| Dedication | xi |
| Introduction: On Writing About the First Helping Interview | xv |
| A Note About the Use of Pronouns | xviii |
| About the Format | xviii |
1. | What Makes Therapy Happen? | 1 |
| Establishing a Pattern | 2 |
| Letting the Client Know You Know | 3 |
| The Therapist as Teacher | 4 |
2. | Who Are Our Clients? | 7 |
| Voluntary Clients | 7 |
| Involuntary Clients | 12 |
| The Role of Anxiety in Acceptance of Therapy | 13 |
| Clients and Trust | 14 |
| What's Next? | 15 |
3. | Getting Started | 16 |
| Setting the Appointment | 16 |
| Your Own Anxiety | 18 |
| Greeting the Client | 20 |
| What Shall We Call Each Other? | 21 |
| Should the Client Be Comfortable? | 22 |
| The Physical Arrangement | 23 |
| Distractions Come in Many Shapes | 24 |
| Starting the Interview | 25 |
| The Home Visit | 27 |
| Client Records | 29 |
| Note Taking | 29 |
| The Business of Therapy: Fees, Appointments and Telephone Calls | 30 |
| Your First Meeting With the Client | 31 |
| A Guide to Observing the Client | 33 |
| Establishing Your Role | 35 |
| And What of the Client? | 36 |
| What's Coming Next? | 36 |
4. | Getting to Know the Client | 38 |
| Listening, the Heart of Therapy | 38 |
| Alerts, Red Alerts and Stop Signs | 39 |
| What If You Miss Something--and It's Important? | 42 |
| When the Client Is More Than One | 42 |
| Other Perspectives on Understanding the Client: Cognitive Processes | 45 |
| How Much Structure--When and Why | 45 |
| Linear and Circular Thinking | 46 |
| Concrete and Abstract Thinkers | 47 |
| Gathering Formal Information | 48 |
| Getting Essential Information | 48 |
| Reviewing Relevant Aspects of the Client's Present Environment | 50 |
| The Use of History | 51 |
| Putting It Together--Defining the Problem | 53 |
| The Written Assessment or Diagnostic Statement | 54 |
| The Client's Response to the Practitioner | 55 |
| What Does the Client Bring to Therapy? | 56 |
| Where Do We Go From Here? | 57 |
5. | Communication Dynamics of the Helping Interview | 58 |
| The Sounds of Therapy | 58 |
| A Quick Review of the Basic Therapeutic Responses | 61 |
| Responses That Don't Work | 64 |
| Other Responses That Help | 66 |
| The Dynamics of Questions: Thou Shalt Not Ask the Wrong Questions | 67 |
| Turn-Around Questions | 70 |
| Dealing With Silence | 70 |
| Other Difficult Moments or Games Clients Play in the First Interview | 72 |
| Other Pitfalls of the First Interview | 74 |
| The Dynamics of Intimacy | 75 |
| Concluding the Interview | 76 |
| Moving Along ... | 78 |
6. | On Rules, Goals and Contracts | 79 |
| The Rules of the Game | 79 |
| Whose Problem Is It? | 80 |
| How Much Structure? | 82 |
| Understanding More About the Problem | 82 |
| Specifying and Setting Goals | 86 |
| Who Sets the Goals? | 87 |
| Setting Priorities for Attention | 88 |
| Specifying the Means of Change | 89 |
| The Contract | 90 |
| The Precontract | 90 |
| Structuring the Therapeutic Contract | 91 |
| The First Interview and the Contract--Implications for Success | 92 |
| Where Do We Go Next? | 92 |
7. | Trust | 93 |
| The Psychological Side of Trust | 93 |
| Trust and Confidentiality | 94 |
| How Is Trust Built? | 97 |
| Back to Trust--and How You Know You're Getting There | 104 |
| And What Now? | 104 |
8. | Special Issues in Working With Couples and Families | 105 |
| The Physical Setting | 106 |
| The Family at Home | 107 |
| Getting Started | 108 |
| Redefining the Problem | 110 |
| Keeping Confidences | 111 |
| The Group Composition in the First Interview | 112 |
| The Absent Family Member | 114 |
| Homework Assignments | 116 |
| Closing the Interview | 116 |
| What's Next? | 117 |
9. | Working With Clients Who Are Different | 118 |
| Culture and Ethnicity: What Makes a Client Different? | 120 |
| Class | 122 |
| Gender Issues | 123 |
| Oppressed Groups | 125 |
| Reification | 128 |
| Know Thyself | 129 |
| What the Practitioner Should Know | 130 |
| How to Find Out What You Don't Know: The True Meaning of Acceptance | 132 |
| One Last Point: On Being a Professional | 133 |
| What's Ahead? | 134 |
10. | Serious Problems: When and How to Refer | 135 |
| Making a Referral: When, How and Who | 136 |
| The Referral File | 136 |
| Physical Symptoms and Complaints | 138 |
| Physical Abuse or Neglect of a Child or Adult | 141 |
| Special Issues for Protective Service Workers | 144 |
| Irrational Behavior and Threats of Violence | 146 |
| What's Next? | 148 |
11. | Legal and Ethical Issues In the First Helping Interview | 149 |
| Professional Ethics | 149 |
| Whose Values Are Better? | 150 |
| The Ethics of Confidentiality | 151 |
| The Worker-Client Contract Revisited | 154 |
| The Ethics of Means and Ends | 156 |
| The Problem of Rules | 156 |
| Accountability | 158 |
| Some Closing Thoughts on Ethics and the Misuse of Power | 161 |
12. | Afterthoughts | 163 |
| On Self-Disclosure | 163 |
| Who Helps the Helper? | 164 |
| On Protecting Yourself | 167 |
| On Rules, Suggestions and Contradictions | 169 |
| On Becoming a Professional | 170 |
| After the First Interview | 170 |
| A Conclusion of Thoughts | 172 |
| Once More With Feeling | 173 |
| References | 175 |
| Index | 179 |
| About the Authors | 187 |