Counselling: How it Begins

Counselling: How it Begins

First comes the decision

The decision to reach out for support with counselling therapy is a dificult process for many. It can take months of pondering, or could happen in an instant when an immediate realisation seems to be forced upon you.
Whatever the circumstances of making the decision to enter counselling, it is a serious, possibly life changing, decision.

Then comes first contact

A person may take weeks to actually act on their decision to contact a counselling therapist. The task of finding one you believe you can work with may be stressful. Choosing a therapist may involve a lot of research. That is why, on the Prevail site I try to provide as much information as possible.
Some clients are happy to book an initial session by email or text. Some like to have a phone chat first. Whatever is comfortable for the client is fine.

Before a client first arrives at Prevail I send an email to them outlining what happens in the first session. This is simply to make the necessary admin work of the first session easier.
And obviously to give them directions. It would be a bad start to helping a client find their way in life if they can’t find me.

The importance of C & C & C

The first session begins with about ten minutes for necessary administration. In Prevail I try to get it out of the way early so that it does not intrude on the therapeutic work later. I always assure the client the admin work will be brief.

I start with an initial scale of your mood and then confirm contact details. The pre-written contract is a basis for the counselling relationship. I view this as an agreement between the client and counsellor as to the expectations of how respect and professionalism will be maintained.

How confidentiality is maintained is outlined in the contract. It is important that the new client is assured that counselling therapy truly is private. Also that it is limited in the context of risk existing to the client and to others the client interacts with. This is especially where under 18’s are involved.

The contract also contains the cancellation fee guidelines. Life happens for both clients and counsellors, therefore cancellations happen.
In Prevail the current policy is if you cancel on the day of the session you pay the full fee. Cancel the day before it is half the agreed fee. Otherwise there’s no charge for cancelling.

I do ask clients to sign the contract. If there is an issue with this we can discuss it. A client may want to assess their commitment to the sessions first. The contract is usually signed at the start of the sessions but can be signed at any session.

The main work of the first session is the assessment.

Tell me about yourself?

In Prevail, when I introduce the assessment I encourage the client to know they are free to talk about what ever the assessment questions bring up for them.
Many clients just want to get their story out into the open, to be heard, to have their story validated and accepted. It has happened in first sessions that I abandon the assessment form so strong is the impulse for the client to tell their story first. I can do the assessment form in session two or three.

My approach to a counselling assessent in Prevail is semi structured. I do use a form which I fill in during a session. If the client is happy to just simply answer the questions I can work through the assessment in about 30 minutes.
However as I start the assessment I inform the client that this is their counselling and that they should feel free to speak as they need to.
Most assessments are done over two sessions.

The Prevail assessment form starts with easy biographical information. I will then ask about your general physical and emotional well-being. This includes a discussion of your risk to self-harm and suicide.

Then comes the personal history. How was life growing up? Has any specific trauma happened, even if it seems irrelevant now? What is the history the client has with counselling and how do they feel about starting counselling now?
It is often at this stage that I finish the first session. This makes sense as the final part of the assessment is best done as one piece and is the most significant.

So what do you want to work on?

All clients come to counselling because there is something wrong. It maybe an intense event or a lingering undefined self doubt. Regardless what the problem is, counselling works best when it is focused on a specific issue and aiming for an agreed resolution.

This is what I call goal directed counselling. In the Prevail assessment I ask the client what problems have brought them to counselling and what problem do they want to focus on first.
We discuss their reactions to this problem in their daily life and how severe of a problem it is for them.

The Prevail assessment ends with asking the client what they want to achieve from their counselling. This may dictate the initial thrust of the session work.
If a client is struggling with defining a clear goal I will help with this. It is important that the client’s expectations of counselling work can be realistically achieved in counselling, especially if the client only has a specified period where they can do counselling.

When it’s over is it over?

When the assessment is finished, all that means is that I’ve completed the Prevail form. Does that mean I no longer assess the clients needs? Absolutely not!

It is not realistic to think Prevail’s assessment form is everything that is needed to make counselling sucessful. Nothing about counselling works in straight lines. It always takes time to get to where the work really needs to go. Ongoing counselling assessment is more like a series of roundabouts than a straight road.
A client will likely be better able to explain their issues by session 4 or 5. The assessment form is only a starting point.

While assessment is ongoing I do refer back to the assessment form for a reminder of the details. Also the form is a good tool for assessing progress. During later sessions I may remind clients of what they said in the assessment. With this reminder they can reflect on what has been achieved or not achieved.

Now it’s in your hands

The purpose of this blog has been simple. That is to outline to you what to expect if you were to start a counselling process with myself in Prevail. I hope this gives you a flavour for what makes Prevail different from other counselling services.
It is important to know that each counselling service works differently. Indeed no two sessions are ever identical because people are not identical.

Many people fear making contact with a therapist. They feel it is a jump into the unknown. That is understandable. Sharing your innermost stories with another is not to be entered into lightly.

I hope this blog helps you to overcome any fears of entering counselling with Prevail that you may have.

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Great post. You should hightlight this one on your homepage, perhaps under the title: What to expect?

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