As Solution Focused Hypnotherapists, we must all have an inner want to do good. We are people who want to help people, we care, we want the very best for anyone that we meet, we should respect people and live by the highest achievable moral standards, that should be reflected in the way we work and present ourselves. Having our own Moral and Ethical code, although vital, is subject to individual interpretation, it is therefore, beneficial and professionally responsible to adhere to a uniform code, that is based on client interests and is available to all who seek our help to see, giving reassurance and clarity to the treatment they will receive from all those that commit to that code.

NCH members have a primary care to protect the health and wellbeing of their clients, to fulfil this duty, it is based on the following principals,

To respect their client’s dignity, individuality and privacy

We should at all times maintain a practice where our client’s information, discussions and treatment are strictly confidential. To gain the trust of those that we meet is the most important aspect of the client, therapist relationship. By keeping discussions private, we maintain the clients Dignity and privacy. We treat the client with respect and their challenges are acknowledge and never dismissed or ignored. We empathise and consider the best possible treatment plan for each individual as everyone is different.

To be sensitive to cultural differences

There is no place for any forms of Discrimination, we should embrace and respect all cultures, beliefs, races, genders, ages and any other “ism” Some changes in structure or wording may need to be incorporated, we may need to be mindful when asking a “Miracle” question for those cultures that believe only their god or profit can perform these. We may have to be sensitive to language and the beliefs of the client. Accepting each client as an individual and being unique. We keep an open mind and the professional ability to structure sessions unique to the human sat across from you, to ensure the best working relationship.    

To respect each client`s right to be involved in decisions about their therapy and care

We work at one step behind the client, we follow their lead in therapy sessions. Agreement for the most effective direction of therapy is sought and customers are required to sign a statement agreeing to receive the therapy that we specialise in. In the case of minors, we seek the agreement of not just our client, but the parent or responsible caregiver. We have also to be mindful of those adults that may also have a carer and may be classed as vulnerable. Cooperation is the key to success, but the client is paramount and their interests should always be the primary driver whist under our care. We seek agreement to continue with treatment and procedure on an ongoing basis.

To be trustworthy and honest

We treat every client with respect and at all times keep the client/therapist relationship at the upmost of professionalism. We commit to our code of practice to ensure this is demonstrated. All those adhering to the code would have to have an Enhanced DBS check and report. Any convictions are reported to the NCH as are any verbal or written cautions to ensure a record of such things are held and decisions can be made regarding the suitability of the practitioner.

We must also be mindful to follow through with any promises made, avoiding promises that would never be fulfilled. We cannot falsely state cures, success rates or remedies that may not materialise, we can though give hope.    

 To provide a good standard of Hypnotherapy practice

 Our working environments should be safe, appropriate, client focused and adequately comfortable to allow the clients to feel relaxed, whist promoting professionalism. We should continually develop our skills and seek regular supervisor assessment sessions to discuss process and best outcomes, whilst maintaining the client/ therapist confidentiality. If a client’s situation or problem is above the level of competence of the therapist, the client should be referred to a more appropriate and experienced therapist, with the permission of the client.

 To protect clients from the risk of harm

 The client’s welfare is at the forefront of everything we do. We allow clients to be the best judge of their lives and the decisions they make, but if we feel that the client is at risk of harming themselves or others, we reserve the right to inform the relevant authority or practitioner. This exception to confidentiality should be discussed with the client in the first instance and it may be appropriate to have a section on the GDPR notice highlighting this, for example

To cooperate with other healthcare colleagues as necessary

Permission to communicate with the client’s medical practitioner is sought at the initial consultation and is used only in circumstances where intervention or clarification from medical practitioners is in the best interest or requested by the client. 

The code of Ethical Conduct and Performance is a bench mark that we must adhere to. Any breaches in the code by ourselves or those that come to light from other practitioners must always be reported to ensure the integrity and professionalism of our governing body. By having rules we provide a framework to work to and ensure we provide the best service we can give to encourage our clients to live better lives… 

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Suggestibility tests are used to identify how susceptible a person is to Hypnosis. These tests are not generally used or needed in the Clinical setting as a light relaxed trance is considered enough for most clients to be open to suggestion and to allow the conscious and unconscious mind to work together to find solutions. As solution focused therapists, we would not encourage suggestibility tests as we would not want the client to think they have failed if the required response is not shown, they may well then believe they cannot be hypnotised and then resist therapy.

These tests can be sometimes used with children as an ice breaker or something they could be taught to try on their parents. A particular favourite, is to hold both arms out, one holding a brick and the other being held aloft with balloons, not many clients fail to show a response to this. But this should not be used, in my belief, as a measure, just a little fun to sometimes relax a child.

Suggestibility tests are often used by stage hypnotists to find the next star of their show, a series of tests would be carried out on the audience to weed out the more suggestable audience members to allow a good display of riding imaginary horses or eating raw onions.

We utilise trance in our process that is induced by a guided relaxation piece that allows the client to enter a state of tranquillity to focus the mind on what has been discussed in the session and to feel rested and calm when brought back to wakefulness. We do not need clients to be too deep into hypnosis to achieve our and their goals.

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Resistance is a psychoanalytical term; it is used to describe situations when a client actively or passively resists any change in behaviour. It is anything that stops therapeutic change.

This can take many forms, it could be that they keep cancelling appointments, they may not speak at sessions, they could be negative thinking when we are perusing positive thoughts, maybe a goal that was set to complete was ignored, they could resist trance intentionally, they could dismiss the SFH model and try to sway us in to more analytical methods, what ever it may be, it will slow their progress and could convince the therapist that the sessions are worthless. But, those “resistant” clients still attend, so maybe they are still getting a benefit from seeing their therapist.

So, what can we do?

Actively fighting resistance rarely works. Instead, the reason for the resistance should be discussed to explore what is causing it. Pointing out that a client appears to be exhibiting some resistance, allows you to process it and move beyond it. They may feel that the decision to attend therapy wasn’t theirs, this in itself opens up a vast SFH conversation and could get the client to buy back in, “so what small thing can you do to get your parents off your back?”

We need to explain to clients that they need to participate in the sessions, we could set ground rules, we could get the client to come up with solutions to their current resistance, “so what could we do differently to make these sessions more beneficial to you? “

It could well be that the therapist has got it wrong, we should not assume that it’s the client that is resistant until we have explored if we ourselves should have been doing something different to get the best out of our client. Our manner towards the client should be thought about, are we friendly, positive, professional, are we giving benefit and value? Rapport is so important!

We have a very well-structured process and we need to ensure that we adhere to it, to allow clients to make the very best progress. Sometimes it may be considered to do a back to the start session to remind the client what the process and structure can do for them.

Resistance comes in many forms and we should remain positive that we will over come it and if the challenge is a challenge too far, discuss with your supervisor as the therapist could well be missing some thing obvious and vital to get the client back on the same hymn sheet.

Abreaction is the expression and consequent release of a previously repressed emotion, achieved through reliving the experience that caused it (typically through hypnosis or suggestion) this is not something that Solution Focused Therapists practice in, we do not focus on upsetting or painful moments from the past, we seek solutions to make tomorrow a better day.

From time to time, we have clients that may well experience an emotional response, which could lead to upset. In moments like this, we should show empathy and understanding. We need in these instances to work towards getting the client to move from the right pre frontal cortex to the positive left pre frontal cortex, to continue with the therapy process. Under no situations should trance be used if a client is upset as this would not provide the best therapeutic experience and may undo any works previously done. I recently had a client burst into tears during an initial consultation, as she finally understood why she was feeling like she did, this though was a release of emotion and not necessarily a negative release. On this occasion, humour was used to refocus the client, which led to a very productive session.

We can acknowledge upset, but we must remain focused in a caring way to get the client to stop shedding those tears that they will never have to shed again. By remaining calm and professional we should focus the client on positive thoughts to allow the negative emotions to subside.

Transference is a situation in which the feelings a person had about one thing, are subconsciously redirected or transferred to another. It could concern feelings from childhood to someone in the present day. Transference occurs when a person redirects some of their feelings or desires for another person to an entirely different person, for example if you observe characteristics of your father in a new boss and then attribute fatherly feelings to this new boss. They can be positive or negative feelings.

It can also happen when you first meet someone, you could instantly like or dislike someone based on something or someone in your past.

Something we have to be aware of is that transference can happen in our clinical sessions. Transference in therapy happens when a patient attaches anger, hostility, love, adoration, or a host of other possible feelings onto their therapist. Freud was aware of Transference and would use this as part of the therapy process.

Countertransference occurs when a therapist redirects their own feelings or desires onto their patients. This may be a reaction to the patient’s transference. It can also happen independently of any behaviours from the patient.

We are guided by strict professional ethical and moral codes, which work to maintain clear lines of professional behaviour between therapist and client, a therapist can’t be a friend outside of the therapy, we need to maintain a professional distance.

A good working relationship is vital in our chosen profession, we need clients to like us and that is all we need.

What is Psychosis?

Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions). 

There are two main symptoms, Hallucinations, where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices. And Delusions, where a person has strong beliefs that are not shared by others; a common delusion is someone believing there's a conspiracy to harm them. The combination of hallucinations and delusional thinking can cause severe distress and a change in behaviour. Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.

It's sometimes possible to identify the cause of psychosis as a specific mental health condition, schizophrenia, a condition that causes a range of psychological symptoms, including hallucinations and delusions, bipolar disorder, a mental health condition that affects mood, a person with bipolar disorder can have episodes of low mood and highs and Severe depression, some people with depression also have symptoms of psychosis when they're very depressed.

Psychosis can also be triggered. Trauma, Stress, anxiety, addictions and sometimes brain tumours can cause a psychotic episode. If we as Solution Focused Therapists witness a client who is experiencing a Psychotic episode, we should immediately seek assistance from the client’s medical practitioner.

If it is identified at the initial Consultation that a client is or has been diagnosed with a mental illness, 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.

Talking therapies can help reduce anxiety levels in those who suffer, CBT is often prescribed alongside medications. If underlying anxiety can be reduced, this helps the medication be more effective in helping to prevent Psychotic episodes. Therefore, Solution Focused Hypnotherapy could assist in anxiety reduction and potentially reducing or stopping any addictions that the client may have.

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.

Hypnotic depth scales or scales of Hypnotisability are used to measure how deep a client is in trance.

There have been many studies into this over the years and I will highlight some of the different scales.

The Stanford Scale is numbered from 0 to 12, the higher the number, the deeper the level of Hypnosis.

0 Eye Closure (not scored)
1 Hand Lowering (right hand)
2 Moving Hands Apart
3 Mosquito Hallucination
4 Taste Hallucination
5 Arm Rigidity (right arm)
6 Dream
7 Age Regression (school)
8 Arm Immobilization
9 Anosmia to Ammonia
10 Hallucinated Voice
11 Negative Visual and Auditory Hallucination
12 Post-Hypnotic Amnesia

Subjects were given a hypnotic induction, followed by different hypnotic suggestions. For example, one suggestion asks you to imagine your hand is so heavy that you cannot hold it up. If you can hold up your hand, you fail that item. Most people are able to perform the first few items but not many people make it to the end of the test. According to the scales, the farther you get, the more susceptible you are to hypnosis.

Joseph Friedlander and Theodore Sarbin developed the below scale to measure susceptibility to hypnosis with items increasing in difficulty in order to yield a score. The higher the score, the more responsive one is to hypnosis.

Arons Depth Scale creator Harry Arons, some refer to this as the “6 stages of hypnosis” or “6 levels of hypnosis”

Stage 1: Hypnoidal - Hypnosis in this stage is very light. Many clients don’t feel or believe they are even hypnotized and feel completely awake and aware. There are two types of hypnoidal states, hypnopompic and hypnogogic. Hypnopompic is similar to the state you are just before waking up in the morning, that sort of half-aware, “twilight” state. Hypnogogic is like the state just before you fall asleep. A slow transition between wakefulness and sleep.

Stage 2 - In this state, the mind and body come more under the control of the subconscious. Larger muscle groups can be controlled and manipulated with phenomenon such as Arm Catalepsy becoming possible. In this state, your ability to discern reality from fiction becomes impaired.

Stage 3 - is characterized by “Aphasia”, a loss of ability to understand or express speech. Subjects will be able to remember a word, letter or number, but can be instructed to not be able to say it

Stage 4 - In this stage, subjects start to exhibit greater phenomena including the beginning of true amnesic stages. A subject at this stage will “forget” very personal and deeply embedded information such as their name, phone number, and address.

Stage 5- This is where true somnambulism begins. Somnambulism literally means “sleep walking”, but in this context it refers to an easily identifiable disconnect of the mind from both the body and the outside world.

Stage 6- Profound Somnambulism, Subjects can experience Negative Hallucinations where they don’t see or hear things that actually do exist.

So, why are these scales important in the Solution Focused Hypnotherapists practice? There is research that suggests that people’s response to hypnotic suggestions is almost as strong without an induction as it is with one. In other words, subjects respond to suggestions even without hypnotic inductions. Therefore, induction may not have a significant effect. This brings up an important question, if induction is not important, what are all the suggestibility scales actually measuring? We know that we all go into trance in our day to day lives naturally and we have the ability to process thoughts and suggestions in a day dreaming state, so why do we need our clients to reach the higher numbers on the scales? The answer is simple, in the main we don’t!

Another challenge with suggestibility testing is that it may interfere with hypnosis, if it leads people to believe they are not hypnotisable. If a patient is given a suggestibility test and they score low, this may lead them to believe that they will not benefit from hypnotic treatment. This idea may or may not exist, but the mere thought in the client’s mind that it may exist can cause it to exist as we know the mind doesn’t know the difference between what is real and what is not. This is the essence of hypnotherapy, expectation becoming reality as a result of the existence of the expectation.  Expectations matter, and if expectations of the effectiveness of hypnosis are questioned, that may lead to a lack of confidence in the hypnotic process.

Deeper levels of trance would be required if a patient was to have surgery under hypnosis. The University Hospital Centre at Liège in Belgium has reported more than 12,000 cases where hypnosis was used to treat pain since 1992. Enabling patients to have quicker recovery times without the after effects of general anaesthetic.

Hypnotic suggestibility testing is almost always used in hypnosis research. For our use, however, it is often ignored. As many therapists feel, it is not necessary for a client to be suggestible for hypnosis to be effective as a treatment method, as we only need a light trance for our clients to allow their conscious and subconscious minds to come together to find solutions.

www.bestmindtherapy.co.uk

As a Solution Focused Hypnotherapist, it’s vital to understand and have a background knowledge of the differing approaches to therapy available today. Although I follow the SFH brief, there may be times when my methods would benefit from additional intervention, influenced by other forms of therapy.

It may be agreed with a client that a task is to be completed by the next session, this method is a favorite within CBT, where CBT would check that the task was completed, we would not mention it and allow the client to bring it up when we ask “what’s been good?” We discuss ways to make things better, we trust the clients to know how to solve their problems, but there may be times where we may indirectly suggest the better path to take. Tasks, goals and homework are set in CBT, elements we can choose to use if thought appropriate. A goal is key to any client and any therapist to allow us to work towards the clients’ best hopes

An area where we most definitely step outside of the usual SFH process is when it is evident that the clients progress would be encourage with the use of NLP. Rewind, Reframing and Swish are methods used very successfully when combined with SFH. In practice we may use the Swish method to allow clients to see their preferred outcome of a situation, or a preferred view of themselves. The joy with this method is that it can be done by the client whist at home at any time and doesn’t require Hypnosis. I have used this with clients who need help with weight loss and motivation at the gym. We use rewind to assist with Phobia and trauma. It is a non-threatening method which detaches the client from the emotional feelings attached to a memory or a trigger. I have used Rewind successfully on a number of Dog and spider phobia and most recently a fear of flying. We use reframe continually to allow clients to see things from a different perspective to the one that see now.

When discussing preferred futures with clients, we may from time to time think back and use the “My friend John” metaphor, used by Erickson, but as we don’t all have friends called John, we may suggest that “many clients have said that they have benefited from doing that” or using the powers of indirect suggestion to gently nudge the client in the right direction. 

We have to be continually looking to ensure we are providing the best level of support to our clients, they are all different, but our process is the same. So, careful use of language is vital to make the session unique to our individual. Some clients will not enjoy being told what to do, this is great if you have mastered indirect suggestion, some clients want to discuss the past, we do this, but it’s the positive past that we are interested in. Clients that want to give up smoking may feel they have a part of themselves that wants to keep smoking and dieters that want to subconsciously eat cake, we can help that using parts therapy. As long as the alternative methods we use are fundamentally positive, we should seek to use what ever we think is more appropriate.

Having the knowledge of many different aspects of other therapies, allows us to develop our techniques to allow choice as to the best possible solution for the client, which operating in the solution focused therapist brief.