What to expect on a first visit to the psychotherapist?

Although the resistance or reluctance to attend psychological therapy is increasing with increasing frequency, there are still certain fears about what it may involve to consult an emotional problem with a psychologist.

One of the main fears that the person experiences may be related to the ignorance of how the first therapy is . Therefore, the following are the aspects that, most frequently, are addressed in the first meeting with a psychology professional enrolled within the cognitive-behavioral current.

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The initial interview

As indicated by Betisa Bárez (2018), there are three main objectives that the psychologist sets out to address with the potential patient on a first visit:

In the first place, it is intended to establish a positive climate of comfort and trust between both parties, so that the basis of a first therapeutic link that allows the subsequent joint work during the intervention process begins to be established.

In addition, in this first exchange the professional begins the process of collecting data on the reason for consultation presented by the patient, in order to make a conceptual approach to the indicated demand.

This purpose will allow the psychologist to elaborate a more detailed idea of ​​the problem consulted by the patient and thus understand it more deeply. Ultimately, it will also be possible to determine if such professional becomes the right person to attend said consultation or, on the contrary, it should be considered to refer the case to another professional more specialized or more appropriate to the patient’s needs.

Finally, in this first meeting the psychologist informs about the conditions and rules that will frame the therapeutic sessions to be carried out from that moment. This set of information is called “framing” and consists of a series of procedural norms or principles that have the function of defining on both sides how the appointments will be made, what can be expected from them and what structure and / or working method set will be followed during the psychological treatment process.

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What specific contents are addressed in the initial interview?

Regarding the information on which the professional asks the patient for the collection of initial data, essentially the following areas are found:

1. Patient demographics

These include the age, place and date of birth, as well as data on their professional occupation and a brief description of the people with whom they live and who make up the so-called nuclear family.

2. The exhibition of the consultation

It refers to the moments in which the patient exposes the different areas that cause his personal discomfort . Initial details about its beginning and evolution up to the present moment are included.

This is also the degree of interference that the problem (s) entail in their daily vital performance.

Finally, in this area it is also possible to inquire about the patient’s expectations regarding the therapeutic process and whether he has undergone any other psychological follow-up before.

3. Explanation

Depending on the consultation requested, the psychologist can make a brief explanation about how he will proceed in the following visits and what structure of procedures he will follow next. This aspect should not be confused with the fact that the professional makes a return or diagnostic hypothesis in the first session.

Although the patient tends to wait for the therapist to determine a clear professional evaluation at the first meeting, it seems essential that he adopts a more prudent position.

In this sense, Betisa Bárez (2018) indicates that, in the usual way, the psychologist needs an average of about four initial interview sessions so that he can have enough information about the consultation presented by the patient, and of all the circumstances that they surround it, in order to be enabled to conduct a well-founded return session.

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4. The framing

As indicated above, it becomes the normative framework in which the entire psychological process established between the therapist and the patient is governed (Betisa Bárez, 2018). Specifically, this content area is composed of the agreement on the following elements :

  • The schedules, that is, the duration and frequency of the sessions.
  • The planning of appointments and if a cancellation policy will be applied.
  • The delimitation of the contact outside the visits, if it will be allowed and in what terms.
  • The space in which the psychological intervention will be developed.
  • The structure and themes to be addressed in therapy sessions.
  • The issues related to the confidentiality of the data and in what cases this deontological principle will be broken. At this point it is possible to inform about the possibility of contacting other entities or organizations that may be attending to the patient, for example the staff of the school attended by the patient, other primary health professionals, psychiatrists, etc.
  • The elements and components from which each session will be formed, for example: presentation of a technique, review of the indicated tasks to be performed between the sessions, if a psychological evaluation process will be carried out prior to the intervention, etc. .

In conclusion

The exposed in this article can be useful to minimize the resistance that a patient can present at the time of deciding to carry out a psychological consultation, since knowing what aspects are treated in the first meeting between both parties can facilitate that person has more realistic and more specific expectations, thus reducing the fear of ignorance that this action can awaken.

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