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

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This essay will discuss why the initial consultation is so important for establishing a good ethical therapeutic relationship between client and therapist. It will take into consideration the ethical factors that should be addressed by the therapist during the initial consultation, and what issues should be addressed with the client through this time.

The aim of the initial consultation is for the therapist to gain a deeper understanding of the client, their issues and to give the client an opportunity to ask any questions they have about hypnotherapy. In turn this will assist the therapist to establish a rapport with the patient. As well as gaining a deeper understanding of the client, and the life changes they are wishing to make, the initial consultation also provides an opportunity for ethical factors surrounding therapy to be discussed and considered by both therapist and client. This will result in the therapist having a good idea of which direction therapeutic intervention should take and whether hypnotherapy is indeed the best method of therapy available for the client at this time.

Palmer and McMahon (1997) in their work, outlined common elements that were said should feature in all initial consultations. These elements consisted of; What is the problem? Is therapy suitable? Is the client suitable? What underlies the problem? And finally, trans-cultural and gender issues.

Taking these suggestions from Palmer and McMahon into consideration, what information needs to be shared by the therapist and client in order to meet these elements in an assessment?

In order for the therapist to obtain a clear view of the clients needs and address the clients problem effectively he/she will need to gain a good understanding of what it is exactly the client wishes to change, what their motivation is, and why they have decided to make this change now. To help establish a comfortable information sharing setting between the client and therapist, the consultation should be held in a room, where it is suitably quiet, and provides an atmosphere whereby the client feels free to share personal information without fear of being over heard or walked in on. The therapist can also help put the client at ease by explaining that all information will be kept confidential, unless the client discloses that he/ she is planning on committing a crime, harming themselves or someone else, or if the client has given the therapist consent to pass their information on. Initial consultations normally only last half an hour so the therapist has to work quickly to establish a rapport with the client to entice them to come back for treatment and to make them feel comfortable to do so. The client should feel that they are dealing with a professional from the first moment of meeting the therapist, so the therapist should have a suitable place to meet the client, and be appropriately dressed. The therapist should also give the impression to the client that they are genuinely interested in and accepting of their situation, and the therapist should check all the details (for example the clients name and information), they have been previously given to make sure it is correct. By doing this it signals that the therapist has respect and focus in the client, which helps build that all important rapport needed to make the therapeutic relationship a successful one and helps put the client at ease. By maintaining these high standards it not only helps to facilitate rapport with the client but it helps to gain the honest exchanges needed to decide whether hypnotherapy is suitable for the client and the information being received by the therapist is the full picture, which will later on ensure the therapy given is as effective as it can be. Once a confidential and open setting has been established the therapist can continue with the consultation to gain the information they need to approach an ethical and fair assessment. At this time the therapist should find out what the clients goals are and decide whether the goals they are wishing to achieve are in fact possible. The therapist should ask for permission to contact the clients GP and establish if the client is on any medication prescribed by a GP, as this will enable the therapist to decide whether hypnotherapy is a suitable method of treatment for the patient. For example, patients who are diagnosed with psychosis/severe depression would not be eligible as they would be on medication, which would alter their mental state, and therefore hypnotherapy would not be an appropriate treatment. In these situations there could be a chance that the therapist would be putting the client or themselves in danger. It is important for the therapist to make sure that hypnotherapy is the best treatment for the client as it would be unethical to proceed knowing it was not in the clients best interest. If a situation arose that the therapist did not feel that hypnotherapy was the best way forward for the client whether it be because of their medical background, unrealistic goals or the fact the therapist felt they were not experienced to deal effectively with the problems the client were presenting, the therapist should tell the client this and possibly offer a referral to alternative forms of treatment elsewhere. There will be at times when the therapist is unsure whether they should take on the case or not. By having the initial consultation it gives the therapist time to seek guidance from a fellow colleague, in supervision to try and make a decision, if need be.

For the therapy to be effective and beneficial for the client, both client and therapist need to be sure they will be comfortable working with one another. There are a number of factors, which may affect this. The client may have religious views or personal issues, which may mean they would prefer a male rather



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