Laurenza Buglisi specialises in supporting families affected by sexual violence, intergenerational trauma, and family estrangement. She also provides training and consultancy in child safeguarding practices for organisations and social work professionals.
Are you an early career social worker or other allied health professional? Have you recently graduated and started your first professional role involving direct practice with clients? Maybe you’ve been given a counseling caseload and are unsure how to put into practice what you were taught at university. Keep reading to learn how to set up the first counseling session with a new client for the best chances of successful engagement.
Why preparation is key
While an important part of social work practice is being able to respond to whatever the client raises during any particular interaction, it is equally important to consider how you want to set the scene for that contact. This is especially true for a counseling session, which is usually scheduled in advance and requires a level of preparedness on the social worker’s part.
Your degree will have provided the necessary training to understand people within their environment, but sometimes new graduates feel out of their depth when applying this knowledge in a workplace setting. It is common to wonder how to structure a therapy session, particularly if your degree was not specifically in counseling. It can take around six months for your skills to consolidate and your confidence to grow in your first social work role. During this time, applying a systematic approach to structuring your first session with new clients can help reduce feelings of overwhelm.
Assessment starts before the client arrives
Reporting obligations
One of the most fundamental things to be aware of before you even meet your client is your reporting obligations. This applies to both internal and external reporting requirements.
Internal reporting obligations are those expected by the organization you are employed by, such as record-keeping policies and incident management procedures. These may include always consulting with a supervisor if you have any concerns about the risk of harm to a client or someone else in the community, including risks to staff.
External reporting obligations refer to legal or ethical requirements to notify someone outside your organization about information you receive or concerns you have for someone’s safety. These obligations are usually outlined in legislation or a code of ethics and might carry serious ramifications if not adhered to, such as professional suspension or even incarceration.
Pre-screening questions to gauge the risk of harm
Another consideration before meeting a new client for their first counseling session is determining the level of screening your organization has already conducted during the intake process. Are all prospective clients offered a counseling session, or is there an intake procedure involving screening and assessment by qualified clinicians?
This is important to know because it will shape how you set up the first session. Has the client already been accepted into the service or program, or is your session part of the assessment to determine their eligibility or suitability?
If a level of screening has already been conducted, were any issues flagged regarding current risks of harm? This includes past or current suicidal ideation and self-harming behavior. It is also essential to assess whether there are any past or current legal orders involving the client, such as intervention orders, which might indicate risks to others using the service or to the client themselves.
If such risks exist, knowing the identity of individuals who might pose a threat to the client is crucial so your organization can take precautions to ensure everyone’s safety. Lastly, if concerns about family violence or child abuse have been raised, determine whether these have been reported. Obtain clarity on which organization received the report, who made it, and when it was filed, as this information is fundamental for effective risk management.
Identifying additional needsÂ
Ideally, any additional needs the client has should have been identified before the first counseling session. These may include physical access requirements, interpreting services, or requests for a female counselor. Accommodating these needs on the spot can be challenging if arrangements have not been made in advance. Addressing such requirements not only demonstrates respect for diversity but is often a legal obligation for organizations.
Understanding the scope of service
It is impossible to structure a first counseling session without a solid understanding of your organizational context. Specifically, you need to know the parameters of the service or program being provided. This is crucial because it dictates the framework for the client’s engagement in counseling.
A drop-in service offering single-session counseling to clients with little or no prior screening will differ significantly from a dedicated counseling service providing long-term support. Short-term counseling services require a stronger focus on the early establishment of goals, whereas medium- to long-term counseling allows for a more thorough assessment phase at the beginning.
While some of this information can be universally applied, this article focuses on setting up the first session for medium to long-term counseling, assuming clients will have access to at least ten sessions.
Introducing yourself and the serviceÂ
As a qualified healthcare professional, it is important to begin the session with a brief introduction that includes your name, position, and qualifications. It is normal for clients to feel nervous or apprehensive in the first session. While some may want to jump straight into explaining their reasons for attending, it can be helpful to take the lead at the beginning.
This approach is important for accountability and gives the client an opportunity to gauge whether you are a good fit for them. The beginning of the first session is a chance for the client to assess their environment and determine if they feel comfortable proceeding with you as their counselor.
This is also the time to outline the scope of the organization and the counseling service, the limits of confidentiality, record-keeping, and privacy. Explain what information is kept between you and the client, what information may be shared, and under what circumstances and with whom. It is also important to describe how information is documented and stored.
The first session is the most appropriate time to ask the client to sign organizational paperwork, including consent and permission-to-obtain/release information forms. Do not assume everyone is literate or that they are literate in the language used in the paperwork. If the client is a child or young person, clarifying family involvement is crucial.
Many social workers insist on seeing parents or caregivers for assessment sessions prior to working with young children. However, if the client is an adolescent, parents or caregivers are often invited to attend the first fifteen minutes of the initial session so they can be present for the introduction and paperwork.
Building rapport through ongoing assessment
The remainder of the first session should focus on building rapport with the new client and establishing psychological safety. Depending on the amount of time left, you can ask the client what they are generally hoping to achieve from counseling or engage in light conversation about their life. Topics that are usually not too sensitive, such as hobbies and interests, work well.
It is important not to start a conversation you cannot neatly conclude within the time remaining. Monitor the client’s presentation and engagement for inclusion in your case notes. This includes observing mood, affect, body posture, expression, volume and tone of voice, and eye contact. These observations should be noted during every client interaction.
Be mindful of any additional support the client might require, such as assistance with mobility, auditory, or visual impairments. Follow up with your supervisor to ensure the organization can accommodate these needs in future sessions.
It can also be helpful to inquire about the client’s culture or religion during the first session, as this may inform your counseling approach.
Follow up
In conclusion, establishing a systematic approach to setting up the first counselling session can be useful for new graduates who are consolidating their professional judgement and skills, often in the context of busy workplace environments.
Check out my online resources here for further professional development and support for social workers and other professionals.Â
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Laurenza Buglisi, Social Worker & Family Therapist
Laurenza Buglisi is a qualified Social Worker and Family Therapist who specialises in child sexual abuse. She was the founder of Juno’s Circle: Counselling, Training and Consulting, supporting families with complex trauma. Laurenza is committed to ensuring all families are equipped with the necessary tools and resources to parent protectively. As a mother to three young children herself, she understands the challenges of raising children in a digital age with an increased prevalence of child sexual exploitation. Laurenza is passionate about working with organisations and social work professionals to ensure a clearer understanding of compliance with child safe practice standards and reporting obligations.
