The consultation and client intake
As a hypnotherapist, the ‘consultation’ or ‘client intake’ is one of the most important parts of the therapy process, and can make the difference between success and failure! Here are some tips to make sure you’re consultation process is working for you.
By building rapport with your client, they are often willing to share a lot more information, which will help you moving forwards. Many different components go into the creation and maintenance of therapeutic rapport. A great start is with authenticity; being the real you, rather than presenting a persona of a hypnotherapist that isn’t really you.
Supporting this is empathy; so being about to relate to and understand what the client is experiencing, rather than how you would experience that same situation. In addition, a key aspect of rapport building, is unconditional positive regard; where you are taking the person for who they are (all aspects of good and bad) without judging, setting criteria or qualifying conditions/rationalising. Rapport is so important that we have an entire blog post on the topic.
Showing a genuine interest in your client will encourage them to engage in the therapy consultation process. You can demonstrate that you are paying attention and enhance this process by:
- Organisation: Avoiding ‘barriers’, such as having a notepad or table in between yourself and the client.
- Posture: Leaning forward slightly with an open posture (avoid crossed arms/legs, which can appear unfriendly).
- Eye contact: Keeping focused on the client and avoiding distractions. This is particularly important when working online (look at the camera rather than out of the window!).
- Observation: By watching a client, you will notice changes of the client’s expression, posture and movement and other forms of silent communication. You can then question them, where appropriate, thereby showing you are paying attention.
- Listening: Listening actively to what is said and the way that things are said is an invaluable therapy skill.
When you or your client start to engage in avoidant behaviour (usually due to feeling distracted or uncomfortable), it needs to be immediately identified and addressed.
Avoidance behaviours can include avoiding eye contact, closed/blocking body posture, focusing elsewhere (e.g., out of the window), distracted fidgeting, such as rustling paper or moving a glass repeatedly, yawning, or repeated changes of posture.
To encourage a client to expand on what they are telling you, a range of verbal, sub-verbal and non-verbal responses can be employed. A superb phrase, “Tell me more about that” is widely applicable, as is the question “and how do you feel about that?”
At other times, a more ambiguous response, such “Umhum” or “oh?” or “ahhh” can be helpful, particularly to keep the client talking about the same topic. At other times you may not want to interrupt the flow of speech, but wish to subtly encourage the client to continue, so a nod or raised eyebrow or encouraging facial expression can be a useful non-verbal approach.
Use of silence and stillness
Rather than having to fill the entire consultation process with constant talk, an absence of sound (silence), movement (sitting still) and expression (facial, gestures) can create space for the client to focus more on their thoughts, feelings and experience and perhaps think through how they would like to move forward. It will also give them processing time for what has already been discussed.
When employing silence/stillness, appropriate timing is important in order to maintain rapport. However, stillness can also be an effective pattern interrupt if other measures to gain the client’s attention have been ineffective.
When exploring a broad topic, it can take a lot of session time to get to the essential information within the wider story. It can be helpful to map the key ‘headers’ or landmarks of the client’s ‘story’ and then using reflection and summarising to keep them focused around the desired areas for further discussion.
Conveying information to your client
When you are conveying information to a client, there are many different ways in which you can do this. Each has their own advantages and drawbacks.
When you give advice to a client, although it may not use a commanding tonality, such giving of advice is directional, from the giver to the receiver. It helps to avoid phrasing it as ‘do/don’t’ as some contrary clients will rebel against being told what to do.
Giving your client instructions can be even more directive than advising your client. In contrast, is consideration. By having the client ‘consider’, you can help the client gain an awareness and an understanding of their actions. This can be collaborative or directed by the therapist, yet can achieve greater engagement from the client than simply telling them what to do.
Finally, within a consultation session, you may find that some therapists will use their own experiences to support a viewpoint, demonstrate empathy or boost collaborative rapport. It is important to remember that the session is the client’s therapy time, rather than a time for the therapist to off-load. Also, it can skew the client’s perception of you, as they may judge you based on what is disclosed.
With clients, aim to keep to professional boundaries. A simple way to do this is to convey your own experiences in the form of a story/metaphor, suggesting that ‘someone you know’ had X experience, rather than it being about you.
With exploratory questioning, a blend of direct and indirect questions can be used with a client to delve deeper into the client’s experience. Rather than just using direct questions, which can be rather blunt, or just indirect questions, which can be perceived as indistinct if there are several consecutively, a blend of both approaches helps you to enquire from different perspectives and can gain greater information overall.
At times you will have some insight into the client’s experience, whether that is their thoughts, beliefs, actions, needs, desires or patterns of behaviour. At these times perceptive questioning can be helpful to the consultation process.
By exploring a client’s perceptions, it can give them an opportunity to consider their own perspectives and gain greater understanding. Rather than ‘telling’ a client how it is, there is more therapeutic value in exploring whether a perception might be relevant or accurate.
During the session, you may become aware of the client demonstrating one or more cognitive distortions (e.g., ‘all or nothing’ thinking) or limiting beliefs (“I never can…”). You may also notice and wish to dispute any inconsistencies in the client’s recounting of events or their experience.
A level of therapeutic rapport is necessary for effective challenging, and the challenging or disputing process needs to be carried out with skill; you are challenging a client’s beliefs, not the clients themselves (it isn’t a personal attack, but if not conducted properly, it can feel like it, from the client’s perspective).
Timing of any challenging and disputing is important as well. You may find it necessary to hear an overview of the client’s story first and then revisit certain beliefs or thoughts, rather than challenge on the first ‘run through’, as this can cause the client to adapt their story to avoid further challenge from you.
Sometimes clients need to be challenged, so rather than this being a 100% positive, lovely and fluffy therapeutic process, challenge your client where appropriate. If you don’t, it can mean that cognitive distortions and unhelpful beliefs remain undiscovered and this can have a negative impact on the success of therapy further on.
Whether you’re only now starting out, or if you’re looking to build upon your existing training and ‘fill in the gaps’, if you would like to learn more about how to perform a super effective hypnotherapy intake/consultation process, check out our Hypnotherapy Diploma Course (London) and our online Hypnotherapy Certification Course. We also offer 1-to-1 supervision sessions for those therapists who’re already qualified. If you have any questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks