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

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Embarking on a therapy is a decision not to be taken lightly by a client in the same way as researching a job role is important. Quite often it is common practice for therapists to offer initial consultations with a client to establish whether both parties are suitable to work together. An ethical therapist will take many factors into account in the initial consultation; these will be discussed alongside the pros and con’s of why an initial consultation is so important. Factors such as a therapists own expertise, misconceptions of hypnosis as a therapy and rapport building with be explored.

Meeting a client face to face in an initial consultation is important on many levels; one instance where this is apparent is when the therapist can assess the client’s suitability for their expertise. In order to do this the problem which the client presents needs to be “within our professional competence as psychologists and psychotherapists to treat” (Karle and Boys, 1987). This is paramount as it would be highly detrimental and unethical to take on a client or patient that is out of a therapists’ realm of expertise. An initial consultation is an ideal opportunity to look for “physical conditions which might underlie an ostensibly psychological problem, the presence of major psychiatric illness, and so on” (Karle and Boys, 1987). In cases where it does seem apparent that a patient is presenting with symptoms of say schizophrenia then they would have to refer them on to a more appropriate treatment suited to help them. However in cases of say depression, through an initial consultation, the therapist could “seek to differentiate between appropriate depression of mood (such as grief at loss, reaction to major life changes such as a job redundancy and so on), neurotic or reactive depression, and endogenous affective disorders” (Karle and Boys, 1987). Hereby the therapist could ascertain whether the patient is suffering from depression at a mood level and therefore hypnosis as treatment may help, but if the depression is reactive or neurotic then the patient would have to be referred on.

In a similar light a client will also be assessing the therapist to gauge how confident they seem and how competent a therapist they may be. If a client has specifically requested to see a hypnotherapist and is therefore seeking a therapist that uses hypnosis as a therapy then this can make the initial consultation somewhat easier. In the sense that the use of hypnotherapy as a therapy is acceptable to the client and therefore the client is willing or more open to hypnosis as a form of treatment. Karle and Boys (1987) have emphasised how “the ease, comfort and confidence of the therapist are crucial” in conveying competence as a therapist. “If [the therapist] suggests the use of hypnosis while feeling (and therefore conveying) that the idea is likely to alarm or disturb the patient or to make the therapist appear a crank or quack, the patient will quite rightly refuse” Karle and Boys (1987). Therefore an initial consultation is not only important for a therapist but also for a client.

If a client or patient is aware that hypnosis is being offered as a treatment by a therapist it is still important in an initial assessment interview to prepare the patient and ask “the patient how [they feel] about the use of hypnosis in the course of the anticipated treatment” (Karle and Boys (1987). As an ethical therapist the aim is always to ensure the client is completely comfortable and is aware of exactly what the offered course of therapy entails before entering into a committed form of therapy. Karle and Boys (1987) have suggested that once the client has accepted hypnotherapy as a treatment and that the client “has accepted both [their] need for treatment and the offer of therapy whilst also believing that the latter can help [them]” a few opening lines about hypnosis can be used i.e. “I wonder what the word ‘hypnosis’ means to you?” This is a very...
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