What to Expect
It may have been months, it may have been years. But on average it can take up to 12 months for someone to eventually see a counsellor. It is a big deal, and even after all these years I don’t take it lightly when people get in touch with me. So this blog is to help you know what to expect in our first therapy session – because you’ve never done this before and the first time for anything is pretty daunting, especially counselling.
First Meeting
I can still recall my first therapy session I attended as a student training to be a counsellor. Even though I had a much better idea about this than most because of my training, I still didn’t really know what to expect. Anxious and vulnerable, it wasn’t comfortable at all, it felt pretty ‘urgh’ – and I really remember that. So when I first meet you either online or face to face I am aware of that vulnerability, not knowing and being outside of your comfort zone. Even if you have seen a therapist before, when you meet a new counsellor its the ‘first time’ again. Knowing this I will do everything I can to help you feel at ease, or feel as comfortable as you can.
Contract
When you are ready I will talk through my agreement which you would have already received. This outlines that I am a qualified, accredited counsellor and a member of the BACP & NCPS membership bodies. Sadly counselling isn’t a protected profession and anyone can call themselves a counsellor, which is dangerous. I also explain before working together that counselling is confidential, but does have it’s limitations.
Under the following specific circumstances, therapists retain the right to breach confidentiality:
For supervision
Which is a monthly meeting with a supervisor, to ensure I am working in a safe, ethical and effective manner. The focus is on how I am working, and your identity remains confidential and not disclosed.
For safety
Circumstances where I feel I have sufficient grounds to believe that you are at serious risk of harm to yourself or others. Selective disclosure may be judged necessary. This would usually occur after prior consultation with you. You would know I was worried for your safety, or the safety of others because I would tell you. I would be encouraging you to reach out for further support . We would create a safety plan to help keep you safe, and it may be appropriate to seek help from other agencies. If you were unable to keep yourself safe I would have to contact others on your behalf to try and safeguard you against harm.
Legal limits to confidentiality
Prevention of terrorism, drug trafficking & money laundering. Police legally need to be informed
Court Cases
In a court of law, a counsellor can be required to answer questions about a client.
Our relationship
The counselling relationship is different to most relationships, which makes it pretty special. It only exists in the counselling room. There is no relationship outside of this (even after counselling has completed). I won’t tell you about me. Not only because these sessions are about you, but also because it may influence the relationship or how you feel towards me. The dynamics could change, altering the relationship and making it less safe. For ethical safety reasons our only relationship is the counselling relationship and that remains in the counselling space. It’s nothing personal. So if I see you out on the street and I’m alone, I will respond to you as you respond to me. If you say Hi, I will too. If you don’t acknowledge me, I will do the same too. But not more than that, our relationship exists only in counselling. To keep everyone safe.
I recognise the imbalance of our relationship, and how it may feel the ‘power’ is all with me. Yes I am the therapist with years of experience, and you have come to me for support.
But I am not an expert in you.
You are.
If I get it wrong, or don’t fully understand – please tell me.
We take up equal space in the counselling room, not one of us better than the other. It’s this safety, trust, authenticity & truth that allows us to work at a deeper level. I will explicitly ask you to tell me if something isn’t working, so we can work on it. The counselling relationship is like a mirco version of your other relationships so ‘bringing it into the room’ to explore our relationship is also of benefit.
How this works
During our first therapy session I will go over appointment times, cancellations, contacting each other out of session and payment. Here we can check understanding and ask any questions. Knowing how things work gives confidence to working together going forward. I’ll also let you know of regular reviews to check the work is progressing, is helping you and is going where it needs to.
Some work may be time limited to 6 or 12 weeks, making staying on track vital.
Questionnaires
Lastly I may ask you a number of assessment questions (depending on whether I am working for an Employee Assistance Program or certain charities) and direct safety questions in the first therapy session. This means checking early in the session if you have been experiencing harmful or suicidal thoughts, or actions. I fully appreciate its our first session and we have just met, but asking directly as early as possible means there is more time to safeguard and reduce risk (I will also check risk in our initial contact). Exploring what can be done to keep you safe, who your safe people or places might be, what your ‘protective factors’ are (reasons for you to stay safe) safer ways to experience your feelings and creating a safety plan can help in these moments.
I cannot offer crisis support.
So its really important to understand if you are at risk, and to what level – so I can help safeguard you. If I had serious concern for your safety I would refer you to the appropriate services and ask you to call your emergency contact.
Due to being unable to contact them yourself, this would be one of the times I would breach confidentiality in order to keep you safe.
Over to you
The first therapy session would then be over to you. To share what brings you to counselling and what you’d like to get from it. You would begin to tell me what’s on your mind and we would begin the process of
- receiving empathy,
- congruence (being genuine),
- unconditional positive regard (not being judged),
- be in psychological contact (understand each other and be on the same page),
- being listened to and understood,
- have an issue that you want to explore, solve, change, reframe … something
Because if there are no issue or psychological discomfort or distress.
Therapy is ineffective.
Which is why no one can successfully be sent for therapy. It has to be your choice driven by a difficulty or issue you want to resolve.
Back to the beginning
Consequently this brings us full circle. It’s your choice to enter therapy. Driven by distress, an issue, a difficulty.
A need.
You may be someone who has experienced a thing or two and have the amazing ‘keep going’ survival power. Despite feeling terrible, you find ways to cope, or ignore, avoid, bury … whatever works so you can carry on. You might have kicked the idea of counselling around and decided ‘Nah I’m OK’…..
Which is why it can take a long time to enter into therapy.
If you find your coping mechanisms aren’t working. Your emotions are spilling over. The buried feelings are alive (just deep down). You feel overwhelmed, anxious, stressed, upset, distressed, tired.
You want to try a different path rather than going down the same old street you know too well.
We have feelings for a reason. Ignoring doesn’t make them go away.
About the author: Chris Boobier is the owner of CRB Counselling and an accredited counsellor.
She got in touch with a counsellor over 16 years ago and it all changed.