The Atlantic

How I Bombed My First Therapy Session

How hard, I think, can this be?
Source: Sarah Wilkins

In my final year of graduate school, I was required to do a clinical traineeship. The traineeship is like a baby version of the 3,000-hour internship that comes later and is required for licensure. By this point, I’d taken the necessary coursework, participated in classroom role-play simulations, and watched countless hours of videotape of renowned therapists conducting sessions. I’d also sat behind a one-way mirror and observed our most skilled professors in real-time therapy sessions.

Now it was time to get in a room with my own patients. Like most trainees in the field, I’d be doing this under supervision at a community clinic, much the way medical interns get their training in teaching hospitals.

On my first day, immediately after the orientation, my supervisor hands me a stack of charts and explains that the one on top will be my first case. The chart contains only basic information— name, birth date, address, phone number. The patient, Michelle, who is 30 and has listed her boyfriend as her emergency contact, will be arriving in an hour. (Because she was a patient, I am not using her real name.)

If it seems strange that this clinic is letting me, a person who has performed exactly zero hours of therapy, take on somebody’s treatment, it’s simply the way therapists are trained— by doing. Medical school, which I had previously attended but neverYou’re deemed competent to palpate abdomens.

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