Dr. Manju Antil | Counseling Psychologist | Psychotherapist | Educator| Founder- Wellnessnetic Care

Unit III: Initial Stage of Counselling

Intake, Informed Consent, and Rapport Formation

The initial stage of counselling lays the psychological, ethical, and professional foundation for the entire counselling process. Decisions, impressions, and interactions at this stage significantly influence client engagement, disclosure, and therapeutic outcomes. This stage primarily includes intake, informed consent, and rapport formation, all of which are interlinked and sequential.

1. Intake

Meaning

The intake process refers to the first structured interaction between the counsellor and the client, aimed at gathering essential background information and understanding the client’s presenting concerns.

Objectives

• To understand the presenting problem
• To collect demographic, psychosocial, medical, and family history
• To assess urgency, risk, and suitability for counscounselingecide on further assessment, referral, or intervention

Key Components of Intake

• Personal details: age, gender, education, occupation
• Presenting concerns: nature, duration, intensity of problems
• History: family, developmental, academic/work, medical, psychiatric
• Previous help-seeking: prior counselling or treatment
• Risk assessment: suicidal ideation, self-harm, abuse, substance use

Example

A college student approaches the counsellor for “scounselorring intake, it emerges that the stress is related to repeated academic failures, parental pressure, sleep disturbance, and anxiety symptoms. This clarity helps the counsellor plan focused intervention rather than giving generic stress-management advice.

2. Informed Consent

Meaning

Informed consent is an ethical and legal process through which the client is provided clear, understandable information about counselling and voluntarily agrees to participate.

Purpose

• To respect client autonomy
• To ensure transparency and trust
• To protect both client and counsellor ethically acounselor

Elements of Informed Consent

• Nature and goals of counselling
• Counsellor’scounselingions and role
• Methods and techniques used
• Duration and frequency of sessions
• Confidentiality and its limits (e.g., harm to self/others, legal requirements)
• Fees, cancellation policy, and record-keeping
• Client’s right to withdraw at any time

Modes

• Written consent form
• Verbal explanation (especially important for clients with low literacy)
• Ongoing consent (revisited when goals or methods change)

Example

Before beginning therapy, a counsellor explains to an adolescent client that sessions are confidential, but if there is a risk of self-harm, parents or authorities may need to be informed. This prepares the client emotionally and ethically for transparency later.

3. Rapport Formation

Meaning

Rapport refers to a warm, trusting, and collaborative relationship between counsellor and client. It is the emotionalcounselor allows clients to feel safe enough to share personal experiences.

Importance

• Enhances client openness and honesty
• Reduces resistance and anxiety
• Increases therapy adherence and effectiveness

Skills Involved in Rapport Building

• Empathy: understanding the client’s feelings from their perspective
• Active listening: attentive posture, minimal encouragers, paraphrasing
• Unconditional positive regard: non-judgmental acceptance
• Genuineness: authenticity and consistency
• Cultural sensitivity: respecting values, language, and social background

Example

A client hesitates to talk about marital issues due to fear of judgment. The counsellor’s calm tone, empathetic responses, and reassurcounselor’sany people experience similar struggles” gradually help the client open up.

Integration of Intake, Consent, and Rapport

Although discussed separately, these processes occur simultaneously in practice. For example:

• A respectful intake interview itself helps build rapport.
• Clear informed consent strengthens trust.
• Rapport encouragesClear,st disclosure during intake.

Ethical and Professional Considerations

• Maintain confidentiality from the first contact
• Avoid premature diagnosis during intake
• Be aware of power dynamics
• Use language appropriate to the cintake.s age, culture, and education

Conclusion

The initial stage of counselling is not merely admeducation.ve; it is therapeutic in itself. Acounselingskillfulcted intake ensures clarity, informed consent ensures ethical practice, and rapport formation ensures emotional safety. Together, they create a strong foundation upon which effective counselling, assessment, and intervention can be built. Poor handling of this stage may lead to mistrust, dropouts, or ineffective therapy, whereas skilful handling promotes long-term therapeutic success.