From the first meeting, to life long improvement

I wrote this reflection for our pre-practicum class at the University of Rochester. The professor asked us to reflect on our readings regarding the first meeting with a new client.

   This week, I reflected on Chapters 6, 7, and 8 in Sommers-Flanagan & Sommers-Flanagan's (2015) Clinical Interviewing. These chapters examined the practical aspects of conducting a first meeting with a new client, commonly referred to as an intake interview. Chapter 6 provided an overview of the intake process, from initial contact with the client to building rapport through small talk, opening a therapeutic conversation, gathering information and forming hypotheses, using interventions, and terminating the interview. Chapter 7 examined the interview and report writing process in more detail, focusing on three major tasks. The first task was to identify the clients' problems and goals, the second was to gather information about them as a person, and the third was to evaluate their overall functioning ability. Chapter 8 then focuses on an essential piece of documentation, the Mental Status Exam or MSE.           

            I found this reading interesting. These chapters were very practical overall and touched on many things, for example, how should a therapist greet the client on the first occasion? Should they shake hands? Or not? How do they recognize the client if they are in the lobby? How much small talk should they undertake? What is the primary objective of the intake interview? What does the therapist gather data on, and how? Then how does the therapist manage time and wrap up? When the therapist writes notes, who is the audience? What does the therapist include or exclude in notes? The readings were practical and information centered.

 For a new therapist, there is so much to remember to do, and to get right. A new therapist may ask, where do I begin? Due to the confidential nature of the therapist client relationship, a therapist can only get feedback from approved supervisors that the client has authorized to discuss their confidential details. Feedback from supervisors, coupled with corrective practice, seems like one of the best ways that a new therapist can improve. There also appears to be a risk that, due to the isolated nature of the therapy encounter, therapists who do not do ongoing supervision and training may develop bad habits and mistakenly believe they are effective when they are not. Lastly, for a therapist to improve, who do they listen to? What if the organization you work with follows a theory that doesn't work for your client? It seems many people offer advice, it is important for a new therapist to be judicious regarding who they take advice from.

            For a new therapist, it takes courage to improve. Watching recordings of sessions is one of the best ways to improve. It can feel uncomfortable for a new therapist to watch themselves on film. Especially when they make mistakes. It takes humility to be able to show mistakes to others and receive feedback, and it takes trust and good judgment to know which feedback to incorporate and how to do it. It takes a lot of determination to keep practicing and trying to improve, rather than resting on your laurels or even regressing into bad practice. A new therapist has a mountain to climb ahead of them, and it may take decades of practice to master the craft. Hopefully the therapist is excited about this prospect of learning and will enjoy devoting their life to improving their practice and learning how to connect with others in a better way.