Whole Therapist, Whole Patient by Patricia R. Frisch

Author:Patricia R. Frisch
Language: eng
Format: epub
Publisher: Taylor & Francis (CAM)
Published: 2017-12-22T16:00:00+00:00

Protocol for Initial Sessions

The first session/initial consultation is an important hour as the therapeutic relationship is defined in more depth, and the patient and the therapist determine if they will go forward together. I recommend a protocol for the first session.

I created a document, the Psychological History Form for Therapists (see the appendix in the web Online Resource Guide for this book), that organizes the therapist’s process through the information-gathering phase of the first few sessions.

To begin, I recommend taking a thorough, methodical survey of any and all problems. Patients have a few in mind when they come into therapy. I request that patients tell me all the things that bother them whether small or large. I also ask probing questions to stimulate recognition of any areas they may not have considered. I will ask if they have reoccurring thoughts, feelings, images that disturb them. I will ask about their medical issues, injuries, prior medical issues, and medications. We can cover items such as sleep, diet, exercise, and body image issues. Relationship issues and work status should be addressed. I will ask for a review of psychological symptoms: depression, anxiety, negative self-talk, anger problems, fears, phobias, and social distress. The goal is that both of us see and understand, in detail, the entire picture of both positive attributes and those that reflect difficulties.

When I supervise other therapists, I notice that the problem assessment is often too thin, as the patient may launch into one specific problem and the therapist does not gather the complete picture. Once therapy begins it gets harder to get a grasp of all problem areas and the specific information that would be helpful in getting a larger contextual view.

Part of the problem picture may include a cursory overview of family of origin dynamics, so it is important that you get an in-depth picture of the basic family template with historic problem areas defined.

Also in your assessment of medical issues, find out whether the patient has had appropriate contact with medical professionals such as periodic blood tests and exams; if necessary advise him to get a physical from his primary care physician. Blood pressure, lipid profiles, triglyceride count, and other aspects of traditional medical exams should be encouraged and noted. If you have questions regarding any medical issues such as potential early onset dementia, sequela from prior head injuries, possible neurological issues, autoimmune symptoms and allergic reactivity, and so forth, ask your patient to get checked out with the appropriate medical professional. Note that personality or behavioral changes that have lasted for over six months can indicate an early stage of dementia or be an early indicator of Alzheimer’s. The patient or family members might complain of changes in mood indicated by increased agitation or emotional sensitivity, changes in normal behavioral patterns, or changes in attitudes such as an appearance of unrealistic, grandiose beliefs. Often patients will avoid following up on problematic symptoms or medical issues. If the patient is not managing weight, alcohol, exercise, and other health issues, that becomes part of the treatment plan.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.