What a Psychology Session Looks Like!

Introduction

• Rowana, a psychologist from Sydney, Australia, shows what a psychology session looks like.

• It is a first introduction session to a psychologist.

• This video is not a substitute for real therapeutic advice.

"What a psychology session looks like!"

First Meeting

• Rowana welcomes the client and asks them to come in.

• She thanks the client for filling out the form and takes it from them.

• Rowana leads the client into the therapy room and tells them to take a seat.

"Come on in. Nice to meet you. Thank you for filling that out. I'll grab that, come on in."

Consent and Introduction

• Rowana discusses the consent process with the client.

• She explains that she will write notes on her laptop after each session with the client's consent.

• The notes are private to the clinic and will not be linked to the public health system.

• Rowana assures the client that she will only break confidentiality if they tell her about harm coming to themselves or someone else.

"Everything we talk about in this room stays between us. The only thing is I'd like to ask you consent so that I can write some notes on my laptop after each session. The notes are completely private to our clinic and they're not linked up to the public health system as well. The only time I'll have to break confidentiality is if you tell me about harm coming to yourself or someone else, in which case I am a mandatory reporter."

Structure of Sessions

• Rowana explains that the first session is longer, but future sessions will be about 50 minutes long.

• She mentions that a set of sessions is usually booked initially and will occur every week or two weeks.

• Rowana states that the goal of today's session is to understand why the client is there and to establish a plan.

"In terms of our sessions together, I know admin will have booked in kind of a set of sessions when you first call up, and those will be every week or two weeks. In terms of today, maybe we can start with a bit of housekeeping, and then we can go on to get to know each other a little bit more and also for me to get an understanding of why you're here today. And I'd like to end today's session with kind of a summary, trying to get on the same page, and hopefully, we have a bit of a plan going forward by the end of today."

Exploring Current Concerns

• Rowana asks the client about their current concerns, starting with work-related issues.

• She inquires about how the client has been feeling at work and asks about their thoughts during work.

• Rowana explains the concept of imposter syndrome and relates it to the client's experience.

"Tell me about how you've been feeling at work recently."

"Sometimes I like to think of thoughts as little speech bubbles. So if someone was drawing you as a comic artist, what would be some of the things that they have in those little speech bubbles above your head."

"I think you're right. I think it is, it sounds a lot like imposter syndrome. It's very common for people who first start working."

Impact of Emotions

• Rowana uses the metaphor of beach balls to explain the impact of suppressing emotions.

• She describes how pushing down feelings can lead to an eventual eruption and gives an example of the client shouting at their mom during a family event.

• Rowana helps the client understand the connection between suppressing emotions and experiencing overwhelming feelings.

"Feelings are like beach balls, and often it's really helpful to push our feelings down under the water just for a little bit, in the short term. But then lots of people get into a pattern where they are often pushing down their feelings long term."

"And so when you described, you know, being at your recent family event and shouting at your mom, it sounds a bit like it was all those feelings coming out."

Assessing Health and Lifestyle

• Rowana asks the client about their sleeping habits and exercise routine.

• She discusses the importance of sufficient sleep and expresses concern about the client not getting enough.

• Rowana also explores the client's feelings about the changes in their exercise and wellness routines.

"In terms of your sleep, how many hours are you getting per night?"

"And how often do you go to the gym?"

"And how have you been feeling about those changes?"

Additional Information

• Rowana asks the client if there is anything important they feel she should know that might have been missed.

• After clarifying there is nothing significant, Rowana suggests exploring the client's family history to gain a better understanding.

"Was there anything that you feel like would be really important for me to know, something that we might have missed or skipped over?"

"Well, in that case, maybe we'll actually take a deep dive back in history a little while. Do you want to tell me a bit more about your family?"

A pattern of pushing feelings down

• A pattern has developed of suppressing and not sharing feelings with others, including parents

• This suppression was initially seen as caring for a sister's well-being , but it has now become problematic and negatively impacts life

• This pattern is hindering personal goals and needs to be addressed

"Thinking about the hiding as a way that might have been a little bit helpful during that time, it came from a place of caring. But now that we've carried that pattern forward, it's actually being quite unhelpful in your current life, getting in the way of you doing the things that you want to do."

Treatment planning and goal setting

• The therapist proposes developing a treatment plan based on the client's goals

• The therapist offers a summary hypothesis of potential causes for the client's difficulties

• The formulation will change over time, but it serves as a working model for therapy

"With those goals in mind, I was wondering if I could give you a bit of a summary of what I'm thinking might be causing some of these difficulties. To see if we're on the same page, and this is just a bit of a working model, it's a bit of a hypothesis of what might be interacting, and this is something that we call a formulation."

Overview of the client's current situation

• The client feels overwhelmed with work and falling behind

• Anxiety, irritability, and exhaustion affect socializing and enjoyment of activities

• The client resorts to online shopping and excessive social media usage

"You're 23 years old, and you've just started work at this new company, and you're really excited about it. But you feel like you're working a lot, and it's not really making much of a dent in your work pile. You're kind of falling behind in a lot of your work. It sounds like you've been feeling really anxious at work, and you've often been getting teary and overwhelmed and irritable with your workmates as well. And that, even though you were really keen on socializing and being able to form new friendships, it's been really difficult because you felt really drained at the end of the day. And you've also been turning down some invitations to go out for drinks or to go out on the weekend."

Exploration of suppressed emotions and their impact

• Client's history of not discussing emotions and feeling the need to keep things in

• The habit of keeping emotions suppressed was helpful in childhood but is now hindering life

"You told me a bit about your history and how growing up, you felt like there wasn't really a space to talk about your feelings and that your parents weren't really sure how to. And that you also felt like you needed to keep things in, and so you might have developed a habit of keeping things in, and that was really helpful for you in childhood because it kind of got things done. But now it's no longer helpful, and it's kind of getting in the way of your life."

Understanding the vicious cycle of depression

• Feeling low at work leads to thoughts of not being good enough

• These thoughts create a sense of lethargy, leading to disengagement from enjoyable activities

• This disengagement increases feelings of guilt and reinforces negative thoughts, perpetuating the cycle

"This idea of the vicious cycle of depression, which is that you feel down about something and so you have thoughts about not being good enough, and that actually makes you feel like you can't do anything. So your body feels kind of lethargic. But then when you disengage from the things that you enjoy and the things that gave you worth before, that makes you feel more guilty afterwards. And you regret not going for that workout or you regret not going out to that social event. And then, in turn, that kind of leads you to feel more lethargic and guilty. And so the cycle kind of continues where it gives you more thoughts and it kind of adds more evidence to these sorts of you not being good enough or that you're an imposter. You feel worse, you feel more down, you feel more anxious, and you're also getting more irritable. And, in turn, your behaviors are making you withdraw so you're actually quitting a lot of things that you used to enjoy, and that kind of feeds back into the cycle."