The first few hundred client hours provoke unimaginable growth.

Maybe you puked a time or two. Certainly there was crying, yours or the clients—probably both. Congratulations! Tears are healthy. So is finishing an internship.

I hope that you learned a ton and made all kinds of mistakes in a supportive environment. If you were in grad school simultaneously, I feel for you. That’s asking too much, but it’s the system in a lot of places.

We all start the journey of becoming a therapist with different levels of previous experience (e.g., teaching, community mental health, volunteering at a crisis line), and some folks show up on day 1 with no prior experience. This early experience involves an amount of learning that is staggering, personally and professionally. I love to debrief with folks at this time to see what’s changed for them.

Some questions and things you may find it helpful to reflect on:

• What’s changed in the way that you think about therapy? About your role and the clients? About how change occurs?

• Did you meet your initial goals? Have they evolved?

• If you could go back in time and meet yourself on day 1, what advice would you give that version of yourself? What’s changed?

• What’s been the most impactful thing you’ve learned?

• What do you wish you knew during the first month?

• How do you now view theoretical orientations? Did you add to your repertoire of approaches and interventions?

• Reflect on some of the challenges you met in these past months. How were you able to get through this? What will you do differently in the future as a result of this experience?

• Reflect on your failures

• What’s your level of anxiety before a session now versus when you started?

• How have your boundaries and self-care changed?

• With all of this change, what might happen in the coming months that would give you a ‘run for your money’ or be challenging?

• What’s next?

The quality of our reflection on this experience is important. I encourage you to be diligent to extract as much learning as you can from this rich experience.

Proust said,

We do not receive wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can make for us, which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world. The lives that you admire, the attitudes that seem noble to you, have not been shaped by a paterfamilias or a schoolmaster, they have sprung from very different beginnings, having been influenced by evil or commonplace that prevailed round them. They represent a struggle and a victory.

Now take a break. I’m sure you’ve earned it!

PS Many of the questions here can represent a parallel process similar to termination sessions with clients

PPS here’s a random collection of brief points that may be of use:

• Write at least part of your session notes during the session. I aim to only have a minute or two of typical note writing left after sessions end, but review video to see how it impacts the alliance and flow

• Watch for calm, happy, effective peers and ask them for their secrets, and how they do specific things you struggle with

• Use email templates, if you aren’t already (for introductions and the what/where details, scheduling and so on)

• Keep a running to-do list weekly for supervision, prioritize it before meeting

• And get some nice pens. We write so much, it’s really nice to use a smoother pen and they’re cheap. I haven’t tried electronic notes in session; my guess is that most versions of it would be unhelpful for connection

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