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Writer's pictureErica Cardenas, LCSW

Tips for New Clinicians Navigating Their Early Sessions

Starting your journey as a therapist can feel overwhelming, especially when it comes to those first few sessions with clients. It’s completely normal to feel nervous! As a clinical supervisor who has worked with many therapist trainees, I know how those early interactions can stir up anxiety. However, these sessions don’t have to be perfect. In fact, they are less about finding the "right" solution and more about building a foundation for a strong therapeutic relationship. Here are some tips to help soothe your nerves and guide you through those initial client encounters.

1. Focus on Rapport Building (Relationship Building)

In the first few sessions, your primary goal should be to create a safe, welcoming space for your client. Therapy is a partnership, and before diving into treatment plans or interventions, it’s essential to get to know the person in front of you. Take time to learn about their background, interests, and current life circumstances. Ask open-ended questions, show curiosity, and listen attentively. Clients are more likely to engage in therapy if they feel seen, heard, and respected.

Remember, rapport doesn’t happen overnight. Building trust takes time, so don’t pressure yourself to form an instant connection. In fact, EXPECT that rapport building will take weeks, months, even over a year sometimes! Just be yourself, show empathy, and offer a non-judgmental presence.

2. Explore Their Perception of Therapy

Clients come to therapy with varying degrees of understanding about the process. Some may have attended therapy before, while others might be completely new to it. Use the first few sessions to explore what they think therapy is—or should be. Ask them about their expectations, hesitations, or any concerns they might have. Understanding how they view therapy will help you tailor your approach to meet them where they are.

You might ask:

  • "What made you decide to seek therapy at this time?"

  • "What do you hope to get out of therapy?"

  • "Have you been to therapy before? If so, what was that experience like?"

These questions not only give you insight into their mindset but also provide an opportunity to address any misconceptions or anxieties they may have about the process.

3. Discuss Past Therapy Experiences

If your client has attended therapy in the past, it’s important to understand what worked for them and what didn’t. This conversation can reveal their preferences, needs, and any potential challenges. Clients who’ve had negative experiences may be more guarded or skeptical, while those with positive experiences may have specific ideas about how therapy should unfold.

Take the time to ask:

  • "What did you like or dislike about your previous therapist or therapy experience?"

  • "Were there any specific strategies or approaches that you found helpful?"

Understanding their past experiences will help you avoid repeating past mistakes and create a more personalized, client-centered approach.

4. Clarify Needs and Goals

The first sessions are a chance to collaborate on identifying the client’s needs and goals for therapy. Instead of diving straight into problem-solving, take the time to explore what the client feels is most pressing in their life. This will give you both a clearer sense of direction.

You could ask:

  • "What areas of your life are you hoping to work on?"

  • "Are there specific goals or changes you want to achieve?"

  • "What are some of the challenges you’re currently facing?"

These conversations set the stage for a more structured treatment plan as you move forward. Even if the client’s goals are vague, that’s okay. You’ll refine them together over time.

5. Be Gentle with Yourself

It’s easy to put pressure on yourself to “get it right” from the start, but remember: therapy is a process, and it’s okay not to have all the answers in the first few sessions. Your job is not to fix everything right away but to provide a space where the client feels comfortable exploring their thoughts and feelings. Focus on being present, curious, and compassionate—and trust that the rest will follow.

The more you practice, the more confident you’ll become. Early nerves are natural, but with time, those feelings will ease, and you’ll find your rhythm.


Remember, if all you do is make your client feel cared about and safe, you've done a lot.

 

Your first few sessions as a clinician are important, but they don’t need to be perfect. Building rapport, exploring the client’s perceptions and past experiences with therapy, and clarifying their needs and goals are key elements of these early stages. Remember to take it slow, stay curious, and focus on connection rather than perfection. You’ve got this!

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