Your first meeting with a new therapist can be exciting as you embark upon the journey of wellness, but also frightening as you imagine exposing your most genuine self to a presumed stranger. Many hope to share things with a counselor that they may not feel comfortable sharing with their closest friends or family. Is the fact that it’s a stranger who is bound by ethical laws to honor confidentiality enough to make it feel okay?
The answer is often no. Many things can influence the ease of that process though. As a counselor, I often hear my clients say things like “it’s too embarrassing” or “you must think I’m a terrible person” or “that makes me sound awful” or “you’ll think I’m crazy if I tell you” or “you wouldn’t understand” and many other similar apprehensions. Some clients are worried about sharing something that may lead to some unwanted result like involuntary hospitalization or a CPS investigation. Being a counselor, I hate to think that someone would withhold their thoughts, feelings, or experiences because of such fears. If they feel so intensely about it, it must be of significance with regard to the therapeutic process. How can a therapist and client overcome this hurdle?
Different counselors have different approaches and the client has some responsibility as well. Sure, all counselors are required to review informed consent which clarifies the details of confidentiality, but it’s often a quick one or two minute conversation and can feel rather routine. It also doesn’t guarantee a counselor’s opinions and judgments. I like for my clients to feel like I’m human, not like some clinical emotionless robot. How do I find a balance that separates me from the client’s social support circle?
One very significant term I exercise as a clinician is ‘unconditional positive regard,’ a term developed by humanist psychologist, Carl Rogers. It’s a matter of acceptance that remains steady regardless what the client shares. I cannot support a person if I do not hold positive regard for them and their feelings so I remember that they wouldn’t be in my office if they didn’t seek recovery or wellness. Has a client ever shared something shocking with me? Sure. Has a client ever been disrespectful towards me? Of course. Has a client ever shared something that stood opposing to my own moral beliefs? Definitely, but the person seeking help in my office is much deeper than their opinions or behaviors. Also, in many many cases, the counselor has heard it before and already had the opportunity to process their reaction. I pay attention to that person; the person who wants to feel normal, the person who wants to overcome the guilt, the person who wants to feel heard beyond those details. Unconditional positive regard is a tight rope to walk in order not to permit your client to abuse the process or mistreat the therapist. It doesn’t mean a therapist tolerates inappropriate behavior in session. It means the therapist maintains the same positive regard once the inappropriate behavior has been addressed and while addressing it…kind of like not holding a grudge…staying focused on the client’s goals with empathy.
Rapport is a major component in the process. Rapport is defined as a close and harmonious relationship in which the people concerned understand each other’s feelings or ideas and communicate well. It’s foundational for the therapeutic process and alliance. When good rapport exists, the client feels safe about sharing and the counselor feels safe about setting boundaries and making challenges in a cohesive and productive way. What can a client do to help build rapport? Simply put, give your therapist a chance. Share your concerns. Be honest. This doesn’t mean you have to share all of your concerns and life story in the first session. It means to peak over the wall you may have put up and reveal pieces. Ask your therapist questions about informed consent. Explore your concerns. Talk about what you expect to gain from counseling; what has and hasn’t worked in the past if you’ve tried it before. Identify your preferences for the process and be open to feedback. Most importantly, remember that therapy can get uncomfortable sometimes and even difficult but that your counselor will be there to guide you safely and support you.
In conclusion, we are not our choices, but our choices are ours. I’ll worry not with how others may see you or how you may see yourself but with how you want be.
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