One of the most difficult moments within the professional career of psychotherapists, whether in the clinical or health field, is the realization of EPS (Supervised Professional Exercise). Keeping this in mind, you may be interested in these little tips for your first session as a Psychotherapist. These tips helps to relieve the nerves of the first sessions with your patients or clients.
Advice for your first sessions as a psychotherapist
Follow these guidelines to get through this process in the most productive way possible.
1. Nerves are not your enemy
Every first step is scary, and the first encounter with a patient or client questions everything you have learned during the 4 or 5 years of bachelor’s degree. Nothing happens, nerves are natural and will be present to a greater or lesser degree regardless of the passage of time and all the experience you accumulate. It’s normal, since you do not know what kind of individual will be sitting in front of you and what their life story is.
2. Have all the necessary paperwork on hand
This is an extremely important part, because having all the paperwork that helps you collect patient information is key to providing the right service. This includes:
Engagement sheet
Having a engagement sheet is relevant in the professional practice, more if you are in your supervised professional practice (EPS), since you still do not have the official degrees and the active collegiate. This engagement will be the endorsement in which the patient or client gives their consent to begin the data collection stage (anamnesis), evaluation and of course the treatment.
Important fact: you must have a sheet for adults and one for children and adolescents that must be signed by the parents.
You must remember that, despite the nerves, if you are offering your help at a professional level, it’s something: you’ve gotten there because your skills have made it possible.
Clinical files
This document is like the “cover letter” of your patient / client, collects: the general data, the reason for consultation, the start date of therapy and the end date, if you feel the need you can include: at what time The problem started, if there is any stimulus or a stressor that is aggravating the situation or the symptoms.
Clinical histories
A type of key document to be able to make a good diagnosis and along with it, a good treatment. This document collects all the life information of the patient / client, that includes:
The general information (name, surnames, age, sex, etc).
Reason for consultation
Start and factors that aggravate symptoms and signs.
Brief history of the problem (important to find out all the details).
Family history.
Prenatal, perinatal and postnatal history.
The history of adolescence.
Adult data.
Medical history and family history related to emotional problems or mental disorders.
Etc.
Collecting all the aforementioned information takes time. As advice, try not to run in the collection of these data, sometimes patients / clients in their first session cry half of it and complain what remains, so you should be taking notes of everything you can take ” the air”. If necessary, ask direct questions.
Mental examination
This document is also key to a good diagnosis. In it you will point out or cross out everything related to the signs of the patient or client, for example: his appearance (he looks careless, unkempt, has scars), his perception (he has hallucinations, illusions, etc.), his thoughts (he has delusions, ideas of reference, flight of ideas, etc.). You should have it on hand from the time you see him/her arrive at the office or see him/her in the waiting room.
Evolution sheets
If you want to be a good therapist, you should keep track of all the progress of your patients or clients, from the first session to the last. In the evolution sheets you will note the changes that occur during the sessions, for example: “SESSION # 7: Tom presents a reduction in depressive symptoms, has done homework and enjoys more activities with her family ”
Control of appointments
As a matter of order and good management of your patients, you can keep track of appointments in physical or digital (for example, with an App). This way you will know which appointments were missing and which appointments were not.
Field diary
This will be essential if you are a practitioner. Even so, I suggest it also to all professionals, you will take notes of everything you do in the sessions with each patient / client, it could be key to discover if the treatment is being effective or not.
Therapeutic Plan
Something that makes the patient feel very safe is to have everything ready, to note that you expect them with an assortment of activities that they will perform in the short 45 or 60 minutes of the session. This will not only give a good image of you, but also the patient will have very significant advances, especially if they are coming to you for a brief therapy.
Data bank
This is at the discretion of the practitioner or professional. Keeping a bank with all the data of the clients that you have attended during the year will help you to know how it has gone and if it is necessary to improve your marketing plan.
3. The evaluation and the first stumbles
Something key and very supportive in the therapy processes is undoubtedly the evaluation. It is important that you know and build your own “standard” batteries of psychological tests. It is not necessary that you be a “machine” and know from memory and literally the instructions of all the tests. That’s why I suggest you choose 2 to 4 basic tests
Choose those psychological tests you master that can yield auxiliary information for the diagnosis of your patient. In some cases personality tests are very useful too, so I invite you to investigate more thoroughly which tests are best suited to the population you will serve.
4. Ethics
As professionals or future professionals, we must follow the rules proposed by our deontological code.
The people who come to the consultation, are that … people, who are requesting not only help but a professional service. For this reason it is good to take care of some details such as clothing, fill out the corresponding paperwork and mentioned above, evaluate and deliver results and to finalize the diagnosis.
It is important to also take into account the therapeutic approach that you will use: the one based on more scientific evidence is Cognitive-Behavioral Therapy, although there are different proposed interventions for each of the psychological problems.
5. Empathy
I believe that this is the key for the client to have significant advances. Establishing a good therapeutic relationship, always within a frame of reference, is fundamental. The problem is that at the beginning there is a severe emotional burden, because patients come to relieve themselves and to resolve their conflicts, and often this emotional burden begins to affect our private life. It is necessary that the therapeutic relationship be a combination of empathy and professionalism.
Never forget…
Finally, always remember that it is not only important to use techniques. In my experience, I have known practitioners and professionals who consider techniques as the center of therapy, I must admit that it is partly true that they are very important, but do not forget that you are dealing with a person. Maintain empathy and compassion always within the framework of therapy.
