The first session of psychotherapy is critical in determining the course of successful treatment because the possibility of engaging a patient is at its height during the initial contact. This book offers guidelines to enhance the clinician's ability to conduct an effective first session. The therapist's stance and its implications for first session technique are discussed (e.g., first words, therapist anxiety, and subtle directives) as well as issues of scheduling, fees, and cancellations. Armstrong identifies eight essential tasks of the first session (including, for example, an atmosphere of safety, patient assessment, the contract, and transition), and demonstrates with rich clinical detail the steps he takes to accomplish them. Specific attention is given to patients with previous therapy, returning patients, compliant and meek patients, and those in need of medication or hospitalization. Well considered and thought-provoking, this book introduces beginning therapists to the complexity and range of first session concerns, and challenges experienced therapists to rethink the techniques and personal mannerisms that may have become automatic in meeting a patient for the first time.

About the Author
Peter S. Armstrong, Ph.D., is a clinical psychologist and psychoanalyst. He is also on the faculty of the Oregon Psychoanalytic Society and Institute and the Northwest Center for Psychoanalysis.

Reviews
The first session of psychotherapy is crucial. It sets up expectations for the kind of treatment that is to follow, and if not well conducted, it may be the last session. Challenging experienced therapists to examine their own habits, Peter Armstrong also guides beginners through the opportunities and pitfalls of this surprisingly neglected subject. From the first words spoken by the therapist through fees, legal issues, the various kinds of assessment, to the offer of a second appointment, he discusses all of the practicalities from a psychodynamic perspective. He focuses on creating an atmosphere of safety that will facilitate exploration of the patient's experience and transference. -- George Pigman, Ph.D., training and supervising analyst, Institute of Contemporary Psychoanalysis, Los Angeles
With rare teaching ability, Dr. Armstrong explicates how the psychotherapist approaches the first session, but this book is as much about the rationale for and substance of the psychoanalytic attitude. A must-read for beginning therapists or those interested in beginning psychotherapy themselves. -- Helen Desmond, Ph.D., past president an dtraining and supervising analyst, Los Angeles Psychoanalytic Society and Institute
Despite the fact that every clinician has conducted many first sessions, until now there has been no definitive book on the subject. Dr. Armstrong has ably filled that vacuum. Buttressed with sound theoretical underpinnings and clear clinical illustrations, he covers everything from the therapist's first words to transference and countertransference phenomena, resistances and counterresistances, arrangement of the office, establishing fee schedules, and much more. All clinicians will welcome this very readable book. It is highly recommended, particularly for those who want to help their patients stay in treatment-and that is just about all of us. -- Herbert S. Strean, D.S.W., Rutgers University; director emeritus, New York Center for Psychoanalytic Training



Book Information
ISBN 9780765702418
Author Peter S. Armstrong
Format Hardback
Page Count 235
Imprint Jason Aronson Inc. Publishers
Publisher Jason Aronson Inc. Publishers
Weight(grams) 558g
Dimensions(mm) 236mm * 163mm * 25mm