Uninvited use of a client’s given name can impede rapport in a number of ways. Moving from a position of formality to informality and intimacy is easier than backtracking.

A therapist’s first encounter with a client usually requires the use of their name, if only to ensure that you haven’t picked up the wrong person. The usual practice is to use either the client’s full name (as given on their referral letter or case file) or their title and family (last) name. Some therapists attempt to establish an air of informality by using the client’s given (first) name, but this is a risky practice for a number of reasons. In decreasing order of seriousness:

The client’s given name is first and most commonly used by their parents and siblings. Being called (without invitation) by one’s given name can throw the client into a child role with the therapist as parent (especially if the therapist then goes on to introduce themselves by their title and family name). Depending upon the client’s experience of childhood, this might be reassuring or anxiety provoking. It is definitely disempowering and may be seen as patronising.

The client’s given name is next most frequently used by their most intimate associates: friends and partners. Using their name uninvited risks creating a sense of forced intimacy. If working with people with issues around control or intimacy (eg: people who have been abused), this might create a sense of intrusion or compulsion which may impede further work.

Least likely, but still worth considering, is that the name you use may not be the name by which the client knows themself. I am known by my middle name and do not like my first name, so anyone who uses my first name without asking is off to a poor start with me!

No one approach will suit every client, but I feel that my strategy serves me well. I address the client by their title and family name throughout the first session, then ask what I should call them at the second session. Moving from a position of formality (and presumably respect) to possible intimacy is less likely to be jarring having first established a rapport by less ambiguous means (eg: listening attentively, responding appropriately and working collaboratively.