When my supervisor gave me my end-of-the-semester review, she gave me a great compliment, saying that I “seem very comfortable in my skin” and how that is a great asset for a counselor. Of all the words of praise she had given me over the past few months, those meant the most.

Years of my own therapeutic work got me to the place I am today, a place where I can be of most help to others. It has been a long, often difficult, but also rewarding journey to reach the place I am today, and that has made me all the more empathetic to the struggles my clients face.

Although our essential issues may not look similar, the human condition of working to triumph over adversity is the same.

I was humbled by the trust my clients put in me, a perfect stranger whom they chose to sit with for 50 minutes once a week, for at least four weeks of their semester. They believed I would listen to them, understand their stories, and maybe help them in ways they had not thought of before. We had success, we had struggles. I truly believe we all learned from the experiences and are better for it.

If I had to pick one word to describe a main issue every single one of my clients presented, it would be “relationships.” Upon further reflection of that thought, it’s really not a revolutionary idea: if you have loving, supportive people surrounding you, there’s probably a good chance your mental health is pretty good. But if you throw even one person who causes angst into the mix, life can go downhill quickly.

I did a tremendous amount of interpersonal work with my clients, but never did I expect that would be the case. I’ll admit—in my DBT training, the module on interpersonal effectiveness was my least favorite, and yet, it was those skills I utilized the most for teaching my clients how to appropriately and successfully communicate.

As a side note to that, I also never expected the role technology would play in how people communicate with each other. My blog earlier in the year on Facebook and process commentary touched on this observation, and this topic on how people (mis)communicate through technology is a subject that needs much more research in the counseling community. I was talking with my mentor recently, who also counsels adolescents, and we laughed about the idea of role-playing with a client how to have an appropriate argument through text messaging! As these young people get older, we will see more of this type of communication affecting the lives of young adults as they move into careers and family life.

To wrap up our semester, for our last group theories class, our professor and department chair brought in his wife, a registered art therapist, to teach us about art therapy techniques. By no means was a three-hour class long enough to impart even the basics to us, but it was an interesting experiential class nonetheless. For one exercise, she had all of us divide a sheet of paper into thirds. In the first column, we were asked to draw ourselves as counselors at the beginning of the semester. In the last column, we drew who we envisioned ourselves to be at the end of our careers. In the middle column, we drew what would get us from who we are as beginning counselors to who we will be years from now.

My first drawing was of a seedling, just poking its head above the brown, newly tilled surface of the ground. It had a tiny red flower with deep, thin green roots, and a bright sun overhead. My middle drawing was of a clock. The last drawing was of a mature tree, with lots of leaves to provide shade, and deep roots, but this time, the roots were strong and thick, and there was grass below the tree, where the open, exposed soil had once been. The sun continued to shine overhead.

I was not alone in putting a clock in my middle panel—the majority of the drawings I saw from my classmates indicated that time was the main element that will get us from the neophyte stage to seasoned counselor. My general theme of starting off as something young and perhaps delicate — as indicated by my flower — then becoming steady, strong and reliable — like a big oak tree — was also echoed by my classmates. Many of us recognized that we already have the core elements we need to become excellent clinicians, but time, training, and experience are what will get us from where we are today to where we hope to be in the future.

On that note, my first year as a Master’s student has come to a close, and it has been a pleasure sharing my journey as a beginning student therapist with the Psych Central audience. Fall brings my internship experience, and I hope to bring you stories from an intern’s perspective then. Enjoy the summer!

Technically, I did say goodbye to four clients earlier in the semester, but over the next few weeks, I’ll be saying goodbye to clients with whom I’ve worked “long term,” as in, longer than our four required sessions, and therefore, with whom I have built more of a relationship.

The client I said goodbye to today made incredible progress during the semester. She came in very closed off, afraid to show emotion, and dealing with issues that would be hard for anyone to deal with, let alone a 20-year-old undergraduate. During our time together, she worked hard and was a rewarding client. However, today during our termination session, I was reminded of what counseling is really about: the client and her needs, not my needs or expectations as a counselor.

Last session, I had reminded my client that today would be our last meeting, and she was fine with that. Today she arrived a little late for our session, which is unusual for her, and was obviously feeling flustered. When I asked my usual, “How are things going?”, she proceeded to answer my question as she would have during any other session. Normally, that would have been great, but I had expectations that today’s session would go differently. Here’s where my expectations and my client’s expectations diverged: For her, today was a “normal” day of counseling, with maybe a quick “thanks” and “goodbye” at the end. For me, I had (what I thought would be) a profound activity for us to do to wrap up our work together.

It didn’t happen. Not even close.

As my client talked, I found myself glancing at the clock more often than usual. I caught myself thinking, “When is she going to stop? What she’s talking about isn’t that important! I really, really want to get to what I want to do!”

Of course, she didn’t stop and I knew that interrupting her to “get to what I wanted to do” was not appropriate. When we had about 10 minutes left in the session, I took the opportunity during a break in her speech to remind her that this was our last session and to start reflecting the themes of the topic at hand to all of the work I’d seen her do this semester in counseling. Ultimately, I was able to praise her for all the progress she had made and to encourage her to keep building on her strengths and successes. When I was done, she sincerely thanked me for my help and said that both she and others had noticed a change in her, which was gratifying, and more than I expected.

Still.

After I walked her out the door of the clinic for the last time, I could only manage a half-smile. I know we did great things together. I know she feels better about herself and her life than she did three months ago. She has changed tremendously. This was a successful counseling relationship. And still, I’m upset that I didn’t get to score a touchdown in the final session. What is that all about?

I’m actually surprised at my strong reaction to “not getting my way” in a session. I think I’m pretty well grounded in the philosophy that the counseling relationship is not about me and my needs and wants. One of the items we have to evaluate about our sessions is “Keeps the focus of the session on the client,” and I’ve always rated myself highly. As a former teacher, I came into counseling at the beginning of the semester with a “lesson plan” of sorts about what a client and I would talk about that day, but quickly learned that what was relevant for a client last week is often not this week, and therefore, the best laid plans often were not used. Some counselors might be more directive and steer the session the direction they wanted anyway, but I chose to try the approach of letting the client guide the topic of the day, while still being mindful of client resistance and avoidance of previous topics presented.

But I wanted this last session with this client to be memorable for her. And if I’m going to be honest, for me as well. What I had planned really seemed like the “perfect” ending, but that’s my bias about what the client “needed.” I have to trust that what the client “needed” is what she presented in the session today, and if it just so happened to coincide with this being our last session, I need to accept that. For all I know, something I said to her today was the most profound thing I’ve said all semester. Or maybe the “perfect” final activity I had planned would have turned out to be the most disastrous choice I’d made all semester.

I’ll never know. And I need to be okay with that.

The Blackberry on my client’s lap was signaling a message. Usually, this client silences her phone and puts it away before our session, without any prompting from me. This time, she glanced down at it, pushed a few buttons, and resumed our conversation. I let it go.

Two minutes later: buzz…buzz…buzz…

My client looked down again and started pushing buttons. I called her out.

“What’s up with the phone today? Usually you put it away. Is something going on?”

“It’s just Facebook updates.”

She pushed a few buttons again and put the phone in her pocket. I didn’t hear it vibrate again during the rest of the session.

In my group theories class, we’ve been discussing the concept of process commentary, which Irvin Yalom described in his book The Theory and Practice of Group Psychotherapy as “taboo social behavior” among adults. Process commentary can be defined as comments on here-and-now behavior and the immediate relationships between people. It’s associated mostly with group therapy, but therapists use it to bring attention and immediacy to individual sessions as well. In therapy, process commentary is a powerful tool; in the wider world, they are the type of comments that we sometimes attribute to people who are less socially adept: “Can you believe he actually said that out loud?”

Adults often use process commentary with children, saying things such as, “Look at me when I’m talking to you!” Using process commentary can also seriously get you in hot water with a significant other: “Hmmm, honey, I’m sensing resistance to my request to take the garbage out” might be met with, “Excuse me, counselor, but I am not your client!”

Yalom put forth his ideas about process commentary long before Facebook was an imaginable concept. I’d be curious to know if his ideas about process commentary have changed now that people are posting millions of status messages a day that answer the question, “What’s on your mind?” That very question invites users to tell the world what is happening in the here-and-now. In fact, “Facebook friends” might even get upset if you don’t keep your status updated or you—gasp!—dare to let any significant amount of time pass before posting a status message about an important life event. A friend posted—on his Facebook page, of course—a picture of a bride walking down the aisle, looking at her phone, with the caption: “Facebook Status: Because it isn’t official until you update it.”

Yalom (1995) gives four reasons why process commentary is taboo: socialization anxiety, social norms, fear of retaliation, and power maintenance (p. 137). Facebook by its very construct has blown all of these fears out of the water, and process commentary has become front and center in our lives and the lives of our clients who use Facebook. This powerful program has changed the face of “social norms” for communication and is increasingly harder to ignore, especially when what is said on a Facebook page can negatively affect clients and their relationships, self-concepts, and interactions with others and the world.

If you are on Facebook, you might have had the experience—as I have—of reading a string of comments about a friend’s status that made you blush because of their boldness (of the comments, but maybe the status itself as well). While of course someone has to be a “friend” to comment on someone else’s status, and your name and picture is posted with every comment (assuming you are using your real name), there is still a sense of safety from being behind a computer and not face-to-face that allows people to feel as if they can say—literally—what’s on their minds, without a lot of censoring or thought about interpretation. I have been continually amazed at the depth of self-disclosure of status messages and the sometimes brash, rude, and cruel humor of ensuing comments. In addition, I have witnessed awkward interactions among my classmates that are carried over from crude humor that was posted on Facebook pages. Clients have come to me with stories of “friends” posting hurtful or embarrassing comments on their pages. Anyone who has a Facebook page and “friends” linked to it is susceptible.

How long before this type of discourse finds its way into the counseling session, coming from the client? I can tell you that text messaging shorthand has already found its way into academic writing, everyday speech, and even memorial services (yes, I experienced that firsthand.) How many times have you heard “WTF?” or “TMI!”, stated just as I typed them? One of my clients described her sibling as “Not my BFF,” and expected that I would know what that meant. (I did.) Process commentary as a regular way of communication is probably not far behind.

Yalom (1995) stated, “If individuals felt free to comment at all times on the behavior of others, social life would become intolerably self-conscious, complex, and conflicted” (p. 138).

Well, that time is here. And now. Process commentary is no longer something that just happens in the therapist’s office, delivered by the therapist for growth and awareness purposes. Millions of people engage in it all day, every day. It’s not just changing how people interact with each other in the real world, but it’s also sure to show up in your office, coming from the client, soon.

Reference

Yalom, I. D. (1995). The Theory and Practice of Group Psychotherapy (4th ed.). New York: Basic Books.

During my supervision session prior to break, I expressed frustration to my supervisor about a client who had asked to continue counseling beyond her class requirement. I questioned this client’s commitment to counseling and whether her problems were significant enough to warrant additional sessions, especially since I had been assigned six new clients, and therefore, continuing counseling with this client would mean extra work for me. My supervisor reminded me that I had been very excited to work with this client initially, and gently encouraged me to keep working with her for a few more sessions.

Then my supervisor did her job: she suggested that my client might have a serious disorder, one I hadn’t even considered, or honestly, would have even occurred to me on my own. Since I knew basically nothing about this particular disorder, I decided to take my supervisor’s suggestion under consideration and do more research while on break.

So I did. I looked online for information, read the DSM-IV-TR criteria, talked with my mentor, emailed a fellow Psych Central blogger about her articles on this topic, and ordered, received and read an entire book about the disorder. I now feel much more educated, enough so that I feel like I would be able to have an informed discussion with my client about a potential diagnosis.

However.

Diagnosis is a tricky, controversial subject. I have several reservations about it, including my lack of experience in making diagnoses (I’m in the diagnosis class currently, and we have not covered this disorder yet) and whether having a diagnosis helps or hurts a client, especially since once a diagnosis is in a medical file, it’s there permanently and can have profound effects for a client’s future. Even though we’re a training clinic, our clinic director told us a story about a former client applying for an FBI position, and having to turn over the client file for a background check. At this stage of the game, given my level of experience, I don’t want that responsibility on my shoulders.

Of course, once I have a discussion with my client about my thoughts, she may tell me I’m full of it, and that will be the end of the discussion. (Maybe. Client denial is a topic for another post.) But what if she says, “Yes, that’s me!”? I can’t anticipate what comes next: “I’m so glad to know I’m not alone and what can we do about it?” or “And so you’re telling me I’m defective?”

So here I am at a crossroads. Now that I think I have a name for my client’s expressed feelings and behaviors, I want to share them with her and formulate a plan to help relieve her distress, based on the empirical treatments for her problem. On the other hand, I fear making the problem worse by subscribing to the medical model for addressing her issues and “labeling” her. Also, I only have four sessions left with her, and if she indeed does have this disorder, it won’t be resolved by then. She would need to see someone in the community to continue treatment, therefore carrying this diagnosis beyond a month’s time and outside of a training clinic.

Thinking ahead to being in professional practice in the real world, I had only briefly thought about what I would do if a client seemed to clearly fit a diagnosis. There are some behavioral disorders that seem to be fairly clear-cut, although that’s probably an inaccurate statement in itself. In this case, diagnosing a disorder that is more about cognitive functioning feels much more subjective. In addition, this particular client also seems to have a very mild form of the disorder I have in mind, which makes diagnosing it feel even more precarious. I fear damaging the relationship if the client tells me I’m wrong.

However, I wonder if, after I present my hypothesis and share what the usual symptoms of this disorder are, she will disclose further symptoms that she either hasn’t thought to share or was too embarrassed to share previously. Will this be a breakthrough in our relationship and work together, giving us direction and purpose that was starting to elude us?

Despite my reservations, this is my time to experiment. I think by prefacing the conversation with “I am new to making diagnoses, but after talking with my supervisors and doing research, I think you might have [this disorder]. I’d like to share what I’ve learned with you and see what you think,” would help soften any potential blow. I very much want to make this a dialogue between the two of us. That way, not only will I get feedback about whether my clinical judgment was correct, I can learn about the effect of having a diagnosis.

I realize every client will react differently to receiving a potential diagnosis, but I can’t learn what happens if I don’t try. I feel comforted by having the backing of my supervisor, the safety net of still being a student, and knowing that I have done research, so this is not just me taking a risk for the sake of having the experience. My intentions are pure and good, and my desire is to help this client to the best of my ability. If having a diagnosis to help shape our time together is the way to do that, then that’s the direction we’ll go.

Last semester, I pretty much agreed to participate in everything. My helping nature made me think, “You might be asking others to do this someday yourself, and good karma comes around.”

This semester, I am way more protective of my free time and available brain cells.

However, a survey landed in my inbox on Thursday morning, and since the caffeine hadn’t connected with my brain just yet, I decided to fill it out. The first half of the survey asked me to assess my counseling skills within a range of “strongly disagree” to “strongly agree.” As I went through the questions, several stirred memories of experiences I had with clients this past week.

3. When I initiate the end of a session I am positive it will be in a manner that is not abrupt or brusque and that I will end the session on time.

This is one my supervisor and I have identified as a growth area for me. I am conscious of the time in my sessions, and at about five minutes before the end, I say, “We’re about out of time—is there anything else you’d like to discuss?” Two of my clients have waylaid me by bringing up topics that need more than the time we have to discuss—classic behavior my instructors warned us about. I have managed to end the sessions on time, but haven’t always done my best of reflecting content and feelings as I should since I have been trying to be respectful of my time, the client’s time, and the fact that one of my classmates is probably waiting impatiently for me to get out of the office I’m using so they can start their session.

Answer: Slightly disagree

11. I feel confident that I will appear competent and earn the respect of my client.

I am always on time. Early, usually. My planner is my lifeline. I generally check my planner several times a day, even though I’m pretty good at remembering when things are scheduled. One day this week, I had individual supervision from 1-2 p.m., a client at 5 p.m., and a midterm review at 6 p.m. It was mid-afternoon, and I had tucked myself away in a corner office in the clinic to catch up on some paperwork. A classmate came in and said, “Kate, your client has been waiting since 3:30.” I replied, “Uh-uh…must be the other Kate.” (There are two “Kates” and a “Katie” in my cohort. Mix-ups are not unheard of.) I pulled out my planner, just to check…oh, $%@^! It was 3:47p. My client had indeed been waiting twenty minutes for me. I apologized profusely to him and he was gracious, but geez. Talk about conducting seat-of-your-pants counseling—I felt totally unprepared and unfocused, and hoped the videotape was not rolling since my tardiness also resulted in a clinic office change from where I was originally scheduled.

Answer: Moderately disagree (That day, anyway. In general, I would answer moderately agree.)

24. I do not feel that I possess a large enough repertoire of techniques to deal with the different problems my clients may present.

Last semester, my Helping Relationships professor asked a question similar to this on a take-home exam: “Do you feel that employing the core conditions are sufficient for counseling a client, or does there need to be more?” My answer at the time was that the core conditions are necessary in the counseling relationship, but other techniques in addition are essential for really addressing the client’s issues.

It would be great if some of those techniques would come to me when I’m in the thick of a session.

One of my goals this semester was to employ techniques from at least four different theories with my clients. I did fairly spontaneously use the empty chair technique with a client. It went well. Gestalt: Check! I tried the miracle question—wasn’t thrilled with the results—but that was a solution-focused approach. Check! I do use CBT and DBT techniques regularly: Check!

I’ll be pulling out my theories book and refreshing during spring break.

Answer: Moderately agree

35. I feel I may give advice.

So far, so good with this one, though it’s been close a few times this week. We were told that our clients would come to regard us as experts, despite our status as students. I have several clients who are very cognizant of and articulate about their issues…and they really hope I’ll give them a verbal prescription for how to make everything better. I won’t deny that advice is rolling around in my head, but none of it has spilled out of my mouth. Yet. My career is young.

Answer: Slightly disagree

This week, I will send three more clients back into the real world, wishing them well on their academic careers and young adult lives, and thanking them for the opportunity to glimpse into their inner lives and see how I could help.

Next week = Spring Break! It will not be nearly long enough.

My caseload is full now: I have six clients. It’s a lot to keep track of and a lot to think about. Each one presents different counseling challenges since each is in a difference place in his/her life. However, I am finding it easier to remember details about their lives than I thought it would be, and making connections between comments in previous sessions to what they are presenting when we are together is coming easily as well. I was concerned about the challenges of not having my own office and the “shuffle” that goes on between sessions that prevents me from taking a minute to settle and focus before greeting my client. The situation is far from ideal, but it isn’t as bad as I thought it might be.

We are still tripping over each other in the clinic, jockeying for time on the computers, and juggling appointment time availability, but the overall atmosphere of the clinic is somewhat calmer than it was at the beginning. Many of us have commented that the current set-up of the clinic is not therapeutic in nature, but we have what we have, and from what I hear from students who have attended other universities, we have it pretty good. It is certainly not for a lack of trying on the part of the department—we just have outgrown our space. Plans are in the works for a new clinic, but I will be long graduated by the time that becomes a reality.

Being taped and watching myself on tape has not been as traumatic as I feared either. We were told that we would quickly forget that the tape is rolling during our sessions, and for the most part, that’s true. I’m aware in the back of my mind that it’s on, but I’m not freaking out that every word I’m saying is being recorded. Playing back the tapes doesn’t send shivers down my spine, and I haven’t buried my head in my hands in shame while watching any of them yet. As I explained to my clients when doing the consent form, these tapes can’t be broadcast on YouTube, and that’s a comforting thought.

Two of my clients this week spontaneously gave positive feedback about their time with me, and spoke of how they (and others in their lives) are already noticing changes in themselves because of counseling. I, myself, had felt that we had established rapport easily and had done some good work in the few sessions we had had, but that’s an optimistic neophyte talking; it means so much more when a client who was basically required to come to counseling shares the same feeling. And to have two clients give positive feedback? Wow!

After a particularly productive session with a client this week, I was writing up the case notes, and wanted to capture for my supervisor many of the things my client said that I felt were particularly important. The case notes were full of direct quotes my client spoke. The next morning though, I felt regret for the amount of detail I went into in the notes. I realized the responsibility that comes with putting notes into a client’s file, which we keep for seven years beyond termination of counseling, like any counseling service that operates under ACA ethical codes. Obviously, everything I put into a client’s file is read by my supervisor, but the bigger picture is that a court of law could someday read them as well. While I know the chances are slim, I have to be mindful that there is always a possibility. On one hand, documenting direct quotes can be very helpful when a client has expressed suicidal or homicidal ideation; on the other hand, if a client is “just talking,” it’s in the best interest of the client that I just note pertinent ideas expressed, not word-for-word quotes. I’m glad I figured that out early, before it potentially became an issue.

In the next two weeks, I will have four of my six clients terminating counseling, as they will have completed the requirements for the project they are doing that brought them to counseling in the first place. (The remaining two clients have expressed interest in continuing counseling with me beyond their requirement. Probably not surprisingly, they are also the two who offered me praise earlier in the week.) My hope for the four who will be leaving counseling is that they have learned something new about themselves and feel that their four hours with me was more than just something they had to do to get class credit.

That’s really all we can ask for as therapists, isn’t it?

I, myself, had originally scheduled three clients for Monday. Luckily, it worked out that all three of them were available on Thursday. Because of the rescheduling, my first client ended up being the one I saw on Wednesday.

I had ten minutes from the end of my class until I was scheduled to see my client. As I walked from my classroom to the clinic, I tried to alleviate the anticipation by reminding myself that I meet new people all the time at my job on campus, and that this wasn’t much different: talking to someone one-on-one, with an “assignment” to complete, which in this case was the intake form.

An hour later, my first “real” session ever was over. I did it! (Now the real test will be if she comes back.)

An added bonus is that I will forever remember my first client’s name, as she is named after a fairly well known singer who had a few hits around the time my client was born. When I asked about her name, my client’s face lit up in a huge smile. She said I was only the third person to ever recognize the name. Score one for the observant counselor…who also showed her age by saying to the client that the singer was popular when she was in middle school.

In my previous post, I said I was hoping I wouldn’t have to say “Tell me more about that,” when I really meant, “I have no idea what you are talking about.” It happened. Apparently, I am out of touch with how college students use technology to entertain themselves.

By the end of Thursday, I felt I had had four successful intake sessions. Counseling is challenging, but in a good way. I am looking forward to working with my clients and seeing what progress we can make in the short time we have together.

But. There’s always a “but.”

Now that I have seen four clients — with two more new ones coming next week — the mountain of paperwork has begun. For my entire life, I have always been extremely organized and completed my assignments long before they are due. My world’s been turned upside down. Besides having an insane amount of paperwork to do for each client individually, our case notes for each session are also due within 24 hours of the session. That wouldn’t be a problem if all I was doing was seeing clients and I was allowed to use my personal computer to write them. But ACA ethics dictate that all client files must stay in the clinic (for good reason), and all of our case notes have to be typed on the clinic computers.

I mentioned there are 31 of us in my cohort. We all have a caseload of six clients right now and have the same deadlines. We have four computers available to us. Those four computers are also the same ones that have our video-watching system on them, so if we need to watch the tapes of our sessions, we have to use one of those. Also, doctoral students and staff are using the same computers to watch our tapes for supervision purposes, so actually, make that around 50 people competing for time on four computers.

Anyone else seeing a problem here? We do not have access to the clinic 24/7.

Did I mention that besides seeing six clients a week, I have 12 hours of class, a 14-hour graduate assistantship so I can pay my bills, four hours a week of supervision, and an hour commute each way? Many of my classmates are in similar situations. Time is at a premium, for all of us.

On Thursday, after having been on campus already for nearly ten hours without a break to even eat lunch in five minutes of peace, I decided I needed to come home before the threat of falling asleep behind the wheel became real, and would return to the clinic when it opened at 8:00 am on Friday to do my case notes for my last two clients, as well as my tape review that’s due Tuesday by 9:00 am.

The weather gods conspired again. Campus was closed Friday. A snow/ice mix fell for most of the morning.

On Monday, I see two of the same clients I saw on Thursday. Not only did I miss the 24-hour case note deadline for their first sessions (admittedly, not entirely my fault), I may not even have them done by the time the second session is over!

I take comfort in knowing that my classmates are in similar predicaments, and that this is not going to last forever, even if the first week of May does feel like forever from now. I’m thinking the only way this is going to work is if I stake out an unseen corner of the clinic and stash a sleeping bag so I can set up camp and work while the clinic is closed.

One of my classmates posted this advice on Facebook: “Just keep swimming… just keep swimming…”

In less than two weeks, I will be contacting my very first clients to set up appointments. Bless these people for actually volunteering to share their stories with me, someone who has been told she is a “good listener,” but isn’t really sure at this point what else she can offer another person therapeutically. We’ve been told silence is golden. I’m hoping it isn’t also awkward.

Yes, I did read my theory textbook last semester, and have my “favorite,” although by no means am I an expert in any of them! I was in attendance at every Helping Relationships class, where we learned specific skills to use with clients. I definitely paid attention in my ethics class—don’t want to lose my license before I even have one! I did my best when role-playing counseling scenarios with my classmates, and received lots of positive feedback. But does that make me ready to begin working with “real” people with “real” problems?

I take some comfort in knowing that experienced clinicians, even some who have been in practice longer than I’ve been alive, still get nervous when they meet new clients. I opened a newly published textbook earlier this week, and the first sentence of Chapter One is, “Embarking on the therapeutic journey with a new patient is a more anxiety provoking experience than most clinicians would ever like to admit to our patients.” If someone who is well known in the field can still feel this way after 30+ years of practice, I guess I can cut myself some slack.

One of the opening rituals of establishing a counseling relationship is the disclosure statement. This little piece of paper explains the therapist’s qualifications, procedures for diagnosis, filing insurance, and more. A seasoned therapist probably has hers pared down to a page, maybe two. Mine was seven pages long. To his credit, my professor did suggest I edit it down a bit. But what to leave out? It’s all important! On the other hand, my professor also did tell us in class that less than 10% of all clients remember being given a disclosure statement, let alone actually reading it. So…cover my bases or save the trees? (It’s down to four pages now.)

Since I am a student, and this is my first clinical experience, I will be working at our counseling department clinic that is exclusively staffed by students, with faculty oversight. Given the age population our clients will mostly be from—traditional undergrads—I anticipate there will be interesting communication challenges, both inside and outside the clinic.

It is no secret that today’s students are technologically savvy, and therefore, I’m fair game for a Google search or two. I know it’s good practice these days to Google yourself to make sure there’s nothing disparaging about yourself online, but even with a clean slate, like I have, I have to make sure it stays that way! (See note above about “not losing license before I have one.”)

Another challenge is Facebook. I’m very grateful for the recent security parameters the site has put in place, restricting who gets to see what on my profile. Even so, it’s out there and anybody can find out at least basic info about me. I know I always have the choice to deactivate my account, but I do occasionally enjoy checking in to see what my friends who are scattered across the country are up to. “Friending” clients—present or past, once we have completed our time together—is a big no-no. I anticipate that will be a conversation I will have to have many times over the next few years.
Face to face with clients, I know I will be surprised by what I don’t know, and I’m not just talking about counseling technique. Much has changed for the college population since I was an undergrad, and I hope I don’t have too many moments where I have to say, “Tell me more about that,” when I really mean “I have no idea what you are talking about.”

This semester, I hope to share with you stories of my journey from absolute neophyte to someone who is ready for an internship outside the safe confines of the university counseling clinic. Wish me luck in making good clinical decisions, taking risks and making mistakes, and maintaining my sense of humor—I’ll need it!