Your Initial Face-to-Face Counselling Session
In a previous blog, we considered what to expect when beginning the process of looking for a counsellor. This article explains what to expect in an initial face-to-face counselling session. Of course, we're all unique as humans (thank goodness!), which means every counselling session is unique. That said, in any initial counselling session, there are common themes and points of discussion. Having some answers to the question of “what happens in a first counselling session?” can help to ease any nerves or apprehension about the process. Here, we focus specifically on what to expect when accessing face-to-face counselling with myself - Claire Law - at Free to Be Counselling in Preston.
Take a Moment to Notice
Before we dive into what to expect, I'd like to offer you chance to pause and notice for yourself any expectations you already have about beginning counselling? The following questions might help:
What do you imagine will happen in the first counselling session?
What fears do you have about your first counselling session?
To what extent have previous experiences of counselling impacted you - and how is this feeding into any expectations?
What hopes are you carrying with you to your first counselling session?
How do you imagine you will feel at your first counselling session?
What thoughts do you have?
Take time to pause to notice and reflect on how you feel about beginning counselling.
It's important to note that how you feel about starting counselling is how you feel! And that's okay. There is no one "right" way to feel, no one "correct" set of expectations to be bringing along to your first session, no "shoulds". You will be welcome to come as you are and feel as you do.
A Matter of Timing
Time matters in counselling. You will have a starting time for your initial appointment. I will greet you at the door at the scheduled start time. It is not my practice for sessions to start late, or for appointments to be running behind. If you find you arrive early for an appointment, please look to wait in your car, or to take time to enjoy a gentle stroll around prior to the agreed start time. If you do find yourself running late for our appointment, I'll wait for you to arrive, and we will be able to use as much time remains in the hour we scheduled together.
I offer hour-long appointments, and so our appointment time will end 60-minutes after our scheduled start time.
There are lots of therapeutic reasons for approaching timing of appointments in this way. Having a secure sense of the exact start time and end time is designed to be containing and supportive. Time boundaries are a way to show and express respect for each other's time, and a way to communicate respect for each other within the therapeutic relationship. These themes are things that can be explored within the counselling itself, over time.
A Warm Welcome
When you arrive for your initial counselling appointment, I'll look out for your arrival, and will greet you at the door to my Preston counselling premises, and show you to the room we'll use for our session.
In previous email correspondance, or during our intial phone conversation prior to this session, I will have asked you about any reasonable adjustments you might require to support accessibility - and discussed with you options that support accessibility. So, for example, if you require a ground floor room - I will have sorted this.
As we make our way to our room, I'll show you where the toilet is located. Once we arrive at the room we'll use for our session, I’ll have a cup of tea or coffee waiting for you if you've told me if you have a preference for a hot drink. There's also fresh water and squash available for you in the room.
Our room will have seating for yourself and me, and I'll invite you to sit down, to settle and make yourself comfortable. I’ll sit opposite you in a chair. There are cushions and blankets available for you to use and you are welcome to use these to help you feel comfortable.
It's my aim to offer you a warm welcome.
Establishing a Relationship
Counselling involves the creation of a therapeutic relationship. The relationship we create is the "container" in which the counselling work happens, and research shows the quality of the therapeutic relationship is one of the most important factors in effective therapy[1].
A strong therapeutic relationship offers opportunity for you to express yourself honestly and openly, without any fear of judgement or rejection.
Therapeutic relationships are different to most of the relationships you have in your life, such as friendships or romantic relationships. For example, a therapeutic relationship involves a counsellor sharing less details about their own life than would be usual with a friendship. Part of our work together will be in establishing this relationship and how this works in practice for us both. Our initial counselling session will be an important step in establishing the therapeutic relationship between us.
The therapeutic relationship already began with any email correspondence or brief introduction phone call we've shared. However, the initial counselling session is chance for us to meet in person and to actively work towards the therapeutic relationship between us. In future sessions, we'll build and deepen this relationship.
In our initial counselling session, all the things we do, discuss, and communicate with each other are ways that we begin to shape and form the therapeutic relationship. Some of what we are likely to discuss in this initial session is the nature and limitations of this relationship. I will be interested in any thoughts or feelings you have about this and will continue to be interested if we commit to working together beyond our initial session.
A Shared Agreement
Having a clear sense of how we can work together is important to the counselling process. Rather than leaving practical considerations as unspoken assumptions, it is my practice to be clear from the outset how we can work together, and what my processes are in relation to cancellation of appointments and payment, for example. I also want to be clear with you about how confidentiality works between us, and what would happen in the event of an emergency.
Before we meet for the first session, it is likely we've already had a brief phone conversation or email correspondence where I've discussed some of these ways of working with you.
In our communication prior to this initial session, I will also have offered to email you through a document I call my "Shared Agreement" containing clear details about the way in which I work as a counsellor. This will have given you chance to read through and consider any questions you may have. In our initial session, we will spend some time looking over this document and discussing - and I will seek to answer any questions you have. By doing so, it is my hope that we both have a clear sense of what we are agreeing to in working together - and, if we are both happy to agree to work in this way - then we will each sign the document. At this point, we have collaborated on a shared agreement between us. The document becomes our Shared Agreement.
Contact Details
It is not my practice to gather unnecessary personal information. There are some basic contact details that are essential for our work - such as contact phone number and email - so I can contact you as needed to rearrange a session in the event of me being unwell, for example. I'll also ask you if they feel comfortable providing brief details of which GP you're registered with and if you would like to share an emergency contact name and number with me. These details may be used in the event of an emergency, and we can discuss this further in our session as needed. You can choose whether you are comfortable sharing such details with me. If you prefer not to share these details - then we can have a discussion around what alternative steps feel appropriate for me to take in the case of any emergency.
Therapeutic Goals
Our first session offers opportunity for you to express what you hope to gain from counselling. What is it you hope will be different as a result of therapy? What do you want from the process of counselling and how do you imagine I can help and support you in this? These questions are not necessarily easy to answer. However, they help us both become clearer on what brings you to counselling and what you are looking for in our working together. We can call the responses to these questions your "therapeutic goals". That can sound formal and, perhaps, somewhat intimidating. That's not the intention. Rather, by talking through these questions in our initial session and by returning to them periodically in our working together over several sessions, we can both ensure that you are getting what you need from counselling.
It's okay for you to not be sure just yet what you want from counselling. It’s also okay for to change your mind as we begin to work together.
As we work together over subsequent counselling sessions, I'll continue to be interested and committed to exploring with you what you are looking for from the process and from our work together, so that we can both become clear about what matters to you and what you want and need from counselling. It’s okay for this to change, deepen and develop over the course of the therapy. Our conversation around this in our initial counselling session is the beginning of this process.
Getting a Sense of You and Your World
Our initial session often also includes chance to begin to explore the themes and features of your life and your world. This can include the things you are struggling with, as well as the strengths and useful resources that are part of you and your life. There's no one way for us to begin to do this. There may be specific questions I'll ask you to support you in expressing who you are, and what challenges you face. However, I won't have pre-planned these questions or have a list of things I need you to tell me. I'll be working in the moment to explore what emerges between us to support me in getting to know you.
I'll be working in the moment to explore what emerges between us to support me in getting to know you.
Some of the areas we may explore include whether you have any history or diagnosis of physical, mental, or neurodevelopmental conditions - and if so, how this impacts you. We may explore who is important to you, and what's prompted you to seek counselling at this time. As well as being interested in your answers to any questions I ask, I'll also be listening out for how you feel and experience the process of talking and sharing about yourself.
Talking About Further Sessions
As we approach the end of our initial session time, we can both take a moment to reflect on next steps. For many people, booking another session is the next step - and we can discuss times and dates as needed. My usual practice is to offer the same day and time for sessions, in the same counselling space here at my counselling room in Preston, so there is a reassuring sense of predictability in our work - which can be very important if we explore painful or difficult emotions. However, flexibility can be important too - particularly if caring duties or work schedules make it difficult for you to have an appointment at the same time each week. We can talk through as needed what we both need from times and dates of sessions. We'll take the final few minutes of our session to discuss arrangements about what you want to do in terms of booking any further sessions.
So, we've explored what to expect from an initial counselling session and some of the features (as well as some of the rationale for these) that you can expect in our first session. There's lots to consider. And so, as you come to the end of this blog - my invitation is for you to take a moment to notice how you feel, and what you're feeling in response. We started from a position of "how you feel about starting counselling is how you feel!" And that remains the case. Beginning counselling and establishing a therapeutic relationship can be a big thing and throw up a range of feelings and anxieties. And that's okay. There is no one "right" way to feel, no one "correct" response. It is my hope that this blog has begun to address any questions you might have about initial counselling sessions - and also reassured you of the accepting and non-judgmental approach that is at the heart of counselling - whether it's your first session, or your 101st.
I look forward to meeting in the flesh at my Preston counselling space.
References:
[1] Stubbe, D.E. (2018). The Therapeutic Alliance: The Fundamental Element of Psychotherapy. Focus (American Psychiatric Publication). Oct 2018 - 16(4):402-403.