Although resistance or reluctance to undergo psychological therapy is increasingly overcome, there are still regular fears about what an emotional problem may involve seeing a psychologist.
One of the main fears a person experiences may be related to ignorance of how this is the first therapy. Therefore, here are the aspects that are most often discussed during the first meeting with a psychology professional registered in the cognitive-behavioral stream.
The initial interview
As reported by Betisa Bárez (2018), there are three main objectives that the psychologist plans to treat with the potential patient during a first visit:
First of all, it is a question of establishing a positive climate of comfort and trust between the two parties, so that the bases of a first therapeutic bond can be established which will allow a subsequent joint work during the process of intervention.
In addition, during this first exchange, the professional the process of collecting data on the reason for the consultation begins exposed by the patient, in order to make a conceptual approach to the indicated demand.
This objective allowed the psychologist to develop a more detailed idea of the problem consulted by the patient and thus to understand it more in depth. Ultimately, it will also be possible to determine whether such a professional becomes the right person to attend this consultation or, on the contrary, it is necessary to refer the case to another more specialized professional or more suited to the needs. of the patient.
Finally, during this first meeting, the psychologist reports on the conditions and rules that will govern the therapeutic sessions to play from this point on. This set of information is called “framing” and consists of a series of rules or procedural principles which have the function of delimiting by both parties how appointments will be made, what to expect from them and what structure and / or common working method to be followed during the psychological treatment process.
What specific content is covered during the initial interview?
Regarding the information on which the professional asks the patient to collect the initial data, the following areas are mainly found:
1. Patient demographics
These include age, place and date of birth, as well as data on their occupation and a brief description of the people they live with and who make up the so-called nuclear family.
2. Presentation of the consultation
This refers to the times when the patient exposes the different areas causing his personal discomfort. The first details of its appearance and evolution to the present time are included.
This point also deals with the degree of interference that the problem (s) cause (s) in their performance of daily living.
Finally, in this area, it is also necessary to research the patient’s expectations regarding the therapeutic process and whether he has been the subject of another psychological follow-up beforehand.
Depending on the consultation requested, the psychologist can perform a brief explanation of how to proceed on subsequent visits and what procedural structure will follow. This aspect should not be confused with the fact that the professional makes a feedback or a diagnostic hypothesis of the case from the first session.
Although the patient generally tends to wait for the therapist to establish a clear professional assessment at the first meeting, it seems essential that he adopts a more cautious attitude.
In this sense, Betisa Bárez (2018) indicates that, in the usual way, the psychologist needs on average about four initial interviews so that he can have sufficient information about the consultation presented by the patient, and all the surrounding circumstances, in order to be able to proceed to a well-founded return session.
4. The framing
As stated above, it becomes the regulatory framework that governs the entire psychological process established between therapist and patient (Betisa Bárez, 2018). Specifically, this content area consists of the agreement on the following:
- The schedules, that is to say the duration and frequency of the sessions.
- Scheduling appointments and whether a cancellation policy will be applied.
- The delimitation of the contact outside the visits, if it will be authorized and under what conditions.
- The space in which the psychological intervention will take place.
- The structure and topics to be covered in the therapy sessions.
- Questions regarding data confidentiality and in which cases this ethical principle will be broken. At this stage, it is necessary to signal the possibility of contacting other entities or organizations likely to take care of the patient, for example the staff of the school attended by the patient, other professionals of primary health, psychiatrists, etc.
- The elements and components from which each session will be formed, for example: exposure of a technique, review of the tasks indicated to be carried out between sessions, whether a process of psychological evaluation prior to the intervention will be carried out, etc. .
What is exposed in this article it can be useful in minimizing the resistance that a patient may experience when deciding whether to conduct a psychological consultation, because knowing what aspects are discussed during the first meeting between the two parties can allow the person to have more realistic and specific expectations, thus reducing the fear of ignorance that this action can awaken him.
- Betisa Pérez Colom, N. (2018). Basic skills of the health psychologist. CEF editions: Madrid.