Q: I know that the first session with new clients is crucial, especially when doing brief therapy. How can I make the most of it?
A: Like it or not, many of us are brief therapists by default. Stats tell us that clients go to an average of five to eight therapy sessions, but most of them go only to one, making it essential that we hit the ground running.
We all know the essential tasks of the first session in any kind of therapy: building rapport and a sense of collaboration, assessing and diagnosing, and formulating and offering a preliminary treatment plan. The tasks in brief therapy aren't different, but they're done in less time--meaning that therapists need to get to work immediately, and there's little leeway for mistakes.
I find it useful to think of the first session the way a family physician might when a client shows up with an ailment. Basically, there are four goals to meet: getting on the same page, changing the emotional climate, clarifying the link between problems and personality, and offering a clear treatment plan--and if you miss any one of them, the client probably won't return.
Getting on the Same Page
It's useful to set the stage for brief therapy by letting clients know a little about your approach during the first contact--that you think brief, that you focus more on the present than the past, and that you give behavioral homework. You may…