What to expect during a first visit to a psychotherapist?

A summary of what happens during the first stage of psychological intervention.

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

One of the main fears that the person experiences can be related to the lack of knowledge of what the first therapy is like.. For that reason, next the aspects are exposed that, with greater frequency, are approached in the first encounter with a professional of the psychology inscribed within the cognitive-behavioral current.

The initial interview

As indicated by Betisa Bárez (2018), there are three main objectives The psychologist will approach the potential patient in a first visit:

First of all, it is intended to establish a positive climate of comfort and trust between both parties, so as to begin to lay the foundations of a first therapeutic bond that will allow the subsequent joint work during the intervention process.

In addition, in this first exchange the professional the process of collecting data on the reason for the consultation presented by the patient, in order to the patient, in order to make a conceptual approximation on 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 make it possible to determine whether this professional is the right person to attend the consultation or whether, on the contrary, the case should be referred to another professional who is more specialized or better suited 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 on. to be carried out from that moment on. This set of information is called "framing" and consists of a series of rules or procedural principles that have the function of delimiting for both parties how the appointments will be carried out, what to expect from them and what structure and/or method of working together will be followed during the psychological treatment process.

What specific content is addressed in the initial interview?

In terms of the information about which the professional asks the patient for initial data collection, essentially the following areas are found:

1. Patient demographics.

These include age, place and date of birth, as well as data on his or her professional occupation and a brief description of the people with whom he or she lives and who make up the so-called nuclear family.

2. The consultation statement

This refers to the moments in which the patient exposes the different areas causing his or her personal discomfort. Initial details about their onset and evolution up to the present time are included.

At this point, the degree of interference that the problem(s) entail in their daily life performance is also discussed.

Finally, in this area we should also inquire about the patient's expectations regarding the therapeutic process and whether he/she has undergone any other previous psychological follow-up.

3. Explanation

Depending on the consultation requested, the psychologist may give a brief explanation of how he/she is going to proceed. a brief explanation of how he/she will proceed with the following visits and what procedural structure will be followed thereafter. This aspect should not be confused with the fact that the professional makes in the first session a return or diagnostic hypothesis of the case.

Although the patient usually tends to expect the therapist to make a clear professional assessment at the first meeting, it seems essential for the therapist to adopt a more cautious stance.

In this regard, Betisa Bárez (2018) indicates that, as usual, the psychologist needs an average of about four initial interview sessions so that he/she can have enough information about the consultation presented by the patient, and all the circumstances surrounding it, in order to be able to carry out a well-founded return session.

4. Framing

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

• The schedules, i.e., the duration and frequency of the sessions.
• The scheduling of appointments and whether an appointment cancellation policy is to be applied.
• The delimitation of contact outside of visits, whether it will be allowed and under what terms.
• The space in which the psychological intervention will take place.
• The structure and topics to be addressed in the therapy sessions.
• Issues related to the confidentiality of the data and in which cases this deontological principle will be broken. At this point it is worth informing about the possibility of contacting other entities or organizations that may be attending the patient, for example the staff of the school the patient attends, other primary health professionals, psychiatrists, etc.
• The elements and components on which each session will be based, for example: presentation of a technique, review of the tasks to be carried out between sessions, whether a psychological evaluation process will be carried out prior to the intervention, etc.

By way of conclusion

What has been explained in this article can be useful to minimize the resistances that a patient may present. when deciding to have a psychological consultation, since the fact of knowing what aspects are dealt with in the first meeting between both parties can help the person to have more realistic and concrete expectations, thus reducing the fear of ignorance that this action may awaken in him/her.

Bibliographical references:

• Betisa Pérez Palomo, N. (2018). Habilidades básicas del psicólogo sanitario. Ediciones CEF: Madrid.