We want to help our clients make positive changes as quickly as possible. In order for them to open up and trust our guidance, especially since a lot of the procedures we use seem quite odd to outsiders, we need to establish and maintain rapport from the first session. One useful way to do so is to remove misconceptions about evidence-based therapy. For example, here is a typical introductory discussion I have with a new client:

Therapist: “What do you think is permitted here, in this room, and what do you believe is most likely forbidden?”

Client: “Well, probably crying is OK. Maybe you expect me to be polite and not shout or scream like a maniac.”

Therapist: “Actually, the opposite is true. Shouting or screaming is not only permitted, but sometimes it’s encouraged. Politeness is forbidden unless it comes out of you naturally. "

The client will usually look at me in disbelief, so I will say: “I can prove it,” signaling the client to cover their ears, turn my head and shout “Yes!”. Then, without saying a word, I point to the client and then cover my own ears, as if suggesting it is their turn to shout.

Once the client shouts, I would say, “that’s an impressive shout, one of the best our neighboring offices have heard in a while.” And you can now lean back, relax, and realize that you never ever needed anyone’s permission to express yourself fully and honestly. This is the ground floor of our journey together. For as long as you come here, I will always be on your side. If you need to shout, cry, whisper, or stay silent, I will support your choice. Your choice. This is the rule here. You don’t act or speak here according to what you think will please me or anyone else. You express yourself honestly, and I guarantee that I will never say it’s wrong in any way. You’re always right (and with a wink and a smile) except when I’m right. "

This tactic, on purpose, generates a shared semi-embarrassing experience between the therapist and the client, by suggesting that the client’s shout was heard by neighbors. Right after pointing that out, we enhance rapport by establishing an easy-to-follow rule and removing misconceptions about what a therapist does. Remember the lessons you’ve learned in the 21 presuppositions? A client is never “wrong” or “broken” or needs to be fixed. When we reach the point in the session to explain it to the client, it is easier for them to accept it after having the experience above shake their mental map.