How to Start a Therapy Session as a Therapist

How to Start a Therapy Session as a Therapist

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Some parts of what we do in therapy are so second-nature that sometimes we forget to talk about them. In this video, I share some thoughts and opinions of some items to consider including at the start of your therapy session.

Don't forget to also check with your local jurisdiction regarding other laws and guidelines in your area as well.

00:00 Intro
00:41 Be prepared
01:23 Start on time
01:50 Have a consistent structure
02:24 Polite remarks
03:32 Incorporate hospitality
03:54 Virtual therapy specifics
05:19 Safety & Symptom Check-in
06:05 Begin your session!
07:17 Closing thoughts
08:03 TherapyNotes

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This video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.

Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.

Insta: PrivatePracticeSkills

Music from Epidemic Sound:

This video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.

[veganscholar]

An interesting watch as a grad student in practicum

[SABRMatt]

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. :)

[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”

[homefryniles]

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.

[EFT-Tapping-Course-and-Videos]

Good to see the preparation before the session. Thisbis the most important part for me, as I can then pick out about 3 traumatic eventsbor limiting beliefs that the client can choose from. This puts them in control of what to let go of in the session. Preparation aldo grounds me. When I see the client, I am empowered with a plan for the session. Then I can just concentrate on keeping a safe space for them.

Maybe I can show this video to my learners 👍

[edbrown]

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.

[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 👏

[bedtimewhisper]

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

[zigtgut]

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.

[Abby-rvyo]

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

[DeLight]

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

[helencastiglione]

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

[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!

[daveowens]

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.

[ltuerk]

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.

[Mindsetolympics]

the sound machine you have going on is soooo fricckin relaxing

[jackyjb]

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

[catherinerichter]

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

[try-uneservices]

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