In this essay I am going to look at the importance and purpose of the initial consultation between the client and the therapist and what happens during this preliminary session. I will also cover the ethical definitions that will need to be explored and established, to ensure the safety and wellbeing of both the client and therapist. Hypnotherapy refers to an “interaction between two people, one of whom is identified as the hypnotist, the other as the subject” (Heap and Naish) The relationship between these two is paramount in ensuring the success of the follow on hypnotic sessions and the hypnotist and subject have to develop a good rapport and feelings of mutual trust, respect and warmth for the sessions to be fruitful.
In many situations in business, social and medical fields, the first meeting of two people is the most crucial and impression forming, as the first information gathering you assimilate about a person can be hugely impressionable. You will both be highly attuned to the information you gather at this first meeting whether that be physical, visual, verbal or otherwise, as the outcome of the meeting will determine whether the client or therapist will want to continue the sessions and further develop the therapeutic relationship. The initial consultation is, in effect, the preparation and groundwork stage,
” Preparing the soil for the planting of new growth “.
The client would have already contacted their potential therapist, to book the initial consultation, usually by telephone or email, so very basic information may already have been ascertained. This would probably only be the clients name, basic contact details and maybe their reason for seeking hypnotherapy. An initial meeting is valuable even when the client may be only having just one session of hypnotherapy, for smoking cessation, for example, as the therapist still would need to gather information on their medical history and any medication being taken at that time. Many therapists offer a free initial consultation to their potential clients. This will probably last in the region of 30-45 minutes. There are both pro’s and con’s for offering this session for no monetary reward.
If it’s “free”, then the client may not be that interested in having any further sessions and just come because you are offering something for nothing. The free session may also be viewed unfavourably, in a legal sense, as acting as an enticement to attract vulnerable clients. Therefore the therapist must adhere strictly to legal guidelines that refer to using free products as sales pitches. You would also be giving away your valuable time for nothing. However, the positives far outweigh the negatives and there are numerous benefits for both client and therapist of conducting this session, during which you are going to meet each other for the very first time.
In order for a therapist to act wholly ethically during this and any subsequent sessions, we firstly need to understand what we mean by the term “ethically”. I believe that ethics are a set of moral beliefs that ensure decent human behaviour. The definition of this varies from agency to agency but I have referred to the “National Hypnotherapy Society” code of ethics for use when constructing my essay. There are different areas in the above code of ethics that I shall look at in this essay. The first area is that of “Client Welfare”. This ensures that the patient’s safety and welfare are met. The initial consultation will be a crucial time to develop a positive rapport between you and them and ensure that mutual respect and dignity for the client are met. You will probably have to explain to them what hypnosis is (and is not) and allay any misconceptions or fears that the client may have about hypnosis. You can gauge whether you think the two of you will work well together and check that there isn’t any inappropriate connection between you in any way that would prevent you working with them, such as them also being your friend or colleague.
This can have a tremendous impact on the therapy relationship and where this could be detrimental to the client, it should be avoided. This is known as a dual relationship. Importantly, you can check their medical history with them and whether they are currently on any medication, particularly antidepressant or anti-psychotic medicines. You will ask them questions about their family history and whether there are any areas that are causing them concerns at this time or in the past. Do they have a partner or children and have they have ever been involved in a committed relationship breakdown? What are the names and ages of important people in their lives? Are there any issues in their lives that have an impact on their motivation or self esteem? Are they experiencing any problems at work or in any close relationships or any other particular problems?
If they are seeking hypnotherapy for the relief of any physical symptoms the therapist must ensure that they have already contacted (or will contact) a medical practitioner before undergoing hypnotherapy as it must be stressed to the client that we are not medical practitioners.
Of course the environment in which you are conducting your practice and the facilities offered will be very important to the client and they should be appropriate and suitable for the service provided. . Ensuring that your room is warm, private and comfortable will give a good first impression and make the client feel at ease. There may be a requirement of the client to be accompanied on their sessions and this could be discussed now, so a suitable waiting area may also be needed. Any other physical restraints could also be discussed and some therapists will also offer to come to the clients home if that is required. A nearby toilet is also useful. In the therapy room, it is essential to have two similar chairs of equal height for the talking part of the therapy so that the client feels at the same level and not intimidated in any way; but for the actual hypnosis, a relaxing recliner is desirable. Mention of whether they prefer their session to be conducted semi prone or more upright could be discussed at this preliminary session too.
In your therapy room you may offer background music or scented candles to help relax the client and this is something that could also be talked about at this session. As we mentioned earlier, first impressions count and in this regard, how you initially dress and present yourself will have an impact on the client. It is generally agreed that a smart/casual dress is the most appropriate attire and it may help the client with continuity and rapport if you dress in similar clothing at each session.
Another area of ethics is that of confidentiality. This should be strictly adhered to by all therapists although it should not contravene any legal requirements or be inconsistent with the safety of client, therapist or any member of the public. The therapist should assure their client that all notes and records about them are safely and securely locked away and computer records password protected. At this meeting a notation form should be constructed giving information about the client that is useful for the therapist to know. This will include their full name and what they liked to be called, their address of home and workplace, contact details and which preferred method of contact they wish us to use. It is also useful to ascertain if we can leave messages or not.
Any occupation and also previous occupations also help the therapist to build a more complete picture of the client.
Finding out if they have any hobbies, special interests or have any leisure activities are also of use.
A very important piece of information is the clients G.P. details. We would also make a note of any medication they are taking and refer to the BNF to see what potential side effects there might be or if they are on anything that would be detrimental to hypnotherapy.
Of course we will need to find out what brought them to us in the first place. Is it a new problem or one which has been problematic for a while?
What is their goal from hypnotherapy and ascertain whether that is attainable in your practice or would they need to be referred on elsewhere? Another important discussion would touch on whether they had ever used any counselling or other forms of therapy before, what it was for and what the outcomes were from that. It would also be helpful to discover their family dynamics and what their living environment is like. Getting the names and relationships of all the people close to the client would also be very useful, especially if they mention these people whilst under hypnotherapy. Using the modality assessments would also be useful as it would help in tailoring the client’s personalised screed for the most beneficial outcome.
During this you would ascertain what their favourite colours and places might be and also discover if there was anything you should avoid putting into the screed that would potentially frighten them or make them feel uncomfortable. Just by being in the clients company for a short while, you will gain some insight into their personality and this will help to decide what kind of screed would be most useful to use when working with them. You would also ensure that there was no sexual attraction between you as this would be completely undesirable in the client / therapist relationship. You may also compose a contract of fees and cancellation policies that you would ensure the client fully understood before signing. The client may ask about your qualifications and experience in this field and it is essential that you are open and honest and paint an accurate picture of yourself.
Any advertising, qualifications and certificates used or displayed by yourself must be valid, truthful and genuine and you must not make “any claim that you hold specific qualifications unless such claims can be fully substantiated” (N.Hyp.S. code of ethics) All hypnotherapy practitioners need to also obtain written consent from an appropriate adult before treating anyone under the age of 18 years, or a person with special needs or vulnerabilities. If time allows, it may be useful to you both to conduct a short hypnotherapy induction at the end of the session. The client will undoubtedly experience a degree of relief from their negative symptoms and leave the session in a more positive, hopeful and peaceful frame of mind.
In summing up, it can be seen that the Initial Consultation is an extremely important part of any therapist’s work. It is where information is gathered about the client, first rapport is built between the therapist and client and boundaries established to ensure the safety and wellbeing of both parties.