Are you currently in the care of or have a history of psychological treatment from a doctor or other practitioner? (If yes please give brief details)
What triggers this issue/problem and how do you react to it when triggered? Describe how you feel physically and emotionally when it occurs.
Describe your childhood, including details about parents/guardians/siblings.
If I had a magic wand and could grant you one wish during the session, what would it be? (Be as specific as possible so that we can make sure we give your mind the exact words it needs to hear)
Once this issue is resolved how do you picture your life to be?
What would you like to hear about the new you, the person you are becoming and the new life that you are moving towards? It can help to think about someone you know or admire and the life and/or attributes they have that you would like to have)