In Consultation

In Consultation

First Impressions: Getting Off to the Right Start is Crucial in Therapy

January/February 2011

First Impressions: Getting Off to the Right Start is Crucial in Therapy

By Dan Short

Q: Some clients connect with me more easily than others. How much can a professional do to foster a good therapeutic "fit" with every client?

A: There's a lot you can do—and the faster you do it, the better. In a matter of minutes, new clients will decide how good your relational fit is, and whether to return for more therapy. The first impression is created by the earliest interactions. Even unconscious signals from clients determine how much self-disclosure and emotional risk-taking they'll engage in during the first session, how much benefit they've experienced, and whether they'll return.

For example, a recent client walked into my office and stood distractedly, not knowing what to do. I invited her to sit across from me on the couch. When I asked her why she'd come to see me, she said she'd seen another therapist the previous day, but didn't think she'd return because she didn't feel "understood." I asked her what she'd discussed with the other therapist, and she replied that he'd asked her about her feelings. Following this exchange, she sat passively on the couch, gazing at me, politely waiting for her next set of instructions. So I asked her to tell me the worst thing that had happened to her in recent months. Cocking her head to one side, she said, "Now there's an interesting question. Let me see. I guess it…

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