First Therapeutic Session Review Essay (Critical Writing)

The first session with a new patient sets the path for the whole treatment and plays a significant role in its success. Approaching therapy in a mindful and educated way allows avoiding common mistakes and helps maximise the effect of the treatment. The goal of this paper is to analyse optimal conditions for a first therapeutic session assuming the role of a therapist and evaluating current personal strengths and limitations in ensuring optimal conditions.

It is essential to create and maintain a positive emotional environment from the very beginning of the session. Multiple studies have shown that a comfortable environment and stimulating positivity facilitate improvement in symptoms (McClintock, Anderson, & Petrarca, 2015). Meeting a new client with an open mind and avoiding any prejudice is vital, as research has shown that stigma present in therapy affects the outcomes in a negative way (Nakash, Nagar, & Levav, 2015).

Moreover, learning about the socio-economic and cultural background of the client is essential for an in-depth understanding of his or her personal experience and personality (Sen, 2017). It also contributes to the development of the sense of acceptance and self-compaction in clients, which is a critical component of therapy (Galili‐Weinstock et al., 2018). Applying the knowledge about these phenomena allows improving the results of the whole treatment and helps maximise the clients’ satisfaction with the therapy.

Engaging the patient in the therapeutic process and building a personal connection is critical for the first session. Therapists need to help the patient develop a sense of agency as it stimulates the client to make more efforts (Huber et al., 2019). In addition to that, adopting behaviour according to the client’s personality is also critical for developing a productive environment and positive interpersonal relationships with the patient (Moors & Zech, 2017).

In addition to that, this approach helps to form a therapeutic allegiance, enhancing the results of the session (Fisher, Atzil-Slonim, Bar-Kalifa, Rafaeli, & Peri, 2016). Failure to achieve it, on the other hand, is associated with the negative result leading to failure in treatment (Weck, Grikscheit, Jakob, Höfling, & Stangier, 2015).

Therapeutic relationships have been shown to have an impact on the drop-out rate (Beck, 2018). Addressing this issue will help not to lose new clients, which is especially relevant for the first session. Between-session interventions have a positive impact on treatment (Cronin, Lawrence, Taylor, Norton, & Kazantzis, 2015). Thus, as a therapist, I would suggest a set of personalised exercises that the client can do individually.

Applying theoretical knowledge to practice helps develop an effective approach to therapy and be aware of potential problems. Reliance on evidence from the latest research and scientific literature are the strengths I can use to facilitate the results of treatment. Personal qualities such as extraversion and openness will also help develop strong relationships with the patients and avoid misconceptions and prejudice. The subjectivity of perception may create a limitation and make work with individuals, who come from a completely different background more difficult, but it can be overcome.

References

Beck, J. S. (2018). The therapeutic relationship in cognitive-behavioral therapy. Journal of Psychiatric Practice, 24(6), 443-444.

Cronin, T. J., Lawrence, K. A., Taylor, K., Norton, P. J., & Kazantzis, N. (2015). Integrating between‐session interventions (homework) in therapy: The importance of the therapeutic relationship and cognitive case conceptualisation. Journal of Clinical Psychology, 71(5), 439-450.

Fisher, H., Atzil-Slonim, D., Bar-Kalifa, E., Rafaeli, E., & Peri, T. (2016). Emotional experience and alliance contribute to therapeutic change in psychodynamic therapy. Psychotherapy, 53(1), 104-106.

Galili‐Weinstock, L., Chen, R., Atzil‐Slonim, D., Bar‐Kalifa, E., Peri, T., & Rafaeli, E. (2018). The association between self‐compassion and treatment outcomes: Session‐level and treatment‐level effects. Journal of Clinical Psychology, 74(6), 849-866.

Huber, J., Born, A. K., Claaß, C., Ehrenthal, J. C., Nikendei, C., Schauenburg, H., & Dinger, U. (2019). Therapeutic agency, in‐session behavior, and patient–therapist interaction. Journal of Clinical Psychology, 75(1), 66-78.

Moors, F., & Zech, E. (2017). The effects of psychotherapist’s and clients’ interpersonal behaviors during a first simulated session: A lab study investigating client satisfaction. Frontiers in Psychology, 8, 1868. Web.

Nakash, O., Nagar, M., & Levav, I. (2015). Predictors of mental health care stigma and its association with the therapeutic alliance during the initial intake session. Psychotherapy Research, 25(2), 214-221.

McClintock, A. S., Anderson, T., & Petrarca, A. (2015). Treatment expectations, alliance, session positivity, and outcome: An investigation of a three‐path mediation model. Journal of Clinical Psychology, 71(1), 41-49.

Sen, D. (2017). What stays unsaid in therapeutic relationships. Psychosis, 9(1), 90-94.

Weck, F., Grikscheit, F., Jakob, M., Höfling, V., & Stangier, U. (2015). Treatment failure in cognitive‐behavioural therapy: Therapeutic alliance as a precondition for an adherent and competent implementation of techniques. British Journal of Clinical Psychology, 54(1), 91-108.