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My First Client

by Madi Ruby (May 2009)

Well, I had arrived. After studying the theory and practice of counselling and case management such as contracting, confidentiality, boundaries, power (Proctor 2002) and assessment (Wilkins & Gill 2003) - and those hours honing my empathy, UPR (Unconditional Positive Regard) and congruence in triads (Rogers 1957, 1959). The letter writing and interviews to find my precious placement in a GP surgery, having begun both group and individual supervision I felt sure I was "ready' to meet my first "real' client.

I had familiarised myself with the surgery computer system. I knew which keys let me into my room and opened the filing cabinet. I'd decided on my counselling clothes - after all I wanted to be comfortable both in my clothes and my own skin!

Despite all this preparation I was very nervous - the kind of nervous that miraculously turns breakfast into "the runs' in less than half an hour - thank goodness for the relaxation techniques I learned in ante-natal class. By the time I arrived I was grounded and ready - reminding myself to trust the process (Rogers 1967).

I went to reception to meet my first client, knowing only the name and age. There were several people in the waiting room that might have been my client, but when I called the name and a timid looking person with a young child came towards me I can honestly say I wondered how would I manage the reality of the ethical considerations? The ethical framework (BACP, 2008) practically flashed before my eyes! How would beneficence to my client, justice in providing a service equally accessible to all who need it (including those without childcare, or too scared to use it), non-maleficence in considering if counselling the adult with the child present could be damaging to either (or both) be balanced? All this in my awareness and we hadn't even reached the room yet.

I took a deep breath and reminded myself we would discuss the client's hopes for therapy and discuss what I could and could not provide. We'd discuss the potential issues of the child being present and jointly decide whether to work together or not.

So, what happened? We talked about what I could offer, what was wanted, the difficulties of childcare and the difficulties of really being able to engage in counselling for each of us with the child present. The client did want counselling and suggested being able to arrange some child care. We agreed the client would investigate this and that I would discuss potential issues with my supervisor. We agreed to meet again the next week to decide how to move forwards.

I'm happy to report this client did come back and completed a course of counselling that we both noticed seemed very useful in sticking with some tough decisions in life. The client was grateful for this. I learned to always expect the unexpected and to be thankful that I had prepared myself well for making ethical decisions.

As I showed my client out after that initial session, I must admit that I did half wonder if my tutor would pop out from behind a screen and say "Well done, you've passed - now you can really see some real clients'!

Note: Some details changed to preserve anonymity.

References:

BACP. (2007). Ethical Framework for Good Practice in Counselling and Psychotherapy (1 April 2007 ed.). Lutterworth: British Association for Counselling and Psychotherapy.

Hill, D., & Jones, C. (Eds.). (2003). Forms of Ethical Thinking In Therapuetic Practice. Maidenhead: Open University Press (McGraw-Hill Education).
Proctor, G. (2002 b). The Dynamics of Power in Counselling and Psychotherapy. Ross-On-Wye: PCCS Books.

Rogers, C. R. (1959). A Theory of Therapy, Personality, and Interpersonal Relationships, as Developed in the Client-Centered Framework. In S. Koch (Ed.), Psychology, A Study of a Science (1959 ed., Vol. Volume 3. Formulations of the Person and the Social Context, pp 184-256). London: McGraw Hill Book Company.

Rogers, C. R. (1951). Client-Centred Therapy (2003 ed.). London: Constable.

Rogers, C. R. (1967). On Becoming a Person, A Therapists View of Psychotherapy (2004 ed.). London: Constable.

Wilkins, P., & Gill, M. (2003). Assessment in Person-Centered Therapy. Person-Centered and Experiential Psychotherapies (Purchased downloadable version from PCCS Books http://www.pccs-books.co.uk/product.php?xProd=210 on 07/12/2008) , Volume 2 (Number 3), pp 172-187.