EXAMPLE ANSWERS: VIGNETTES MORE

(Student answer here) Ideas how you would proceed i.e. suitable intervention, ethical complexity, referral etc.

I would first ask if Mark had sought any medical advice. I would hope that he was already receiving medical attention, at least from his GP in the first instance. If he hadn’t seen a medical professional I would strongly advise him to see his GP. If I felt that Mark was in immediate danger of harming himself, I would be inclined to contact his GP myself to express my concerns. I may be inclined to offer contact numbers for further support, such as counsellors, Samaritans etc.

I would ask Mark more details about his current feelings and emotions, while assessing his unconscious communication too. I would ask questions surrounding his current motivation for smoking cessation, whilst assessing his commitment to change through the language used and unconscious communication. I suspect that at such a low point in his life, his motivation for the smoking cessation would be minimal, though I wouldn’t want to just presume this, not acknowledging it as this was the reason for his contact initially. It may be that Mark didn’t feel comfortable asking for help with his current emotions and difficulties, and as smoking cessation may be seen as being an ‘acceptable’ reason for seeking help, he used this as an excuse for seeking help.

Once Mark had explained more about his feelings and emotions I would begin to reframe his statements in order to encourage a more positive outlook for his future. I would ask him about his hopes for the future, encouraging him to think about ways to move on his life, focussing on a positive outcome. I would find out his views on the divorce he is going through, and again reframe this to encourage Mark to think about the positive aspects that the divorce may bring.

Once I had gained this information from him I could then incorporate this into the chosen intervention. I could use a control panel intervention. If he had told me for instance that he felt he needed self- belief in order to allow him to move forward from this point, I would work on increasing his self -belief through the control panel. I would ensure that the future pacing was a large part of the trance work, incorporating the aspects into it that he had disclosed during the meta questioning. For example, if he had told me that he wanted to make a decision regarding where he was going to live now that the relationship was over, I would include in the future pace that he see himself confidently choosing a new apartment, and in doing so, believing in his ability to make the right decision for himself. I would then build up the picture of him living there, how it may look (based upon the details he had given in the discussion), building up a very positive picture of how life will be in the future. I would also give suggestions about how he feels more able to relax and is sleeping well etc.

In order to ensure that he contacted his GP and to find out how he is, I would request a second session. If he seemed resistant to this, I may use the smoking cessation as an ‘excuse’ to check on him. For example, I may explain that because it was probably a good idea to address the issues around his current emotions in this first session (hopefully this would have been expressed by him early in the session during meta questioning), it would be beneficial for Mark to return for a further session in order to address the smoking cessation. During the second session, I would like to ask if he had contacted his GP and the outcome of this, and also whether the GP was happy for him to continue working with a hypnotherapist.

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table)

Correct. |There are no right or wrong answers here of course and whilst I applaud your practical considerations with regard to further support for your client, I would like to pick out a few strategic points here “and as smoking cessation may be seen as being an ‘acceptable’ reason for seeking help, he used this as an excuse for seeking help.” Your recognition of this is extremely valuable as we say we are so glad the world is full of people who smoke and want to lose weight as they may never enter into the hypnotherapy session. “I would begin to reframe his statements

a very positive picture of how life will be in the future” This again is so important as there is a grief involved in the demise of all relationships where the future that has been planned for with the partner has disintegrated with nothing there to replace it, intuitive insights on your part and an important point missed by some. “feels more able to relax and is sleeping well” Again this point is imperative and often overlooked, seeming insignificant to some in light of the comparison with such dramatic life changes, though it is important that the person maintains, or initiates, that ability to relax properly and to sleep peacefully, regardless of the trauma surrounding them, well done.

Also, you have set out a very clever and diplomatic strategy for ensuring that a follow up session takes place with your opportunity then to make sure benefits are continuing. Great work Tracy.

I would firstly ensure that I build a very strong rapport with Mary. I feel that this would be very important to ensure the success of the session. I would be checking that I had built and maintained rapport through pacing and leading.

Once rapport had been built and maintained for a while I would ask if Mary had sought any medical advice, from her GP or another medical professional. I would then sensitively explain that it is my duty as a professional practitioner to ensure that clients receive the appropriate support and that I feel that she currently needs more support than I can offer her as a hypnotherapist. Therefore I would like to contact her GP in order to ensure she receives the correct support, alongside the help I can offer her.

I would encourage Mary to realise that she has choices available to her, life doesn’t need to be this way. I would endeavour to open up her way of thinking, offering suggestions of different choices available to her. I maybe ask if it would be possible for her to cook a meal sometimes with her son in order to improve the diet and to strengthen their relationship. I may do this in an indirect manner such as using an imaginary client who was in a similar position to her and tell her how this had really worked for her.

Overall, I would be reframing to the positive. So by asking her if she is happy with how things are at present, and asking her how she would like things to be different, we could create small steps together in order to bring about positive change.

I would use the information gathered from these questions to devise a suitable intervention, such as new behaviour generator in order to reinforce the positive changes desired. Whilst addressing the obvious problems with her present situation, I would be including work based around weight control, as this was her motivation for seeking help, it would be good to include this, not only to help with the weight control issue, but as a motivator for change in other areas of her life.

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table)

Correct. It is necessary and professional to deal with this client in practical terms of advising other professionals etc and this has to be done tactfully so as not to break any sort of rapport, yes. I admire your reference to the indirect approach on this one particularly with regard to the mother and son cooking a meal together or doing some household tasks. A good answer here, though I add a few thoughts for helping in similar situations.

The recognition that the anger which is displayed at the son has its root elsewhere and is coming out inappropriately within the trance experience is helpful too. The information given is privileged and can be delivered to you either because you have created a rapport of yourself and environment to such an extent that she feels safe to deliver it (and therefore betrayed if you announce too early on your decision to report to authorities). Or it can be delivered to you as you are just someone who is standing still long enough as she volunteers her problems to all and sundry. It is a judgment call on your part as to which of these is more likely.