Ethical Therapist

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

INTRODUCTION

In this essay, I will discuss how important the initial consultation is to both therapist and client alike, some of the ethical issues that are likely to arise at this time and how the therapist should address them for the benefit of all involved.

THE INITIAL CONSULTATION

It is fair to say that, in a course of treatment, the initial consultation is the most important of all, as it establishes the basis for that treatment as well as the essential rapport between the two parties. Although some basic information may have been gathered in a preliminary telephone call, this is the first opportunity for those involved to meet face to face and affords the therapist the chance to establish more details of the problem or issue that has brought the client to see them and whether or not the therapist can actually treat the client. For example this may not be an issue that is suitable for hypnotherapy at all or unlikely to be beneficial to the client. Also, the therapist will need to be satisfied that their skills are sufficient or appropriate for this particular procedure or whether the correct course of action would be to decline treatment at that stage or refer the client to another professional practitioner.

However, should both parties agree to proceed, then the therapist can begin to gather information that will form the basis for the on-going therapy to be successful and so it is essential that a thorough assessment of the client is conducted during that initial consultation. The best way to do this is by creating a 'Notation', a written record of all the information gathered at this point, which will be added to as the course of therapy continues. The first part of this may be presented to the client to fill in themselves and should contain basic information such as full name, address, contact details and preferred method of contact (in order to maintain client confidentiality), present and previous occupations and their desired outcome for the therapy. It is also advisable to gather any relevant medical history including current health problems and any medications they might be taking, which can be cross-referenced in the British National Formulary (BNF) to establish their use and any possible side-effects. It is also advisable to establish the name and address of the client's GP should the therapist needs to gain the doctor's consent for treatment (having established the clients permission to do so) or to advise them that their patient is undergoing hypnotherapy and to request any comments.

The therapist can then go on to fill in the rest of the Notation with details such as any family medical history, information regarding the client's home life past and present including a partner or children and whether they have been through a committed relationship breakdown, as this could have a bearing on their current state of mind and relevance to the problem. Also some family background and general information regarding the client's childhood e.g. good, average or bad will be useful as this may give the therapist the basics from which to work. If the client has any hobbies or engages in specific leisure activities may be useful to know, as finding out how they relax out of their usual environment could be relevant when writing a client-specific screed.

Further "problem areas" should also be explored such as any current difficulties either at work or at home in the client's close relationships, any financial difficulties they are experiencing and any other problems that they would like to share at that time. It is also important to establish any fears or dislikes that the client may have, as these are likely to arise as contraindications to the success of their therapy. Finding out if they have any previous experience of hypnotherapy or counselling or any other types of therapy will be useful to know and whether that therapy was deemed successful or otherwise and probably the most important question is what brings them to seek therapy at that point. Delving into this, even at such an early stage, might give a greater insight into what course of action to take, as issues may arise here that take the therapy on a completely different course. In short, any information is valuable information no matter how trivial and it is extremely important that the therapist listens actively and attentively, as important clues and signals can be forthcoming during normal conversation.

It is during this initial conversation that the therapist can gain other useful insights into the client such as their particular modality and possible induction style. However, none of this can be achieved, nor indeed can a potential successful outcome, without a positive professional connection between the two parties and it is here that the therapist can establish a good rapport with their client and for the client to make a positive connection with the therapist. The therapist should endeavour to make the client feel comfortable and instil a feeling of confidence and trust that can subsequently be enhanced and intensified. It will be a learning experience for both and it should be remembered that the client will also make judgements regarding the therapist who should be willing to answer any questions that may arise. How the client feels during this initial consultation