First Therapy Session…What to Expect

Hey, guys, and welcome to today’s session. My name is Gilles Brideau, and I’m a psychotherapist coach and hypnotist that lives and works in Sudbury, Ontario, Canada.

Today’s session is around what happens in your first therapy session with me. I get a lot of clients and people that I’ve talked to that are fearful about what happens in a therapy session, so I thought I’d just do a quick video today to cover the fundamentals of what happens when you want to book an appointment with a professional or more specifically with me. Let’s get it going. Usually, the first thing, the first step is to place a call. When a call is made to my office or my phone, usually you’ll get, unfortunately, a voice mail because I’m usually working with clients. Please don’t hesitate to leave a message. I usually contact people within 24 hours.

I’ve had, unfortunately, stories of clients that have come to see me that have said that they waited two, three, four or five days, if not a week, before a message is returned. Now I can understand that especially in the summer because people are on holidays and all that kind of stuff, but even when I’m away, messages are forwarded to my cellphone and I try to make sure that people get a response from me within 24 hours. The reason for that is usually when clients are calling, they’re in a place of pain and I don’t want anyone to stay in that place too long. The first step is usually call to book the first appointment.

My wait time is about a week. Like, today is Tuesday, if you were to call me, probably I would see you at some point mid to late week next week. Once the call is made and the appointment is set, usually what I ask people to do is to send me a quick email. This is just how I work. For me, it’s to save time for clients, so if they send me a quick email, I will send them information, paperwork to fill out. In that there is my informed consent form and within the informed consent, it talks about the expectations within counseling and what it’s all about, as well as limitations as it pertains to confidentiality.

That one is just a signature so once they read the document they could sign if they’re okay with what’s been stated. Then the second form is my intake form. The intake form covers stuff like demographics, your family of origin, so how many brothers and sisters you have, your immediate family, so if you’re married, if you have children, that kind of stuff. Then we get more specific into problematic areas. There’s also medical history and medication that you may take, that sort of thing. Then we get more specific into what brings you to counseling. That could be anything from depression, relationships, anxiety, wanting to improve quality of life, anything like that.

Within the form, it’s usually filled out. Then I have a short page that ends on things that are most important to you because my approach is very strength-based and I want to make sure that we highlight what your strengths are, not just things you’re having problems with. Once that’s filled out, you bring that to your first appointment. Once you get here and that’s filled out, all my clients when they come in the door, they fill out what’s called a Brief Mood Survey. A brief mood survey is just simply a small tool that measures different areas life, anything from how you’re feeling today to positive towards self, your relationship towards others, if you have any anger or any kind of thing like that.

I use this tool for two major reasons. One, it gives me a quick snapshot of how the person is doing on that day or how you’re doing on that day. The second thing is it allows me to fail fast. Now that doesn’t sound very good, but let me explain. We can make the assumption that when you come to counseling, let’s say your scores are elevated on depression or they’re low on your relationship score, well, we can make the assumption that if you’re in a problematic area your scores, let’s say elevated, that with counseling, those scores should go down. If they don’t go down, it’s usually one of two factors.

One, you’re going through more situational stress or two, the approach that I’m using with you is not working or there’s some problem within our relationship. I don’t like people staying in pain too long, so I use this tool to ensure that we’re on the right track. The other thing that it’s really useful too is I usually give my clients a photocopy of the chart and within the chart is just simply the scores on the tool, that Brief Mood Survey. It’s just numbers on a page and at the bottom it has a little legend of what the scores mean. Physicians really, really like this tool because it gives them a really quick idea not only of how many sessions you’ve attended, but whether or not it’s been useful in bringing down your scores of anxiety or depression or your relationship with others scores.

Like I said, it helps physicians, especially if there’s medication involved, to monitor and see if things are actually improving, the quality of life of the person is actually improving. Once all that paperwork is done, within the session, especially the first one, is really getting to know each other. It’s really around the basics of rapport building and making sure that I get a really good idea of what’s going on in your life. I think that’s an essential thing. Without rapport, it doesn’t really matter what I bring to the table, whether that’s cognitive behavioral therapy or solution focused or the other psychobabble that can come up with. That rapport is a key element.

In other words, if you don’t feel comfortable with me or I’ve done a poor job in making you feel comfortable, then I don’t hesitate to refer to somebody that will make you feel more comfortable. For example, I had client come in one time. When he peeked into my office, my door was open and he peeked in and he saw me, he had this disappointed look. Now my name is Gilles, but he thought, when he had called to my office, he thought it was with Jill, J-I-L-L, so he thought I was a woman. When he came in, he was disappointed that I wasn’t a female counselor. The issues that he wanted to talk about, he said he would be much more comfortable in working with a woman.

I have great colleagues in my network, so I referred him to a woman. He found that really beneficial and helpful. The client initially was hesitant in terms of saying something because he felt I would be insulted in some way, but it’s actually the opposite. My greatest attribute to you is by remaining flexible so you get more of the quality care that you deserve. If that’s seeing somebody else, then by all means. I don’t let my ego or anything get in way. I easily refer clients. Like I said, I have a good network of people that work really well with other clients. That’s the important part.

Then after we get to know each other for a little while … The other thing that’s important to know it’s the average counseling session is about 50 minutes. A lot of people really expect the hour, but we make it 50 minutes so that it gives me a little bit of time to do note taking and to get prepared for my next client. What that sometimes simply means is go to the bathroom so I can provide the best level of care for the next person coming in. At the end of the appointment, we booked your next one. In the beginning, I usually see people more frequently, so it’s usually about one week apart, but as they start doing well, we can push those appointments back, but it’s really in a collaborative way.

I ask the person, “How do you feel? Your scores?” It’s not just my gut. It’s really a collaborative thing in terms of having the person move from maybe a state where they’re not functioning very well to a state of functionality. Once the appointment is booked, usually a payment if they’re paying out of the pocket. If they have an insurance provider that would have been either arranged within the intake form or in the referral because sometimes in my city I get referrals from like the City of Greater Sudbury, for example. Sometimes they’ll refer directly to me if it’s a very pressing issue. Once the payment is done, we usually send you on your way and look forward to meeting you again.

A really important takeaway from this too is, don’t be intimidating by counseling. I went to counseling myself when I was going through some times in my life and have always found it beneficial. I think it’s sometimes difficult to ask for help, but recognize by doing so, it could really improve the quality of your life. Sometimes it just feels good to talk to somebody other than family and get things from a different perspective with someone who’s not emotionally attached to your situation. That’s it for today. Thanks so much for joining me. Again, as usual, if you have any comments, questions, please don’t hesitate to write them down below. I’d love to hear from you. As always, I wish you a fantastic day. Thanks for joining me.