Beginning therapy: what to expect and feeling at ease

“Courage isn't absence of fear, it is the awareness that something else is important”

S.R. Covey, 1989. The 7 Habits of Highly Effective People

Deciding to consider counselling is a big step for most people, especially those who have not had an experience of talking therapies before. Every client who calls me is navigating mixed emotions but in almost all cases nervousness, worry or fear about what it is going to be like to speak to a stranger about personal problems and about what this means for them is almost always a part of the picture.

My job is to put clients at ease from the very first contact they make. I offer a clear process and warm encouragement to express what is going on for them. I aim to help clients feel heard and empowered from the very beginning - whether they decide counselling with me at this point in time is right for them or not.

Like any relationship, it is normal for the beginning of therapy to feel daunting. For many people, life has got to a crisis point and when they turn to counselling the stakes can feel high. I can reassure you that there is a huge relief to be met by someone who gives you space to air your concerns and dilemmas.

Here is a little more detail about the process of beginning therapy...

The process of beginning therapy;

• No blueprint for beginnings; Beginning the therapy process may have started much earlier than the first email enquiry. There may have been months or years of on and off consideration. Clients may have had counselling before and may have been exploring all sorts of self-help approaches rooted in therapeutic theory. Other people in their lives may have played a role, consciously or unconsciously, in their readiness for counselling. Clients might have made enquiries but never made it into the therapy room or they might have found themselves questioning the benefit it could bring. On the other hand, therapy might be feel desperately needed. Every client brings their own reservations, expectation and enthusiasms for counselling. There is no 'right way' to begin.

• Initial phone call; most therapists offer a short no-obligation phone call to give you a sense of them and to enable them to identify any clinical factors that might make it inappropriate or beyond their competency to work with you and so they can refer on to suggest alternatives. I offer a 15-minute free exploratory call (or 30-minutes for £15.00 if needed). It can be booked online or arranged via email or phone call. It can be arranged via video call or telephone to suit the client's preference. Clients can expect a warm hello and a chance to explore if counselling could be helpful for them at this time. I will listen and be interested in the readiness for counselling as well as to check what frequency of sessions the client would like and whether I have availability. At the end of the call, clients are not under any obligation to commit to counselling. I usually ask whether they would like to receive my Standard Contract for them to consider before deciding whether to book the first session.

• Contracting: Different therapists contract in different ways but counselling is a professional relationship and like any professional relationship, the client should have a clear understanding of what the service includes and what is beyond the terms of the contract. They should have a clear understanding of the format and frequency of sessions, the limits of confidentiality, how to rearrange sessions and the terms of payment. The contract provides the terms of the service and in doing that provides an important framework around the therapy. I like to send this in advance of the first full-length session so there's time to familiarise and reflect on the terms. It is vitally important that clients are happy with the terms of our work together and so there will be time in the first full 50-minute session to clarify or amend any elements of the contract before it is signed.

• First session: The first full session is an important one for establishing the work together. We explore what motivates them to seek therapy and the expectations the client may have about what will happen in therapy. If there are any strong preferences for therapy I like to know these early on. For example, they may want relational depth or strategies and techniques, they may want to focus on unpacking the past events or focus on present experiences. Each client can expect space and time to express what seems important at the time. This can be different to what was discussed in the initial call - life changes in a moment and we work on whatever is present for you! If there is a particularly 'live' issue then we can give time to this or we might give attention to general experiences. As with every session, they will be able to share as much or as little as they feel comfortable with.

Time will be given to gathering feedback on the standard counselling contract. Wherever possible I will amend the contract to accommodate your expectations.

• Early session work: Early session work will vary significantly between clients. As an Integrative therapist I generally work with clients to gain a common understanding of their goals for therapy, what the current situation is and what the clients' understanding is of the difficulty they are in. With the help of the client we develop a collaborative approach and define goals and a plan for how we will measure success. I will offer and we will develop different activities (within and between sessions) that the client can experiment with. Sessions become a space for checking in on how life is changing as the client integrates 'the work' in their day to day life. The relationship is critical and over the early session work, not only do I listen and ask questions to facilitate client understanding and sense-making of the situation but I aim to establish safety and trust so that the client can deepen their self-enquiry and find answers that may be long-locked away beyond awareness.

Unlike any other relationship in your life, between counsellor and client, there is only one agenda in mind – yours – and that means you can show up in the relationship entirely from day one exactly as you are. It is completely natural to feel stressed, nervous, unsure, ambivalent, hopeful. There is no right way to be. Come exactly as you are and begin from there.

I am always willing and happy to hear from potential clients whether this is a concrete decision to start therapy or a tentative first step with no desire to start sessions immediately.

If you have found this blog useful and you would like me to write on another topic that is not already on my website. Feel free to email me therapywithandie@gmail.com