 We demystify what goes on behind the therapy room door. Join us on this voyage of discovery and co-creative conversations. This is The Therapy Show, behind closed doors podcast with Bob Cook and Jackie Jones. Welcome back to the next episode, which is episode 125. Bob, can you believe it? I know. And we're going to kind of go right back to the beginning with this one. And we're going to be looking at how to prepare for your first client, which I'm not sure you can even remember that far back. Well, well, you know, I was thinking about this because you tell me the last podcast, what this would be. So I started training in 1986 at Metanor Psychotherapy Training Institute. That's a long time ago. That's what? Where are we now? 23? So that's 37 years ago, is it? Something like that? Yeah. Now in those days, psychotherapy is a bit like the wild west. What I mean by that is it really just started. It was in its infancy in the United Kingdom. And there wasn't much regulation around it in many ways. So the UK CP, as a major regulated body, hadn't even been created. BACP, which was in its creation, the BAC, wasn't even created. I was training in transaction analysis. And there was a European Association of Transaction Analysis, which was a created, I can't remember where, when I was 78, maybe was 80. But anyway, there was no national regulated bodies really. So that's what I meant by the wild west because Metanor Psychotherapy Training Institute, when the first Psychotherapy Training Institute in London, I think the TA program, and I don't think they had any, I think they had one more training program actually in Gestalt Psychotherapy. But neither of them, as I said, there weren't the national, there wasn't the UK CP, BACP, or other regulating bodies around. So I was part of this European one. Okay, but this is right at the beginning of psychotherapy in this country. Where we are in 23, there's many regulating bodies. Training is usually a four-year program or could be more. BAC camps and courses are usually four years, three years, and sometimes two years, but they have level one, sorry, level two, three, four, five, and six. And the training I was on was a four-year training program actually, which was regulated by the European Association of Transaction Analysis. But it was before the days of placements, it was before the days of essays, it was before the days of the requirement of hours, it was before the days of many different things. And I'll just show you how wild it was. I could start seeing clients probably in the first three or four months of the first year. That shows how absolutely we're in a different world. So training is completely different in terms of regulation requirements. And I think I, well, it's interesting because I think in the February of that year, I saw my first client, so that'd be February 87, something like that. No, it'd be no past then. What was it? I can't remember. I was just thinking it was February, might have been earlier. But so I do remember my first client. I remember very well. And I remember me thinking, how shall I prepare for this first session? And I had no idea. There is no preparation for the first one. People now, they don't see clients so early in their training. They're using start-off and placements. They've done clinical competency practices before they get to the placements. There's used to be lots of discussions and training about what happens, or might happen, or could happen. They've probably got a supervise on all these different things. So you trained in 2010, was it? Or something? 2012. Yeah. So you would have done placements, wouldn't you? No. You've trained at our MIPS, didn't you? Were the placements going then? Oh, yeah. Well, I did the low-cost therapy. That was a placement. You would have done that in your second year. Yes. So you would have probably even done clinical competencies. Yeah. You practiced these competencies to have them evaluated by a trainer. Yeah. So you've got this whole discussion and this whole platform of experience, which is protecting you with everything else. Back when I started, there wasn't any of that. No. That's why I smile to myself. Wild West. Yeah. What should this first session be like? So I thought, so how it happened was, this is back in the day. Does anybody listen to this? Pardon me if I don't know people's ages, but back in the day where I decided to advertise, try and get clients, because there weren't placements and things like that. It was something called yellow pages. Love the yellow pages. It was a really good door stop. It used to hold the door open. So I decided I'm going to advertise in the yellow pages. Now, the problem with that in many ways was, well, it was positive. It worked, by the way. But I didn't think about, well, what do I do? Somebody phoned me up. What do they say to them on the phone? How do I work out whether they're suited for psychotherapy? Any of this assessment stuff I hadn't thought about. And I was very surprised when they had to be phoned me up. So somebody phoned me up and I wasn't quite sure what to say on the phone. And to my credit, I've had supervision. I had managed to get myself a supervisor and had spoken to them sort of about four days before this yellow page ad came out. So it had some training, if you like, on assessments and what to ask. And this person who was probably about 30 at the time, 29, he decided he'd like to have fair with me. So we arranged the time. And I can't believe I did this. But I arranged it 12 o'clock that's a midday on a Saturday, which A is working the weekends, but B much more prevalent. It was across a television program that was on at that time of the day called football focus. I always watched football addicts. Now, this was really devastating. It may not be for you, but because this person stayed with me for over two and a half years, I never saw football focus again for two and a half years. That's so funny, Bob. I can't believe that that's the one thing that's coming to mind. Well, if you think of preparing for your first session, it's important to think about, well, am I going to work out of social hours? Like at the weekend, for example. What time, if I am going to do that, does that then interfere on my, well, it did in this case, I've just told you, but interfere on my social time, am I prepared to do that? Going along with that, Bob, as well, I think it's important to look at it long term. This isn't just a short term thing. You might think, oh, well, I can give up my Saturdays for a couple of months. This client stayed with you for a couple of years. So it's about doing those, you know, unsociable hours long term, maybe. Yeah. Very good thing to say, but it didn't occur to me at the time. It's a tip for people listening. It's a really good thing you've just said there to think about if you're going to work long term clients, then, yes, it's a very good thing to think about. Yeah. One of the things, do you know what I mean? For me, in order for people to pay when, you know, we're in private practice, the majority of them are in work Monday to Friday, nine to five. So a lot of my clients early on were after six o'clock. So it was a lot of, in fact, I still do a lot of evening work. Do you know what I mean? So it's not like being employed by somebody and having a working day. And I did used to work weekends, but found I gave that up as soon as I could. Yeah. Well, I used to watch Top of the Pops. Do you remember that? I do remember that. Yeah. On Thursday night. When I started seeing clients, I never saw Top of the Pops again for years. I don't know. You survived the early days, Bob. I really don't. I think I did survive it very well, because many of my favourite programs, especially around football, I didn't see for years. And again, there's a program called The Prisoner On around that time. I've never saw the ending of that. But I'm going to catch up on YouTube now, Bob, if you want to. In a serious note, you're correct. It is important to think about this in terms of social time. If you're going to see somebody long term, I think it's an important consideration how to prepare for your first client in terms of the logistics of the appointment. Yeah. So I think it's a very good point. And I didn't. Yeah. What I did do in the time before the person came was my phone was supervised again for a second session, because I had one already. Talking about, I think I've only wanted Tuesday. And I've said, well, you know, how do I prepare my room? Do I have the chairs opposite each other? And if they are opposite each other, how should I get a sort of ruler out and measure how much distance there is between one chair to the other chair? And should I have the chair at the side? Because if I've got the chair opposite my client, I might be staring into their eyes and they might feel intimidated. So I got myself obsessed with how the environment that my client was walking into. So should I make them a cup of tea? Do I need to make sure that there's some water around all these biscuits around all these things? And how many cushions should I have? And should my cushions be colour coordinated? And there should there be tissues in the room? And my supervisor, I think after listening to me for about 40 minutes said, it's okay, just calm down. If we're preparing for a first session, even though I went over the top and I was projecting my anxiety onto all these practical things, I do think it's important the environment that the person's coming into. Yeah, yeah, absolutely. Do you? Yes, yeah. If anybody again on YouTube, you can kind of see this is where I see clients behind this part. This is my working room. So this bit is where I do my videos and the other bit. But I paid a lot of attention to it, you know what I mean? There's a couch on one side and then there's my chair. I've had clients that come in and want to sit in my chair, which is absolutely fine. Do you know what I mean? But I agree with you. Do you put the chairs directly facing each other or on a slam tour? Yeah, what do you do? That's fine. So I think it's an important point, what I said was that most people, they are anxious because it's their friends' client. Yeah. And people project their anxiety out onto practical things and often to the supervisor they're talking about. I did it obsessively. So when she started talking about, we can talk about that and it just calmed down, you feel anxious. Once I talk about my anxiety, then the obsession about getting a ruler out, about measuring how much distance from one chair ceased. Good. I think as well, it's worth mentioning that sometimes we're hiring a room or using somebody else's room but we don't really get much chance to do anything other than jiggle the furniture a little bit maybe. That's a really good point because many, many people do hire rooms out. Depending on where they are, of course, or depending on the policy and regulations that that organisation has. So they might have rooms and regulations about when you can't change the pictures, you can't change this, you can't do that. So there's no personalisation of the room. Yeah. And you might only have it for one day a week. So to me, you need to work from 9 o'clock in the morning, right, food's on 9 o'clock at night because that's the only day that you can see clients. So you might be limited to certain things. I still think for the first sessions, when you're starting out, one way to, even if you're working in that type of organisation you just talked about, there will be small things you can do. Yeah. There will be, whether it's bringing in tissues, whether it's about bringing in different types of cushions, whether it's about, there will be things you can do. Yes. Because for me as well, I like a throw, you know, I don't know why, but when I'm in a therapy session, as in I'm the client, I always feel cold. I don't know why that is, but I always feel cold and need the toilet whatever that's about. I don't know. So that's another thing to be mindful of, you know, to me, having a bathroom available to the clients. Yeah. Yeah. And it's really important because of the relational needs for safety and security. Yeah. Are really important. Things like warmth. Yeah. Yeah. Things like, well, many of the things that will help somebody feel secure are really important to attend to. Yeah. Also, if you're working with somebody who's anxious, somebody who's getting in touch with their younger self, somebody who's regressed, somebody who's not their adult, they might be so full of anxiety, fear or scare, which is the way you want to talk about it. Going to toilet, going to the toilets is really important for them. Yeah. So I think it's really important there's a toilet. I think it's really important it's warm. I think it's really important it's secure. I think it's really important it's safe. And it's important for the therapist, I think, at the beginning when they're going through probably their, you know, their admin contract, whatever that is, to show the client, well, this is worth all it is. Yeah. You know, and all the various really important things around security and safety. So the person feels, oh, this is a place I can actually feel safe in. Yeah. Because one of the things that I always thought, and I think it goes back to when I was a foster carer, I often used to think what it was like for the foster kids the morning after they'd been placed with us, how it would feel to be in a strange house with somebody that I've never met before, that first morning coming downstairs. Do you know what I mean? And I would have hated that. So for me with new clients, not necessarily me as a new therapist, but with all my new clients, I give them as much information about the area that I am, where's the best place to park. Do you know what I mean? On my website, there's a picture of the outside of my house, so it's familiar to that, you know, there's quite a bit of thought gone into putting my clients at ease on that first session. Yes, I think that's very, very important. And people that ignore that or discounted or minimise what we're talking about here, I think it can promote a place where the client may not feel that safe to do the work they need to do. Yeah. The other thing that I did on my first session was had reams and reams and reams of activities and things I could do because I didn't feel confidence in my ability to just be in the moment with clients. It was like, no, I need, I need something that I can work through step by step. Yeah, well, I know you like a lot of diagrams and techniques, but all these things are important. And they're often, you know, we just talk about security and safety for the client, which I think is extraordinarily important. We also need to think about how do we maintain our anxiety ourselves in that first session? Yeah. Or is the therapist by definition their first session that going to be hugely highly anxious? And how do we take care of ourselves so that we can soothe our own anxiety? Now, if that's by lots of exercises, techniques, whatever it is, that's not bad. Yeah. I think I can remember in my early days, because I used to rent a room from you at MIP. And, you know, it was interesting because there was, you know, therapists that had been there for years and like me, a newly qualified one and everything. And I can remember one therapist used to have a snooze in between clients. And I can remember thinking, there's no way that I could be that relaxed in between clients that I would literally lie on the couch and have a 10 minute snooze in between clients or whatever. But yeah, that's what they did to take care of themselves. Yeah, maybe. But I bet that person's quite experienced and I bet that person, it wasn't their first session. Absolutely not. No. So, you know, for me, I think it was a really good environment as a first time psychotherapist to be amongst therapists that had been doing the job for different amounts of time to see it's not all bad. So how we manage our own anxiety is really important to think about. Another thing she's absolutely important to think about is safety and protection. And I don't know how many people, and I've never done any research on this, see their clients for the first time at home. You know, they're okay. So your first client wasn't in the placement of MIP, it was at home. Oh, no, I'm with you. My very first one. No, it wasn't. It was at MIP. Yeah. Yeah. That's right. So in a way, the organisation took care of the safety of the building. Yeah. There's other people around. Yeah. So in a way, that's that's great for you because they don't have to think about this. Yes. Yeah. People who work from home for whatever reasons, economic or whatever it is, so their first session is at home. They need to think about several things around protection for themselves. Yeah. That's really important. And that will start off in the assessment. Yes. Yes. Absolutely. Again, at MIP, I did the assessment. So I probably worked out the placements for you asking all those years ago. Yeah. You're doing yourself on the telephone. You know, you're, it's really important because in essence, you're inviting a stranger when she has. Yeah. Yeah. And when I did, even though I was experienced as in, you know, a couple of years in, even when I did start seeing clients from my house, I can remember feeling really vulnerable when I first started and even asking the question, should I have a panic button? Yeah. Well, that's, see, that's a very, very real question. And, and actually, a supervisor might suggest you do have a panic button, especially if you work for a loan from your house, your first client, you're going to be tremendously anxiety. It could even be somebody, well, it'll be a stranger probably. Yeah. You know, it's a very important question to take to a supervisor about. Yeah. And, you know, the advice supervisors might give probably things which might go from panic buttons to make sure your friend knows when you start a session and when you end a session. Yeah. And if anybody else in the house, and if there isn't, make sure that you fix up things with friends who know when you start and when you finish. I think that's what I did was to you, because for confidentiality, obviously, you can't be sharing lots of information about who you are seeing, but you can say, I will be with clients from this time to this time. Do you know what I mean? So that if they don't hear you from you afterwards, then something might have happened. Yeah. Yeah. So I think to think about your own protection, think about where you're going to be working from is really important. Yeah. Especially if you live alone. In fact, you know, I think it needs to be a lot of supervision about if you're alone seeing clients, you know, for those of you being in an organization or working from a center or working from a place where there's a lot of people around. It's a big discussion, I think. Yeah. In the early days, or generally as a psychotherapist? Generally anyway, but I was talking about this. Well, generally, yeah. Anyway, hopefully through supervision, I've worked it out more and all these sorts of things. But in terms of a first session, particularly. Yeah. It's strange as well, because I suppose, you know, as you're talking about, you know, the safety, I personally can remember feeling quite vulnerable in the early days when I was doing it. And I was thinking, would I have felt that way if I was a man? I don't know. Is it just talking about females on their own? Or potentially anybody can be open to something happening in a therapy room? Yeah, I mean, as a male. Now, my first part was a male, so I didn't feel what I'm going to say now. But, you know, generally, if you think about it just as a man with a woman, the opposite sex, you know, it's just as open to allegations or, or whatever, you know, as a same sex. So we live in a world now where, you know, it may, I was just thinking of protection, but I know, I know this is a really important area for people to think about when they have their first clients. Yeah. Yeah. I think how we manage our anxiety is a really important thing to I think, as I said, the environment and the safety and everything else. Yeah. I also think to have your supervisor set up is really important. And if you can, have a session before you see your first client with your supervisor. I mean, back and then I remember, as I said, phoning my supervisor up for at least one session, maybe even two, I can't quite remember, before I saw this person, mainly to deal with all the anxiety I have. Yeah. So again, we, I didn't really have much of that because we were trained at MIP. Part of the course was to have supervision. So we automatically took our low cost clients to supervision. It was a very cost-eated way of doing it, which is why I loved it. You know, for two years, we were still training and had supervision and it was a very nurturing way of becoming a psychotherapist. Obviously, you put a lot of thought into that, Bob. I did. And I think maybe a lot of people listening on the various counselling courses or therapy courses will have what is called placements now. Yeah. You know, all these things are considered and they have to have a placement supervisor. And they should be having a session, I think, before they start seeing their first client. And if they work in, you know, a beacon or mind or whatever placement provider we're talking about, they should be providing the assessment process. They should be providing the premises XXXXX. Now, MIP had very nice premises and I know not all placement providers do, but or stroke and I think these are the things that are important in the first session. And you need to make it, I think, one really big tip, to make it as easy as possible for you, which means minimizing your own anxiety, usually. Because in general, the clients would it usually be more scared than you? I can remember you saying that to me Bob I literally can't you've just broken that I can remember you know what I mean and the other question I think that I asked you was am I gonna damage them if I get it wrong that was a big fear of mine if I get this wrong in the therapy room potentially I'm gonna damage this person yeah this is where supervision is really important isn't it yeah when you start seeing crimes yeah ultimately you are going to be anxious on your first session you know it's not going to be perfect I think you need to prepare yourself for the fact that you're going to be scared when you walk into that first session yeah okay well actually I'll go further than that it's really odd if you weren't anxious yeah something very wrong if you don't have the anxiousness or apprehensiveness the main thing is that you have that first session that you do it don't talk yourself out of it yeah that's a big one you have to it's really important and most groups I know again on our training that have got placements you have a social Facebook page where they actually do sort of not talk about all the confidential stuff here I'm just talking about you know about your first session you know and it didn't collapse did you or whatever it is yeah the confidential stuff and the exologist of all goes to the supervisor but there was something about mutual conversation if you like yeah so people have gone down the same road yeah absolutely and I was really honest and open with the people that I was in training with do you know what I mean I think you need to be in that safe space where you can talk about the things that you get wrong and how you felt without fear of judgment or criticism yeah that's a really never big thing isn't it for people just starting their first session is support yeah he is yeah not just supersizing it obviously really important but you know colleagues peers people are going down the same road as you yeah really important yeah absolutely it is it's a it's a nice community to be in I think as a psychotherapist that's a good way again to manage your anxiety and to manage what you just talked about there often might be unrealistic unrealistic expectations because when you say starting off of course like everything else you have to learn by mistakes you have to learn by challenges you have to learn by difficulties and if you don't then actually you're in the wrong career yeah yeah but I remember my first session like yesterday and how do you remember mine now now the other thing about that I was amazed you ever came back because first of all it was very late and secondly I have no idea well in general terms I do Jack is some sort of exaggerating AI smiling because I just remember this how I got through the session and secondly what on earth did the person talk about because because my anxiety was so high I mean I know they talked about you know what they can issue was and everything else but to be perfectly honest that 15 I wasn't 15 it's three courses now because I came late when so quick yeah I had that when they went away first of all I had to write down why I did remember which wasn't much and I had convinced myself when I've come back anyway so I was amazed when they came back and it came back and came back and came back anyway so I think it's important to prepare yourself as much as you can to minimize your anxiety and and also disappointment and victories and things that go on on the way but that's my biggest tip I think to minimize yourself so to to really prepare how to manage your own anxieties or disappointments yeah do you think it's important or not important to mention to the client that you are new to this well that's a wonderful question according to what's seen by you okay well we'll say different things I think that in terms of ethicality and transparency it's important so again well I didn't have to worry about that because the low-cost clients it was an understanding that they weren't newly trained or in training psychotherapists so it was kind of the done but I'm just thinking outside of that I think you need to and also your prices should reflect that you're a trainee anyway so no I think it's very important that if it's that's your first client that when you advertise and when you accept somebody and in the contractual stages you say that you're a training psychotherapist and several things happen there one it'll take anxiety off you number two I was thinking yeah number two you've got transparency three your prices should reflect that so yeah that might be one of the reasons they come anyway and also then the client will feel more honoured by your level of transparency and honesty yeah yes is the answer to the question good I'm glad because I think I would say that that's important as well mainly for the first bit that it will help with our anxiety if the other person knows that we're in training yeah I did that I definitely did that for the reasons I've just said and I would certainly recommend that everybody does yeah and like I said you know I would recommend MIP for anybody that wants to get into this training I'm always you know singing your praise is the way that it was it's set up it's designed it's very it's a smooth process that sees you from the start on the you know transactional analysis 101 all the way through to being a fully placed person no I think really helps in terms of safety security transparency assessment all the things we're talking about here and I hope some of the tips we've said in this video will help people and might also remind themselves when I think of a more experienced people might be listening and take themselves back to that first time with their first client and I think I think to remember the beginning and how it was and how we've grown and where you are where you've come to today is it's important to reflect on the journey and I love listening to your stories Bob because for me you've been you're my mentor and my guru and you've been doing this forever but to hear you talking about your early days of being a psychotherapist doing it at 12 o'clock on a Saturday and not being able to watch a football program it's terrible I was always you know avid football person, Manchester City particularly and that I don't know what earth took me to do that but I'm on a reflection now talking this it would have been around anxiety over adapting to the person in front of me or on the phone in this case yeah when they could fit in rather than when you were willing to do it and again you know looking at it long term which is one of the reasons why I said you've got to think that you're doing this long term is because resentment can set in if you're not being able to do what you want because you're seeing a client so don't go there don't do it when football focus is on all the accidents anyway yeah or Coronation Street it's never a good at half past seven on a Monday Wednesday or Friday either yeah yeah blimey yes so Bob until next time we're what we're going to be looking at which is up your street important books that will be influential for the clinical therapist a review of literature so maybe your you know I could talk forever honestly I think I've had I think I probably have got nearly all books that have been written in transaction analysis since 1960 I reviewed most of them I think I've got most of the integrated books in terms of earthskin and many many many many so that podcast I do not know how we're going to fit it into the 40 minutes you'll have to write me back in in the podcast and then there's of course all the you know all the books that you've written as well well yes we could do a part one and part two if it's going to be a long one but I was just gonna say I don't think there's a podcast that goes by that you don't throw a book title in there that's relevant to the podcast you're probably right because if I'm going to mention a book I'm going to talk about how that fits in what it's about and why should people should read it I don't know if we can do it too but we can maybe have a part one and two if need be yeah and anyway what was the second one which we probably won't get round to but we might get round to um how we present ourselves in the therapy room and does it matter yes I think if I I think I don't know if we're going to get around to that but at least I'll know what the one is for the three weeks after or whatever it is yeah so come back and you'll be surprised whether we're doing a one or two or or what or a hybrid a hybrid yeah mix them all up so until next time Bob thank you so much yeah thank you bye bye take care bye you've been listening to the therapy show behind closed doors podcast we hope you enjoyed the show don't forget to subscribe and leave us a review we'll be back next week with another episode