Why is the initial consultation so important?

7 July 2016

When a client visits a hypnotherapist for the first time, the therapist will begin with an initial consultation. Most therapists will offer a free initial consultation, usually lasting around half an hour. Usually no hypnotherapy takes place at this time, it is merely a fact finding session for both. This first meeting is extremely important for a number of reasons.

The client has to feel comfortable in their surroundings, and the initial consultation is the time when the therapist will ascertain whether or not the client has previous experience with therapy and explain exactly what will happen during the course of therapy to allay any anxieties that the client may have. The relationship between a client and a therapist is built on trust and honesty so the first meeting is an opportunity to build rapport between the client and therapist and ensure that both parties are comfortable working with each other.

Why is the initial consultation so important? Essay Example

The reason that hypnotherapists often offer a free initial consultation is that this is the time that they find out why the client has come for therapy. In the National Hypnotherapy Society Code of Ethics it states that practitioners only provide services to the clients where they are competent to do so. If a therapist believes that they are not qualified to deliver the therapy for the client then this is the time when they will ascertain this and where appropriate refer the client to another therapist or medical professional who would offer suitable treatment.

If you have charged a client for this first session but then you are not able to help them and refer them on then this may give your practice a bad reputation. It is also imperative that the therapist establishes if they know the client in any way or if there are any connections between the therapist and the client. This is called a ‘dual relationship’. This is described in the Code of Ethics: ‘Dual relationships arise when the practitioner has two or more kinds of relationship concurrently with the client, for example client and trainee, friend and client, colleague and supervisee’.

These relationships can be detrimental to the therapy hence why it is so important to ascertain this in an initial consultation. For example, the therapist may discover that they know a client’s parents and this may make the client feel uncomfortable which will affect the therapist’s ability to build rapport and trust. Another factor that must be addressed in the initial consultation is the client’s medical history. The therapist must check if the client is taking any kind of medication paying particular attention to anti-psychotic or antidepressant medication.

Hypnosis is rarely used with patients with severe bipolar affective disorder or psychotic patients. Mental illness is extremely complex and the therapist must not treat people who have or have had a psychosis. These patients have trouble engaging in hypnosis and also encouraging these patients to focus on their thoughts, feelings and asking them to imagine certain scenarios may prove counter-productive given their state of mind. This is why it is also important to get the clients GP details during this initial consultation; if the client is reluctant to give this to the therapist then the therapist should proceed with caution.

Hypnotherapists are not equipped to diagnose a psychosis so if a client has a history of mental illness or is on psychological medication then the therapist must have a doctor’s written consent to treat the client and this note must state the client is not psychotic. This is another reason why the therapist must get the GP name of the client, especially if they are suspicious that the client is mentally ill or has a history of mental illness. The Code of Ethics states the initial consultation should always be conducted face to face and by no other medium such as telephone or even Skype (under Client Welfare, point 7).

This is important when studying a client’s behaviour. As discussed here, it is of extreme importance that you ascertain if a client is psychotic and a person’s behaviour can help to establish this. For example if a client withdraws when talking to you and loses concentration easily this can be a sign of a psychosis. If a client comes for hypnotherapy for a physical condition if they have not already done so the therapist should advise the client to contact a medical practitioner for a diagnosis. Therapists are unable to diagnose a physical condition unless they have the relevant medical training.

This will be established during the initial consultation. If the client does not have a formal diagnosis it is the duty of the therapist to advise the client to get a formal diagnosis before they will treat them. One of the main purposes of the initial induction is to prepare the client for hypnotherapy. It is highly likely that the client will not have a realistic understanding of the nature of the therapy or the type of experience they are going to have.

Naturally for a majority of people when they hear the word hypnosis they conjure up images of stage hypnosis and people running around a stage clucking like a chicken or seemingly being forced to do things out of their control for entertainment purposes. It is important that the therapist allays any anxieties or misconceptions that the client may have of what hypnotherapy entails. It is important that the client understands what a hypnotic state is so that they are aware of what will happen during the therapy. Also, there is a common misconception that hypnosis ‘knocks you out’ and you are unconscious and will not remember what has happened during the hypnosis.

Another common belief is that the client will have no choice on how they behave during the session. The therapist must inform the client that they will be conscious and in control during the session. The client may also worry that they have no control over what they say during hypnosis and may be afraid of exposing something that they don’t want to. The therapist must inform the client that they will be in control and also make them aware that the usefulness of the therapy depends on their willingness to participate and continue in the process.

People often use hypnotherapy as a last resort for a problem they have had for a long period of time and they will come for this therapy with a lot of anxiety and doubt probably. It is the fear of the unknown, naturally this makes a person anxious and it is the job of the therapist to allay these anxieties which is an essential part of the initial consultation. Whilst the therapist talks to the client and establishes why they have come for therapy and what their fears and anxieties surrounding the treatment may be this is time that the therapist will begin to build rapport.

As previously stated, the relationship between the client and therapist will be built on trust and confidentiality and in order for the client to fully engage in the therapy it is essential that they trust the therapist. It is important that the client understands the processes involved in this relationship moving forward so it is essential that the therapist explains that anything that they discuss is strictly confidential and a confidentiality agreement will be signed by both the client and therapist to confirm this.

This agreement can be at the end of your initial consultation form, which forms the beginning of your ‘Notation Form’. This form can be filled out during the initial consultation then given to the client at the end of the consultation to read and ensure that they have understood what has been discussed. This form will also confirm the price for the therapy, payment instructions, cancellation charges or charges if a client does not turn up for an appointment, along with the confidentiality agreement.

The therapist must also explain that there are certain circumstances and conditions where the content of the session will no longer be confidential such as if you fear they may harm themselves or someone else or if there is any reason to believe any form of child abuse or neglect. This form should be signed by both parties at the end of the initial consultation. The wording on this form should be clear and transparent and does not restrict the statutory rights of the client. Some therapists also like to use the initial consultation to perform a trial induction to assess a client’s aptitude for hypnosis.

As well as assessing this, if some level of trance is achieved during this induction then this can also help to allay some of the client’s anxiety and fear of hypnosis. Also if the therapist is putting a client in to a relaxed state this can help a client who is feeling anxious or depressed and encourage them to continue with this method of therapy. They will leave the consultation feeling more hopeful and positive of hypnotherapy as a treatment. During the initial consultation a therapist will also assess the client’s personality in order to decide what type of screed would be appropriate for them during treatment.

This can be assessed using a screed questionnaire such as the Chrysalis Client Screed Assessment which focuses on a client’s appearance, personality and behaviour in order to assess which type of screed would be appropriate for the client. If a client is very logical and analytical and quite direct and scientific in their views i. e. there are no grey areas in what they think, then they are much more likely to respond to an authoritarian type of screed where the client is not given choices, the screed is very to the point and they are based on the client staying in control.

The therapist will use direct suggestions in the screed therefore these types of screeds are often very effective for habit changing behaviour such as quitting smoking. If a client is more creative and imaginative and a caring person then they are more like to respond to a permissive screed using indirect suggestion. It is also important to assess a client’s preferred modality in order to form a screed based around this. Whilst it is important to use all modalities in a screed a client will respond better and deepen in to a trance if the script is tailored to their preferred modality.

A therapist can assess this with some specific questions and also by asking the client to close their eyes and describe a scene in three different modalities and ask the client which description resonated with them the most. The therapist can also use this initial consultation to find out where the client feels safe and calm and at home and perhaps incorporate this in to their special place as part of the screed. It is important to gain enough information to personalize the screed to the client in order to deepen the trance and increase the chances of the therapy being effective.

In conclusion, the initial consultation is an essential part of hypnotherapy treatment. The therapist must comply with the code of ethics and ensure that they are able to treat the client based on their level of expertise and to assess whether the two parties are able to work together. If a therapist did not offer this initial consultation for free then this exercise would be paid for by a client and after the first session it may be that the therapist does not feel able to treat the client or there may be a dual relationship in place that would be detrimental to treatment.

If this consultation is paid for and the client walks away with no treatment he or she is left frustrated and this affects their ongoing treatment and the reputation of the therapist. The kind of information that is gathered in this session and given to the client ensures a firm understanding of the problem and the therapy which is being suggested as well as allowing the therapist to gain enough information to personalize a screed to increase the chance of a successful therapy.

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