Objectives of the first psychological interview

For most people, making the decision to seek psychological treatment is very difficult; since not all of us like to have to tell our intimacies and most hidden feelings to a stranger. That’s why finding the right therapist is crucial, and like any relationship, chemistry is essential.

The subject generally tends to fight against some of the feelings that he considers unpleasant; He does not realize that feelings are part of each individual and highlight the essence of it. It is best to understand that those feelings that you dislike must be accepted as part of a process. This acceptance of feelings becomes one of the first steps to not only get help, but also to begin the psychotherapeutic process of change.

The first psychological interview

The   first psychological interview could be thought of as the psychologist’s first meeting with the client. This  is primarily an information gathering session for the therapist. Where he meets the consultant -future patient-, the consultant explains the reasons that led him to want to start a psychological session, and the psychologist explains his procedures and decides if the consultant is suitable for treatment or prefers to refer him to another psychologist , or specialist. Some psychologists may offer a second interview or “trial therapy.”, which lasts approximately four to six weeks, after this “trial therapy” the patient and the psychologist decide whether to continue with psychotherapy.

Not all psychologists use the same techniques or have the same style. Some will maintain a professional distance while others will warmly hold your hand; some will have a nice sense of humor, and others will be totally serious; some will answer your questions directly, while others will explore the motivations behind each question.

From the point of view of the objectives, the first psychological interview is different , since perhaps in the first encounter the objectives of the first interview cannot be achieved ; although they are commonly achieved, they may take more sessions.

Objective of the first psychological interview (from the psychologist’s point of view)

First, I must mention that to meet the objectives expected in the first interview, an open dialogue must be generated , through the tools and knowledge that the professional psychologist possesses, such as listening and clinical gaze , inter-seeing what verbal and paraverbal , which often do not coincide. Always aiming at the resolution of the clinical consultation.

Know the manifest reason for the consultation

The manifest motive is what the patient explicitly brings, complementing this information by inquiring about the context and origin of said motive. I have to interrogate the patient as best as possible to discover the manifest reason being open and attentive to what is received in order to discover the latent motive , which in general does not come together and is very difficult to elucidate in the first meeting.

What does the patient demand?

I have to ask myself, what is he asking me? What do I have to do? . Which has to do with the demand for the psychologist. What I have to do generally does not match the demand since I do not have to do what the patient wants. You have to know that there are two demands, one manifest and the other latent , which may or may not coincide.

Pay attention to defense mechanisms

In dynamic dialogue I have to try to observe the defense mechanisms that prevail in the subject . Taking into account that according to the maturation structure of the individual, it may use certain defense mechanisms typical of the evolutionary stage that it is passing through. The more defense mechanisms, the more plasticity and the more health. But you have to differentiate them well from defensive behaviors.

Give a possible diagnosis

Pay careful attention to every movement, every word, and every gesture made by the consultant. Also know your history in a short period of time, in order to properly assess your concerns and arrive at a possible diagnosis. This diagnosis helps us to conduct the appropriate treatment for the client’s conflict or its possible psychopathology. This is an essential part of the first psychological interview process.

Some psychotherapists are not completely comfortable making a final diagnosis after just one session; This may be because the session was not effective enough to determine an exact diagnosis. Therefore, it must be known that a psychologist can change his diagnosis after several additional sessions that help him to know the patient better.

Enter the patient’s mind and help him resolve internal conflicts

As psychologists we must have a wide  disposition to attend to the other and make him feel that he is being cared for, based on verbalizations, questions, gestures. Each patient is a unique individual who needs help. It is necessary to enter the anguish or fears of the other without worrying about or fear for the other ( instrumental dissociation ), in a good management of the transference .

We must glimpse how the subject is positioned in front of life , that is, if it appears confused, depressed , anguished, anxious , insecure , etc – this will open lines of analysis.

Solve the situation of that which is presented as something new for the consultant, where anxiety is always present and the field to be analyzed opens up.

Pose hypotheses

Raise hypotheses, open lines of significance, to be confirmed or not in the next interviews and in the application of tests if necessary. Thus building a first sketch of a work strategy.

After the first psychological interview

Many people will leave their first session feeling : relieved that they have removed a backpack, fears what the psychotherapist will think, anxious about the next interview, intimidated by all the questions the psychotherapist asks, hopeful because they think they have taken the road right, or sad to remember some stories that have been traumatic or upsetting.

Most people who are treated with psychotherapy end up taking it as part of their weekly routine – it is usually done once a week, depending on the psychologist – and they value their time with the therapist very much, since the psychological session can be seen as an opportunity to explore new ways of being, thinking, feeling of an individual.