Starting Therapy

What to expect at a first counselling session.

So, you have decided you need some counselling! Going to see a new counsellor can be a very daunting prospect. You might have been to counselling before or it could be a completely new experience, either way it can be a nerve-wracking meeting a new counsellor for the first time. It can be especially challenging when you are already experiencing some sort of difficultly in your life.


You’ve already passed the first hurdle of making contact, whether that was by picking up the phone, sending an email or asked your GP or Employee Assistance Program to make a referral. The first step – asking for help – can feel like the biggest and the hardest one, but once you’ve taken that step what next? If you are going through your GP or a local charity you may have been placed on a waiting list. This can be a bit of a frustrating anti-climax. After plucking up the courage to make the call, feeling like it’s now time to make a change, deal with a problem or confront an issue, you’re now left playing a waiting game. At this point, some may decide to look elsewhere for a private therapist who can see them quicker. Either way, sooner or later you will eventually get to that all important first appointment.


Meeting your therapist for the first time.


On the first session you may feel apprehensive about meeting a complete stranger to talk about your inner most thoughts and fears. Client’s come into the counselling room with all kinds of anxieties about meeting a new counsellor: Will my counsellor like me? Will they understand me? Will they feel like I am wasting their time? Will they think I am crazy? Will they be able to help me? Your counsellor will be aware of your nervousness (and may well be nervous themselves – after all they are only human) so they will do their best to make you feel welcomed and comfortable.


When you arrive at your counsellors office you may have spoken to them on the phone before the session, maybe you have already seen them for an initial assessment or it could be that you will be meeting them for the very first time.


It has been my experience that clients arriving for a first session generally fall into two different categories. The first kind have been bottling up all of their troubles for so long that by the time they sit down in that chair they are almost ready to pop. This type of client can talk none-stop for the full session (and sometimes more), off-loading years’ worth of issues without coming up for air. The other kind have also been bottling things up but due to nerves or just feeling too overwhelmed they don’t know where to start or what to say and so find it difficult to say anything at all.


Whichever type of client you are, don’t worry! Your therapist will be there to help and guide you. If you arrive and need off load in the first session, they will listen to you patiently, they may interrupt to ask clarifying questions or wait until you have run out of steam before going back to things they have particularly noted about what you have said.


If you are struggling to know what to say they will ask questions about your history and background, your personal circumstances, what brought you to counselling, how you are feeling in that moment etc. They have ways of helping to get the conversation flowing, however if you know that you find it difficult to talk to new people it might be helpful to have a think about what you want to discuss before you arrive at the first session.


The first appointment is also time for you to ask any questions you may still have about the counselling process or the counsellor, to express any concerns or fears you may have about beginning counselling and make clear any particular requirements you have about the counselling or the environment.


The formalities.


There’s usually some paperwork to fill in, the type and amount depend on the setting. Sometimes these might have been sent to you in advance or completed at your initial assessment but your counsellor will be able to help you fill these in if you are unsure about them in any way. They should make it clear to you what information they collect, why they collect it and how it will be used. You also have the right to request to see any data they hold on you (including counselling notes) and you can ask for these to be changed if they are incorrect or deleted all together.


The therapy contract or agreement is an important document. This sets out the terms of the service being offered. Your counsellor should read through this with you. It will usually include details about how many sessions you are being offered, the fee for each session (if any), the counsellor’s policy on missed appointments, the complaints procedure and the policy on confidentiality.


Confidentiality is a key component of any counselling relationship. When people are opening up about their fears and anxieties, sharing their deepest darkest secrets or revealing something very personal about themselves, it is important that they can trust the counsellor to treat this with sensitivity and in the strictest of confidence. However there are usually exceptions, instances where confidentiality may be broken. This will vary between services as there are relatively few circumstances where reporting is mandatory, the rest will depend on the organisational policies or the beliefs and values of the individual counsellor. Again, such circumstances should be made clear to you when you go through the agreement.


Moving on from the first encounter.


Counselling is a co-created relationship, one you will shape in collaboration with your counsellor. You need to be able to build a trusting relationship with them, one where you feel you can be open and honest. Your counsellor should help you to feel safe, comfortable, accepted and respected without fear of judgement or criticism. This means you have to find the counsellor who is the right fit for you, as one-size does not fit all. If, at your first meeting, you find you have an instant rapport with the counsellor then great! Sometimes it may take a few sessions of working together before you build this rapport, and that’s fine. Other times, no matter how nice, pleasant or competent the counsellor is, you just don’t click. That’s ok too. If this happens talk to your counsellor about it. It maybe something you can work through together and sometimes this can have real therapeutic benefit, but you may also decide that the relationship is not working. This is not a reflection on you or the counsellor, it’s about finding the right person for you.


Counselling is often described as a relationship, a process and a journey, but first and foremost counselling is about you and your needs. This is your space for you to bring whatever is most important to you in that moment and your counsellor will want to hear from you. At times it may be difficult, working through this difficulty is all part of the process, and your counsellor will be there with you, alongside you every step of the journey. The initial session is just the first step.


#counselling #therapy

Sheffield: England

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