Why Is the Initial Consultation So Important? What Factors Will an Ethical Therapist Cover at This Time?

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

The initial consultation is probably the most crucial aspect of Hypnotherapy. Everything from the interpersonal dynamics to the eventual success of the intervention has a basis in the first meeting between client and therapist. The client's decision to remain engaged with the therapeutic process will be determined by factors from this early stage.

At the most basic level there are certain physical factors that are likely to play a role in a successful consultation. For example, a room that is suitably furnished (with two similar chairs for the talking part of the session and preferably a reclining chair for the hypnosis) a room that is quiet, comfortable and provides confidentiality. The exact details will be dependant on the therapist's style, budget etc and the desires of the client. ( E.G, temperature, lighting, distance between client and therapist ECT).

However, obvious 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 on.

The next level for consideration is the initial contact between the therapist and the client. Here the knowledge and use of basic counselling skills are paramount. The client must feel that s/he is dealing with a professional who is genuinely interested in and accepting of their situation. The client needs to know that the therapist is listening and attending to them. The therapist can convey this to them in different ways using behaviour, body language, posture and speech. Throughout the process it is important to maintain these high standards, not only because it facilitates open and honest exchanges with the client, but also good communication skills which help to build rapport.

"All clients are entitled to good standards of practice and care from their practitioners in hypnotherapy. Good standards of practice and care require professional competence; good relationships with clients and colleagues; and commitment to and observance of professional ethics." (1)

The skills that are considered important for therapists to have, for a successful consultant are:-

1) Greeting and identity check (shaking hands confidently and directing them to the chair you would like them to sit)

2) Introduction of self and role (whilst sitting next to the client or side on without placing a barrier in between)

3) Clarity of language

4) Audibility

5) Eye contact (without employing a fixed stare)

6) Non verbal behaviour ( 'open' posture with no crossed arms or legs)

7) Empathy (encouraging responses, nodding, smiling when appropriate)

8) Sensitivity of questions

9) Respect of patient's view (suspending judgement)

10) Paraphrasing (focusing on content and facts rather than emotions in order to gain the essential information)

11) Reflecting (focusing on the feelings that are been expressed by the client)

12) Clarifying ( to avoid going ahead with an incorrect understanding of a situation)

13) Summarising ( brief outline of the main points, issues and themes that the client has raised)

14) Respect for privacy and dignity

15) Careful attention to consent and confidentiality.(2)

In order to collect relevant information on the client during the initial consultation, the therapist uses a 'Notation' which as a tool, can be added to as the therapeutic sessions continue. The following is usually found on the initial consultation form:-

1) Full name and the name in which they like to be known by.

2) Address and contact details plus relevant telephone numbers, home and mobile

And permission to leave messages for the client on any of their contact numbers.

3) Occupation and any previous occupations.

4) G.P name and address.

5) Goal to which they have come to therapy for.

6) Any medication the client is taking- BNF can be checked to see what the medications are used for and possible side effects.

7) Medical history including current health problems.

8) Family medical history.

9) Whether they have a partner or children- names and ages are important in knowing who the client is talking about in their situation.

10)Whether they had a good, bad or average childhood, and to what degree?

11) Hobbies and leisure activities.

12) Problems at work.

13) Any problems in their close relationships.

14) Any financial problems.

15) Any other problems.

16) Any experience of therapy or counselling.

17) Any experience of other therapies.

18) Dislikes and fears.

19) What brings the client to therapy now? Is it a long term problem or a new problem.

It is only once this information and data is collected that the ethical therapist can decide whether hypnotherapy is suitable for the client. The G.P name and address, medical history and current medication is particularly important to identify mental illnesses such as psychosis and neurosis.

During the information gathering, the therapist should always enquire as to the emotional and psychological health of the client's parents. If they tell the therapist that one of them was excessively anything that could be taken to indicate schizophrenia, then the therapist should explore the client's psyche much more carefully. It is vital in these circumstances to employ extreme caution and to obtain an accurate diagnosis from the client's G.P.