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What Happens In The First Telephone Call?

You've decided to telephone for an appointment. For most people, the hardest part is that first phone call. I thought it would be helpful to let you know what will happen when you call. This might decrease your anxiety about the unknown.In your very first phone call, either one of the counsellors or a person who will be able to make an appointment for you will answer the call, or you may encounter an answering machine. If so, you only need to leave the following information:
  • that you want more information, and wish to speak to someone or
  • that you would like to make an appointment
  • your name and telephone number
  • briefly, when you can be reached

 If you do not encounter an answer machine:The person answering will identify themselves and ask you how they can help. You will probably say that you want to make an appointment. You may mention the source of your referral. You may have questions about the cost and length of sessions etc., which we will answer. Depending on your location in the South West, we may then give you another number to telephone in order that you may arrange an appointment time and date with your counsellor directly. Otherwise, a day and time no more than a week away will be suggested immediately. In either case, we will agree on a day and time. (Note: you may have to be flexible here; be aware that good Counsellor's schedules are usually full, especially evening hours. However, in an emergency, say so.) We will take your name and address so that we can send you a confirmation of your appointment and clear directions to the consulting room. We will confirm the appointment again, say good-bye and hang up.

 That's it. At this time, it is not necessary to explain the reason for your call. (You should never have to discuss the reason that you want to talk to a Counsellor with anyone except the Counsellor). You won’t have to convince us to see you. Don't feel that you have to "qualify" for the appointment by offering a suitable reason. If you've used the answer machine and left a message, We should call you back within a few hours, certainly the same day (unless you have called in the evening, in which case we may return the call the following morning).
The first contact is for the sole purpose of arranging your appointment as soon as reasonably possible. Everything else is superfluous at this point and should be left until the first session (the exception being that you should make clear any emergencies, such as acute personal crises). There may be some need for working out difficulties related to the appointment, but it is best not to confuse the issue with extensive details at this time. These are better worked on in the first session. Likewise, we will not ask you lots of questions or get into an extended conversation in that first call.

 

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What Happens In The First Session?


The day is here and you have arrived for your first session with me. You will ring the doorbell and we expecting you, will answer the door. The Counsellor will show you into the consulting room which will be a private room shielded from any contact with other people or intrusive sounds from outside. The room will be comfortably heated or cooled, and we will sit in comfortable easy chairs. The windows have heavy nets and curtains so that no one can see in. You will not encounter other people when you arrive at or leave your session.

By now, you no doubt can see that all these elements are ensuring your privacy and helping you both to build a safe place.
When you are both settled, the Counsellor will ask you for payment, and then it's usually up to one of you to start; otherwise the Counsellor may prompt you with a general question such as "What brings you here?" You can describe the problem you are having, or anything else that comes to mind. Don't worry about whether you can say everything with absolute precision. The Counsellor should be able to help you both get it all out.

In this first session, you can both expect to do a lot of the talking. You can expect your Counsellor to listen actively. The Counsellor may not say anything at all until halfway through the hour, or may make one or two interpretive comments or ask for clarification. While you are talking, the Counsellor will be listening carefully, evaluating your situation and deciding on possible treatment. In order for the Counsellor to do this, s/he must listen to you both, and not influence what you say, or the way you say it.

Toward the second half of the time, the Counsellor will indicate whether or not s/he can be of help to you, and will explain to you what may be causing the problem if that is appropriate at this time. The Counsellor will then propose a therapeutic treatment plan; a schedule of appointments and any other related details. You will both have the opportunity to react to this structure, and decide whether to continue. You may wish to go away and discuss the appointment with your partner, family or friends before deciding whether to continue. Remember that this treatment plan, schedule and other details, is not incidental, it is a very important element of therapy. This "holding" environment is an important step in establishing the safe place. The proposed treatment plan will be clear and unambiguous, and should reflect safety, consistency, and containment. Though you may think, consciously, that flexibility on the part of the Counsellor is desirable, the opposite is true. At this point, you will need the Counsellor to be firm and consistent.

Having agreed on a regular day and time for your appointments, you are both on your way to emotional and relationship healing. You say goodbye and leave.


Safety Is In The Boundaries


Fees and times may seem incidental to the actual therapy; but consistency in the these boundaries of your therapy contributes greatly to your sense of security, of being “held.” If your schedule is constantly changing, you will find that it is difficult to get any work done in therapy, and you will likely find yourself with subtle feelings of danger, chaos and abandonment. If, however, these details remain solid and secure, your unconscious mind will see the Counsellor as healthy, consistent, safe, strong, and devoted to your care.

Schedules and time - The usual schedule is once a week, though we may decide to meet more frequently; or less frequently depending on your presenting problems and particular circumstances.
During your first session, we will agree on a regular day and time for your appointment. After that, your appointment should, ideally, stay the same as long as the therapy lasts; that is best for the success of your treatment. You may think that “flexibility” in the schedule is helpful to you; but it has been shown over and over again that to your unconscious mind, it is not. If you are depending on a structure for support, any change to that structure will leave you feeling unsafe.

Therapy sessions are 60 minutes. To maintain the secure frame, the Counsellor will hold you to that time absolutely. If you arrive late, you still must stop at the agreed time. At some point, it will probably happen that you will be in the middle of something deep and anguishing when the time comes to stop. This may be extremely frustrating to your conscious mind, but the Counsellor will not allow you to run over the time, and that should satisfy your unconscious. If, on the other hand, the Counsellor is late, you will receive the full time.


Ground Rules For Further Safety


At the end of your first session together, the Counsellor will explain all the safety and ground rules. You will cover subjects such as confidentiality, missed session payments, holidays, counselling ethics, complaints procedures, supervision and other topics. The Counsellor will give you a written copy of these safety agreements for you to keep.

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