What you can do to help yourself before your first appointment with a Psychologist

Seeing a psychologist for the first time can feel daunting. Here are some valuable things to keep in mind to help your prepare for the first appointment with a counsellor or psychologist.

It's normal to be in two minds about seeing a psychologist


Most endeavors people take to try to improve a situation in their life involve mixed feelings. Asking for help from a psychologist is hard. Talking to a person you've never met before about what troubles you is probably even harder.

Having feelings of both hope and fear about seeing a psychologist are entirely normal. It has been theorised that we have competing drives as humans: one to improve our life and one preserve our self views, even if they are negative (Leary, 2007). Even if you have a great amount of hope and determination to address something in therapy, it is likely that fears of failure and vulnerability will show up too before the first session starts.


You aren't locked in to seeing the one therapist


It can be a good idea to treat your first session or two with a psychologist as an experiment. Do you feel at ease talking to your psychologist? Do you feel understood? If you feel either of those factors aren't quite right, it's a good idea to ask around for another well renowned psychologist or to see your GP for a new referral. The American Psychological Association's task force to identify effective psychological treatments have concluded from their research that "the therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method" (Norcross, 2011).

Clarify what you want to address

The 50 minutes for your first session may fly by quite quickly and it might be hard to clarify your thinking. I always think it's a good idea to write down prior to you first session:

What is the problem that you're bringing to therapy that you want to address?

What would you like to get out of seeing a psychologist?

Given that changes in human behaviour, perspectives or feelings can often be slow, what small changes in my life am I hoping to make in the few weeks after the first session?

Expect that you'll probably be given something to do between the first and second sessions

It's not the job of a psychologist to lecture you, to find a solution to your problems or to provide advice. It may sound cliche, but people people going to therapy generally get out of it what they put in. Most therapeutic approaches ask people between sessions to do something to get the most out of therapy: this can including writing, monitoring thoughts or feelings, trying out an experiment or a new approach to a problem, or reading up an area of psychology that gives new perspectives. It is a good habit to either complete these tasks between sessions, or at the very least, note to your therapist the barriers that got in the way of their completion.

Most psychologists won't provide you with a diagnosis after the first session

Clinical psychologists trained in Australia have an emphasis on case formulation rather than diagnosis when they are completing their training. Case formulation is just a fancy way of 1) summarising the problems someone brings to therapy, 2) listing some hypotheses of how that person has ended up in that situation, and (3) most importantly, summarising the habits, actions and ways of thinking that are keeping someone stuck in that problem. A diagnosis generally just summarises a cluster of symptoms someone is experiencing without accounting for individual difference. Case formulation allows psychologists to make a plan for treatment that goes beyond symptom reduction. A good case formulation and treatment plan also sets up clients to solve their own issues beyond therapy, without dependence on the therapy sessions.

References

Leary, M. (2007). Motivational and Emotional Aspects of the Self. Annual Review of Psychology,58(1), 317-344.

Norcross, J. C. (Ed.). (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York: Oxford University Press.

Patrick Sheehan is a clinical psychologist who works with adults and adolescents in his private practice located in Glebe, Sydney. If you want to enquire about an appointment, please head over to the contact page.

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