Therapy and a first meeting – explanation or exploration?
I meet with clients in a pleasant office in an old country house on the outskirts of Basingstoke in North Hampshire. It is a good location providing a comfortable consulting room which encourages reflection. It certainly provides a safe environment which can be particularly helpful for the first discussion with a new client.
This first meeting is important. It can be a crowded session with much to cover. Clients have made the decision to come into the counselling room and will want to tell at least part of their story. I try to provide clients with a glimpse of what the experience in the room will be like. Yet time during that first meeting is limited. That means that there is a lot to cover in perhaps an hour or so and that can require an interesting balancing act.
I regard this initial appointment as an informal conversation. Clients need to have an opportunity to decide who to work with before opening up what may be very personal avenues of thought or feeling. That means this first meeting should be about sharing information and not about trying to fix things. It is a time for general exploration. That should be focussed on both the material that the client intends to bring into the room and also on expectations around the counselling process.
There is work for the counsellor to do in explaining aspects of the work and what may lie ahead. Counselling may take many different forms but often at the heart of the work is a concern to understand what has happened and to bring about change. Different strategies may focus on different elements of that process. CBT and solution focussed work can help clients to bring about change but other approaches from existential to psychodynamic can greatly assist understanding.
A challenge for the therapist during that first meeting is to decide how much detail to go into as far as different forms of therapy are concerned. A comment sometimes heard within the counselling world is that there can be too much emphasis on explaining modalities such as cognitive behaviour therapy or rational emotive therapy. The suggestion is that this can be confusing for the client.
Although I have some sympathy with that argument it is important that clients are not patronised. I prefer to work in as open a way as possible and that means sharing information. If modalities are seen as too complicated to explain perhaps we as therapists need to look more closely at how we communicate these ideas. Some counselling terminology is rather opaque and seems almost designed to confuse. It does not need to be that way. The reality is that many counselling concepts and techniques are really quite straightforward.
Each client is unique and brings into the room different requirements and expectations. We need to tailor the work in that first meeting to fit those individual needs. If we can find the right words then it is appropriate to spend few minutes explaining in common sense terms what the work will entail.
Perhaps on reflection the most important aspect of this first conversation is flexibility. Having found the courage to come into the room some potential clients will want to just voice those thoughts which they have held on to for so long. Others will want to know with some detail exactly what will happen if they decide to go ahead with this work.
The twin opportunities for explanation and exploration should be acknowledged at every initial discussion but the time spent on each should reflect those individual client needs. As counsellors our role is to ensure that at the conclusion of the first meeting the client has the necessary information both factual and also from an experiential perspective, to decide whether to go ahead with the work. This means ensuring that both client and counsellor are able to at least begin that process of exploration and explanation.