In this essay I will be discussing why an initial consultation in hypnotherapy is so important. I will be talking about the questions a hypnotherapist should ask their client and the ethical factors and contraindications the therapist should be looking out for. Whether a person is aiming to improve their self-esteem or reduce their anxiety the hypnotherapist will need to understand the client before proceeding with the therapy. I will show that an initial consultation is always a huge must before carrying out proceeding sessions on a client but there are also cons on regards to the factors that the therapist may face.
The initial consultation begins from the very first time you have contact with a client from either the initial contact or the first time an enquiry is made via a phone call or email. The purpose of the consultation is many faceted. It is the time for a therapist to explain what hypnosis is to the client and answer any questions that may arise. It gives the therapist an opportunity to establish a rapport with the client, gain them confidence and assist the client to perform several simple exercises to put them at ease. The establishment of rapport is amongst the most important objectives of the consultation and many believe that the success of the therapy depends upon it.
In order to build the all important relationship the client needs to feel respected, heard, understood and liked by the therapist which is why it’s important for the therapist to remain professional at all times. The therapist may advertise a free initial consultation, if they do, it should be made clear that only the first half hour is free, then if both the client and therapist are happy to continue, the client must then pay for the therapists time. This can be considered a con to some as the therapist is giving away their free time and the client may lose confidence and then never come back again. However, as stated previously it is important to build up rapport so the client cam be in a better frame of mind on regards to the therapy.
Before the therapist can decide the correct route to therapy it is necessary for them to conduct an assessment of the client during the first consultation. It is important that the goals of therapy are clarified by the client during the session and are based upon the information elicited from the client. The goals are usually attainable, realistic and appropriate to the client’s emotional state. Goals that are too ambitious or introduced prematurely can increase anxiety and may even threaten the client. The initial consultation is an important time for the therapist to get to know the client and to understand them so that when the therapist carries out the hypnotherapy sessions a hypnotic script can be tailored to suit the client. It is also the time to discuss the treatment schedule and a time, if appropriate, for an initial session of hypnosis to prepare them for what it is like and also to give the client some relaxation after completion of the administrative part of the initial consultation.
It is important that the relationship between client and therapist never oversteps the boundaries of a professional relationship, it is necessary to build a relationship with a client but this relationship may never become anything else, if at any time the therapist suspects the relationship is becoming anything but client and therapist, they must end any treatment and refer the client to another therapist. A therapist can also use the initial assessment to make sure they do not already know the person they are about to treat, this is called a dual relationship. The therapist must also ensure they do not have any other personal feelings for the client. General conversation can often get a client to consider things that they may not have considered previously.
The presenting condition is often not the real issue and it may take time for the client to realise and put into words other issues they may have. The actual process of talking in confidence to an empathetic person may release many emotions and it should be kept in mind that the client may take time to begin to trust and be able to divulge historical events that they find difficult. A therapist should obtain a history of the problem or issue and explore with the client what they think may be causing the issues. The procedure by which the therapist gathers information from the client during the initial consultation is termed as ‘notation’, this is of course added to as therapeutic sessions continue. The following are questions that are usually carried out: •Full name and the name that they like to be known by. This piece of information will obviously be gathered during the initial phone call or email but it’s crucial to get it again to make sure that it’s right.
•Address and contact details, relevant numbers; work, home, mobile etc. it is always important that you ask your client if you can leave a message on their phone clients often don’t tell their partners that they are having therapy sessions. •Occupation and any previous occupations.
•G.P. name. It is important that a therapist is cautious if a client isn’t willing to give the name of their G.P. •Issue they want you to work on, the presenting condition may not necessarily be the real issue but a cover for issues that may be more difficult for a client. •Any medication that the client is on.
•Medical history including current health problems.
•Family medical history.
•Family details to include relationships with parents, siblings and significant others. Names and ages are important here so that if the client talks about their family you know who they are referring to. •Whether they had a good or bad childhood, this doesn’t need to go into complex detail as it is just a basis to work with.
•Any problems; work, financial, family (just generally any problems).
•Whether or not they have had hypnosis/counseling before.
•The client’s objective in seeking help including any reservations they may have. Is it a long-term problem or a new problem.
In addition, the question of who is asking for treatment also needs to be answered. This is especially the case with children and young people under some degree of parental control, where it may well be the parent who desires treatment or change rather than the patient himself. At some point in the assessment interview the patient should also be asked about how they feel about the use of hypnosis in the anticipated treatment. As with everything else in therapy, the ease, comfort and confidence of the therapist is crucial so therefore if you imply that the use of hypnosis will disturb and alarm the client then it is more than likely that they will refuse to proceed with treatment.
Our subconscious is up and running with functional instincts from the moment we are born. The conscious mind starts to develop later on and as we experience more things our belief systems start to form. Between these two parts of the mind exists the Conscious Critical Faculty. The CCF can be seen as a filter between the conscious and the subconscious that enables us to compare a new situation with our belief systems. During hypnosis it is essential that the CCF is bypassed in order for the hypnotherapy to be more effective. During the initial consultation it is possible to start to bypass a client’s CCF by using the right words and suggestions.
The use of suggestion is one of the most important factors to the use of hypnotherapy. Waking hypnosis is defined as ‘the suggestions that are given to a person in a certain manner while they are in a normal state of consciousness’. They achieve a hypnotic effect without the use of a relaxed state. Hypnosis is only effective if the client is totally focused on one thing so starting the process of bypassing the CCF is the initial consultation is ‘paving the way’ (so to speak) before the proceeding therapy sessions begin when this process can progress further. Milton Erickson was a master at this style of therapy and some techniques that he used to bypass the CCF were retaining good eye contact, talking in a sincere and calming manner and keeping with the client’s own personality, keeping the conversation on a positive and motivational level and creating a ritual for them and a special chair.
It is always important for a therapist to create a calm and professional environment for their client. It is important to have two similar chairs for the initial consultation and a reclining chair for the hypnosis. Although the client is obviously there to use your service, nice décor and cleanliness will create a good first impression. Some therapists like to play music, this can however distract the client from hearing the suggestions that are made.
Sometimes therapist burns oils or scents, however as our sense of smell holds memories the client may not respond well. A smart appearance is also important however you don’t have to go as far as being dressed in a suit as this may make the client uncomfortable as they may percieve you as being too much of an authority role. Dressing in a similar manner each time is important for the client as they will feel like they can pick up where they left off and this will help build rapport.
In order to build up rapport it is important that the client knows you are listening to them and this can be conveyed through the use of body language, posture and speech. It is always crucial that eye contact is maintained without a fixed state as this can make the client uncomfortable. Encouraging responses, non-judgemental expressions, open posture and avoiding outside distractions all play a major role in building up rapport. All that matters is that you make the client feel relaxed and comfortable with your presence as the client needs to feel accepted and understood by the therapist. First impressions are always very important so how a therapist conveys themselves during the initial consultaion will be acknowledged by the client. If the therapist isn’t listening, sitting far away, fidgeting or doodling this could impact the client’s opinion on whether they would like to return for proceeding hypnotherapy sessions. Professionalism and a positive attitude are key factors during this time. Being empathetic towards a client is also something that needs to take place, the client needs to know that you understand why they are there and why talking about their problem to a stranger may make them feel anxious.
In this essay I have included the ethics and also the different theoretical approaches which have to be considered when carrying out an initial consultation and it is very clear to see that the pros outweigh the cons. The initial consultation is a fantastic way to create a good first impression for a client which helps build up rapport giving the client peace of mind before their hypnosis sessions. The only way hypnosis is effective is if a client’s mind is calm and at ease as this gives access to the subconscious, the initial consultation paves the way so to speak as the client can ask any questions that they may have for the therapist which will help put their mind at ease. The importance of keeping records can not be stressed enough and the initial consultation is a perfect time to gather all the appropriate information and details needed for the hypnosis sessions. Although a therapist has to give away their free time I believe that the initial consultation plays a very important role in hypnotherapy and without it the proceeding sessions could not take place as effectively!
Courtney from Study Moose
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