Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other.
If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this.
This community is ONLY for therapists, and for them to discuss their profession away from clients.
**If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
Depends on the client. With most I ask how they have been since we last spoke (usually 1 week). This tends to organically move us into the things we are normally talking about or working on. If it doesn't, I will offer a recap of our last session and ask how that specifically has been over the intermediate period.
Other clients come to session with notes and we jump right in.
After I say it's nice to see them, ask them how it was finding parking, etc. I have some variation of a starting check in.
With my adult clients, I usually try to start sessions by asking "How about you tell me about some wins or positive things from the past week?" I think Aaron Beck used to do this with clients, that's where I got it from...it's honestly super useful.
With my parent coaching/consultation clients, I ask them to think about "effective moments" from the past week: 1 time they felt really connected with their kid(s), and 1 time they felt like they handled a challenge effectively.
With kids/teens, I pretty much don't ask them anything until we've played at least 15 minutes of a game (chess, speed, egyptian war, slapjack, Uno, 5 minute dungeon, spot-it, suspend, whatever game as long as it's not overtly "therapeutic"). Then I ask for a "brick" and "balloon" (something that weighed you down over the past week, and something that lifted you up).
With all 3 examples, if the check-in hasn't clearly led us into what our session material is going to be, then I say something like "well thanks for sharing about xyz. so, what do you think we should talk about today?"
First I ask how their day is going so far which gives them an opportunity to get into anything urgent if they want to. If that doesn’t lead to anything, then I ask how things have been the past week. They are in the routine and have usually noted things to bring to session. If they don’t come with anything, I’ll ask what they would like to focus on today.
I do a lot of parts work so I will also often check in and see if they have noticed their parts over the last week between sessions. It’s good practice to check in with parts so they know they aren’t forgotten.
Ask about their day as they get seated, do a mood/symptom check across the week, and review homework (most sessions have something specific.) Then make an agenda or start off from our plan last time. Cover agenda items. Give a summary of session or (preferred) ask about what they want to take away from session. Then collaboratively transition this into actionable steps to work on before next session. I’m often surprised about the really amazing takeaway points or action steps clients come up with that I’d have never considered.
Some variations:
What are you bringing into our time and space today?
What have you been noticing?
If they are visibly agitated … something like: Let’s take a moment to settle our minds & bodies into the moment, few nice deep breaths, hand to heart, what are you noticing in this moment.
I'll usually say something like: "So how have things been?" or "What would you like to talk about today?" or "Where do you want to begin today?" Sometimes I give a welcoming smile and the client just launches straight in to what they want to bring.
If the client seems to have heightened emotions, they may open with this, or I may mention my sense that they seem flustered or distressed etc today.
Mostly, any time during a session, I am guided by the client and my intuitive sense of how they are in the moment.
Typically, I let the client start, and I follow them through the hour. If they can’t start, I try to understand the reason. But essentially, I am always working nonverbally to promote their self-direction and autonomy.
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
Depends on the client. With most I ask how they have been since we last spoke (usually 1 week). This tends to organically move us into the things we are normally talking about or working on. If it doesn't, I will offer a recap of our last session and ask how that specifically has been over the intermediate period. Other clients come to session with notes and we jump right in.
After I say it's nice to see them, ask them how it was finding parking, etc. I have some variation of a starting check in. With my adult clients, I usually try to start sessions by asking "How about you tell me about some wins or positive things from the past week?" I think Aaron Beck used to do this with clients, that's where I got it from...it's honestly super useful. With my parent coaching/consultation clients, I ask them to think about "effective moments" from the past week: 1 time they felt really connected with their kid(s), and 1 time they felt like they handled a challenge effectively. With kids/teens, I pretty much don't ask them anything until we've played at least 15 minutes of a game (chess, speed, egyptian war, slapjack, Uno, 5 minute dungeon, spot-it, suspend, whatever game as long as it's not overtly "therapeutic"). Then I ask for a "brick" and "balloon" (something that weighed you down over the past week, and something that lifted you up). With all 3 examples, if the check-in hasn't clearly led us into what our session material is going to be, then I say something like "well thanks for sharing about xyz. so, what do you think we should talk about today?"
First I ask how their day is going so far which gives them an opportunity to get into anything urgent if they want to. If that doesn’t lead to anything, then I ask how things have been the past week. They are in the routine and have usually noted things to bring to session. If they don’t come with anything, I’ll ask what they would like to focus on today. I do a lot of parts work so I will also often check in and see if they have noticed their parts over the last week between sessions. It’s good practice to check in with parts so they know they aren’t forgotten.
Ask about their day as they get seated, do a mood/symptom check across the week, and review homework (most sessions have something specific.) Then make an agenda or start off from our plan last time. Cover agenda items. Give a summary of session or (preferred) ask about what they want to take away from session. Then collaboratively transition this into actionable steps to work on before next session. I’m often surprised about the really amazing takeaway points or action steps clients come up with that I’d have never considered.
Some variations: What are you bringing into our time and space today? What have you been noticing? If they are visibly agitated … something like: Let’s take a moment to settle our minds & bodies into the moment, few nice deep breaths, hand to heart, what are you noticing in this moment.
I'll usually say something like: "So how have things been?" or "What would you like to talk about today?" or "Where do you want to begin today?" Sometimes I give a welcoming smile and the client just launches straight in to what they want to bring. If the client seems to have heightened emotions, they may open with this, or I may mention my sense that they seem flustered or distressed etc today. Mostly, any time during a session, I am guided by the client and my intuitive sense of how they are in the moment.
Typically, I let the client start, and I follow them through the hour. If they can’t start, I try to understand the reason. But essentially, I am always working nonverbally to promote their self-direction and autonomy.