Do you know about - Consultation Guidelines For Hypnotherapy
What Colleges Offer Physical Therapy! Again, for I know. Ready to share new things that are useful. You and your friends.The introductory consultation may well be the most crucial aspect of hypno-psychotherapy, if not all therapies. All things from the interpersonal dynamic to the eventual success of the intervention has a basis in this first meeting in the middle of the client and the therapist. Indeed, the client's decision to remain engaged with the therapeutic process will be considered by factors from this early stage. Despite this, it is not possible, or even desirable, to proscribe the process. As a dynamic, evolving interaction, dependent on the individuals complex and the policy the therapy is to take, until the consultation begins to take shape it is unhelpful to try to impose too much structure upon it. This view is expressed by the Nchp, as evidenced by the following;
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It is, therefore, not possible, or even desirable, to suggest a blueprint which all should follow. (Nchpa)
With this in mind the following consulation will be involved with one individual's advent and focus primarily on those features that this author believes are most decisive in fulfilling the aims of a consultation. If it is not wise or helpful to be prescriptive then we can possibly understand Feltham's (1997) comment,
"the best we can aim for is practitioners who are honest, conscientious, flexible and experienced enough to offer each client suitably individualised counselling."
The goal of the consultation is to furnish direction for informing therapeutic intervention. At the most basic level there are inevitable corporal factors that are likely to play a role in a flourishing consultation. For example, a room that is suitably furnished and offers quiet, relieve and provides confidentiality. The exact details will be dependent on the therapist's style, budget etc and the desires of the client (e.g., temperature, lighting, distance in the middle of client and therapist etc).
However, inevitable considerations are furniture that is adaptable to a range of positions and for a range of people, which offers a clear view of the client, a room that is welcoming and so forth. Ideally the consultation and rehabilitation would be conducted in two separate rooms so that the client company one location specifically with the hypnotic process.
The next level for consideration is the introductory sense in the middle of the therapist and client. Here the knowledge and use of basic counselling and communication skills are paramount. The client must feel that s/he is dealing with a expert who is de facto concerned in and accepting of their situation. Thus, greetings (including checking the client's name and any other identificatory facts the therapist already has), timeliness and other aspects, which signal respect and focus, must be incorporated into the first moments when the clients make their introductory appraisal.
Throughout the process it is foremost to pronounce these high standards, not only because it facilitates open and honest exchanges with the client, but also good communication skills help to engender rapport. communication skills are for the most part considered to be natural, any way modern work within rehabilitation and dentistry has begun to highlight the significance of developing an awareness of what makes communication work (see Lloyd, 1996; Fielding, 1995). The skills that are considered foremost for clinicians to organize and be flexible with for fruitful consultations are;
i) Clarity of language
ii) Audibility & enunciation
iii) Eye contact
iv) Non-verbal behaviour
v) Empathy
vi) Methods of questioning
vii) Sensitivity of questions
viii) Greeting and identity check
ix) Introduction of self and role
x) Respect of patient's views
xi) solution and summarising
xii) Checking insight and closing
During the hypno-therapeutic consultation the therapist would do well to have had practice in these skills and not rely on their trust that as they are a caring individual, that will plainly make them a good communicator. The Nchp suggest that it is considerable to 'like' the client (Nchpb). There are inevitable issues with this, for example, a therapist might be more likely to be seen to be collaborating with a client's unhelpful thoughts or behaviours, or there may be complex issues surrounding transference during therapy. Equally it might make inevitable aspects of therapy more difficult to experience if one's relationship with a client is based on liking them, rather than respect for them.
It is de facto true that one can like a someone without endorsing their beliefs and behaviour any way it does make the therapeutic relationship potentially more complex than necessary. Traux and Carkhuff (1967) suggest that rather than liking the client it is foremost to impart empathic understanding, unconditional inevitable regard and to be 'with' the client.
Although the two previously described issues are important, they are basic to most flourishing human interaction, i.e., a convenient location and interpersonal skills. Without an awareness of these factors it is unlikely that a therapist will expand with a client to the consultation proper. It is the next step where the therapist's singular skills come to the fore.
The consultation process is involved with two original aims; knowing the someone and informing the person. The latter is somewhat less complex and aims to ensure that the client has a clear insight of the therapist, the nature of hypnosis, and the guidelines within which both are framed. Clients need to know that they are dealing with a trained individual, and how that someone will work with them.
This means that they should know the therapist's qualifications (and possibly even a formula of checking them, such as a telephone amount or web address) and their singular philosophy or advent to therapy. Some clients may have sense of beloved or disliked therapies. The client also needs to be clear about the nature of hypnosis, what it is and what it is not, issues with regard to loss of control, revealing secrets, not coming out of a trance etc. It might be beneficial to send such facts to clients when they make their consultation appointment and then impart it during the first face-to-face meeting.
Such an advent also allows for more detail to be in case,granted than might be convenient during the first consultation, for example some history of hypnotism, facts with regard to the therapist's background and training etc). Clients should be made aware of issues surrounding confidentiality, what the limits are, and how they will be protected. The order of presentation of this material is foremost as population tend to remember the things they have been presented with at the beginning and ends of a session, so the report of hypnosis might best be presented last so that the prospective client has good recall of the details of hypnosis whilst inspecting either to come back. It is foremost to ensure that the client does fully understand this facts and again good communication skills will facilitate the process of checking either this is the case.
Regarding confidentiality, it is my conception that no sources of facts should be contacted (e.g., Gps) without the client's written consent, and no facts passed on to others unless (a) the client gives written consent, (b) a court requires it, or (c) facts divulged by the client suggests that s/he is planning to harm her/his self or another. At times this might mean that some clients will have to be referred on, or not accepted for rehabilitation if they deny entrance to facts that the therapist believes is necessary, or they cannot accept the guidelines for releasing information.
Assuming that the therapist is now in the company of a seated, comfortable, informed and engaged client it will be potential to begin to get to know the client. It is foremost that the therapist remembers that there is both a 'client' and a 'concern', and that the two cannot be separated, nor should they be confused. My beloved advent to this stage of a consultation could be termed "unstructured structure". In essence this means that there are inevitable key elements that must be covered in the consultation, but the exact order and manner in which this will be achieved is considered by the flow of the consultation. It also means that the specifics of the questions are for the purposes of this paper, by definition, vague because they must tie in stylistically and temporally with the client.
Most foremost is the client's hypothesize for coming for therapy - and it must involve some report of
i) The concern
ii) The motivation for change
iii) Why now
The way in which the client describes these three factors provides much detail. For example, the report of a presenting concern, and the language used to impart it, gives an indication of how the someone understands and relates to the issue. Epicetus, the stoic philosopher, stated that population are disturbed not by things but by the views they take of them and this view is embodied in cognitive approaches (e.g., Beck, 1964).
Although one might not wish to use cognitive therapies, or one may not be trained in them, all therapeutic philosophies share this central conception that at some level, either conscious or unconscious, it is how we sass to our world that determines our control of ourselves within it. The concepts and terms the client uses may point toward a familiarity with inevitable therapies, including hypnosis, and these may suggest routes for the therapist so that s/he can use the client's familiarity with these concepts in therapy. That is, the therapist can use the client's already existing 'working model'.
The use of language is central to hypnotherapy because we must find methods that can be de facto assimilated by clients, which they can understand and sass to. Communicating at the same 'level' as the client plainly works in will greatly sustain this. Responses to motivation for convert and 'why now' furnish not only extra language facts but also insight into how much responsibility the client is taking for change. A someone who wants to cease smoking for their own health will be a qualitatively separate sense to a client whose partner is badgering them to give up.
Language use and level of responsibility are foremost because they interact with my philosophical orientation, which is broadly Gestalt. It does not rule out or quiz, any singular tool, formula or philosophical orientation, as these must be considered by the needs and experiences of the client. It does see the therapeutic process as collaborative so that the client appreciates the significance of their active involvement. By being collaborative, therapy will be a transparent, shared process, with a shared schedule and analysis of expand through feedback which the client slowly takes more and more responsibility for through learning self-hypnosis and the use of tapes (where appropriate), and by taking on inevitable homework tasks e.g., keeping a diary, experimenting with ideas etc.
Having covered these three original areas it is foremost to organize a deeper insight of the client and their concern. This is part of what Palmer and McMahon (1997) have outlined as being the common elements in all assessments.
i) what is the problem
ii) is therapy suitable
iii) is the client convenient (are there contraindications)
iv) what underlies the problem
v) transcultural and gender issues (e.g., differences in verbal and non-verbal behaviour and the recognition that one's own social/cultural biases (e.g., Ridley, 1995) may affect therapeutic decisions etc.).
In essence we are assessing the fit in the middle of a therapeutic framework and a client or presenting problem (e.g., Ruddell & Curwen, 1997). These questions cannot be addressed until the therapist understands the client, unless the presenting problem is one that the therapist does not feel competent or inclined to address.
Often population are not fully aware of the range of factors which can affect their desire to convert and those which can be obstacles to change. These factors can be internal or external. It is also beneficial to contextualise the client, so that the therapist can begin to understand what boundaries there may be in the person's life that could sustain or detract from therapy.
For example, it is foremost to be sensitive to any disclosures the client might make with regard to old experiences with therapy, early problems that may or may not be what the client sees as a central part of their current concern (e.g., being a victim of corporal or sexual abuse, time with thinking health issues etc.). Further this extends the exploration of how the someone thinks of themselves and their world. Partly it is foremost to uncover aspects of the client's personality as there is evidence that compatibility on a range of personality characteristics is foremost for the therapeutic relation (e.g., Parloff et al., 1978).
Areas that should be covered here are family and work life, any past, gift or continuing problems or difficulties (other than the presenting problem), contacts with other forms of services, and evidence of successes. The issue of sense with old services contains healing and thinking health facts so that the therapist is aware of either contraindications for hypnotherapy (e.g., psychotic episodes) or issues that might make inevitable inductions inadvisable (e.g., asthma). It also includes hypnosis, in case the client has old sense of hypnosis, either flourishing or not. The therapist may be able to survey induction methods that the client is comfortable with, or prefers to avoid, their visualisation capability, Imr etc. If the client has no old sense then the therapist knows to comprise exact questions (e.g., favourite 'safe place' etc) and even visualisation exercises.
The final area, successes, is foremost because the therapist may need entrance to inevitable material if the client has issues with self-esteem or if s/he plans to link success with the presenting problem with old successes. It is also beneficial for the client to know that that are seen as a someone with a range of qualities, rather than with a list of defeats, ailments and issues.
Having covered the exact material related to the presenting problem and hypnosis, and the more normal areas relating to the individual's other relevant life sense (and having paid close concentration to non-verbal behaviour, language etc) the next step is to focus back to the presenting problem. The therapist needs to know what the precipitating factors are for the thoughts/behaviour that the client wishes to change. Armed with the biographical knowledge, the therapist can supplement the client's descriptions with exact questions relating to events and situations that the client has previously described (e.g., family, work, past failures, past experiences). This provides beneficial target areas for change. Additionally the therapist needs to survey the consequences that the client sees as coming from their thoughts/behaviour, both inevitable and negative as this can advise issues related to a client's barriers to change, or extra motivations to succeed.
This approach, precipitating factors, behaviours and consequences is found in many therapeutic approaches and is known as Abc (Activating event, trust (Behaviour), Consequence, e.g., Ellis, 1977).
Part of Abc is looking at underlying beliefs and thinking errors (e.g., catastrophic thinking, dichotomous thinking) which, as the quote from Epicetus suggested, is believed to be the central area for developing problems that a client might wish to change. The hypothesize why these two themes are foremost is that they identify where hypnotherapy might be beneficial and how it would be best targeted. For example, if a client comes in claiming to be shy, and they have the underlying trust that they are unlovable that would suggest one policy of action, whereas a similar client with a similar issue, but with the thinking error that to overcome their shyness they needed to be assertive and superior at all times would suggest another. The manifestation of the issue under concern cannot be the depth at which the therapist ceases their exploration.
Once the therapist has to their pleasure gained enough facts so that they can form a photo of the client, albeit at a later date, it might be advisable, time permitting, to give the client the occasion to sense leisure or mild hypnosis. Particularly in prospective clients who have a fear of the process this might be the aspect that decides if they will engage in therapy.
With the knowledge gained during the consultation the therapist will know either imagery can be used, and if so what images should be used or avoided. No therapy should be attempted at this stage. It is foremost for the client to get a 'feel' for the therapist and to know if they are comfortable with the methods used, the voice etc. On completion of this (if undergone) the issue of the sense should be raised. Initially the ageement should offer a 48-hour period during which the client needs to decide if they want to continue with therapy, with the current therapist, under the framework that the therapist works within.
Also, the client will know the costs and recommended amount of visits and can make an informed choice with regard to financial commitment, payments, failure to attend etc. The ageement should re-iterate the confidentiality clauses, and detail what the client is according to, and cancellation policies etc and furnish the client with sense details.
The above report makes it very clear that a detailed consultation will be both time inviting and succeed in the change of much information. Sometimes it is not the explicit facts alone which is foremost but reactions, comments, etc and these tiny details do need to be remembered. How should the therapist do this? There are a amount of approaches.
Firstly the therapist might decide to rely on memory, and with practice it is potential to organize the potential to use exact points in a consultation to 'hang' other facts from, so one remembers a report which can later be written down. The alternative is to either take notes or to report the consultation. In the old case there is the issue of concentration - is it potential to fully attend to a client and accurately note down all the detail and nuances of a consultation? In the latter there are issues of privacy - how comfortable are clients with the idea that their words are being recorded, even with the knowledge that these recordings will be erased later?
Possibly of all the issues within consultation this is the thorniest. As with other aspects it is probably best to be flexible, and know when one cannot rely on memory alone, and know when one must attend de facto to the client and thus some mechanical means of recording is required. Although clients might be uncomfortable with being recorded it is likely that they will be less upset with that than with a therapist whose head is enduringly in a note pad, or who has remembered some foremost detail of the life story that the client presented at consultation.
Consultation is neither a science nor an art, but a blend which must be performed on a collective tightrope, where the demands of equilibrium co-exist with the cognitive demands of accuracy in an evolving dynamic. In some sense we know what it is, but essentially we need to know how to do it. However, the complexity, which makes it so engaging, also makes it difficult to define. possibly a paraphrased and adopted version of Heisenberg's Uncertainty Principle is at work here; if you can do a good consultation then you can't know how to impart it, if you know how to impart it you probably can't do it.
References
Beck, A.T. (1964). thinking and depression: Ii. System and therapy. Archives of Genreal Psychiatry, 10, 561-571.
Ellis, A. (1977). The basic clinical System of rational-emotive therapy, in A. Ellis and R. Grieger (Eds.), Handbook of Rational-Emotive Therapy. New York: Springer.
Fielding, R. (1995). Clinical communication skills. Hong Kong: Hong Kong University Press.
Lloyd, M. (1996). communication skills for medicine. Edinburgh: Churchill Livingstone.
Nchpa (1996). rehabilitation Schedules. National College of Hypnosis and Psychotherapy, Nelson: Uk. P. 1
Nchpb (1996). rehabilitation Schedules. National College of Hypnosis and Psychotherapy, Nelson: Uk. P. 4
Palmer, S. And McMahon, G (1997) (Eds). Client Assessment. London: Sage.
Parloff, M.B., Waskow, I.E., and Wolfe, B.E. (1978). Research on therapist variables in relation to process and outcome, in S.L. Garfield and A.E. Bergin (Eds.), Handbook of Psychotherapy and Behavior Change. "nd Ed., New York: Wiley. Pp. 233-282.
Ridley, C.R. (1995). Overcoming unintentional racism in counselling and therapy: A practitioner's guide to intentional intervention. Thousand Oaks, Ca.: Sage.
Ruddell, P. And Curwen, B. (1997). What type of help? In S. Palmer and G. McMahon (1997) (Eds). Client Assessment. London: Sage.
Traux, C.B. And Carkhuff, R.R. (1967). Towards efficient counselling and psychotherapy: Training and practice. Chicagoe: Aldine.
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