There and many benefits to working online, it allows or clients to receive therapy in the comfort of their own homes, they haven’t got to drive to us and park and get dressed, they can wear what they want, sit where they want and have a therapist on the other side of the world. They save money in fuel and we can save money too, buy not renting a therapy room for the session. During the Covid Pandemic, it was the only way to receive therapy and many Hypnotherapists embraced this and now only work this way, some say it is equally effective as face-to-face therapy. Payments can be taken by sending payment links and accepting credit cards, making the process very easy.

Working online does pose some questions.

Are the conversations we have with our clients confidential? we have no control who else may be listening to our sessions, you would assume that it would be a family member or friend of the client that may overhear, but this is totally out of our control. We should advise the client to find a comfortable, private area to receive therapy, one where they will not be disturbed or potentially over heard, this allows the client to be in control of their environment with our recommendations.

How do we gain consent? Verbal isn’t good enough and we will not be recording the sessions, so we will still have to resort to sending consent forms to the client to complete prior to the session. Sending a signature link to sign a consent form is a possibility, or accepting an email stating the client agrees to hypnotherapy is another option.

Are our client’s “Tech Savvy”? will they be able to log on to sessions, do they have a good enough connection or broadband speed and what happens if the internet goes down? Is the session rescheduled at no cost, or lost? Allowing extra time for the first session is wise to allow for a little first time set up. We may have to instruct clients in the use of the online system the first time they use it. Agreeing in advance of what will be done if the line goes down is important as we do not want the client to feel that they have paid for a session ands lost it through no fault of their own.

What happens in an emergency? How could we deal with something that could be happening many miles away? What if the client doesn’t come out of trance and falls asleep? Rules would have to be in place as to whether the client would like to be woken up at the end of the session, if they do, we should ensure we have access to their phone numbers to give them a wake-up call. We need to know where they are and have the address and phone number, in case of an emergency.

Are we missing something? Can we gauge their expressions properly? Can we see their breathing pattern? Can we tell if they are in trance or not? the question is, do we actually need to?? We only rely on the client being in a light relaxed trance for Solution Focused Hypnotherapy, so this may not be such an issue for us. But of course, being aware of body language helps greatly and the more we can gauge how our client is behaving, the better it is for their session.

So, we have pros and cons to Online therapy, as long as we can confidently offer a beneficial service that adheres to the codes of conduct that we subscribe to, is in line with GDPR and we have emergency contact information, it would be wise to offer as an alternative to face to face sessions and gives the clients a free choice. If our clients are comfortable and happy, their therapy will start on the right foot.

In my experience, online therapy has produced very similar outcomes to face to face sessions, so whichever method the client is happy with, you can rest assured that it will provide them with what they need.

The initial consultation is one of the most important stages of the time we will be spending with our clients. It is an opportunity to build rapport and gather important information to ascertain what we will be helping them with and how we will deliver it. We utilise a specific information gathering form to complete this. Information gathered is used to adapt our workings of the mind presentation to allow us to make it relevant to the client’s needs, offering suggestions as to why they may be feeling like they do and what we can do to help. We follow the same structure, for the most part, with every Solution Focused Hypnotherapy session, but use client specific information to make it relevant to them.

We draw out information on how we can help, what is the client’s goal or goals if therapy is successful. This is vital as we have a starting point and an instant miracle question/ scaling conversation when we see the client at the next session. We can also review this goal regularly to keep the sessions on track and show them how they are moving towards that goal in a positive way.

Details on their immediate family is taken, which allows us to understand the workings of the family and to bring questions to the client for example “what would your husband John think if he saw you less anxious” “how would your children react” etc, allowing us also to understand the support network of our client.

Phobias, addictions, habits, sleep patterns are noted, as these could be causes, or side effects, of the issues that the client has decided to come and see us about. We know that poor sleep is a factor in reducing the brains’ ability to empty our “Stress Buckets” the more stress in that bucket, the less likely our clients are to have the capacity to lose their phobia or addiction or reduce general strass levels. Knowing these pieces of information give us clues to the direction to take.

We need to know details of the Drs Practice and whether the client is on medication, also what the medication is used for, there may be situations where therapy may not be continued until clarification from the GP is sought as to the suitability of our sessions, Psychotic or clinically depressed clients, for example.

It is also wise to find out what previous therapy they may have received, to enable us to build on this, or try something different.

We have to be sensitive in gathering information, we should take whatever is offered by the client and use what is helpful only. We should appear inquisitive, but not overtly nosey! If the client wishes not to give us the basic levels of information, we should be curious as to why, as they may be hiding something that could prevent us from continuing therapy. A discussion with our supervisor on this matter would be the best course of action.

Solution Focused Hypnotherapists can work without knowing all the facts, but having a basic understanding adds to our resources to ensure the best possible way forward for our clients.

www.bestmindtherapy.co.uk

Hypnotherapy is a wonderful solution for reducing anxiety, fears, phobias and changing attitudes, it has a vast realm in which it is very successful, some of the conditions that can be treated are below,

• Alcohol addiction
• Anger management
• Anxiety
• Bruxism -Teeth grinding
• Chronic pain management
• Confidence/self-esteem issues
• Depression/low mood
• Drug Abuse
• Eating behaviours
• Exam/performance stress
• Fear and Phobias
• Gambling addiction
• Irritable Bowel Syndrome (IBS)
• Low motivation
• Obsessive Compulsive Disorder (OCD)
• Panic attacks
• Post-traumatic stress disorder (PTSD)
• Public speaking
• Sexual issues
• Self-Harming
• Sleeping problems
• Sports performance
• Stop smoking/vaping
• Stress
• Substance addictions
• Unwanted habits
• Weight management
• Working with Children
• Working with Teens

All of the above have the potential to be treated without any other interventions from other practitioners, with the exception of IBS, (which medication can be prescribed), Drug abuse, (when the client may be on alternative prescribed drugs) and depression, (where the clients may be on prescribed anti-depressants).

We should always be mindful that we are not General Practitioners and cannot prescribe or recommend anything to do with medications. We can ask if a particular complaint has been diagnosed and mention that it may be helpful to get it checked at their GP to ensure that we can work safely and effectively with the client and compliment any medication that has been prescribed. If asked by a client, if they should seek a doctors opinion, we should ensure we support the clients decision to do so.

Many conditions are affected by stress, Psoriasis, IBS, heart disease, tension headaches even the common colds can be worse when we are feeling low and not producing the “happy” chemicals in our bodies to fight it off. Using Hypnotherapy, we can help to reduce stress levels and work alongside the treatment that the clients are already taking. Clients with terminal conditions or at the end of life can use Hypnotherapy to give them some relief and relaxation during their challenging times, allowing them to get temporary respite from their worries. 

“We can help……...!”  if we remember this phrase for the rest of our careers, we will rarely give false hope . What we do is hard to quantify, its difficult to measure, but we know it works for the majority of our clients. But we cannot ever promise results, its too reliant on the client working towards their own goals to be able to measure the therapists result, we just help them get to where they want to be. Any websites or general advertising needs to offer “help” to find solutions to problems, not a guarantee of an end result. We should avoid using percentages to describe the success rates, we should never suggest that everyone is “fixed” as this could well cause not only disappointment, if they have felt no benefit, but also this could damage their feelings of self-worth as they could well feel they have failed in some way.

But……… we need to give hope and encourage the client to use their intellectual brain to find solutions and stay positive, so maybe the phrase “I feel confident I can help you” or “I feel you have the strength inside you, to allow us to work together to help you make your life better” may be more appropriate.

How do we ensure that the client is getting value? The answer there lies with both the client and the therapist. We could assume if they turned up again to the following appointment, they are feeling some benefit. But it could be because we told them that they needed between 8 -12 sessions and they feel obliged and feel that this is how it should be. Having a good working relationship should allow the client to believe they can be honest as to when therapy is over, it may be prudent for the therapist to ask when the client may feel they are ready to stop, based on scaling or maybe when a phobia or symptom has gone. We should strive to ensure that the clients only have the number of sessions that they need and not one more.  We can of course suggest that a course of therapy may need to extend if we truly believe it is the right thing to do, but the client has the final decision.

There may be times when the therapist decides that therapy comes to an end. This could be because the client doesn’t engage in the therapy, it could be they regularly cancel or don’t show up for appointments. Maybe it is felt that the client is fulfilling an emotional need for something, rather than attending our sessions for a specific symptom, we cannot become paid friends to chat to, or allow the clients to get emotionally attached to us, we should leave no trace on their lives…

At times we may have a client who comes to us as a last resort, they may have been to a number of different therapies with no results. They could be very dismissal of every other therapy that they attended. Our views of these other failed attempts at therapy cannot be encouraged, we are only specialists in our own field and cannot suggest otherwise. Our methods encourage positive actions, positive interactions and positive thoughts, this in itself should and does not conflict with other principals of therapy, so we have the tools to find good in anything they may have tried before. Acknowledging that they know what hasn’t worked and they are strong and resilient enough to keep seeking help is already singing from our hymn sheet, so we should embrace this.

We should also bare in mind our limits of expertise in all areas, if deep down know we cannot help, after seeking advice from a supervisor, we should refer the client to someone more qualified. The person in front of us has come for help, we need to ensure we do just that and if telling them that we can’t help is the right thing for them, we must find the strength to do it. Our clients should never be viewed with pound signs on their heads………

Clients should not be treated without written consent. Consent to hold the information gathered and for receiving Hypnotherapy. This ensures clients are willing to proceed with therapy and to understand its uses and benefits.

If a client doesn’t want to be hypnotised, this could be classed as without consent.

If you’re not sure you can help them, if their presented problem is not one we can help with, it would be unethical to take them as a client

If the Therapist is underqualified, they would need referring to a more qualified therapist.

If a client wants help with a medical ailment that has not been diagnosed by a GP. For example, IBS, severe headaches or skin conditions.  Underlying reasons for medical complaints need checking by a GP, to ensure that the correct treatment is given. We are a complimentary therapy and cannot diagnose and therefore assume that the complaint is anxiety related..

Clients with Psychosis or a personality disorder. If it is identified at the initial Consultation that a client is or has been diagnosed whether currently taking medication or has previously taken it, then at these times we should contact their GP and our supervisor for advice. We should get clarification that what we can do for the client, will do no harm. I strongly believe that if the Solution Focused Hypnotherapist has even the slightest reservation regarding dealing with a client with a diagnosed Mental Illness, they should refer to a colleague with the experience to give the level of support the client needs. We should always work within our limits of experience to give the best possible care. 

We should also not treat a client who may show signs of making physical harm to themselves or to others. Although we work to reduce stress and anxiety levels in our clients, if the situation is potentially dangerous, we should inform the appropriate resource.

Common sense should come into play regarding this issue. Remembering we should do no harm and have the clients’ best interests at heart will guide us to make difficult decisions when we feel that treatment cannot be given safely and effectively.

As Clinical Psychotherapists, we are dealing with people, whether face to face, on the telephone or online. Some of these people will be vulnerable, some will be children, some may have caregivers who escort them to appointments, some may present behaviours that we feel may be dangerous to themselves and others. We don’t always know clients before we see them, our first hello at the Initial Consultation could be the first interaction we have had.

As we operate a confidential practice, we have to consider when this cannot be honoured. For instance, when we have to safeguard those that are vulnerable. Vulnerable adults may need a chaperone, children under the age of 16, should be accompanied by the primary caregiver, disabled clients may need permanent care and assistance.

This asks the question, “how do we remain confidential?” Firstly, informed consent should be sought for the session, this is taken at the Initial Consultation, giving agreement to receive Hypnotherapy. Future consent is applied consent, as they continue to attend appointments. At this point, the session will be discussed and the arrangements regarding who attends will be agreed. If a chaperone is to remain, this should be noted on the Initial Consultation document, if it is preferred that a chaperone not be present, it would be insisted upon that an open-door policy is agreed, where the client remains in the practice room, with the chaperone waiting closely outside, close enough to see inside the practice room, but not close enough to hear what is being said, the therapist keeping a working distance away from the client and never having any physical contact with them.

We have to also understand who is the client. Every effort is to be made to discuss issues with the client, rather than the caregiver/chaperone. Although at times their input maybe of importance, our concern is our clients’ thoughts and best interests. Some of the clients’ issues may well involve the caregiver, so during Miricle questioning and scaling, we have to be mindful that we allow the client freedom to discuss what is on their minds. Session rules should be discussed at the Initial Consultation, which will lead to a much more productive and beneficial session.

If we feel a vulnerable person or child is at risk, we are legally and morally bound to take action and report this to the relevant authority. It is advisable to have an Enhanced DBS check carried out to give confidence to those seeking a therapist.

Another issue to be considered would be that of insurance. Insurance to practice Hypnotherapy and insurance on the facility in which its being performed. We need to provide a safe environment and have public liability insurance in the event of any claims. If we follow the procedures of Solution Focussed Hypnotherapy, it is highly unlikely that there would ever be grounds for complaint as consent is always gained.

Discrimination of any sort, is also to be taken into account legally and morally. All humans are equal and should be treated as so.

If a therapist adheres to the code of conduct and ethics of their chosen professional body, they are signing up to a promise to ensure they give the upmost care and professionalism. Solution Focused Hypnotherapy is about doing good and making lives better, this we will do if we practice what we preach and stick to the rules, legally, ethically and morally.

As therapists, we reserve the right to choose who we work with. The reasons for not working with clients, should never be made on reasons of discrimination, if this would be the case, the therapist is in the wrong profession and is in breach of the code of ethics for the NCH and AfSFH.

There may be times when a therapist chooses not to work with a particular client for some of the reasons below,

If the therapist feels the clients’ needs are above his/her experience level.

If a client is aggressive or behaves inappropriately.

Clients that don't actually want to see a therapist and show extreme resistance to the process

Clients under the influence of drink or drugs.

Those clients taking medication that would need referring to a GP before the sessions continue.

Clients with strong beliefs that go against the therapists’ moral codes.

Clients that continually cancel appointments at short notice or don't settle their bills

Friends where it could be considered to change the dynamic of the future relationship.

It could be the client doesn’t want to attend and is being forced to attend sessions.

Those in a relationship with the therapist

All clients should be referred to another more suitable therapist in the event of any of the above and discussed at supervision to ensure we do not turn away anyone that needs our help. Helping them to find alternative therapy, could be more beneficial to the client in the long run.

www.bestmindtherapy.co.uk

For more info, email me This email address is being protected from spambots. You need JavaScript enabled to view it.

Continuing Professional Development (CPD) is widely recognised as a fundamental way to improve the professional standards and skills of Therapists. It exists to ensure that an individual enhances their skills and abilities once they have qualified. CPD is important as it helps to ensure that further learning is progressed in a structured, practical and relevant way. CPD allows a therapist to focus on what specific skills and knowledge they require over a short-term period, maybe 12 months, in order to be confident that there is recognisable improvement in their proficiency and skill sets. As more people become professionally qualified with similar qualifications, CPD becomes more important as a means of separating yourself from the pack and being able to offer a greater level of professionalism. Thoughts, procedures and science moves on continually and we need to ensure we have the most update training and knowledge to best help our clients. A minimum of 15 hours of CPD is required by the AfSFH.

Whist knowing what you need to know is vital, doing what you need to do is more important. Giving our clients the very best professional care and attention is our aim. We must ensure we evaluate every session and challenge ourselves whether the session was the best it could be for the client. Learning points are recorded on our session logs and identified to allow us to build upon any weaknesses in the last session to ensure we give our very best next time. What could I have done differently? What should I have done differently? What did I miss? Did I give the best that I could? Am I adequately qualified for this situation? Do I need to change the approach? Did I speak too quickly? And the list goes on. Fundamentally we need to learn what was good and do more of it, identify what didn’t work and do something different. Once a client has ended their therapy sessions, the entire story of their journey should be evaluated to enable reflection and constructive criticism. This could identify weaknesses in the therapist’s ability, enabling them to plan future CPD, or it could be that it gives the therapist the joy in seeing that the sessions have helped, driving increased positivity and belief in themselves to strive to work even harder for the clients.

Evaluating our own performance is a great way to improve our skills. There may though, be more effective approaches that only come with experience. But should we wait to gain experience? Should we practice on our clients until we get proficient? The answer to these questions has to be no! Part of the code of conduct states we all have to undertake supervision from a qualified Supervisor. The AfSFH state a minimum of 6 hours. Supervision is an effective way of discussing cases, in a professional, confidential and constructive way. Individual cases can be discussed to allow the Supervisor to ascertain if the therapist is adhering to the code of conduct and to offer insight into what worked, what could have helped and what further training may be needed. No details of clients are given, to ensure privacy. Supervision is important when a new client presents issues that the therapist feels underqualified to help with. Discussions on the best course of action can be had to best serve our clients and to ensure they see we are doing our upmost to help.

To summarise, we need to do the best we can for everyone that chooses us to help them. We must constantly work towards having the most up to date knowledge, continually evaluate ourselves and be monitored by trained Therapists to ensure we give the best possible level of service to our clients.