What Your First Session Will Be Like
After you arrive in the lobby, I will come out and greet you when your appointment time has arrived. Payment is expected before the session begins.
Once we have gotten settled and you have picked a comfortable place to sit (and yes, you can lie down, too!), we will simply chat and get to know one another a bit. Many things can happen in the time we meet. Some people like to get right to their reasons for seeking counseling, others take their time. The pace of how things go is entirely up to you. In our first session, we will go over the Treatment Release forms and other information such as fees, confidentiality, and expectations. I will answer any questions you may have. There is no right or wrong to how counseling and therapy works. Of course, counseling is based on scientifically tested theory and practice that will be utilized (that’s where I come in!), but what is truly important is your level of comfort in using such theory and practice. It is up to you what you want to discuss in the timeframe that you want to discuss it. Some come to work out an immediate issue they may be dealing with while others may want to explore patterns or the history of past issues relating to the present. Some aren’t sure why they are there, but just feel a need to talk with someone. Others know specifically what they want to talk about and have very definitive ideas on what they want to accomplish. Others just feel a bit unbalanced and want to check in with someone.
My job, as your counselor, is to help you find your way through it all. We, as a team, will work together to get you to a place in which you are feeling centered again, or maybe for the very first time. For some, this takes just a few sessions, for others it may take longer. We may work on behaviors, or thought processes, or take a look at the past for answers to the present. Together, we will work together by utilizing treatment plans and goals. My job is to support you and walk with you through your story to find your best possible self – sometimes we may know what that looks like, other times, we may have to dig a little. Not all of this will happen in the first session. It may take time to focus on understanding the things that play into your story, such as nutrition, sleeping habits, and/or your moods and support system. It is important to understand the many facets that make up your story. Overall, counseling and therapy is an alliance between you, the client, and me, the counselor. The first meeting will help you to determine a lot - how comfortable you are with me, how comfortable you are with the process, and whether it is something you would like to continue. After our time is up, you may decide to schedule another appointment. I may even ask for you to do some homework, such as read an article or think or write about something we talked about for further exploration. The journey is yours and I am there to walk with you and support you as you navigate it all to lead to your best possible self.
Confidentiality in Therapy
My professional ethics and the laws of Florida prevent me from telling anyone else what you tell me unless you give me written permission. These rules and laws are the ways in which society recognizes and supports the privacy of what we talk about — this is the “confidentiality” of therapy. However, I do have state laws that I must abide by. For instance, when you or other persons are in physical danger, the law requires me to tell others about it. If I come to believe that you are threatening serious harm to another person or yourself, I am required to try to protect you or that other person. If such a situation does come up, I will fully discuss the situation with you before we seek outside help, unless there is a very strong reason not to. If I believe or suspect that you are or have knowledge of abusing a child, an elderly person, or a disabled person, I must file a report with a state agency. To “abuse” means to neglect, hurt, or sexually molest another person.
There are a few other things you should know about confidentiality and therapy:
Children and families create some special confidentiality issues. For instance, when I treat children under the age of about 12, I must tell their legal guardian(s) whatever they ask me. As a child grows and is more able to understand and choose, they assume legal rights. For those between the ages of 12 and 18, most of the things they tell me will be treated as confidential. However, legal guardians do have the right to general information, including how therapy is going. They need to be able to make well informed decisions about therapy. I may also have to tell legal guardians some information about other family members that I am told, especially if these actions put the child or others in any danger.
In cases where I treat several members of a family, the confidentiality situation can become very complicated. I may have different duties toward different family members. At the start of treatment, we must all have a clear understanding of purposes and roles. Then we can be clear about any limits on confidentiality that may exist. At the start of family treatment, a family member must be designated who will sign all forms. If you tell me something your partner does not know, and not knowing this could harm him or her, I will work with you to decide on the best long-term way to handle situations like this. In the case of co-parenting situations, if you and your partner have a custody dispute, I will need to know. I do not do custody evaluations. I do not take sides in any divorce/partner separation proceedings.
I am required to keep records of your treatment. You have a right to review these records with me.
Limits to the Therapeutic Relationship
Mental health counseling is a professional service I provide. Because of the nature of therapy, our relationship is different from other relationships. It may differ in how long it lasts, in the topics we discuss, or in the goals of our relationship. It must also be limited to the relationship of therapist and client only. If we were to interact in any other ways, we would then have a “dual relationship,” which would not be ethical and may not be legal. My profession has rules against such relationships to protect us both. Dual relationships can set up conflicts between a therapist’s and client’s best interests. In order to offer clients the best care, my judgment needs to be unselfish and professional. Because I am your therapist, I cannot be your supervisor, teacher, or evaluator. I cannot have any other kind of business relationship with you besides the therapy itself. For example, I cannot employ you, lend to or borrow from you, or trade or barter services. I cannot give legal, medical, financial, or any other type of professional advice. I cannot have any kind of romantic or sexual relationship with a former or current client, or any other people close to a client.
There are important differences between a therapeutic relationship and a friendship. Friends may see you only from their personal viewpoints and experiences. Friends may want to find quick and easy solutions to your problems so that they can feel helpful. These short-term solutions may not be in your long-term best interest. Friends do not usually follow up on their advice to see whether it was useful. They may need to have you do what they advise. A therapist offers you choices and helps you choose what is best for you. A therapist helps you learn how to solve problems and make better decisions. A therapist’s responses to your situation are based on tested theories and methods of change. Lastly, when our therapy is completed, I will not be able to be a friend to you like other friends may be. As a therapist, I care for you and your mental health in the professional role of therapist. My goal is to help you find your best possible self and to help you reach the goals that you would like to achieve. As your therapist, I am required to keep your identity secret. The fact that you are in counseling is not my information to tell. Therefore, I may pretend not to see you in public unless you acknowledge me and I must decline to attend any functions in which you and I may both attend.
These ethical considerations are for your best interest, which is of the utmost importance.