Opening gambits

Early contact with a patient offers the best chance to draw them into treatment, which is why the opening session shapes how therapy unfolds. This guide offers practical direction for running a strong first meeting. It looks at how a therapist carries themselves, including word choice, the anxiety a clinician may feel, and the subtle cues that can steer a patient. Practical matters such as setting appointments, charging fees, and handling cancellations are also covered.

The author sets out eight core goals for the first session, among them building a sense of safety, assessing the patient, forming a working agreement, and moving the patient into the next phase of care. He illustrates each step with detailed case material that shows how these goals can be reached in practice. Separate sections address patients who have been in therapy before, patients returning after a break, compliant or passive patients, and patients who may need medication or hospitalization.

The book is meant for newly trained therapists learning the range of concerns that arise at intake, and for experienced clinicians who may want to examine habits and mannerisms that have become second nature when meeting a new patient.