What happens in a counseling session?

After first meeting the client, what is the process that a counselor facilitates?

Elissa Gross
Elissa Gross
clinical psychologist

Hi.  This is an excellent question !   I think that the answer probably varies depending upon the particular therapist .  In my work with people , once we have met and I have gotten an idea of the person'a concerns and the issues they want help with , I spend the next few sessions gathering as much history and as much information about the client's current concerns in order to formulate some ideas about what may be causing distress .  I would then share my thoughts with the client to see if they feel I am understanding them and on the right track.  We would then discuss the best plan to address the client's concerns .  Usually I will suggest strategies that I think may be helpful and ask the client for feedback about whether or not they think my suggestions feel helpful .   I always encourage clients to be really honest with me about this.  I tell them that I would hate for them to agree to try things that they know they won't try just to avoid "hurting my feelings" or "offending me."  I want to be helpful and while I have the expertise as far as typically helpful  strategies, I really like to work collaboratively and have clients tell me what they do and don't like / agree with or not agree with when I share my thoughts about a treatment plan .  We the   work together to come up with a plan that will be helpful , but also realistic and then revise it and try new things if necessary as we go along.   If things aren't improving , I am very happy and willing to try something new ! 

I hope this is helpful for you ! 

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide. If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.
Victoria Haag
Victoria Haag
Find direction for your life...
There are probably no two therapists alike because first and foremost we are human beings!
And...our personalities may somewhat guide how we go about getting to know you, identifying what you would like to be different in your life and developing a plan to get where you would like to be. The very most important thing that will determine a successful outcome is the healthy therapeutic relationship between you and your therapist.  If you don't feel safe, comfortable and ready to work together, then it is likely not a good fit.
And that's OK...speak up and the therapist should assist you in finding someone you can readily work with.
The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide. If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.
Allison  Velez
Allison Velez
Is your relationship worth it?

Each counselor may have a different process, so I'm not the end all authority here.  For myself, I review policies and confidentiality concerns with people first and answer any questions they have. 

Then I'll let them know I'll be writing a lot in this session and I have an assessment form that I like to get completed, but I want to have a conversation and I'll ask questions as we go.  My first question is usually, "How do you feel I can best help you today?"  Some people are very at ease and tell me many details.  Others are a bit more reserved and I have to demonstrate more curiosity.  

Even people who have been very apprehensive are usually feeling very relaxed by the time the session is over.  Usually, when we get close to end of session time, I'll summarize what I think are the biggest concerns from what I've heard and confirm whether or not the person wants to work on those things.  I also try to give an exercise targetting my biggest concern for them to work on in between sessions.  For instance, a relaxation method if they are very anxious.  

Counselors are just humans as well, so it does take a bit of time to really get to know another person.  I always tell people that are apprehensive to give the counselor 3 or 4 sessions to determine if they really connect with them.  

I hope that helps, 

Allison 

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide. If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.
David Routt
David Routt
Totius Therapies

After meeting a client, many Counselors will ask you lots of questions in order to complete a thorough assessment of what you came to counseling for. This assessment is required by most insurances and allows the Counselor to give a diagnosis, which is also required by most insurances in order for them to pay the Counselor. If you are paying out of pocket, this diagnosis is not really required for payment, but many Counselors will still perform a comprehensive assessment because we really want to know what the issues are that brought you to us. The better we understand what it is that bothers you, what you would like to get out of the counseling, and all the various things that tend to affect people such as family upbringing and medical issues, the easier it is for us to help you reach those goals. How the counseling actually plays out from there depends a lot on the theory that the Counselor uses to direct their approach to counseling, and that information is too much for this little post.

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide.   If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.

A good therapist will discuss what brought you to therapy in the first place and devise a therapy plan with you on some of the things that you may want to work on.  The plan is not set in stone as things may arise during your therapy sessions. You also agree on how often and when you would like to meet. 

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide.   If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.
Sherry Katz, LCSW
Sherry Katz, LCSW
Couples and Family Therapist, LCSW

Great question which I imagine many other people have as well.

The therapist will want to know your main source of life discomfort.  In what areas are the problem interactions which you hope will disappear?

The therapist is trained to listen for your emotions to your story.  

And to open these up to you in a kind and safe way so that you'll start to see your circumstance in a new light in which you feel more of your own authority to handle the troubling conditions.

The therapist and you will refine your thinking and theories.   

The therapist will ask questions to help you prepare for any stumbling blocks along your way of creating your own new answers to the problem you brought to counseling.

I hope you'll enjoy learning and creating new thinking and interacting patterns!

The information above is intended as general information...  (more)The information above is intended as general information based on minimal information, and does not constitute health care advice. This information does not constitute communication with a counselor/therapist nor does it create a therapist-client relationship nor any of the privileges that relationship may provide. If you are currently feeling suicidal or are in crisis, call 911 or proceed to your local emergency room.

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