Today marks the third week of my Practicum and Professional Orientation class. This is the first opportunity for many of my students to begin live counseling experiences in their Practicum settings. Most seem to be settling in nicely.
If you have been a green counselor in your first session then you know the terror of: “What will they say???? What will I say????” It doesn’t matter if you have a 10 year file on the client or a 1 sentence “presenting problem”, the green counselor cannot predict the outcome of the session–hence the fear.
To alleviate some of the fear, let’s review what makes for a good first session.
1. Introductions. Make sure they know who you are and who is supervising you. Give them a chance to tell you why they are coming for counseling. Sometimes what they say differs from what they wrote on the forms.
2. Help the client tell their story without too much interruption. Don’t be too quick to jump in and direct with too many questions.
3. Gathering the following data (again, without too much interruption):
- content and scope of problem (frequency, duration, intensity)
- solutions attempted, things that help/harm, prior counseling attempts
- current family/community make-up
- other mental illness
- relevant medical history, current meds, sleep quality
- substance abuse
- spiritual dynamics
- supports, strengths
- typical mood, suicidality
- Other important factors (employment, finances, relational conflicts, etc)
- dreams, hopes, goals
4. Summarize (briefly) and discuss possible initial directions or goals as well as alternatives they may wish to consider
5. Counseling model and nuts and bolts of professional care (confidentiality limits, scheduling, contacting you, payment options, etc.)
That will be more than enough for an hour. Most likely, you get great data in some areas and just a tad in others that will require you to follow-up in the next week. The more talkative the client is, the less data you can gather. The less talkative, the more likely you will get the data but the less likely you’ll form a good connection (Q & A leads to very passive clients more often than not).
It is good to have these very general categories in mind as you start that first session. Be wary of either forgetting the categories or obsessively forcing the client to answer all the history questions. You may end up with a wonderful piece of history for a client who never returns.
Today starts our 3rd trimester of the 2007-8 school year and Cohort 3 begins their Practicum and Professional Orientation course and first fieldwork experiences of the program. Last year I ran across an article (see reference at end) trying to articulate the domains and levels of competence in focus in a psychology practicum experience. Though the article is directed to doctoral level practicums, I think the domains fit for any level of trainee and are a good reminder for both practicum students and their professors. The authors summarize the “Practicum Competencies Outline” and in turn I will quote/summarize/highlight them below. Click here for the whole document.
- Baseline Competencies (for entry to practicum)
- Personality Characteristics
- interpersonal skills (verbal and nonverbal forms of communication, open to feedback, empathic, respectful)
- cognitive skills (intellectual curiosity, flexibility, problem-solving, critical thinking, organizing)
- affective skills (ability to tolerate affect and conflict and ambiguity)
- personality/attitudes (desire to help, openness to new ideas, honesty, courage, valuing ethics)
- expressive skills (ability to communicate ideas, feelings, ideas in multiple forms)
- reflective skills (ability to examine and consider own motives, attitudes and behaviors and recognize one impact on others)
- personal skills (ability to present oneself in a professional manner)
- Knowledge from the classroom
- assessment and interviewing
- ethics and legal issues
- Skills to Develop during Practicum
- Relationship/interpersonal skills
- Applying research (less so for MA level)
- Psych assessment (not for MA level)
- Consultation/interprofessional collaboration
- Supervisory skills (not for MA level)
This second major bullet point (competencies built during practicum) is fleshed out further by listing levels of competencies. The article illustrates relationship/interpersonal skill competencies by listing how it will show up with clients (e.g., ability to form working alliances), colleagues (e.g., ability to accept feedback nondefensively from peers), supervisors (ability to self-reflect), support staff (respectful of support staff roles), clinical teams (participates fully in team work), community professionals (ability to further the work and mission of the site).
Hatcher, R.L, & Lassiter, K.D. (2007). Initial Training in Professional Psychology: The Practicum Competencies Outline. Training and Education in Professional Psychology, 1, 49-63.