EXAMPLE ANSWERS: Q22

Q22. How would you as a therapist assess the suitability of a technique, its outcome and your own personal performance of delivering that technique.

Learning outcomes: 3.7

Student answer As every client is unique there may be occasions in which a therapist has to ‘think on their feet’ and adapt based on the information gained within the pre-talk and/or metaquestioning. An example of this was a session I planned which involved an induction based on visual imagery (a garden with bright colours and steps down to a lower section). However during the metaquestioning I identified that the client was using audio based feedback – “I hear what you are saying but”… “she never listens to me”, “its as clear as a bell.” On further questioning the client revealed that they struggle to visualise and cannot get clear images within their head. I rapidly re-thought my initial plan. I established that the client had an affinity with the sea and changed the induction to being on a beach – feeling the sand and listening to the waves. I used the waves on the beach as the deepener and watched the client carefully to see if this was working. His physical responses indicated that it was and I continued the session. Throughout it I ensured that I continued using audio style descriptors. I had also had an initial plan of using a control panel – which I then also changed to a new behaviour generator with future facing where he could hear himself being assertive and confident. At the end of the session the client reflected that he felt the session had gone well – he was able to ‘hear’ the difference. In a follow up session I used a similar technique but changed to him being on a boat which added the physical sensation of rocking with the waves and he also responded well on that occasion. I followed up that session a week later and he reported that he was still experiencing positive outcomes. After this first session I reflected on the intervention and wrote it up in his client notes and my reflective journal. My concern was that this had gone well on this occasion but I wanted to ensure that I would be ready to think on the spot in future- I was concerned that I might ‘freeze’. I made some brief notes on the different sense perceptions and how I could adapt these with a range of combinations on a set of cue cards so that I can have these nearby in a session. I have never needed them – probably because the action of writing them meant that I had reflected and avoided this happening. I am sure as I develop as a practitioner I will develop more and more ideas for inductions which will enable me to adapt freely. Reflecting after a session, using peer support and the reflective journal are an essential part of the feedback loop for continuous development. (LO 3.7 An ability to implement new techniques without direct supervision and critically reflect on this, e.g. assessing the suitability of the technique, outcome, and personal performance)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct. Again, a comprehensive answer and well put together with good inclusion of your own personal experience and attention to the detail this work deserves. I particular enjoy your recognition of the importance of reflection and the recording of pointers to help in the future and the essential nature of peer support . I encourage you to share such things on the forum too as they are invaluable hints and tips to help other therapists. Thank you.

(Further student work goes here if requested through feedback)

Further Example Student Answer:  Generally the suitability of a techniques depends on if it works for the client sitting in front of you at the time of use, the outcome would be via client feedback initially during the session i.e. are they responding physiologically and hypnotically as expected, blushing, muscle flaccidly etc. are they accepting the suggestions and do they come out of trance in a good frame of mind, which would also lead to an initial judgement on the delivery/performance of the therapist.

All of these should be recorded in your client notes, how they felt, how they responded etc. including how you felt the session went with notes for improvements so as to improve your client's experience and your performance overall as an informal reflective journal on each client.

The next phase of the judgement would be either at the next session or by some other form of feedback off the client (verbal, phone or email) stating how they felt after the session, how well the suggestions have worked and what changes they have made to their lives since the session.

It is also very useful to keep a more formal reflective journal to ensure you are working to your best and to help identify any areas you should work on to provide the best for you and your clients, which would then be used during mentoring and/or peer support sessions.

Q22. Correct. You have provided good strategies for assessing the suitability of the technique, outcome, and personal performance, as required by the learning outcome. I am marking this answer as correct due to your previous answer regarding using a volume control metaphor of your own devising, to deal with a client's pain response, which has shown your ability to implement new techniques without direct supervision and to critically reflect on it, which is also part of the learning outcome to this question.