I remember my first counselling session. I was pretty freaked out. I didn’t really want to be there. I didn’t know what to expect. I think that last part was what made the situation difficult – I’d never been before, I didn’t know anyone who had seen a counsellor before, so I was completely lost and anxious about it.
I saw a new client yesterday and this reminded me of my own first experience seeing a counsellor. This client had never been to counselling, had no idea what to expect, and I could see that there was definitely some anxiety about the whole situation.
While every counsellor will be different in their approach, I thought I’d write an article about what to expect and how to make your first session as successful as possible when you meet with your Registered Clinical Counsellor for the first time.
Here at Alongside You, your first interaction will be with our front desk staff who will explain much of the administrative details that you’ll need to know, give you recommendations on which of our counsellors might be the best fit, and help to book your first session. After that, they will send you our online intake form to fill out prior to your appointment. This helps us take care of the necessary paperwork ahead of time, and also helps our counsellors get an idea of what you’re coming in for and some details before you arrive.
When you arrive, you’ll enter the waiting room to wait for your appointment. We have a self-serve waiting room, so please feel free to help yourself to water, coffee, or tea and take a seat. We want you to be as comfortable as possible! If you have any questions before your appointment and it’s during our reception hours, feel free to wander toward the back and speak with our office staff, they’ll be happy to speak to you.
Once your appointment time arrives, your counsellor will come greet you in the waiting room, and invariably, probably offer you another drink. Feel free to get a refill, they’re free! Now it’s time for the main event. Your first appointment with a Registered Clinical Counsellor.
Each counsellor will have a bit of a different interview process to start out your work together, but remember, they need to get to know you and also, you need to get to know them for the relationship to work. The first appointment will be about building the relationship and getting to know each other.
Here are some areas that I usually ask clients about at our first session to get to know them and how I might be of help. Again, every counsellor will be different but a lot of these questions are fairly common to ask new clients.
Things A Counsellor Might Ask You At The First Appointment
Personal and Family History
I like to know what life was like growing up, and how clients got to where they are today. This can be a short or lengthy discussion. As a marriage and family therapist by training, I believe that our personal and family history have a strong influence on our development and I like to know how people came to be where they are now. I usually suggest that clients tell me their story – however, they want to tell it – in as much or a little detail as they feel comfortable.
Mental and Physical Health History
I like to know the history of a client’s mental and physical health. What has your health been like throughout their life? Do you deal with any chronic mental or physical health conditions? Does anyone else in your family deal with any of these conditions?
Another question I often ask is, “When is the last time you saw your family doctor? When is the last time you got a checkup and bloodwork done?” This may sound overly-medical for a counsellor to be asking, but it’s important. If you’re coming in because you’re feeling depressed, anxious, or otherwise, I want to make sure that there isn’t a physiological problem at the root of your symptoms. There are many physiological issues that have symptoms that can masquerade as psychological or psychiatric issues. If you are dehydrated, have a thyroid imbalance, your blood sugar is off, iron is low, etc., these can all cause symptoms that look like a mental health issue. The last thing I want for you is to treat something as psychological if there’s a physiological cause.
Now, these areas not mutually exclusive conditions either. You may have a physiological issue and also be struggling with a psychological issue. We want to cover all of our bases.
What Brought You To Counselling
This may seem like an obvious question, but it’s also an important one. We all struggle with various things in life, it’s the joy of being human. I want to know what it is that brought you in today, what are the challenges, how did they start, and my favourite question, “Why now?” What made you decide to come get some help now, particularly if this has been an ongoing thing for a while. This question is important because it clarifies what is the key issue that you are experiencing, and what your motivation level is, and what is specifically motivating you to get help now.
How To Measure Success
I often ask clients, “If this works, what will be different?” I want to know what your goals are and how they’ll gauge if counselling is a success. This both handles the goal setting, and how to find out if the counselling process working. My goals and metrics may not be what my client is going to use. I want to know what your gauge is. This doesn’t mean I don’t have my own tools and metrics for the process (I do), but it gives us a common language to monitor the relationship and the process on an ongoing basis. It helps us answer the question I ask pretty regularly with clients, “How’s this going for you? Is this helpful?”
What Do I Need To Know About You For This To Work
We are all special little snowflakes. We have our idiosyncrasies, oddities, preferences, hot button issues, and more. I’m no different. I want to know what is going to help you in the process, help us build the relationship, and help you feel safe and supported while trying to avoid things that do the opposite. Some people need a very gentle approach, others need a straight shooter. Some are very wary of a particular gender because of past experiences, others aren’t. I want to know these things so I can be the best help I can be for you.
I remember my first appointment with my current counsellor about 7 years ago. As you might imagine, I can be picky about my counsellors, and I’m also pretty headstrong and assertive. I know what I need in a counsellor. So, I sat down in his office and said, “Here’s what you need to know about me if this is going to work. I need someone who isn’t afraid to call me out on my crap. I need that, and I respond well to it. If you can do that we’ll get on famously, and if you can’t, no harm or foul, I’ll give you your money for today and be on my way.” I know myself and know that if I’m matched up with a counsellor who is softer and non-confrontational, I’ll be able to get away with things and manipulate the conversation easily and this won’t help me. I need accountability.
Things To Know About Counselling As A Client
As a Registered Clinical Counsellor, I want your experience to be as positive and helpful as possible and I know I can speak for the whole team here at Alongside You on this one. It’s important to know, however, that counselling is a team effort. Counsellors aren’t magicians with a magic wand that can fix all that ails you. The process works through the development of a safe therapeutic relationship and a joint effort to move forward. Here are a few things to keep in mind as you start your counselling journey.
Your Counsellor Cannot Read Your Mind
Some of you who have been to counselling before may laugh at this, and I know that I’ve had clients who were relatively convinced I had this magical power based on some of my interactions with them. We have intuition, not mind-reading powers. What this means is, it takes two active participants in a counselling session to get to where we’re trying to go. If you’re not an active participant, the process is very difficult if not impossible.
Being Open and Honest Are Important
We know this is a big ask of you. It’s not easy to sit down with a stranger and talk about the difficult parts of life. The counselling process needs this, however. If we can’t be open with each other, we can’t work together and create a safe space to wrestle with life. It’s not all-or-nothing, however. It takes time, and you don’t have to be an open book from the first minute. Build the relationship, and share as you do so. We’re in this together.
Try To Know What It Is You Want From The Session
This is sometimes a difficult one. I know that I often struggle to know what I want out of a session with my counsellor, but part of that is because I have a standing appointment that I go to every month regardless of how I am feeling that day because that’s what works best for me. Some of the questions I’ve outlined above can also be used on an ongoing basis to figure out goals and focus points, but it’s always helpful when clients know what they want to focus on in the session. It helps keep the process on track.
Ask The Counsellor Questions
Sometimes clients are surprised when I turn the tables and ask them if they have questions for me! As I mentioned above, counselling is a two-person endeavour and process. If I need to get to know you, it only stands to reason that you should get to know me as well. Ask away! The fit between a counsellor and client is important and getting to know each other helps us figure out if we’re the right fit. I always encourage clients to ask whatever questions they want, with the caveat that I may choose to decline to answer questions of a personal nature if they go beyond what I choose to reveal to clients about myself or my personal life. Every counsellor is different in this area but feels free to ask. You may want to ask about experience, qualifications, approach, personality, or things like hobbies, etc. It’s up to you and your counsellor to navigate how best to get to know one another.
Give The Counsellor Feedback
I always tell my clients, and then remind them periodically, that I need their feedback. Going back to my inability to read minds, I need feedback to know if we’re on the right track, if I’m focusing on the right things, and if things are helpful. Sometimes clients are afraid to tell the counsellor if they feel the process isn’t going in the direction they want or isn’t working. I absolutely want to know these things. I’d rather find out that something is off than continue believing all is well only to find out after the fact that it wasn’t helpful. I also want to know what is working so we can do more of that!
Counselling Is A Journey
I know that going to see a Registered Clinical Counsellor for the first time can be anxiety-provoking. I promise it’s not as scary, and we’re not as weird as you might think. We’re just regular people too, who have some training and experience to help you through some of life’s challenges. If we keep some of the above in mind and are open with each other, we can find a path through the challenges and help you thrive!
Feel free to give us a call or send us an email through our contact form if you have any more questions. We’re happy to answer them! Have you been thinking about taking the first step in seeing a counsellor? There’s no time like the present – take the first step, that’s the hardest part. It gets easier from there.
I recently attended the Recovery Capital Conference of Canada 2018 with our associate, Richard Somerset. This is the second year we’ve gone to the conference, and each year I leave, reminded of one thing: the importance of hope. It’s wonderful to hear the research, discuss different topics, see old friends; but, what I enjoy most are the stories from clinicians and people from the recovery community alike – stories of recovery, rejuvenation, and hope.
The role of counselling in recovery is an interesting one. I remember my earlier days working on the downtown east side with youth living on the street and suffice it to say, my “office” was pretty different back then. Most of my work involved a trip to Tim Horton’s, or sitting in a local park, or even sitting on the ground in various alleys. Most of my work back then seemed less “clinical” if you will – you might even call it counselling guidance.
The reality was, as it still often is, that there was precious little I could do to make things better. Some of the stories I heard from these youth were devastating, horrific even, and it didn’t stop. I could help find them a place to stay at Covenant House, my employer at the time. I could talk to them about job opportunities, addiction treatment options, mental health resources. What I couldn’t do is change their past, or sometimes, their present and future.
So, what then? What good is counselling guidance? How does it instill hope in a life where there doesn’t seem to be any?
What I found in the alleys of the downtown east side of Vancouver, and what I continue to find in my nice, cushy office in the suburbs, is that most of my role in the lives of others is as a guide – helping people find their way back to seeing hope in themselves. Hope in who they are. Hope in what they could become. Even if some of the circumstances don’t change.
This is the power of empathy and connection. While our current circumstances are important, I find that they have very little to do with hope. We can be in the worst of times and be hopeful, and we can be in the best of times and find it meaningless. This is where the guidance fits in.
Counselling guidance, in this case, takes the form of slowly helping clients entertain the idea that hope resides in self and others, and not in the situation. Hope resides in the idea that you are still, at your core, worthy of love and that life can be different. In the words of Marsha Linehan, life can be worth living again.
How, then, can we start finding hope, and even joy in the midst of emotional and/or situational turmoil? How can counselling help this process along? Here are three things to keep in mind in terms of counselling and hope:
- You are not your addiction, your depression, your borderline personality disorder, or otherwise. These are all things that love to tell you otherwise, preying on the negative thought processes and painful emotions that may be running through heart, mind, and soul.
- There is always hope. You may not see it right now, and you may think that what you’ve done, what you’re battling, or what you anticipate are too much for hope to conquer. What I can tell you is that in all of my experience, I’ve never seen these things evidenced in truth. There are no hopeless causes, hopeless battles, or hopeless futures if we continue to hold on.
- You may not be in a place where you can hold hope for yourself. You may need someone to hold if for you. This is where a counsellor comes in. Our job, in my view, is to hold hope for those that can’t hold it for themselves. I know I’ve been there. I consider it an honour to be able to hold hope for others.
If you see yourself in any of the above, I would encourage you to give counselling a try. Sometimes counselling is a very specific clinical intervention. Sometimes, however, it’s guidance, and guidance toward the possibility of hope.
If we have hope, we have a chance.
When I sat down to write this, the first thing that came to mind was a poem by Elizabeth Barrett Browning, titled, “How Do I Love Thee? (Sonnet 43).” The opening line says, “How do I love thee? Let me count the ways,” and continues to explain in great detail, all the different ways the subject loves the other. This is how I feel about counselling and its importance – there is no simple way to summarize why counselling is important because, in my opinion, the importance of it is endless in usefulness and application. So, I’ll offer three reasons counselling is important to start the conversation off.
Reason #1: Safety
Many of us have wonderful families, friends, and colleagues. But, how often do we feel completely safe discussing our innermost difficulties, the things we’re struggling with, the things that we’re afraid of, or perhaps the things we’re ashamed of? The reasons people come to counselling are many, whether it’s anxiety, depression, addiction, relationships, or otherwise, sometimes we just can’t bring ourselves to talk about these things with the people we have in our inner circle.
This is one reason counselling is important – a place of safety. By coming and entering the counselling room, you are entering into a space that was set up specifically to provide safety; the ambiance of the room, the highly trained professionals ready to engage in dialogue, the confidentiality provided by the interaction, and more. If we are to wrestle with our deepest longings, we need to feel safe and this what counselling provides.
Reason #2: Empathy
Empathy is key to our wellbeing and our functioning. In order to feel safe and feel connected to others, we need empathy. This is different than sympathy, which I’ve covered in previous articles because sympathy drives connection away. Empathy is healing, change making, and supports the re-wiring of our brains.
Empathy helps us feel known, understood, and validated; many times, this is what is missing in our personal lives. Sometimes this is because we are not surrounded by people who are capable, or willing to provide this for us; other times, it’s because we’re not in a place personally where we’re able to open ourselves to this possibility and this is where the skill of the counsellor comes in. Through counselling, we can experience empathy in a 1:1 relationship with the counsellor, evaluate our relationships, and if there are things preventing us from accepting empathy from others, work through these things will a skilled professional.
Reason #3: Guidance
When I went through my clinical training, one thing that was impressed upon us is that we’re not here to give advice. While I don’t disagree that this is not our primary function, I do disagree that we never do this. Sometimes counsellors are there to give advice. Depending on the client’s cultural background, they may actually be quite frustrated by not getting advice at times. What a counsellor is more apt to do on a regular basis, however, is to give guidance. Sometimes it’s guidance on a specific issue (i.e. school counselling, career counselling), and sometimes the guidance is in the form of a sounding board, offering alternatives to how the client is thinking about different issues.
Sometimes the guidance is more pointed – in my work I often see clients who have been through the various mental health systems without success and my clinical expertise and knowledge of the system is helpful in navigating next steps in looking for treatment and recovery.
As I mentioned at the beginning, this is just scratching the surface of why counselling is important, but I hope it’s a good introduction for you. In future articles, we’ll explore in specific detail how counselling is important for specific issues. If you have any questions about this, feel free to send us a message through the contact form and we’ll be happy to answer your question in a future article.