“ Why the initial consultation is so important?
What factors will an ethical therapist cover at this time?”
Word count – 2236
A consultation normally consist of a meeting between the practitioner and a new client and will involve the filling in of a consultation form. A consultation will last for around 30mins. Some practitioners may charge for an initial consultation others choose not to.
It is a really good way of getting to know more about a potential client. It is an opportunity to explain about the treatment and answer any questions the client may have.
An initial meeting is a very good way of helping both the client and the practitioner decide if they will get on. A strong personality clash my well get in the way of progress during treatment. This assessment is normally made by both the client and the practitioner with in the first few minutes of meeting. It is completely natural for most people to use their own judgment, intuition or awareness to see, sense or feel if they will be able to get on. It is instinctual and happens when we meet people for the first time in all sorts of situation. An initial consultation facilitates the space for this.
There are a number of things a practitioner needs to be aware of if there is a strong negative reaction to a potential client and must be willing to examine their own prejudices or judgments.
This is referred to in and is a requirement of the National Hypnotherapy Society – Code of Ethics – Delivery of service 2013*
2. Have a fully developed, professional awareness of diversity and specifically not permit considerations of religion, nationality, gender, sexual orientation, marital status, age, disability, politics or social standing to adversely influence client treatment.
Both the practitioner and the client are then able to use the rest of the consultation to clarify a number of things. For example – to find out why the client has come for treatment, to explain to the client what hypnotherapy is, what to expect, what type of approach would be best for them, to find out if they have had treatment before, if the clients issue is treatable by the practitioner, what has helped before or not, how many sessions are they likely to require, how much the sessions are, cancellation charges and contracts among other things.
An initial consultation and the filling in of a consultation form is important because it will safeguard both the client and the practitioner.
The information gathered about a potential client will inform the practitioner of a number of things. The practitioner is able to find out how much the client knows about hypnotherapy as a treatment. If there is little or no understanding then this is the perfect time in which to explain about hypnotherapy to the client. Informing the client and helping them to understand the process will set the clients mind at ease, give them reassurance and they will start to feel confident in the abilities of the hypnotherapist and the method.
When clients are informed and able to learn and understand through a good explanation, this is actually empowering for the client and for this reason they are more likely to engage with the treatment. It can put a skeptical mind to bed. Any fears or prejudgments about hypnotherapy can be laid to rest as the myths are blown out of the water.
The practitioner can find out what the client has come for and more intimate questions about family, childhood and partners can help build a bigger picture for the practitioner to work with.
Just listening to how the client talks and answers questions will give information about what approach would be best to use when creating a screed for a client. The client will give away clues as to how they use their senses to relate to reality. Clients will be predominantly either kinaesthetic ( feeling ) , auditory ( hearing ), visual ( sight ) or a mixture of them. All of these things can be assessed through out the consultation. Listening to the descriptive words that the client uses, being aware of eye movements. Of how tactile they are with furniture for instance. What the client is wearing and their general appearance will help the practitioner to understand the client a bit more .
The consultation also gives room for a personality questionnaire to be filled in. This questionnaire can help to find out what personality type the client is and which style of approach that the client is most likely to respond to. The two main approaches are the authoritarian style or the permissive style. It may well be that the client would respond to a mixture of both.
This is also a good time to find out if the client has any thing that they like or fear. If they have a favorite colour, a preferred landscape. If they fear heights, water or birds? This will all help the hypnotherapist decide what to put in a screed.
During the consultation a hypnotherapist can also be determining other factors which are important. The hypnotherapist once finding out about the client’s problem will know if they will be able to treat the client or not. If the hypnotherapist current training covers the area that the client would like help with this is great but if not then it would be important to be able to refer the client to someone who could help.
This is referred to in and is a requirement of the National Hypnotherapy Society – Code of Ethics – under Client welfare section 2013*
2. Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment
As a hypnotherapist unless otherwise trained is able to treat neuroses but never psychoses cases.
Neuroses includes,General anxiety, panic attacks, phobias, obsessive compulsive disorders, separation anxiety, post traumatic stress disorder, psychosomatic disorders, reactive depression.
There are different categories of psychosis – Functional psychosis which can be caused by imbalances physically within the brain. These can include Bi-polar, some depression, schizophrenia and being delusional.
General psychosis – Some people with psychosis are unaware they have a problem and can blame doctors or family members.
Organic psychosis- Toxic confusion, Alzheimer’s, Parkinson’s, Kausicoffs syndrome, Alcohol/ drug, sever PMT, Post-partum psychosis ( excessive post natal depression ) ( Chrysalis 2013 )
If as a practitioner any of the above conditions related to psychosis are suspected it is important that the client get’s written permission from their doctor stating that the client is not psychotic before the start of any treatment.
It always good to check if the client is on any medication and if the practitioner feels that the client is keeping something from them, it is possible to look up the medication in the British National Formulary. Which will tell the practitioner what the client is being treated for or at least give an indication.
It is important to look out for any one who may have any mental health disorders. Some clients will share with you what they are experiencing others may try and hide details. Things to look out for or that may raise suspicion are, not want to give details like a home address or a doctors address. Again how the client looks, their body language, is dressed, lack of eye contact or not willing to cooperate. If a hypnotherapist is concerned about whether to treat the client it may be best to get a note from the doctor just to safeguard both the Therapist and the client.
Contraindications for hypnotherapy include –
Epilepsy – completely contraindicated
Serious/current heart condition – contraindicated, care needed Blood pressure (extremely high or low) – contraindicated – much care needed Depression – contraindicated. Clients with depression would benefit more from counselling Elderly or frail – contraindicated – much care needed
Persistent alcohol or drug abuse – completely contraindicated Psychosis – completely contraindicated Pregnancy – first trimester at least, 2nd trimester on GP’s authority, 3rd trimester fine but still with GP’s authority. National Hypnotherapy Society – Code of Ethics – Treatment of minors and those classified as persons with special needs or vulnerabilities 2013* Obtain the written consent of an appropriate adult (i.e. parent, legal guardian or registered medical practitioner) before conducting treatment with clients who are either under the age of majority or are classified as persons with special needs or vulnerabilities. It is further advisable that the therapist should hold a current Full Disclosure CRB certificate if they wish to work with minors.
The consultation is also a good time to find out if the client is also receiving treatment from other practitioners or counselors and what approaches they are taking in the therapies that are working for them. It is good to find out if the client has had therapy before here you may get a picture of the client. Some people can be therapy junkies, or find fault in every modal of therapy, possibly because they what some one else to fix their problems. It will also be useful to find out why they have decided to use hypnotherapy and why they initially chose to come. If they are at a treatment because their partner told them to come, then there is a possibility that the treatment may not work as well. It is good to ascertain the client’s commitment to their own treatment and if they really want to heal the issue.
It is also good to know if the client has let any one know if he/she is choosing to have therapy. Discussing how the client would like to be contacted, e-mail, phone or letter is important as they may not want any one else knowing that they are in therapy. If a client has come to the practitioner regarding relationship issues it is good practice to explain that if the therapy works for the client it may well change the dynamics of the relationship they are in. It is important not to glamorize the possible effects of hypnotherapy and explain that it is not a cure or a replacement for any conventional medical treatment. It is good to discuss what type of treatment the practitioner is intending to use, the possible out come and the duration of the treatment.
Let the client know the price of the sessions and draw up a contract about payment for the client to sign so that there is no ambiguity about any thing. It is also important to make clear about any late cancellation fees policy the therapist may wish to impose. National Hypnotherapy Society – Code of Ethics – Delivery of service 2013* Explain fully to clients in advance of any treatment: the fee levels, precise terms of payment and any charges which might be imposed for non-attendance or cancelled appointments and wherever relevant, confidentiality issues. Use clear and transparent contracts which do not use unreasonable terms or restrict the statutory rights of their clients.
If the practitioner already has consent form already printed for the client all they need to do is sign it once everything has been explained. It is good to let the client know about confidentiality, there are only few occasions where breach of confidentiality will happen and are a legal requirement to report. If the client appears as though they may harm them selves or another person the authorities will be contacted . Inform the client that all contracts and notes taken will be locked away in a secure cabinet. National Hypnotherapy Society – Code of Ethics – Confidentiality, maintenance of records and recording of sessions 2013* 1. Maintain strict confidentiality within the client/therapist relationship, always provided that such confidentiality is neither inconsistent with the therapist’s own safety or the safety of the client, the client’s family members or other members of the public nor in contravention of any legal action (i.e. criminal, coroner or civil court cases where a court order is made demanding disclosure) or legal requirement (e.g. Children’s Acts).
2.Ensure that client notes and records be kept secure and confidential and that the use of computer records remains within the terms of the Data Protection Act. N.B. Manual records should be locked away when not in use and those held on computer should be password coded The initial consultation is important because it covers so much. For the client it will put their mind at ease and help them to understand the treatment and they will also know where they are as regards to payment. Any ambiguity is best cleared up before any treatment begins otherwise it may get in the way of the client being able to relax and receive treatment. For the practitioner it is a safeguard for their practice, their business.
It is about being clear and setting boundaries straight away. In today’s world I think it is important to clarify a contract verbally and then have a copy for the client to sign and take away and one for the practitioner to keep also. This way you are working to the codes and ethics of the National Hypnotherapy society, and following legal requirements all of which is documented. This will put the hypnotherapist mind at rest, leaving them to get on doing what they enjoy knowing that they have covered every angle they can.