The initial consultation is a very important piece of the therapeutic journey with your client, and therefore deserves some careful attention and consideration to ensure the success of your private therapy practice.
Usually, 30 minutes to an hour long, the consultation is the beginning of your clinical assessment, in which you will start to build your clinical formulation and, most importantly, determine the client’s suitability for counselling, whether your particular therapeutic approach is best suited to the issues at hand and whether there is a good relational fit between you and the client.
Recently I was asked by a potential client to have a free 15 minute telephone call rather than my usual hour long consultation, giving me pause to reflect.
For some counsellors, particularly those just starting in private practice, offering a free call may be something they would consider to attract clients, however, it also means that you may lose income a) if you and the client don’t continue and b) you have too many occasions where persons use the consultation for ‘free advice’ and then never return, something that happened to me on a number of occasions early on in my private practice career.
The other consideration is time. Will 15 minutes be enough for you to get a sense of your fit with the client and their fit to you?
We know from this work that everything we do and say with a client (potential or otherwise) is a communication; an emotional communication, that informs the therapeutic work, even if it is simply an initial email before any work begins.
How you conduct a consultation, from the length of it to what happens within it, is all part of that communication.
Which all brought me to the question; what is the value of the clinical consultation and what should it ideally achieve?
In an initial consultation I want to get a good sense of the client.
How do they interact with me? Are they forthcoming, finding it easy to talk, or not?
What do they see as their difficulties (the presenting issue/s)? And what is their current understanding of what might be getting in the way of achieving resolution?
Many of my questions will be open ended, others more direct: have they ever had counselling before, and did it help?
Have they experienced trauma before? So, I can accurately assess their needs and develop a more specialised treatment plan.
What kind of help are they looking for?
For example, do they want practical tips and strategies, better suited to short term solution focused counselling, or are they looking to get to the roots of their problems in a way that would require long term depth psychotherapy?
The value of the consultation is therefore twofold. It obviously helps to determine if you are a good fit for the client and the client for you, based on how you are both relating to each other within the space of the consultation.
It also is practical, answering all the questions the new client may have about the counselling process in general and the way that you specifically work as a counsellor.
The consultation is the first important step in establishing a good therapeutic relationship.
It’s therefore crucial that we think of it as more than just a clinical assessment, in which we must garner as much information as possible.
Your clinical assessment will be an ongoing process and there will be future opportunities to ask your questions if the client goes on to engage in therapy.
Your focus instead, in this first session, should be to attune yourself to the client as much as is possible.
This way your client is more likely to feel supported, understood, and to form a positive therapeutic alliance with you.
All of which, will encourage them to commit to therapy with you and ensure that the therapeutic process will be fruitful for them.
This in turn forms the bedrock of a successful private counselling business.
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