One of the things we hope to do here on the blog for COMPASSion is to offer a glimpse behind the doors of our Center. Because we know that reaching out for help requires a degree of vulnerability, and that anxiety about the unknown can be prohibitive, we want to help “de-mystify” the process of counseling. What is counseling like? How does it help? What happens in an intake appointment? What happens in a counseling session?
Today we’ll begin a series called “Inside COMPASSion,” and from time to time we will continue to highlight and educate about a particular aspect of the counseling process. Please note that you can get to know our Executive Director and Counseling Clinician here, on our website.
The first thing we’re going to (un)cover is the intake appointment. To keep it simple, we’ll be talking about an intake appointment for an individual adult today, but much of what we discuss can be applied to an appointment for a child, adolescent, couple or family.
Here are some concerns people sometimes express when attending counseling for the first time:
Do I have to lie on a couch? AND
Are you going to analyze everything I say?
In the case of CC, the answer to both questions is unequivocally “NO.”
Counseling is not psychoanalysis, the technique developed by Sigmund Freud, and practiced by fewer and fewer specially trained clinicians. If you are interested, you can learn more about psychoanalysis here http://www.apsa.org/content/about-psychoanalysis
CC does not even have a couch in the office! And while psychoanalysis involves a person talking about everything that comes to mind in a free-association manner so that it can be “analyzed,” counseling is more problem and goal-focused, and more collaborative in nature. While people undergoing analysis are usually seen by their clinician several times per week, counseling usually takes place weekly or biweekly.
After filling out the necessary paperwork, an intake appointment, which simply a person’s initial appointment with a counselor, usually begins with a simple question:
What brings you here today?
And in a conversational manner, the client is invited to tell the story that led him or her to CC. The counselor may ask questions to help the client elaborate, such as
When did this begin for you? What was going on at the time? Have you struggled with these feelings or behaviors at any other time in your life?
Depending on what the presenting problem is, the counselor might ask about the client’s relationship, educational, or work history, health history, and, in particular, any history of past counseling or other mental health treatment. Once the client and counselor have identified and elaborated the problem, the next step is to identify the goals of counseling. Questions are addressed such as:
How would your life be different if this problem didn’t exist? What would you like to change? How will you know when this is better?
Goals for counseling then help the counselor and client develop a treatment plan together. In other words:
What will we do to address these goals? How often will we meet? When? What time? For how many sessions before we review progress? What sorts of things will we work on improving? How?
This process of creating a treatment plan does not always happen in one visit. Sometimes it takes a couple of visits, and the treatment plan is always fluid, as new problems are identified or as old problems improve.
In short, a first visit only requires that a new client be prepared to address the question, “What brings you here today?” in a safe, supportive, and collaborative environment, and to take the first step toward change and improved wellness.