EXAMPLE ANSWER: Smoking

(LO 4.1 Advanced thinking around difficult ethical issues, particularly those outside of codes of ethics and where an unambiguous and universally agreed upon solution is unavailable)

Smoking
from Anna Taylor, with thanks

Student answer This is a difficult situation and in which the response will need to include the following considerations It is not appropriate to conduct a smoking cessation session with someone who does not want to participate. Unless the wife agrees to participate I would offer a refund as this is a compromising situation. Given the assumption that I am able to get some level of agreement to participate, I would progress with the focus on the wife as the client (not the husband who paid for it). I would then use meta-questioning to ascertain why she is reluctant to stop smoking and what perceived benefits she feels she gets from it At this stage I may reference research and public health information campaigns which are widely available but it is important to note that many people have developed selective perception around these – as an ex-smoker myself I know that I actively avoided or minimised ‘hard hitting’ adverts. I knew all of the reasons not to smoke but these did not apply to me! The occasion on which I stopped smoking (this time) was when I found the key arguments that worked for me – that I ran for a bus and couldn’t breathe. I was unable to balance that with my view of being relatively fit and started the non smoking process. Whilst I would not share this with the client I would see if a similar approach worked- has she seen the adverts and does she identify with them? What are the reasons for her continued use- how does smoking fit with her view of herself? Does she see herself as a smoker? Does she see this as a permanent state? How does this fit with her perception of herself as a mother? How would she feel in future if her child starts smoking? What were her own reasons for starting?.... It is important that there is a balance of perspective here rather than being accusatory or blaming. An open and empathic approach of curiosity is more likely to be effective. If there is a genuine and open acceptance to change at this point I would continue, but if there was not I would be declining the rest of the session and offering support in the future if she changes her mind. One possibility is that this might actually shock her into being open to change – there is nothing more irresistible than something which is not available. By declining to continue the hypnotherapy the idea of non smoking may actually become more desirable.