What to Expect in Counselling

Meet Ali

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An initial 15-20 minute phone consultation is often very helpful for both you and myself as a therapist.  This is an opportunity for you to ask questions, determine if it feels like a good fit, and explain what brings you to counselling and what goals you are hoping to work towards.  It is also an opportunity for me to tell you if your goals fit within my scope of practice as a therapist. Some people prefer not to have a consultation and dive right into the first session, this is okay too.  

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Initial Session

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We will discuss what has brought you to counselling in more detail, and what areas are most important for you to start working on.   During this session, I may ask if you feel comfortable speaking about your background and key life events, this helps me to understand the context of your experiences, which can allow for richer support.  Some people prefer to take their time to share important aspects of their story.  For couples and families, we look in depth at the history of your relationships, your ups and downs and your goals and hopes.  At the end of the first session, I may invite you to do some home practices and reflection based on what we spoke about.

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Session Two

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Much of what happens in the second session is to further define the goals that were set out in session one and collaborate on a plan of action. We will explore your thoughts and feelings, and begin to look at themes in your experiences. Working through these thoughts and feelings, at a pace you’re comfortable with, helps to clarify where we need to go, where to focus, and can be a significant release—and relief.  I may assign some things to work on before your next session.

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Subsequent sessions

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We continue to revise your goals as you make progress in therapy. I will normally ask at the start of the session what you wish to discuss and what you need from each session.   I may check-in with you part way through the session to make sure that we are talking about and spending time on the areas that you had hoped to cover.  If you have been working on home practices, we may speak about how these have gone and what you have learned.   Home practices and reflection often become more tailored over time, as better I understand you and your needs.

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How many sessions do I need ?

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This is a common question, and the simple answer is that it depends on your goals, the problems that you are identifying, the types of treatments and interventions that you are receiving, and sometimes most relevantly finances. With all this is mind, there are several options to consider when it comes to the frequency of counselling sessions:

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Short-term  (1-6 Sessions)

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Some people are looking for short-term or brief therapy to address a specific issue or get 'unstuck' in a certain area.  Narrative Therapy Solution-focussed therapy, and Mindfulness-based therapies lend themselves well to these needs.   Sessions will focus on exploring the impacts of the problems you identify and increasing awareness of the coping skills you already have in place, and building upon these through teaching new strategies and skills to navigate stressors and enhance wellness.  Families, Couples and Individuals can find benefit from short-term focused counselling.

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Medium-term (6-20 sessions)

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For people seeking  who would like to address more significant mental health concerns or who are specifically looking for Cognitive Behavioral Therapy (CBT),  6-20 should allow for significant progress.  Research indicates that CBT is most effective when provided in 12-20 sessions, although many people will find benefit from a smaller number.  The treatment of trauma normally requires a minimum of 12 sessions.   Most evidence-based treatments for couples counselling recommend a minimum of 8 sessions.

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Long-term (over 20 sessions)

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Some people are looking for longer-term counselling.  This could be because they find it helpful in maintaining their mental health and wellness, or because they have multiple or complex issues that they would like to address.  The decision to attend counselling on a longer-term basis is often not made right away,  and would be discussed in sessions as counselling progresses. 

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Session Frequency

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People often ask, “How often do I need to come for therapy?”, as with considering how many sessions to attend,  it is helpful to keep in mind your current situation, your goals, and the rate of change you are seeking.   Finances can also be a factor in determining frequency of therapy.  Many people begin attending counselling more frequently and decrease frequency as gains are made.

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Weekly Sessions

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Opportunity to make solid gains and meet your therapy goals. Having regular weekly sessions is often the best choice at the beginning of therapy as this allows you the opportunity to keep momentum in the areas that you are working on, and sessions can allow for richer exploration.

 

Bi-Weekly Sessions

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For people who are seeking to maintain gains made in therapy and /or begin to explore goals more independently.

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Light Support

 

One session every 3-4 weeks. Outstanding concerns benefit from some focused, regular attention but such concerns are not all-consuming; you are doing well in most other life areas. 

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Maintaining Gains

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Almost all goals have been reached but you may have a concern about maintenance over the long term. Typical counselling schedules in this category are one session every 6 weeks or one session every 3 months.

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