How to Start a Therapy Session as a Therapist

[@SABRMatt2010]

The all-important "and this is now the session" line. My therapist always says "So, what's new? What's different?" I didn't even notice this right away...it's a stealth transition and it works perfectly. :)

[@rogueerised979]

😂 Ya same. They have lots of stealthy ways for many issues. Once you realize it, you're like damn! That was good didnt even realize it, but not in a bad way.

[@ww9192]

I like that too.

[@bedtimewhisper2551]

1. Ask about their comfortability ( temperature or etc) 2. If online , ask if the connections is okay, location etc 3. Ensure Confidentiality 4. Have safety n symptom check in (if feeling suicidal, depression, anxiety etc) 5. Start session : so we can pick up with last time/ do u have any preferences .. / last time we focus on this this 1-2 summary sentences

[@veganscholar8348]

An interesting watch as a grad student in practicum

[@christineclare6374]

How has your experience been?

[@veganscholar8348]

@ it’s been great! I am now licensed and practicing 😊

[@christineclare6374]

@ Amazing and congrats, that is HUGE! I’m just starting my Practicum. Did you have prior experience before your Practicum, or just educational credentials?

[@veganscholar8348]

@ depends on what you mean by experience. I’m a navy veteran so this was a second career/retooling for me. I did volunteer crisis line work for about a year prior to beginning grad school and that gave me some training. But as for therapy, I only had experience on the client end 😋

[@christineclare6374]

@@veganscholar8348 ahh ok I see, that’s wonderful!! I was in real estate prior, so this is a second career, as well. Before the practicum, I did work for a mental health company, doing intake and assessment for therapy and psychiatry patients. Of course I’ve never done one on one, next week it will be my first patient. It’s exciting but scary. I saw your post was a year ago, and figured you must be licensed by now. Hoping a year from now I could look back on this comment and say the same!

[@kaylac114]

Thank you so much for this!! I am going to start grad school in the fall and I am trying to learn things to prepare myself. How to conduct a session, once I start practicums, sounds daunting. This helps so much!!

[@Rorshacked]

For consistent structure, I always open visits with “so I want to follow up on our conversation last time and the ideas we discussed trying between visits, but what do you want to make sure we address?” And for the polite remarks walking back, I typically ask “what have you been up to today” which usually occupies the time well enough, can be interesting/relevant and is different than the bland “how are you”

[@lovesarita]

Personally I really hate being asked 'what have you been up to'. I would rather be asked how my journey in was - less pressurising.

[@Rorshacked]

@ that makes sense. However, when I had a therapist, that would ask me that, I felt like it only led to a one or two word response. Then there was the rest of the walk-in silence back to their office.

[@lolasworldofminis]

I’m a USC MSW grad student. This was such a helpful video. Thank you so much for sharing your framework.

[@homefryniles3983]

Good topic. I, too, review my notes before the client comes in. Doing that is like gathering and integrating the client's, therapist-client, movement over time. With that info and conceptualisation in my mind, I go the waiting room, invite the client into my office, sit down, and say, "so...what have you been noticing"? Sometimes I say, "what's it been like to be you this past week?". After they answer these open questions and I find out their orientation to self and world, and me, their affect, thinking, appearance, voice, I skillfully lead into the ongoing work, the goals let's say. Exception: urgent, emergent issues, including safety or med management, substances, legal actions.

[@becomingatherapist]

This is so helpful to have everything laid out like this. I just finished my practicum and am headed into my internship, which means a BUNCH of intakes this month. This will definitely help me start off confident, thanks Dr. Fang!

[@PREP-Registrar]

Love the reflection on these first few minutes and how important they are.

[@Abby-rv6yo]

Helpful tips, thanks Marie! Great reminder to focus on clients' comfort and feeling of safety from the moment they walk in :)

[@zigtgut1]

These suggestions are very helpful, especially for a therapist like me who works with quite a few clients who are working to manage heightened anxiety, stress and ADHD.

[@mixtape-mixer]

Wonderful topic! I am a student and find that hearing examples of what to say in each of these scenarios so helpful if you could provide more examples of what to say would be much appreciated! Thank you for your content!

[@Enchanteralle]

Whew, I do all of the things you mentioned in this video. I agree, it creates routine and safety for my clients. However, my new office is in a building where I don't get to adjust the thermostat myself and will wait and see if I need to have the building mgr tweak something in the summer. Thanks for sharing!

[@jackyjb5856]

Brilliant ! I am just starting my therapeutics counselling journey and can see so much basic respect and courtesy shining through

[@apple1hun]

I love taking one to two mins to review the treatment goal or what was done in last session

[@ww9192]

I wish my therapist I had before had done this. Good thing you do.

[@helencastiglione5513]

Great content AND your approach shows what a courteous and professional therapist you are !

[@edbrown5956]

DON'T ask how are things in the lobby! I've thought of lying and saying like "Well I've stopped myself twice on my way here from driving into the overpass support beams on the interstate." Just to get a rise out of them but never did. Although I stole another person's idea and would say "If you want the truth you need to wait 2 mins" as we walked back. Now it's a simple "Ready?" In the lobby and "How are things?" in session. That is my kind of therapy. No BS. Although they did start getting the room perfect for where I like to sit which is not needed but a really nice gesture.

[@daveowens271]

I'm watching this as I'm waiting for my online therapy session! I'm in more of "maintenance" mode, but this stuff rings true. It's all about client- centered respect.

[@keyrosellc]

This is a great video. I didn’t even consider this a component 🤦🏽‍♀️ I DO IT but don’t realize it. This is great to share with student clinicians. Thanks 👏

[@christianjackson9298]

That's one of the things they teach you first in Therapy 101, that you've spent your life doing the things that make therapy beneficial, you just didn't realize it until you got the traning that named it 😉

[@catherinerichter8317]

Lol my therapist is always late and once I even had to wait 40 minutes but it's ok 😂👍

[@DeLight333]

This is great! Have you done/could you do a video about ending session??

[@neya292]

Yes! A good discussion is when clients start imposing at the ending of session.

[@LAST-11111]

Great content and detail. And your info applies to consultation work in general, not just therapy!

[@elizabethjoiner]

This is so weird listening to because I have a good therapist that is late sometimes. I don't feel less important to her. I just know she has a full workload and is there when I need her. I don't mind. I think it's also important to take into consideration, the relationship. If it's a good fit, I'm assuming for others it is, then it depends on how you two interact with each other. As a first impression, yes. Be on time. and she was.

[@fisharefwends]

My therapist usually offers a compliment or makes a remark on the shirt I am wearing (I typically wear graphic tees) then she asks how my week has been and that usually launches into the session. If nothing exciting or relevant to what we have been working on happened in my week then she kind of leads with questions and stuff

[@try-uneservices7832]

Great video with practical information. I can make so adjustments to my style. Thanks for what you do!

[@curiouscat5045]

I like this video! I'm an RD so, I find her videos helpful. I especially appreciate each tip/snip-it was linked in the show notes. Yay!

[@Mindsetolympics]

the sound machine you have going on is soooo fricckin relaxing

[@encouragedlaunie]

I love these tips! I sometimes comment on the weather to ease into the session

[@anshardglow9426]

Helpful to review! Thank you so much, love your energy, simple straight to the point and positive attitude.

[@neya292]

This was a great video! So helpful!

[@shariecebrewster5962]

Yes I have questions on all of it's

[@FadedHolySoldier]

Ive outsmarted psychotherapists. I always leave them stumped.

[@ednaezekiel1498]

Pls is it advisable to take notes while client is with you or you make your notes after client has left?

[@Hisdesire1st]

Thanks so much. This is very helpful for me.

[@pamelatopjian]

Great information - as always! Thank you. Any tips for an initial consultation?

[@shoegirl8186]

Thank you !!!

[@JulieHerrick]

I was doing teletherapy on the phone (no video) and she just started every session with "how are you?" and that was it...I was just expected to take it from there. I found it extremely jarring. I wish she had seen this video.

[@mesmerizingmuse]

This is helpful, thank you ! I would like to know how do you do to pass assesments (or psychological tests) for your clients in online therapy?

[@venus_blue25]

Hello! What about the initial meeting? To hug or not to hug? Handshake? I’m transitioning from online to in person and haven’t done much in person work. Would love your thoughts! And, note taking in-person-how do you do it? ❤

[@dorothyonyango6575]

Hug or shake hands only if the client's culture allows. My two cents.😅

[@Liloldliz]

Just in case you were still wondering. When I was first starting therapy, if a therapist went in for a hug I would hate that and also not have the confidence to tell them it made me uncomfortable. I would have just gritted my teeth through the session then ghosted them and never come back. Your clients might not be the same. But some of them might.

[@rsh793]

​@@Liloldlizlol just incase it's still in then heck no I would never ever hug a client I would ghost them 😂🤣 Also for the OP I don't - I write a review in the previous week's invoice as I have everything transparent and also it keeps notes for people to read during the week and for me to flick through before session - and I allow 2 hours per session - 30 minutes to prepare, 1hr session and 30 minutes to review and write the notes and send as an invoice or receipt.

[@BettieBoo]

Hello, Good tips! How do you prepare for a session in only a few minutes? Does it come with experience? Would love to know!

[@lovesarita]

What helps me is to write myself a little note at the end of the session; a brief summary and next steps - so it's like i'm doing my session prep ahead of time and then just reading that quickly. Feels self-loving too to receive that degree of prep!

[@TheParadiseParadox]

I almost always start my sessions with some yogic breathing to get us both focused, and then set an intention Setting the intention can be a subtle way of guiding the client, giving feedback about the way they were thinking last time, suggesting a different way they can look at their lives or themselves Then i ask about the tasks we set the previous week

[@IanStockwell-if7sl]

I would find the leader after you

[@quellentmetah1239]

This is so nice 😊am a psychologist to be

[@Psylinguist]

i had problem catching up with very fast speech.

[@shariecebrewster5962]

I am new on there's

[@shariecebrewster5962]

No help on depression and anxiety and other

[@shariecebrewster5962]

Do one on one on it's

[@danielhayes7967]

My advice. "Don't Be So Horny To Begin Asking About Goals For The Future." Depending on your client he/she may have gone through with goals before. To just put together goals for only the sake of having something to look forward to isn't healthy either. Patient may have tried making goals before but wasn't able to make them happen. Only for therapist to point out "You're Trying Too Hard You Have To Let It Happen Naturally." Sometimes you may need to rehash old attempts to figure out a new strategy. Perhaps a bit more.

[@lovesarita]

Agreed, and, I think there's a point in the intake session where they've said a lot about what they don't want, about what's not working, and you can naturally ask, 'so what *do* you want?'and it feels like a natural progression rather than a mis-matched coachy intervention! Hopefully this can become of interest to them, even if not as a 'goal', then as a vision of what could be possible - without that there's not much to move towards.

[@TheTarotButterfly]

❤❤❤

[@Ionut-lm9cj]

Abcd

[@joshuacherogony4435]

Nice experience

[@RoyalTeaNation]

Sn: you look like Charlotte York (sex and the city) when you ran through the door 😊

[@KTMGUNNER]

Like , like , like totally

[@queenwilmah5299]

I have an idea, why don't we create a WhatsApp group so that we can get educated on what do, for beginners

[@agneskweyu9292]

Was this created?

[@christineclare6374]

Was the WhatsApp group ever created?

[@ninibuzariashvili9640]

Please add me. ❤

[@loutirador2421]

If you follow this advice you'll be in therapy for decades! The therapist is not your friend. client wants to deviate the therapist iisok with that ( what it actually means is you will never solve your original issue but you'll find many more issues once she let's you go there.

[@coomdoon]

Depends on the population you are working with but yeah, you want a therapist to solve your issues and send you on your way

[@robertwadeexpertkidsdentist]

As a client, what would you propose the therapist do when you deviate to a topic not directly related to their presenting problem?

[@zianawind2970]

People that do that quite possibly aren’t exceptional therapists. Great therapists help you see coherence in what they are doing and what you are going through the patient should always feel in control

[@lavenderkisses9461]

But a lot of times processing a current issue reveals a pattern of relating/coping that goes back too long term client goals. A good therapist will help a client make these connections and weave them together.

[@ClandestineGirl16X]

Are you ok lol

[@LukeXMV]

This is a very Anglo American approach, passive aggressive and not genuine.

[@stratoslek2330]

You are very very good but why are you such in a hurry to say everything?

[@ffytgm]

Could you please let go of this artificial funny stile and speak slowly?

[@vitaera1085]

Why do you judge her being artificial without knowing her in person? This may be her true talking style. I think her speaking speed is normal.