In therapy and counseling sessions, therapists and clients use what-if constructions to meet distinct communicative needs. Odds in what if uses can be related to symptomology for anxiety troubles as well as to set therapeutic practices. Clients use what if to voice uncertainty, worry, and doubt, and to seek reassurance from their therapists. Therapists use what if to present contrastive views and to strengthen, resume, and reconstruct client scenarios. A linguistic view can help observations on the uses of what-if constructions in clinical environs.