Published articles by Rebecca Mitchell on issues around sexual abuse
Meeting A Client for the First Time
Published in the BACP Private Practise Journal Autumn 2012
As soon as I saw him I felt instinctively that he was the one.
After spending most of my adult life in counselling I had got pretty clued up as to whom it was going to work with – but that didn’t stop my contempt.
Unusually perhaps for a counsellor he offered me a cup of tea on opening the door . “I’ve got one” I snapped and looked him up and down disdainfully. He looked robust which was lucky because I was up for a fight. I had enough self awareness to know I needed therapy but a big part of me didn’t want to be there. Strangely, however, the cream-coloured carpet that swept through the hall and up the stairs suddenly caught my attention and I could feel myself softening “Do I have to take my shoes off?” I enquired almost politely. He looked surprised and said no.
I was soon back in child mode as he ushered me into the room and I moodily slumped in the allocated chair as he went to get a glass of water.
The First Session
In so many ways the first therapy session have the same dynamics, feelings and experiences of a first date. All the ingredients usually are there for both parties:
- Eagerness to impress
- And, as with all first dates the knowledge that it can never be repeated. As a client I know that often so much is at stake. As a counsellor too at times with my own finances or those of the service I work for in the balance, the pressure is on too.
So what can we do to ensure that our clients receive a good welcome from us in that precious first meeting? David Mearns and Brian Thornes set the bar high “First impressions have profound significance…. For the person centred counsellor everything she says and does …will be attempting to convey the same unambiguous message; ”I welcome you, I accept and value you as a human being, I want to understand you, I want us to be able to be open and honest with each other.” (1)
I couldn’t agree more but, as with a first date, the most important factor you need to be aware of is safety.
As a Group Facilitator for a Women’s Survivor Group for over thirteen years I always had an initial meeting with each of the prospective group members to talk through whether the group would be beneficial to them at this stage in their journey. So I perhaps conduct many more first meetings than an individual counsellor. To me this initial meeting was effectively a “first session”. I would take their details and a short life history and also we would talk about what they wanted from the group and if this would fit in with what the group could offer them.
This worked well until one session I had five years into the practise. I had arranged to meet a new perspective group member and we went into a small counselling room. I could sense immediately she had a lot of pain as soon as she sat down. Foolishly, however, I had forgotten to sit nearest the door and I had hardly began when she became very agitated and angry. I was acutely aware that she was nearly double my size. I tried to contain her feelings and, after a few minutes offered her some space to take a break but she refused. Then suddenly she got up and lunged towards me, I thought she was going to try and hit me and I drew back in my chair ,but instead she just walked out.
I was left alone in the room and very shaken. Later, with the support of my supervisor and in line with BACP ethical guidelines about personal safety which state that “Practitioners have a responsibility to themselves to ensure that their work does not become detrimental to their health or well-being by ensuring that the way that they undertake their work is as safe as possible” (2) I decided to make some changes to my practise. I started to meet perspective clients in discreet but public places, for example I used a quiet café. I would scout round early to make sure there was plenty of empty tables. This worked surprisingly well. For some of clients meeting a “counsellor” type was a frightening and intimidating enough and so being taken for a coffee and a chat was a pleasant surprise. Although this was an informal meeting for us both to consider whether this was a good time to attend the group, and didn’t involve in-depth exploration, as might be appropriate for counselling or psychotherapy, I was extremely vigilant about confidentiality. I became an expert at identifying a space where we could neither be overheard or disturbed by other customers, and had back up plans to hand if the environment got busy. I also tailored my questions as best I could to avoid triggering strong rushes of emotions. I found the clients were more open and relaxed with me than in a counselling room. Some women even commented to me to this effect as they were leaving.
Of course some counsellors would be horrified by this idea, but it is worth remembering that there are some very broken people out there; and whilst working in a centre with a receptionist is all to the good – without wanting to scare monger- when you first meet a client it is just you and a stranger. So, as with all first dates when meeting someone new – stay in touch with the outside world during and after the meeting. Let someone know what time you are going to be finishing. This could be the centre receptionist, or if you are meeting clients in your own home, get a friend to give you a call five minutes after the session.
Who’s Picking Up The Tab?
On a first date it is my experience that most women (and possibly men) often want to pay for themselves because unfortunately some people want something in return if they pay for you. Paying for yourself gives you independence and power and sets the boundaries clearly with your new date.
Many counsellors however offer client’s the first session free of charge. This is a good way of getting a client to come and meet you in the first place. It also of course provides the opportunity for both of you to see if you can work together and a taste of what that might be like.
This can be very for beneficial for both parties. However, it is worth considering though that some clients may experience the balance of power shifting away from them if they don’t pay a fee even if it is a small one. Some may even feel obliged to stick with you simply because you have invested something in them already.
Perhaps a good idea could be – as on a first date – to “Go Dutch”. This could look like charging the client the possible cost of the meeting e.g. the cost of hiring the room and for some of the supervision costs.
The first meeting is also a point to discuss fees in clear and simple terms and that includes finding out what resources the client has to fund his or her therapy. I remember years ago when I was a student, I was desperate to go to a particular therapist and at the initial session she was quite intrusive about my finances and in fact turned me down because she did not think I has the funds to finance the therapy. I was gutted at the time but realized later it was the right decision.
In an attempt to impress a new date it can be very tempting to exaggerate where you are in life and what you can offer. This is also true of when you first meet a client. When someone comes to us looking for help in whatever way – especially if we are drawn to them or their story it can be really hard to gain distance to be able to think even with supervision whether you have enough training and experience to work with this person. Let’s face it, for many counsellors in these times of real economic hardship the pressure can be really on to say yes to everyone who comes our way. This could be personal financial pressure situation or the circumstances of the service we are working with.
If a client asks you directly if you have experience with a situation or issue be very clear in your response. Taking courses or reading books on sexual abuse for example is very different to being in a room with someone who is displaying extremely raw feelings e.g. anger, betrayal and powerlessness. Revealing your inexperience may well not count you out as far as the client is concerned but it may do – and they need that choice.
There is nothing worse for the client or counsellor if the counsellor realizes, as therapy progresses that they are out of their depth. Even the great Yalom admits looks back on one of his clients and admits “I knew I had good reason to be guilty. I had once again fallen prey to the grandiose belief that I can treat anyone.” (3)
Don’t be afraid to sign post clients onto someone else who has more experience and qualifications. Having learnt from mistakes in the past I always have a list on me of other services and counsellors that I can give to clients at that first meeting, if I sense that I can’t offer them what they really need. So, at least they go away with some specific direction on where to go next and the meeting for them has not been wasted.
Supervision is the key here. For clients who you are not sure about always check it out with your Supervisor first before you say yes. Which brings us to another point… key to both first dates and first meetings with clients: take time to decide if this is the right one.
A Supervisor I know said that after the initial meeting there should be a couple of days for both parties to decide if they want to go ahead with the next session or group of sessions. She said this was a good “cooling off period” and gave both people time for thought and reflection. That might not be to every counsellors way of working, but it does empower both client and therapist the chance to make a thoroughly thought out decision.
Back to me again sitting in a spacious sitting room in South London. My potential therapist seemed to “get me” but I remained still suspicious as I tried to explain my motives for being back in counselling once again. His presence was holding though and I began to relax a little. Towards the end of the session he asked me if I would like to book two more. I said “Yes” straight away and we sorted out dates. However, my resistance started to kick in again as he began putting the dates in his phone. “Would you like a couple of days to think it over” I volunteered trying to wriggle free . He didn’t even look up “No” he said with a firmness I hadn’t expected. Secretly I was pleased.
(1)“Person Centred Counselling In Action” Mearns and Thorne Pubished by Sage 1988 page 112
(2) BACP Ethical Framework – Point 64 Care of Self As A Practitioner.
(3)“Love’s Executioner “Irvin D Yalom Published by Penguin 1989 page 65