26 July 2011

Preparing for the Ist Counseling Session

Counseling usually starts with an introductory session, followed by Information Gathering, Discussion, Conclusion and Homework!

Let’s have a look at what goes on in the first session and how to prepare for it.

Step 1: Introduction – the first 10 minutes

·         Start the session with a warm greeting, escort the client to your office.

·         Make the client feel comfortable by offering a chair and a glass of water

Usually the clients are not sure what to expect in the first session. So explain to her or him right away what to and not to expect in counseling – briefly. (Structuring) Do not make any false promises. Tell the client about your credentials, the forms that will need to be filled out, the assurance of confidentiality, the duration of the visit, etc.

Step 2: Information Gathering – about 20 minutes

Start by asking the client, “So what brings you in here today?!” If the person doesn’t know where to start, tell the client to “start anywhere.” Some clients would be very descriptive about the issues bothering them while others may not be that vocal. Usually certain clearly recurring themes or patterns would be visible. Take note of these.
 Taking short notes at this point would be helpful but this needs to be done quite discreetly, for it should not hinder the client’s train of thought.

A successful first visit is one in which the client has done almost all of the talking – its all about them!

Step 3: Discussion / Counselor Input – about 10 minutes

At this point the counselor tells the client what he thinks she/he is saying and develops a list of issues bothering the client. The client can then either confirm or dispute the facts stated by the counselor. In case the client feels otherwise, this is the opportunity for the counselor to clarify the client’s concerns. Ask the client to rate the concerns from most problematic to least, and ask which one she/he would like to work on first.
The first homework assignment could be in various forms. I personally like “my autobiography” wherein the client pens down his life story, highlighting the major events in his lifespan. It gives the counselor a lot of insight into the issues concerning the client.
 Another interesting first homework assignment is “ mapping"  - filling out a week-long time sheet where the client can write down when the problem happens and what is going on at the time.

Step 4: Conclusion – about 10 minutes

End the session on an optimist note. Assure the client that she/he can do it. If you honestly feel that client can't, it is a sign that you need to refer.
It is crucial that the client have a printed copy of services available to her/him – especially of warm-lines and crisis services.
Tell the client that she/he can always reach you – by answering machine and by email and that you will respond shortly, and the client can discuss the stated concern(s) at the next meeting.
End all counseling sessions on a positive note.
The client should be able to list a few things that she/he has to look forward to over the next few days.

If the client seems to have nothing to look forward to, this is a warning sign for suicide.
You will need to ask her/him, “Are you thinking of suicide?” If she/he takes a noticeable pause before answering or says “Maybe” or “Yes,” you need to know the protocols of your organization for what to do when you suspect a client is suicidal.

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