What Really Happens in the First Session?

Sphere jigsaw in handFollowing from the previous article (Counselling – What to expect in the first session), having viewed this, although it was informative, I felt there was a great deal missing .  This article seeks to share some common experiences of the first session.

Before I go further, I write this from my view as a therapist and other counsellors may agree or even possibly disagree with how I work.  Also, to view the previous article click here. 

Without doubt, the first session is often a landmark as there is likely to have been a significant process of recognition that there’s an issue, contemplation, possibly denial, courage and action before a step has been taken to make the appointment.  This process can take years.  Walking through the door for the first session represents a great step.  

Fears and apprehensions are to be expected and internal questions such as Will I be able to speak?, What will I say?, What’s expected of me?, Will I get on with counsellor?, Will they like me?, Will they think I’m mad/bad/a lost cause? are all quite normal.   

My primary aim is to provide a safe and accepting environment and from our first contact will look display core conditions.  Core conditions are a set of principles identified by influential psychologist Carl Rogers and they are – Unconditional Positive Regard (UPR), Empathy and Congruence (being genuine).  These underpin most therapists approach and I believe them to be vital.  They are values that I uphold rather than skills that have been practised.  I would hope from our first contact whether it be email, telephone or face to face, that you feel you are walking into an accepting environment. 

What do we talk about?

Initially taking contact details provides a brief structure to communicate around and this communication allows us to begin to relate.  These necessary bits are valuable as we get to talk and are unconscious minds are feeding us as we take in each other’s body language and tones of voice.  This can allow you to feel more comfortable as you reel off details such as telephone number and address very easily. 

We are likely to talk about what made you decide to come and what you would like to achieve from the sessions.  A skilled therapist will be able to ask the right questions for you in a way to allow you to feel open and accepted to answer.  They will also know when not to ask anything to allow you to talk and articulate in your own manner. 

What you would like to achieve often provides a direction so we know where we’re heading. This can be very specific such as ‘I want to stop gambling’ or ‘ways to cope with my anxiety’ or less specific such as ‘I want to feel normal again’ or ‘to not feel like this’ or ‘I want to be happier’ or something completely different.  Sometimes the aims of therapy are hard to articulate and become more apparent as we continue. 

Asking ‘What made you decide to come’ or ‘Why come to counselling now’ often gives an insight into what’s been happening recently that you’re not happy with or what’s gone wrong in the past.  It can provide the opportunity to let go of something or to explain the details of problems which can be beneficial to allow you to express yourself and process what you’re saying. 

The first session can be a very emotional experience as it can be the first time certain things have been said or explored.  It can be hard as by talking we begin to take responsibility for ourselves or what may have happened.  It can be extremely relieving and empowering to realise that the light you hoped was there may be more defined than you thought and you may feel it’s now possible to move towards it (although that light sometimes changes shape, size, colour or even sound as the sessions continue). 

As I write this, it becomes increasingly apparent how difficult it is to state ‘this is what happens’ due to each person and their circumstances at that particular time differing so greatly.  Hence, this is why it’s so important for the individual to always be at the forefront of what we do rather than trying to fit a specific theory or technique to the person.  The overarching fundamental of all therapy is that it is focused on you and moving towards your aims or goals. 

Often at the end of the first session, people say that the time has flown by, that they’ve talked more than they thought, that they thought that they wouldn’t know what to say or that they wouldn’t be able to talk as they have.  I would hope that your first session is a useful experience and would encourage anyone to take this important step if you’re contemplating it.  If it’s really not for you then you are under no obligation to have a 2nd session but it could be one of best things you’ve ever done.

Please comment or contact me with any questions or feedback. 


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