Counselling – What to expect in the first session

So, having made the decision to see a counsellor, having found one or been referred to one and booked an appointment, you now wait wondering what to expect in your first session.  Making this step takes courage and strength as by this point you’re likely to have acknowledged that there’s an issue or set of issues, even if you’re unsure of the exact details.   Read on further ….

You may be feeling anxious, depressed or unsure of who or what you are.  You may be having relationship difficulties or be feeling stuck about circumstances in your life.  Either way, you have made a strong positive step.

The information that is stated below relates to how I work and there maybe differences between different therapists.  Working as a Counsellor in Private Practise and having worked for a number of agencies, there are many similarities in how the first session is likely to go.

Fundamentally, your therapy is for you and the counsellor is not there to give you advice or tell you what to do.  You’re the greatest expert on you as only you know how you feel in any given situation, therefore, you’re also the greatest expert to know what will or won’t fit for you in your life. 

In the first session, a number of things will be covered such as – Confidentiality, Boundaries, Your hopes, aims or goal of the session and an assessment maybe undertaken to cover safety aspects. 

Confidentiality is a key area of therapy and is of the utmost importance.  Without it it’s unlikely that you’re going to feel comfortable to disclose all that you wish.  The session will be confidential, however, there are some exceptions to that.  If you disclose you are involved with a terrorist act, disclose you are about to harm yourself or somebody else or if you disclose any current child abuse (whether you’re involved with it or not), then the counsellor has a legal and ethical duty to report this to the relevant authority.  Often the counsellor will try to discuss with you first if this is possible.  The next person they are likely to discuss this with is their supervisor.  Counsellors working ethically will ensure they have regular supervision therefore they will be their first port of call when confidentiality needs to be broken.  Supervision is a time when confidentiality can be broken as cases are also discussed to ensure the counsellor is working to the best of their ability and that nothing significant is being missed.

Boundaries are discussed which means that session timings, cancellation policies and scope of counselling maybe talked about.  The scope of counselling is about what counselling is and what it isn’t to ensure both parties are in agreement as to what is being offered.  Numbers of sessions can also be discussed, whether that be to have an initial number of sessions before an evaluation, a set number of sessions or whether to leave them open ended.

Your hopes and aims of the session are important to give the initial session and future sessions something to work to.  As the sessions progress, often the hopes and aims alter and they can change completely.  This depends on you, the sessions and the progress being made.

The rest of the assessment may include the counsellor asking for your address details your GP details, any medication being taken, previous mental health history, existing medical conditions, previous history of self harm, your eating patterns, sleeping patterns, alcohol and substance use and they may ask why you feel now is the right time to be seeing a counsellor. 

Once this is complete, the counsellor may ask you about what made you come and ask related questions to allow you to delve a little deeper.

It is important to remember that the counselling session is Your session to discuss whatever you wish, so you can disclose as much or little as you please.  Just because you’re being asked a question, does not mean you have to answer it if you do not want to.  It is Your time.

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