What is done in a first session with a psychologist?

Today and with increasing frequency, a considerable proportion of the population has attended or will ever seek the services of a psychologist. Although in the past it was frowned upon and many people were ashamed or singled out for it, this stigma has been reduced considerably over the years, encouraging more and more people to resort to this type of service in case of need.

Despite this, it continues to be a type of service that is seen as something strange and to which most people have some reluctance, since they do not know exactly how it works or what is going to be done. One of the moments that generates 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.

• Related article: "Types of psychological therapies"

What is done in the first psychotherapy session

The first thing 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 center's website or the opinions regarding the professional. And especially in the case of the therapist, who will not have any kind of knowledge regarding his 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 deep aspects of the psyche are generally going to be dealt with. Without an adequate level of trust between professional and patient, the user will not give rise to the expression of fears, doubts, emotions and thoughts, making the relationship unproductive and hindering the success of the therapy.

Of course, the positive rapport or good therapeutic relationship will be built not only during this session (in which it is common to be somewhat self-conscious) but throughout different sessions.

First contact with the patient

The first thing will be to receive the patient, have him sit down and make any relevant introductions. It is common to try to break the ice with the patient to generate a positive climate and trust, to gradually 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 so). directly, giving it for granted or having informed it in forms or previous contact channels), either at the beginning, during or in the end, what 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 carried out in order to obtain information about the case itself, generally through the process called anamnesis. It is the method by which the most relevant information of the specific case is collected, including the problem in question that has made him come, life and social habits and history and basic data of the subject.

Generally, you will begin by asking about the problem or demand that the subject has, focusing on the current situation, as well as what has specifically made him come here and now. Questions will also be asked 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 a doctor or by court order), so that the professional can see what demand has the subject and if there is a problem how he lives and expresses it, getting an idea of ​​his focus of him. It is proposed that the patient express the demand / problem of it at the present time,

Once this has been done or just before it (the specific order depends on how each professional approaches the order and on the characteristics of the patient), in order to know more about the patient and obtain more information about both the problem and the circumstances surrounding it, He usually asks 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 to know the presence of possible antecedents, both personal and family 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: if you have children or siblings, the state relationship with the parents and their occupation or in general the family structure with which live together Also about social life, whether or not there is a partner and the status of the relationship or work life.

It is not about asking things without further ado and knowing all aspects of your life, but rather 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, being able to address any topic with greater depth.

Obviously we are in the first session, being a dialogue that seeks to obtain information but neither 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 provided is not unchangeable and should not 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 clarification of key aspects and will make sure that he understands and assesses what is being told. The therapist's attitude will be one of active listening, attending to what the patient wants to tell her (and also to what she does not say, being something that also provides a lot of information), empathetic and cordial. You will also try to be authentic and professional, and at all times you will try to make the patient who is not going to be judged regardless of what he tells, generating a climate of trust and acceptance.

• You may be interested in: "Anamnesis: definition and 8 basic clinical aspects"

Assessing expectations and setting objectives

Once the situation has been assessed, the professional will discuss with the patient the expectations and objectives that the patient has regarding his reason for consultation and the fact of going to a professional.

It is important to assess this aspect since the initial objectives or even what is expected of the professional it may be unrealistic or even not value the actual overcoming of the problem but rather a specific difficulty that generate. Based on all the information acquired, the general objectives will be negotiated that 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 in order to assess the presence of a disorder or assess a phenomenon, symptom or difficulty at the level quantitative. However, even if this were the case, the information from them must be collated and assessed 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 assess 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. In addition, not all professionals are going to use them in clinical practice or in all cases, depending on each specific situation.

Summary and orientation towards the following sessions

Before finishing the session there is usually a recapitulation of everything that happened in it, in order to help establish for the patient a mental scheme of what has been done and discussed and assess whether the professional has understood all the information information.

In addition to this, it is possible that a small advance of what is proposed to be done for the next session is made. Also and depending on the problem and the professional Some general psychoeducational guidelines can be established, in the absence of a greater depth on the subject.