What Is Done In A First Session With A Psychologist?
Nowadays and with increasing frequency, a considerable proportion of the population has used or will someday use the services of a psychologist. Although in the past it was frowned upon and many people were embarrassed or singled out for it, this stigma has been considerably reduced over the years, making more and more people encouraged to resort to this type of service if necessary.
Despite this, it is still a type of service that is seen as something strange and to which most people have some reluctance, not knowing exactly how it works or what it is going to do. One of the moments that generate the most 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 topic that we are going to talk about throughout this article.
The first thing we have to keep in mind 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 know nothing about each other, beyond having read the center’s website or the opinions regarding the professional. And especially in the case of a therapist, who will not have any type of knowledge regarding their patient.
In general, we have to keep in mind that the general objectives of the first session are going to 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 be given the opportunity to express fears, doubts, emotions and thoughts, resulting in an unproductive relationship and making the success of the therapy difficult.
Of course, positive rapport or a good therapeutic relationship will be built not only during this session (in which it is common to be somewhat inhibited) but throughout different sessions.
The first thing will be to receive the patient, make him sit down and make the relevant introductions It is common to try to break the ice with the patient to generate a positive and trusting atmosphere, to little by little explain what is going to be done throughout the session.
It is also common for it to be mentioned at some point during the interview (although many professionals do not say it directly, taking it for granted or having reported it in forms or previous contact channels), whether at the beginning, during or at the end, that All information 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 himself or third parties.
Anamnesis
After the presentation, an interview will be conducted in order to obtain information about the case itself, generally through the process called anamnesis. This is the method by which the most relevant information of the specific case is collected including the problem in question that caused you to come, life and social habits, and history and basic data of the subject.
Generally, one will begin by asking about the problem or demand that the subject has, focusing on the current situation, as well as what specifically made him or her come here and now. Questions will also be asked regarding aspects such as when the problem began, what it is associated with and the feelings it generates, and what specific difficulties it generates in the patient’s life.
It It occurs even if the professional had a report about it (for example if it comes from a doctor or by court order), so that the professional can see what demand the subject has and, if there is a problem, how he or she experiences it and expresses it, getting an idea of ​​his or her approach. The patient is asked to express his/her demand/problem at the current moment,
Having done this or just before it (the specific order depends on how each professional approaches the order and the characteristics of the patient), in order to get to know the patient better and obtain more information about both the problem and the circumstances surrounding it, It usually asks for a series of general data about the patient and their life that may be of interest and be related to the problem.
In this sense it will be useful Know the presence of possible personal and family history of the same problem or of one that may have had a specific effect on the subject. Basic information about the environment is also usually asked: whether one has children or siblings, marital status, relationship with parents and their occupation or, in general, the family structure with which one lives. Also about social life, whether or not there is a partner and the status of the relationship or work life.
It is not about simply asking things and knowing all the aspects of your life, but rather they will be questions to find out 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, if deemed necessary, address any topic in greater depth.
Obviously we are in the first session, being a dialogue that aims to obtain information but nor be an interrogation In fact, many times important elements for the case will end up being discovered throughout the sessions that were either hidden or not considered relevant at this first moment. The information 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 or she may ask for clarification of key aspects and will make sure to understand and value what is being told. The therapist’s attitude will be one of active listening , paying attention to what the patient wants to say (and also what he does not say, being something that also provides a lot of information), empathetic and cordial. Likewise, you will try to be authentic and professional, and at all times you will try to make the patient see that they are not going to be judged regardless of what they say, generating a climate of trust and acceptance.
Assessment of expectations and setting of objectives
Once the situation has been assessed, 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 may not even assess the real overcoming of the problem but rather a specific difficulty that it generates. Based on all the information acquired, 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 psychology service or consultation it may be necessary to use some type of evaluation instrument in order to evaluate the presence of a disorder or evaluate some phenomenon, symptom or difficulty at a quantitative level. However, even if this were the case, the information from these must be compared and evaluated based on the interview, the results not being absolute.
An example of this would be patients who attend a neuropsychiatry service, and it is common for their abilities to be assessed in the same session. Also in a psychology consultation it may be considered necessary to evaluate the level of anxiety or assess to what extent a personality trait is present , although in a first session it is not as common as one might think. Furthermore, not all professionals are going to use them in clinical practice or in all cases, depending on each specific situation.
Recapitulation and orientation towards the following sessions
Before ending the session, there is generally a recapitulation of everything that happened in it, in order to help the patient establish a mental scheme of what has been done and talked about and assess whether the professional has understood all the information.
In addition, it is possible to make a small preview of what you plan to do 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 depth on the subject.
