What happens in the first consultation session?

Considering counselling can be a daunting prospect if you’ve never accessed it before. If you’re uncertain of what to expect and this is preventing you from taking the first step, please read on for an informational guide on what to expect from the very first session. 

What you can expect

As standard, counsellors should offer you an initial consultation session to discuss your needs and how you might work together to reach your desired outcome. If the therapist hasn’t already sent you an agreement and overview of how they work, they should discuss this with you in the first session. Quite often, counsellors and other therapists will go through the completion of a written ‘contract’ or agreement that takes some of your details, outlines confidentiality, data protection, boundaries, fees, cancellation policies, and any other relevant formal information you will need to be aware of particular to the place of therapy. Sometimes this is a verbal agreement, but your details will still be taken. Details will usually include your home address and the contact details of your GP and next of kin. It is rare for therapists to use this information and they will only use these in the event they become concerned for your welfare, or you have agreed to some contact for other purposes such as a referral for additional support.

Confidentiality

Confidentiality will be paramount within the sessions, even the consultation, and will only be broken if the counsellor is genuinely concerned for your safety or the safety of someone else that you talk about within your sessions. The counsellor has a duty of care, not only to you but to other members of the public and must act if they feel anyone is at risk. There are exceptions to this where breaking confidentiality will put you or someone else at more risk and the counsellor should work with you to put support measures in place to minimise these risks. There are also particular conditions around criminal activity that may need to reported and, if you are worried about discussing these, you should check this out with your therapist as, what they need to disclose will be outlined by their registered professional body and/or their insurance company.

Working together

Your counsellor should explain the types of therapy they offer and how these work in order to give you an idea of how the sessions will be formed, find the right option for you, and give you an idea of what you can expect from them. They should also discuss the frequency of sessions with you and offer you regular, ongoing sessions. Weekly sessions are normal and ensure consistency across the sessions. Each session usually last 50 - 60 minutes. You should ideally commit to a minimum of fortnightly sessions in order to benefit fully from the work you will be doing and to give yourself and your therapist the opportunity to build a good relationship quickly in order for the work to be personal and relevant to you. Where there is concern for your safety, the therapist is likely to want to see you weekly.

You can find more information on the expectations of a counsellor outlined by the BACP (British Association of Counselling & Psychotherapy) in their ethical framework here.

Formulating a plan

Your therapist will offer you the space to go over the difficulties you are experiencing in order for them to get a good feel for the work that may be undertaken, and they will summarise this for you toward the end of the session, bringing everything you’ve told them into a ‘neat’ package and checking that they’ve understood you correctly. They may then formulate a plan going forward, though this can sometimes take another session or two if there is a lot to cover, or you haven’t felt comfortable enough in the consultation session to offer a full picture. This is okay too. Your therapist will work at your pace.

Your counsellor may discuss whether your therapy will be short-term or long-term depending on the complexity of the issue(s) you bring. It’s important to give yourself the time to work through your difficulties, your mental health deserves attention and when looked after can have a significant impact on your overall wellbeing.

Types of therapy

The type of therapy you enter into will dictate how the sessions will be structured, so, for instance, if you decide upon CBT (Cognitive Behaviour Therapy), you will find the sessions quite directive and focused on one particular issue. You will be given homework to complete between sessions that will inform the work you do face to face in your sessions. If you choose a Talking Therapy however, you will be able to take more control of the sessions and explore whatever feels the most relevant to you at each session. Therapists often integrate talking therapies with other, more structured therapies in order to offer practical strategies you can use immediately whilst you explore the more deeply rooted difficulties you might be facing. Some therapists work to one modality only so it’s important to make sure their way of working is right for you.

You can find more information on counselling and CBT here.

Benefits to you of the consultation session

You can use this session to ‘get a feel’ for the therapist to make sure you click and ask any questions. It is important you feel comfortable with your therapist if you are to get the most out of the therapy. If you haven’t felt comfortable, the therapist won’t be offended if you tell them you would like to explore other options. 

You should come away feeling much more confident in how you will benefit from your sessions.

You may already feel somewhat better for having shared your difficulties with someone impartial, feeling heard and understood and confident that you will be supported going forward.

Take action

You can find a list of questions to consider before you make an initial appointment here.

If you feel you’re ready to take the first steps into a therapeutic relationship with a qualified, experienced therapist, and you’d like to book in for an initial consultation to discuss your needs, you can make contact here or ring Tracy on 07831202104 to book in at a convenient time for you.