One of the most difficult moments in the professional career of psychotherapists, whether in the clinical or health field, is the completion of the EPS (Supervised Professional Practice). Bearing this in mind, you may be interested in these little tips for your first session as a psychotherapist . You help to relieve the nerves of the first sessions with your patients or clients.

Tips for your first sessions as a psychotherapist

Follow these guidelines to go through this process as productively as possible.

1. Nerves are not your enemy

Every first step is scary, and the first encounter with a patient or client calls into question everything you have learned during the 4 or 5 years of your degree. Nothing happens, nerves are something natural and will be present to a greater or lesser degree regardless of the passage of time and all the experience you accumulate. This is normal, since you don’t know what kind of individual will be sitting in front of you and what his or her life history is.

You must remember that, despite your nerves, if you are offering your help on a professional level it is for a reason: you have got there because your skills have made it possible.

2. Have all necessary paperwork on hand

This is an extremely important part, as having all the paperwork to help you collect patient information is key to providing the right service . This includes:

Commitment sheet

Having a commitment form is relevant to your professional practice, especially if you are in your supervised professional practice (EPS), since you do not yet have the official qualifications and active membership. This commitment will be the endorsement in which the patient or client gives his or her consent to start the stage of data collection (anamnesis), evaluation and of course treatment.

Important fact: you must have a sheet for adults and one for children and teenagers to be signed by the parents.

Clinical records

This document is like the "letter of introduction" of your patient/client, collect: the general data, the reason for consultation, the date of beginning of therapy and the date of completion, 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.

Medical records

A key document type to be able to make a good diagnosis and together with it, a good treatment.
This document collects all the life information of the patient/client, that includes

  • General information (name, surname, age, sex, etc.)
  • Reason for consultation.
  • Onset 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.
  • Adulthood data.
  • Medical history and family background related to emotional problems or mental disorders.
  • Etc.

Gathering all the above information takes time. As a tip, try not to run around collecting this data, sometimes patients/clients in their first session cry half the time and complain the rest, so you should take notes of everything you can take on the air. If necessary, ask direct questions.

Mental Examination

This document is also key to a good diagnosis. In it you will write down or cross out everything related to the signs of the patient or client, for example: their appearance (looks neglected, untidy, has scars), their perception (has hallucinations, illusions, etc.), their thoughts (has delusions, reference ideas, flight of ideas, etc.). You must have him at hand from the moment you see him arrive at the office or see him in the waiting room .

Evolution sheets

If you want to be a good therapist, you must keep a record of all the progress of your patients or clients , from the first session to the last. On the progress sheets you will write down the changes that occur during the sessions, for example: “SESSION #7: Juanita has a reduction in depressive symptoms, has done her homework and enjoys her activities more with her family”.

Appointment control

As a matter of order and good management of your patients, you can keep track of the appointments in physical or digital (for example, with some App). This way you will know which appointments were missed and which were not, if they have done their homework, if you have to cancel them…

Field Diary

This will be essential if you are a practitioner . Even so, I also suggest to all professionals that you keep 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 if perhaps you have made a mistake in performing any technique.

Therapeutic Plan

Something that makes the patient feel very confident is to have everything ready, notice that you wait for them with a whole range of activities that they will do 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 short therapy.

Database

This is at the discretion of the practitioner or professional. Keeping a bank with all the data of the clients you have served during the year will help you to know how you have done and if it is necessary to improve your marketing plan .

Extras: teacher interviews and reference sheets

Sometimes children are referred by the school to the clinic. For your personal control,** asking the teacher to provide information** is very useful or anyone who is making the referral to your office.

3. The evaluation and the first setbacks

A key and very supportive part of the therapy process is undoubtedly the evaluation. It is important that you know and put together your own “standard” psychological test batteries . You don’t have to be a “machine” and know the instructions for all the tests by heart and to the letter. That’s why I suggest you choose 2-4 basic tests

Choose those psychological tests that you master and that can provide auxiliary information for the diagnosis of your patient. In some cases personality tests are very useful too, so I invite you to investigate further which tests are best suited to the population you will be treating.

4. Ethics

As professionals or future professionals, we must follow the rules proposed by our code of ethics .

The people who come to the practice, are that… people, who are asking not only for help but for a professional service. That is why it is good to take care of some details such as clothing, fill out the corresponding paperwork mentioned above, evaluate and deliver results and to finish the diagnosis.

It is also important to consider the therapeutic approach you will use: the one based on the most scientific evidence is Cognitive-Behavioral Therapy, although there are different interventions proposed for each of the psychological problems.

5. Empathy

I believe that this is the key for the client to make significant progress. 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, since patients come to vent and manage to solve their conflicts, and many times this emotional burden begins to affect our private life. The therapeutic relationship must 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 met practitioners and professionals who consider the techniques as the center of therapy, I must recognize that it is partly true that they are very important, but do not forget that you are dealing with a person. Always keep empathy and compassion within the framework of therapy.

Author: Hary Winther