The Toolbox at LisaKiftTherapy.com

Have you ever been in counseling or therapy? People have all sorts of ideas about what to expect. I’ve seen my share of “first-timers” come in with a slightly suspicious, fearful and unsure look in their eyes as they unsteadily lower themselves onto the couch in front of me. I believe many myths are perpetuated by movies and television. It’s true that the days of classic psychoanalysis where the therapist sat out of view of the patient lying on the couch are probably a thing of the past (the therapist “out of view,” not the “couch” part…I have several clients who are at their most relaxed laying on the couch and this is fine by me…but I’m sitting in front of the couch facing them). Some people expect that the therapist will remain passive except for a few “uh-huhs” as they scribble in their notebooks. And it’s not to say there are therapists out there who do that. That just doesn’t happen to be me. Clients have admitted to me that they were afraid that I was going to start “tinkering” in their head as if they were some science experiment. I understand the fear, especially for those who may have very negative ideas attached to what it means to go to a therapist at all. I don’t “tinker” but rather to do what I can to help add insight to people’s issues and look for paths to change. Having an understanding of emotions and their impact is often a part of that process.

So – what can you expect from your first therapy or counseling session? I’ll lay out what you would be able to expect from me – as I am the only one I can lay claim to knowing about. The basic structure is likely similar to other therapists.

1) Intake and Consent for Treatment: You’ll fill out these forms ahead of session – either download them from my website – or fill them out in the waiting room. They’re standard office procedure for most that ask for information about you and require you to sign your consent to engage in the therapeutic relationship. Fees and office polices are also layed out.

2) Assessment: If you’re in my office for individual therapy – there’s likely something you’re in distress about. I’ll want to hear about how you define the problem. What are you looking for help with? If there are uncomfortable symptoms associated, I’ll want to assess the level of severity as well as know about your support system, your coping skills, etc. At some point I might talk a little more about how I work as it applies to your issue, give you a chance to ask me questions, etc.

3) Your Story: I’ll ask you to tell me your story as how you think it might relate to your current problem. It may not be obvious to you and that’s ok. My job is to put the pieces of your life puzzle to begin to look for possibilities. I’ll ask about your family of origin, important relationships, childhood and other questions as I look for potential sources of the problem. I likely won’t get your entire story in one session but we’ll begin to look at it.

4) Wrap Up: In the last few minutes of the therapy session, I try to wrap things up by summarizing what information has been revealed. I’ll probably ask how you’re feeling after the session and offer you an opportunity to ask questions. If it feels like there is a good therapist-client fit then we’ll move on together.

The first session is really about information gathering and the very beginning of establishing the therapeutic relationship. I cannot stress the importance of the “therapeutic relationship.” Research has shown that this is one of the most important elements behind success for people in individual therapy. It is paramount that the highest level of trust and emotional safety is established in the environment of the therapy office. I strive to listen, validate and empathize with your situation.

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Lisa Brookes Kift is a psychotherapist in Marin County, California.  See more therapy and counseling articles by Lisa in The Toolbox at LisaKiftTherapy.com: A Resource for Emotional and Relationship Health.

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