What is done in a first session with a psychologist?
Nowadays, and more and more frequently, a considerable proportion of the population has come or will ever go to the services of a psychologist or psychologist. Although in the past it was frowned upon and many people were embarrassed or pointed out, this stigma has been reduced considerably over the years, causing more and more people to take advantage of this type of service if necessary.
Despite this, it continues to be a type of service that is seen as something strange and to which most people have a certain reluctance, not knowing exactly how it works or what it is going to do. One of the moments that generates more uncertainty is the first contact with the professional, often not knowing exactly what is going to be done or what to expect to happen. What is done in a first session with a psychologist? It is this issue that we are going to talk about throughout this article.
- Related article: "Types of psychological therapies"
What is done in the first session of psychotherapy
The first thing that we have to take into account is that the first session is, with the possible exception of a first telephone or internet contact, the first contact between therapist and patient .
This means that at this moment we still do not know anything about each other, beyond having read the website of the center or opinions about the professional. And especially in the case of a therapist, who will not have any knowledge about his or her patient.
In general, we have to keep in mind that the general objectives of the first session will be to get in touch, know the case in question and generate a good therapeutic relationship .
This last aspect is essential, since in general, deep aspects of the psyche will be treated. Without an adequate level of trust between professional and patient, the user will not give expression to fears, doubts, emotions and thoughts, resulting in an unproductive relationship and making the success of therapy difficult.
Of course, the positive rapport or good therapeutic relationship is going to be built not only during this session (in which it is usual to be somewhat self-conscious) but throughout different sessions.
First contact with the patient
The first thing will be to receive the patient, make you sit down and make the relevant presentations . It is usual to try to break the ice with a patient to generate a positive and trusting climate, to gradually explain what is going to be done throughout the session.
It is also customary to mention it at some point throughout the interview (although many professionals do not say it directly, either by understanding it or having informed it in previous forms or contact ways), either at the beginning, during or at the end, all the information that is provided will be absolutely confidential . The only exceptions are that there is an order or request from a judge or that there may be serious damage to the life or integrity of the subject or third parties.
Anamnesis
After the presentation, an interview will be held in order to obtain information about the case itself, generally through the process called anamnesis. It is about the method by which the most relevant information of the specific case is collected , including the problem in question that has made him go, life and social habits and history and basic data of the subject.
Generally, it will begin by asking about the problem or demand that the subject has, focusing on the current situation, as well as the fact that he has specifically asked him to come here and now. It will also ask about aspects such as when the problem began, what it is associated with and the feelings it generates, what specific difficulties it generates in the patient's life.
It occurs even if the professional had a report about it (for example if it comes from the doctor or by court order), so that the professional can see what the subject has demand and if there is a problem how he lives and expresses it, getting an idea of his approach. It is proposed that the patient express his demand / problem at the current time,
Done this or right before it (the specific order depends on how the order approach each professional and the characteristics of the patient), in order to know more about the patient and get more information both the problem and the circumstances surrounding it usually ask for a series of general data about the patient and his life that may be of interest and related to the problem.
In this sense, it will be useful know the presence of possible antecedents, both their own and family of the same problem or of one that could have a concrete effect on the subject.They also tend to ask basic information about the environment: whether they have children or siblings, marital status, relationship with parents and their occupation or, in general, the family structure with which they live. Also about social life, whether or not there is a couple and the state of the relationship or work life.
It is not about asking questions without more and knowing all aspects of your life, but they will be questions to know the general situation. The collection of information must respect ethical limits: the professional will focus on those aspects that are relevant to approach and address the reason for consultation, and may consider it necessary to address a topic in greater depth.
Obviously we are in the first session, being a dialogue that aims to obtain information but neither be an interrogation In fact, many times you will end up discovering important elements for the case during the sessions that were either hidden or not considered relevant in this first moment. The information that is given is not unchangeable nor should it be too exhaustive, as this can be exhausting and even aversive for the user.
The professional will listen to what the patient has to say, although he can ask for the clarification of key aspects and he will make sure to understand and value what is being told. The attitude of the therapist will be active listening , attending to what the patient wants to say (and also to what he does not say, being something that also provides a lot of information), empathetic and cordial. It will also try to be authentic and professional, and at all times will try to make the patient see that he will not be judged regardless of what counts, generating a climate of trust and acceptance.
- Maybe you're interested: "Anamnesis: definition and 8 basic clinical aspects"
Valuing expectations and setting objectives
Assessed the situation, the professional will discuss with the patient the expectations and objectives that the patient has regarding their reason for consultation and the fact of going to a professional.
It is important to assess this aspect given that the initial objectives or even what is expected of the professional may be unrealistic or even not assess the real overcoming of the problem but a specific difficulty that generates. Based on all the information acquired, the general objectives will be negotiated what is sought with the professional relationship and the roles of each one will be established.
Evaluation with quantitative instruments
It is possible that in a service or a psychology consultation it may be necessary to use some type of evaluation instrument in order to evaluate the presence of a disorder or to evaluate some phenomenon, symptom or difficulty at a quantitative level. However, even if this were the case, the information coming from these has to be checked and evaluated according to the interview, not the absolute results.
An example of this would be the patients who go to a neuropsychiatry service, and it is usual to assess their abilities in the same session. Also in a psychology consultation it may be considered necessary to assess the level of anxiety or assess to what extent a personality trait is present , although in a first session is not as usual as you might think. In addition, not all professionals will use them in clinical practice or in all cases, depending on each specific situation.
Recapitulation and orientation towards the following sessions
Before the end of the session there is usually a recapitulation of everything that happened in this, in order to help establish the patient a mental outline of what has been done and talked and assess whether the professional has understood all the information.
In addition to this, it is possible that a small advance is made of what is proposed for the next session. Also and depending on the problem and the professional some general psychoeducational guidelines can be established , in the absence of further deepening on the subject.
