiatric & Medical History
? Have you experienced anything like this before?
? Have you ever been diagnosed with a mental health condition?
? Have you ever taken psychiatric medication or been in therapy before? What was your response to it?
? Have you ever been hospitalized for a mental health or medical reason?
? Do you have any ongoing medical conditions or take any regular medication?
? Do you have any known allergies?
5 | Personal History
? Could you tell me a little about your childhood and upbringing?
? What is your educational background?
? What is your current occupation, and how do you feel about your work?
? Could you tell me about your current living situation and relationships?
? Are you married / in a relationship? How would you describe it?
? Do you have children? How are things with them?
6 | Family History
? Who is currently in your immediate family / household?
? Has anyone in your family experienced mental health difficulties?
? How would you describe your relationships with family members?
? Is there a family history of substance use, suicide, or significant medical illness?
7 | Substance Use History
? Do you drink alcohol? If so, how often and how much?
? Do you smoke or use tobacco products?
? Have you used any recreational drugs or misused any prescription medication?
? Has your use of any of these changed recently?
? Has anyone ever expressed concern about your use of alcohol or other substances?
8 | Risk Assessment (Ask Directly, Every Session)
! Have there been times recently you've felt life isn't worth living?
! Have you had any thoughts of harming yourself?
! Have you made any plans, or taken any steps, toward harming yourself?
! Have you ever attempted to harm yourself in the past?
! Have you had any thoughts of harming someone else?
! Do you feel safe at home right now?
Note: Asking directly about self-harm and suicide does not increase risk — it is a necessary, standard part of every intake. If
risk is identified, follow your service's safety-planning and escalation protocol before ending the session.
9 | Mental Status Examination (Observational)
Unlike the sections above, this is completed by the clinician's observation during the session, not asked directly:
Domain What to Note
Appearance & Behavior Grooming, eye contact, psychomotor activity, cooperativeness
Speech Rate, volume, tone, spontaneity
Mood & Affect Client's stated mood vs. observed affect and its range/appropriateness
Thought Process Logical/coherent vs. tangential, circumstantial, or disorganized
Thought Content Preoccupations, delusions, obsessions, suicidal/homicidal ideation
Perception Any hallucinations or perceptual disturbances reported or observed
Cognition Orientation to time/place/person, attention, memory (brief impression)
Insight & Judgment Client's understanding of their difficulty; quality of decision-making
10 | Closing the Interview
? Is there anything important we haven't talked about that you'd like me to know?
? How are you feeling right now, having talked about all this?
? Do you have any questions for me before we finish today?
“Thank you for sharing all of this with me today — I know some of it wasn't easy to talk about. Here's what I'd suggest as next
steps...”
Summarize what you've heard, outline a tentative plan or next appointment, and confirm the client knows how to reach
support if they need it before your next session.
Good Practice Notes
Do Don't
✓ Let the client set the pace and level of detail ✕ Rush through the checklist mechanically
✓ Use open-ended questions before narrowing ✕ Comment on the client's character, choices, or
in lifestyle
✓ Reflect and validate before moving to the next ✕ Interrupt with your own conclusions too early
topic ✕ Skip risk questions because they feel
✓ Explain why you're asking sensitive questions awkward
✓ Screen for risk every session, not just the first ✕ End the session without checking in on how
they feel
“A good intake isn't a checklist to complete — it's a conversation that happens to cover everything you
need.”
This guide is intended as a flexible clinical prompt sheet for training and practice purposes. It does not replace clinical judgment,
service-specific protocols, or validated assessment instruments where indicated.