Where’s the couch??!

There isn’t one.  My office doesn’t have a couch; it has comfy, individual chairs.  I’m just not your basic “couch” type of therapist, I guess, although there are times when I’d like to be able to lay down somewhere and close my eyes for a few minutes.

The last few posts have been about my view of counseling and what you’ll gain from working with me as your therapist.  Today I’ll share some details about what a counseling session is like.  Because I can tell you’re dying to know!

Most sessions last from 50 minutes to an hour.  Any longer and the time becomes increasing less productive; any shorter and there doesn’t seem to be enough time given to really make a difference.  That being said, some sessions ARE shorter and some ARE longer.  It just depends on each unique situation.  But mostly, I meet with people for about an hour each time.

Most clients meet with me once a week.  That gives us some consistency and accountability, and it doesn’t feel like we are starting from scratch each time we get together.  Some people will come in more often during a time of crisis, and as time goes on, most clients will slowly wean down to every other week, or every month, and then only as needed.  Because the goal isn’t to keep you in counseling FOREVER (even though there are some clients I really hate to see leave), contrary to what some folks may think!   Each situation is different.   Counseling can last a short time – only a session or two – or quite a long time – months or years.

Basically, you are the one who is in charge of deciding how long you want the counseling process to last.   Some people come in for a session or two, load up on information and advice, and they decide that’s all they need.  Other times, a client will continue to meet with me, even after their initial issues are resolved, because they find that they benefit from talking things over and receiving additional mentoring.  It’s not a personal affront to me when someone decides not to come see me anymore – there are many, many valid reasons to be all done with counseling, and you are never under pressure from me to keep coming when you’ve decided you want to stop.

So back to the session itself.

The first thing we’ll need to do is sign an Informed Consent document, which explains exactly what I will do, what it will cost, and what the exceptions to confidentiality are.  Stuff like that.  You’ll also fill out a basic Client Information form so I can have your basic info on file.

After the forms are out of the way, we’ll get on with the session.  The first time we meet, I’ll ask you a lot of questions.  I’ll ask questions about your physical, emotional, and mental health.   I may (or may not) have you fill out a series of assessments.  Generally, I like to do the assessments indirectly, while we are talking.  Then I have some context to put your answers into.

But those first few sessions, and definitely the very first one, you will do A LOT of talking.

I need to find out why you’re coming to see me, what circumstances in your life have brought you to the point of seeking help, and find out what your expectations of counseling are – what you want to get out of the process.

Some people know exactly why they’ve come in for an appointment, and what they are looking for.  If that’s the case, great.

But most people are not quite so sure why things aren’t going well for them.  Many people don’t know exactly what they want to accomplish – they just know that they are “stuck” or unhappy with life the way it is right now.  That’s ok too because we’ll explore many different aspects of your life to figure out why you’re feeling that way.

During that first session, and any time really, you’ll have a chance to ask me questions too.  Don’t be afraid to speak up and ask me anything that’s on your mind.

You’ll have plenty of opportunity to let me know what’s on your mind.  But I also see my role as one of a mentor and educator, and that means I will do some talking too.  If you had all the answers, you wouldn’t need to come see me.  Ultimately, I want my clients to be able to figure things out on their own, but most people need some help learning how to do that.

We’ll spend some time talking about your life up to this point – the dynamics of the family you grew up in, your school years, your adult life up to this point.  Some people wonder why we need to talk about all that stuff – why can’t we just dive right into the problem you’re having now.  There really is a point to discussing your history.  I need to find out as much as I can about you and your life to really understand what makes you tic.  We definitely won’t spend all our time reviewing your childhood, because you have to find a way to move forward regardless of what happened way back then.  Understanding what happened in the past doesn’t give you an EXCUSE to get stuck in the past, but it DOES serve some really important purposes.

One thing I want to be sure you understand:  meeting with me in my office once a week, conducting sessions on the phone or over the internet – that alone doesn’t guarantee that you’ll get “better”.  I don’t have a magic counseling wand that I wave over you that makes all your problems disappear.  The truth is, successful counseling involves work on your part too.  Just coming in to see me won’t do a heck of a lot for you if you don’t practice the things we talk about on your own.   When you decide to learn a foreign language, say, Spanish, you can’t simply sit in a room with a person who speaks fluent Spanish and expect to become fluent too.  You have to do the work to get the result.  And it takes time.

I’ll have expectations of you, just like you have expectations of me.  I may want you to do some reading between sessions, or try some things at home.  It takes about 21 days to break an old habit or learn a new one, so if you come back and tell me, “hey I tried that once, and it didn’t work…” well, I’m going to tell you to try it SOME MORE.  Change is a process.  Change is hard, and people don’t like change, even positive change.

But I guarantee you, if you are willing to work and willing to try some things you haven’t tried before, and agree to be honest with me and trust me, we’ll find an answer to your problem.

Oh, and I’ll also offer you a refreshing beverage – cold water, hot or cold tea, hot chocolate, apple cider, coffee – while you’re here!  I was never as excited as the day I got my Keurig and could expand what I had on hand to offer.  I don’t drink coffee.  You don’t want me making your coffee, believe me.  But the Keurig?  Perfect every time!

But no couch.  There is no couch.