Julie Docherty

Word count: 1948

Why is the initial consultation so important? What factors will an ethical therapist cover at this time?

Introduction In this essay I will firstly look at the environmental factors that need to be looked at before a session even happens, then I will try to discuss and describe the initial consultation and what will be discussed in this appointment, and I will discuss the ethical factors that should be considered when treating any clients. In the conclusion I will sum up what I feel about the initial consultation appointment. Environmental Factors Before even meeting the client, one of the most important things a therapist should look at is the environment that they will practice in. A good environment does create a good first impression. (Chrysalis Pg 17). Many therapists practice from their own home and therefore we need to make sure the environment in this therapeutic space is warm and inviting. The space needs to be in a quiet area of the home so as nothing will disturb the session. It is important to consider the layout of the room to ensure the safety of the client and the therapist. The space would ideally have a comfortable chair for the therapist and then either a reclining chair or couch for the client. Soothing relaxing music can be played if the client so wishes. It is also an idea to have a jug of fresh water for the client for when the session has finished. Some clients like to see the therapists professional qualifications so it is nice to have certificates of achievements framed and displayed in the therapeutic space. The Initial Consultation The initial consultation is an important part of any therapy treatment plan, and should be carried out with each client before undergoing any planned treatment and usually does not last for more than an hour. It is an essential time for the therapist to observe and interact with the client before any treatment starts as through training, experience and with the therapists knowledge, the therapist will be able to identify the best way to treat the client or if the therapist feels they have the right skills to treat the client successfully. Some therapists choose to do the initial consultation for free. This may be beneficial but this can be an issue as the client may only come because they see the word free and then may not come back again, and this has then wasted the therapists time which could have been used for a paying client. Some people may be put off if there is charge for the initial appointment as they may feel they are paying for something that they are not certain about or whether they feel it is something they want to do, so this appointment is an ideal time to discuss fees and how many sessions will be needed.

Julie Docherty

The therapist must use the initial consultation time to quickly build up a rapport with the client. It is vitally important that the client feels safe and comfortable to be able to talk about their issues. The client must be able to relax with the therapist. When the client first arrives they are likely to be nervous and anxious so the therapist needs to make them feel at ease. The foundations of the relationship will begin at the initial consultation appointment but trust will only be gained after a number of sessions. The therapists appearance is also important and we should dress in a smart but casual appearance, and must remain professional at all times in appearance and manner. The initial consultation provides an ideal opportunity for the therapist to gain all of the essential important information, even if the client is only coming for a one-off session. This can be done by completing a Consultation Notation Form. A Consultation Notation Form will become your clients record card and will contain essential information about the client. This should be then kept for 5 years and kept in a lockable file. The Consultation Notation form should include the clients full name, what the client likes to be known as, the address, date of birth and age and contact details, it is a good idea to note down how the client wishes to be contacted and if messages can be left with other members of the family or on an answer phone. The clients occupation can be recorded, both past and present as a lot can be learned from the type of occupation the client has. It is really important to get information on past and present medical history and whether they are taking any medications. The therapist should be looking specifically for physical, psychological or and psychiatric issues or illnesses either past or present and whether they are taking any anti-psychotic medications or any anti-depressants. It is also wise to discuss any addictions, any use of drugs and any alcohol use. All medications can be checked in The British National Formulary which is a book listing all medications, with contraindications, side effects and dose ranges. This can be accessed also online from www.bnf.org . It is essential to have to name and contact details of the clients General Practitioner. If there is any doubt that the client may not be suitable for hypnotherapy it is advisable to ask the client to contact their GP to make sure that is safe for the therapy to proceed. It is also advisable to have information about other members of the familys medical history. It is important to gain information on anything that might be causing the client any stress or worry at the present time, for example any financial problems or relationship problems. It is a good idea to do a basic close family tree to get names and any details of partners and children as these names can then be built into the scripts that you may use with the client. A brief description of the clients childhood can be useful, whether it was happy, unhappy or average as there may be issues that still concern them. It is also a good idea to discuss likes, dislikes, fears and phobias, hobbies and leisure activities as this information can be useful when designing the scripts for the client.

Julie Docherty

It is important to discuss with the client their thoughts about hypnotherapy, whether they have had any previous experience of hypnotherapy, and if so was it successful or did they encounter any problems and to find out what the clients expectations of hypnotherapy are, and what they would like to achieve from their hypnotherapy sessions. The therapist should be alert to any misgivings and anxieties on the patients part and allay these in a confident and reassuring manner. (Heap et al, 1991, 18). It is also an idea to discuss their motivation, is it something the client wants to change or is it something that the client has been told to change, for example quitting smoking or losing weight, because if the motivation is wrong the client may resent coming for therapy putting all sorts of barriers to success. Is it a new problem or a long term problem and why they have chosen to come for therapy at this time? Limit suggestions to one problem area at a time. Trying to accomplish too many changes at one time or reprogram several areas of your life all at once will only dissipate the effect any one suggestion can have. (Hadley et al, 1996, 45). Each Consultation Notation Form should be signed and dated by the client and the therapist. All of this information is relevant and can help to build up a picture of the client and their background. Every client is an individual, and the initial consultation appointment is the ideal time to start to assess the clients modalities and the induction style of script that is going to suit the client and whether they find visual descriptions more powerful or whether they would prefer a kinaesthetic or auditory description to achieve the best outcome of the hypnotherapy sessions by making it individual to suit them and to achieve a successful outcome. Usually during the initial appointment no hypnotherapy would take place but if the client seems sceptical a basic PMR could be used to show the client how the relaxation would take place. The first induction may not be a wholly reliable indication of how the patient will respond in the future, but it will give some idea of his acceptance of the procedure itself, an opportunity to assess the kind of induction, deepening, and imagery that should be used in future sessions, and some guidance as to the patients willingness and capacity to use the technique. (Karle et al, 1987, 70).

Julie Docherty

Code of Ethics Any reputable, professional hypnotherapist holds an ethical responsibility towards every person s/he treats. (Bryant et al, 2006, 149). All responsible hypnotherapists should subscribe to a professional code of ethics, as determined by a professional body. As hypnotherapists we should always work in an ethical way, which means that our professional conduct is always appropriate when working with clients. We must at all times respect the confidentiality of the client, anything that is discussed or disclosed to us must remain confidential, if anything needs to be discussed with another professional we must make sure that the name or any personal details about the client remain confidential. Before we can do any therapy, both the therapist and the client need to feel that their communication is open and truthful as honesty is the cornerstone on which trust is built. As a hypnotherapist we should always show an unconditional positive regard which means not being judgemental and we should show genuine empathy at all times and accept each client as individuals. We must always act within our limits of our knowledge and skills and experience and work within our own level of competences and if necessary we must refer onto another member or healthcare professional. It is very important that the relationship between the hypnotherapist and the client is always kept at a professional level, in other words we should not become friends with the clients or we must not form a relationship with the client, if any time this starts to happen we must stop seeing them for therapy. We can also check that we do not know the client in anyway and that you are not connected to them in any way that is inappropriate which is known as a dual relationship. You can make sure that you are not sexually attracted to the client as that will undoubtedly interfere with therapy (Chrysalis pg 15). Every hypnotherapist should have Professional Indemnity Insurance that covers for malpractice. Most professional bodies insist on insurance as a requirement of membership. It is also important that you discuss with the clients your fees and how many sessions of therapy you think the client will need as it is vital not to prolong the therapy unnecessarily.

Julie Docherty

Conclusion In conclusion then I feel that the initial consultation appointment is a very important part of the hypnotherapy session to start to build up the relationship with the client. It is an important time to make sure that we do not know the client in any way and to make sure we do not feel that we could become attracted to the client. It is an ideal time to get all the information from the client to make sure that the sessions will be as successful as they can be. We can begin to assess the client on their modalities and what type of induction that we think would be the most suitable for the client.