EXAMPLE ANSWERS: Q8

Q8. Describe a client scenario where you would choose to use Erickson’s utilisation technique.

Learning outcomes: 1.1

Student answer Erickson’s utilisation technique is a method of bypassing the critical factor. It is possible that the client feels uncomfortable in directly addressing an issue –for example financial, relationship or sexual difficulties and therefore appears to be resistant which could cause a barrier to therapy. This approach involves accepting the problem or situation as presented by the client but using their own stance to address the ‘unspoken’ issue. This increases rapport as it does not involve direct confrontation of the client and issue which would be likely to damage the therapeutic relationship. It enables the client to know that you understand the issue and therefore they can trust and engage with you. An example of this would be a client who is experiencing relationship difficulties but has described enjoying playing football. The analogy of being part of a team; knowing a game plan and a formation in which to be the most effective; adapting that plan as required to ensure that the team and game are supported; having a goal to aim for and having to overcome problems presented by other people could be used. (LO 1.1 An understanding of advanced interventions)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct, an excellent answer detailing the advanced intervention required and giving appropriate examples, thank you. .

(Further student work goes here if requested through feedback)

Further Student Example Answer:  I would consider using Erickson’s utilisation techniques on a situation where the client is so deeply wrapped up in their problems they have difficulty in seeing any solution, resulting in them rejecting any offered alternative thought patterns out of hand.

The technique of agreeing with the client on their particular problems would allow me to project an empathetic understanding of their issue, which could allow them to accept a non-judgemental response that in turn could help to shift their perspective of the “problem” which according to Erickson’s theory should allow the client an opportunity to view the problem as a potential resource.

EXAMPLE ANSWERS: Q7

Q7. What approach would you take when hypnotising a child?

Learning outcomes: 1.1

Student answer When working with children there are additional factors which need to be considered by the therapist. This is to ensure safe, legally compliant practice which adheres to the General Hypnotherapy Register code of Ethics. It is likely that any request to work with a child will come from a parent or guardian. However legally and for safeguarding purposes a child is considered as anyone under 18 years old and written permission from the parent or guardian must be obtained if someone is under that age. It would also be advisable if not essential to have a current Disclosure and Barring Service (DBS) clearance which can be verified as required. This provides assurance to all parties that the therapist does not have convictions – in particular ones in relation to working with children and may be a requirement of therapist insurance. When agreeing to work with a child, having a chaperone in attendance is also strongly recommended. This could be the parent or guardian but could also be an older sibling or friend if this is more appropriate. The methods used for work with children will need to be imaginative, interesting and fun. Use of play, Ericksonion metaphor story telling or a guided visualisation is more likely to engage children and ensure that they are able to fully participate in a session. An induction may be shorter as often children are better able to bypass the critical factor and progress into the body of the session. Engagement with the method used is key – and a variety may be required within one session. Children’s attention span will increase with age and a guideline can be obtained from the attention displayed within the meta questioning – it is easy to see when a child is losing interest in what you say! Language used should match the child’s where possible –in sentence length, content and tone. This promotes engagement and is likely to build rapport. When working with children it is often useful to have an understanding of where they are in their own personal development and how this compares with child development milestones. For example their parents may describe a child as not being sociable or as over social without fear but there are stages of childhood in which this is not unusual. As a therapist it is also important to expect or anticipate that a child will be less likely to sit still; they may vary in the depth of their trance and may need to be re-oriented and re-engaged at intervals. However all of these factors vary from child to child and it is as important to treat as individuals as it is with adults. (LO 1.1 An understanding of advanced interventions)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table Correct, you have demonstrated an understanding of this advanced form of intervention and brought up some important practical considerations and insightful points.

Further Student Answer Example:  Personally I would not choose to work with children, however for those therapists who do they have to take into account certain factors:

As their client is under the age of consent they need written permission of the parent / guardian as well as a current CRB certificate for working with children, and a chaperone should be considered in many circumstances.

The formal style of hypnosis generally used today would not be recommended for children as they struggle with their attention span so are difficult to induce using the normal form of hypnosis.

As children are more imaginative than adults the preferred forms include play therapy, Ericksonian metaphor story telling, a guided visualisation such as between the child and the therapist making up a story where the client is the central player and the therapist leads the story feeding appropriate suggestions to bring about the required changes.

...the Utilisation Technique is particularly useful with the resistant client and that resistance may well be due to the subject matter being uncomfortable for the client to discuss or where the clients, as you say, are so deeply focussed on their own problems that the usual approach may be filtered out of awareness. Sexual matters, financial matters and emotional discord are examples where the client may feel uncomfortable discussing matters and where it is important to adopt a matter of fact approach or, to project this empathetic understanding and adopting a sincere acceptance of the situation. Utilisation of whatever they bring to the session is helpful in the therapy.

EXAMPLE ANSWERS: Q6

Q6. In a maximum of 1500 words, explain what is meant by the term extratherapeutic factors, how you would get to know about them from the client and suggest an example that may impact on the outcome of therapy.

Learning outcomes: 1.9

Student answer For the therapist it may be disappointing to realize that the majority of the ’magic’ of therapy can be attributed to factors other than the content of the therapy itself: Lambert (1992) attributes 40% of the outcome to extratherapeutic factors; 30% to relationship factors; 15% to expectancy and hope and a mere 15% to techniques and models of the approach. As the largest proportion of influence it is important to understand what is meant by extratheraptic factors; every human is a complex blend of ingredients which make them unique within this world. This is the joy of being human and no one person is exactly the same as any other. “The only thing that made me, or any of us, special was that no one in the whole of history would ever see the universe in exactly the same way any other of us saw it” Morrison G (2011) Within therapy this means that the response to every client and indeed within every session must be tailored to the unique individual who will be participating in it. So what factors are included? Although not a definitive list the following may have influence: the environment in which a client exists; what support they have; their inner strengths, abilities, and chance events (Hubble et al 1999). Even within this list there is variation reflecting the true individuality of a human – support for one person might mean family; to another a pet or a friend or any combination of all… For one person “Faith” may mean a religious creed, for another a set of values to live by. Every experience – positive or negative; past or present; real or imagined - has made the person who they are and influences how they will respond to life let alone any interventions. Before commencing therapy, metaquestioning and the creation of the therapeutic contract will elicit some of these factors. It is essential that attention is paid to what is both said and unsaid; a client may express an outcome they believe they desire only for fears or beliefs to create an unconscious sabotage. Asking ‘around’ a subject to see if there are different responses, checking your understanding is correct, asking what a term which is used means to an individual are all techniques which may assist. A client’s honestly held belief should not be directly challenged but finding out if the stated anticipated outcome is congruent with the clients life is an important factor. “Do not free a camel of the burden of a hump; you may be freeing him from being a camel” GK Chesterton An example from my own practice was working with a female client who wanted to “stand up for herself better”. Firstly we examined what ‘better’ meant to her – how would this be seen, experienced – how would she feel if she stood up for herself “better”? This produced some interesting results – she was often perceived as aggressive when she did stand up for herself and then felt very sad and angry with herself afterwards. However ‘better’ was also linked for her with dominance, ‘winning’ an argument and being heard. She worked in an environment in which there was a culture of competition and challenging dominance. Further questioning elicited some interesting confounding variables. Her upbringing had produced some beliefs that women should not be assertive – they should be subservient to men, to elders and to ‘her betters’. She feared being called ‘manly’ which she associated with being dominant in a conversation. On a conscious level she felt strongly that she “should” be able to be an equal in any conversation and assert her opinion but at the same time subconsciously she felt this was disrespectful and rude – not being rude was extremely important as a value for her. Often she overcompensated especially if she felt she was being talked ‘over’ or was asked not to shout and therefore was perceived as even more aggressive. She also still lived at home with her parents and was experiencing conflict with respect and the balance of being an adult. We concluded that the work needed to focus on how she felt when she wanted to make a point – being calm, with a normal voice tone and feelings of being able and entitled to make a valid point. This example illustrates the power of the subconscious and the extratheraputic factors which needed to be considered. In this case these included gender, upbringing, age, personal and family expectations and her job role. (LO 1.9 An understanding of the nature and impact of extratherapeutic factors)

Further example Student Answer:    Extratherapeutic factors are other elements of the client’s character and their issues that are brought to the therapy session, such as life experience, their knowledge (which includes knowledge of therapies) their strengths and fears etc. their willingness to participate in the therapy. An older person is not necessarily wiser or mentally stronger than a younger person, a more informative factor would potentially be a greater experience of life. Also someone who is afraid of losing control will require a different style of induction from a somnambulist.

This can also include hidden issues even the client may not fully realise they have such as nail biting due to past stresses. A client may present with a lack of motivation only for meta-questioning to expose a fear of success as a deeper issue. Some fears may be illogical to the client and possibly even the therapist and as such the therapist must recognise and take into account such fears during the session.

A detailed and thorough Meta-questioning will help to identify such areas of concern and their meaning to the client allowing a more productive intervention to take place. If the meta-questioning is not sufficiently deep enough or the client evasive / refuses to divulge information relevant to the issues then the outcome of the session will be unsuccessful in most occasions as the root of the problem needs to be dealt with or it will either return or produce different symptoms neither outcome is helpful to the client or the therapist.

Q6. RESUBMIT PLEASE

The first two parts of Q6 are correct, however please elaborate on the example that may impact on the outcome of therapy. With the nail-biting issue that you have offered as an example, specifically which metaquestions would you ask in order to expose the fear of success?

n-depth meta-questioning should reveal the true thought process behind a clients actions even if they do not consciously know themselves. They state they are lacking in motivation for a project but later reveal they actually fear successfully completing a project, as they would then have to deal with other issues such as praise, recognition or promotion and more responsibility.

A person may state they want to stop biting their nails when stressed, on basic questioning they might offer a reason of they have always done so or they don’t think about it, offering that it just happens.

On deeper questioning the true nature of the habit may be revealed to be they consider only beauty obsessed people would have nice nails and they do not consider deep down they are worthy, or they are putting their fingers to their mouth to stop them saying something they feel they shouldn’t at the time of being stressed such as telling someone off or swearing etc.

My line of questioning would (obviously dependant on their individual response to each question) be along the lines of:-

Was there a time when you didn’t bite your nails?

Can you remember the first time you started to bite your nails? (possibly using regression to establish the trigger)

What do you feel when you notice you’re biting your nails?

How do you feel when you are biting them?

“But if you did know the answer, what would it be the reason?”

or

When you look at your nails what do you see?

How does that feel?

If you were to have nice nails what would that mean to you?

And how would that feel?

The particular client with nail biting issues was a young quite attractive female in a fairly pressurised job complained of poor nails, blaming stress as the cause, on questioning she eventually revealed she didn’t want to be perfect (pretty, nice hair, figure AND nice hands) as she might lose some friends, so to remain flawed she would keep her hair fairly plain (required for work anyway) wear baggy clothes and bite her nails and the skin around them to have ‘horrible’ fingers…

To proceed with a particular direction of therapeutic suggestions to stop her biting her nails would be difficult as her sub conscious desire not to be “perfect” would fight any suggestions to stop the stress biting and grow beautiful nails and take pride in her fingers etc. By establishing the thought processes and root cause, the therapist could work on the real issues and thus the session would become more successful.

This particular client has had an initial consultation to discover the issues but she acknowledges the root issues isn’t ready yet to move forward from this position but has promised one day she will visit for therapy to release her fear.

Thank you for this resubmission Bob and it is very useful to acknowledge the approach and success you have had with this particular client and the revelation of the reasoning’s behind such behaviour. A thorough, specific and unique answer. 

EXAMPLE ANSWERS: Q4

Q4. Which of the following are NOT a factors of 'pseudoscientific therapies/treatments'?

1. Does not adhere to a valid scientific method
2. Lacks supporting evidence
3. Lacks plausibility
4. Cannot be reliably tested
5. Involves the use of sugar pills
6. Vague, contradictory or improvable claims
7. An over reliance on claims rather than evidence

Learning outcomes: 5.6

Student answer It is unlikely that pseudoscience would use XXXXXXXXX and therefore it should not be considered as a factor of 'pseudoscientific therapies/treatments' The following ARE factors of pseudoscientific therapies/treatments' Does not adhere to a valid scientific method Lacks supporting evidence Lacks plausibility Cannot be reliably tested f) Vague, contradictory or improvable claims g) An over reliance on claims rather than evidence (LO 5.6 An understanding of the term 'pseudoscientific therapies/treatments'.)

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

EXAMPLE ANSWERS: Q2

Q2. Giving examples of classic non-commitment language, identify a client lacking commitment to the behavioural change they state they would like and discuss methods of increasing motivation and inspiring desired change.

Learning outcomes: 2.2

Examples of non-commitment language include ‘I might want to stop eating sugary foods’; ‘I want to lose weight but I don’t want to change my diet’; ‘I want to make changes some of the time, like during the week, but would like to have weekends off’; ‘I thought I might like to lose some weight’; ‘I can’t understand why I have gained so much weight’; ‘I can’t seem to be able to make lasting changes to my diet’; ‘I’m not ready to make changes straight away but would like to learn how I can be more ready in the future’; ‘I just have so many problems and issues around this whole “weight loss thing” I just don’t know where to start’. Increasing motivation can be achieved through actual post hypnotic suggestion, and also through the line of questioning used. Using suggestions within a hypnosis session could be achieved through the ‘control panel’ method, asking the client to locate their internal control panel then more specifically the dial/lever/switch for ‘motivation to change [Specified behaviour]’ turning the motivation down, looking for a physical response to indicate that the process has been carried out- such as a finger movement (ideomotor response/reflex, IMR), then adjusting the dial/lever/switch to increase motivation and getting another IMR to signify that the change has taken place, also looking for facial expressions and/or physical reactions (such as sighing or smiling or relaxation of facial muscles) to indicate that the client has made those positive changes. It is also possible to inspire motivation to change an unwanted behaviour through questioning alone. People who are finding it hard to make change are generally ambivalent about change, they are unsure whether they want to change or whether they want to continue doing the same things- they feel two ways about it. Resolving the ambivalence and therefore increasing motivation to change can be achieved through questioning and listening and building rapport in a very short space of time. Using a mixture of open questions –‘when do you think your issues with food started?’, ‘What do you think is the root cause of your issues with food?’- and closed questions, ‘Do you want to make changes to your behaviour?’, ‘when will you start?’- the therapist can guide a client towards being more motivated and less ambivalent about making permanent change. Leading and directing the client can take shape using questions such as ‘if you make no changes at all then how can you see your life in 5 years time? How about if you made those changes now? How will you be, then, in 5 years? Encouraging the client to imagine their life without addressing and making changes can help them to be more motivated to change. It is very important to build good rapport with the client in every situation as a hypnotherapist who does not have good rapport with their client will yield poor results. The therapist needs to instigate a number of different questioning techniques in order to increase motivation and desire to change, such as future pacing (as mentioned) and leading questions (“What do you think about restrictive dieting? Many people tell me that they consistently fail when dieting”); Loaded questions ‘Have you already stopped overeating or do you want to stop that now?’. I had a client who had what she called ‘an addiction to sugar’. She repeatedly chose foods that were high in sugar despite the fact that they left her feeling tired and sick and made her gain weight. She had had gastric surgery and lost a vast amount of weight in a very short period of time and was in face now under the weight that her surgeon had advised her to reach, though still a healthy weight. She found that even though she knew the risks involved with eating sugary foods- such as diabetes, she had had chronically uncontrolled type 2 diabetes prior to surgery though this was under control at the time of her session, her weight had been fairly stable at her low end of the range for several months though in the past few weeks she had gained a couple of pounds, she felt physically unwell after having what she called ‘a chocolate binge’. Despite all the alarm bells that were ringing for her she reported feeling very demotivated when it came to changing her behaviour and was finding that her own version of ‘trying’ to cut down or have will power just wasn’t working any more. I led her towards feeling more motivated by asking her questions about how and where the behaviour had originated, how she felt about her body, how she had come to terms with being a significantly smaller weight and size, how she felt her relationship with food and with herself and others had changed as she had changed and delving into whether she believed that she was worthy of making lasting and healthy changes to her behaviour. It turned out that she was ambivalent about changing her behaviour and lacking in motivation in part because she still felt like ‘the fat woman’ and like she had no right to look and feel good. Her self-esteem and self-worth were severely low and I was able to steer her thinking and attitude in the direction of the root issue- that she felt unworthy of being slim and healthy, without even going into too much detail about how that attitude had manifested- eg her experiences as a child- she began to see for the first time how much she had allowed that inappropriate view of herself control her behaviour and how unnecessary it was to live up to that out-dated view of herself and I could physically see her thinking change and her motivation to change her behaviour increase without ever having to address her original lack of motivation whilst she was in trance.

From your first section of this answer I would have advised you to be more specific, in terms of taking each example you stated and then addressing each one in turn, rather than generalising. However, your very specific actual client experience addresses this and tells me how you have not only understood the question but have had real time experience of it. Additionally, the generalisations are valid and true though and add much to communicate your understanding of the question.

(Further student work goes here if requested through feedback)

Q2. Giving examples of classic non-commitment language, identify a client lacking commitment to the behavioural change they state they would like and discuss methods of increasing motivation and inspiring desired change.

Learning outcomes: 2.2

Student answer Classic Non-commitment language is characterised by disassociation with the action or event. An example of this when working with a person presenting as wanting to lose weight is as follows: “I have tried everything but I can’t seem to be able to lose any weight. Sometimes I do lose a tiny amount but I do try hard. I’d like to do something about it – I thought I might try and go to slimming world but its on a Tuesday and my husband sometimes has to work late. I should have done something a long time ago but there are so many nice things to eat” Problems – Use of might – not a commitment to action. Use of ‘should’ and ‘able’ - can imply blame and hopelessness Repeated use of try/trying/tried – this is not action or commitment Use of past tense; the language implies this is not current – the individual may have ‘given up’ Use of thought – past tense and not implying action will occur I’d like to – implies that something is stopping them – not I will or I want to In order to address this I would discuss some of the options having first developed rapport with the client. I would seek to achieve a commitment to a specific action. I would need to look at the barriers and seek to overcome these. Firstly I would explore the reason the individual wants to change – is this real? Does the individual actually want to commit to this path? I would explore language used – for example going through the response and changing ‘should’ for ‘could’ and ‘can’t’ for ‘choose not to.’ This is likely to change the dynamic from passive to being present within the statement and therefore closer to the solution. I would also redirect from might and try to more active measures – “so what will you do…” This leads to more concrete and realistic aims and goals – be this to lose a pound a week or the impact that this will have; when I lose a pound I will feel more confident. This leads to being able to explore what feeling more confident would look and feel like which enables re-framing; so when you have lost a pound a week, you will look and feel that your clothes fit better and that you know you are on a path where you feel attractive and confident. By using positive language and assuming positive outcomes this increases the likelihood of these becoming the reality. I would reflect back statements whilst framing them which enables the client to agree or to adjust in a more committed way. For example changing might – which is non-committal- to will; prompting the client to commit to change. Alternatively the emphasis on certain words can prompt a client into recognising the non-commitment and reframe themselves: “you are going to try?” I” ….”I mean I will….” In further sessions and having achieved the desired weight loss, I re-emphasise and reinforce all of the positive changes that have been made. Future pace could be used to allow her to imagine herself in the future state – with clothes fitting in the way that she would like them to. (LO 2.2 A demonstrable understanding of psychological theories of motivation and behavioural change and an ability to apply this to clinical practice.)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct. A comprehensive and detailed answer to this question, giving appropriate examples and clearly citing the language of non commitment and your ability to respond to such and to motivate accordingly. A pleasure to read, thank you.

Further Student Answer Example: Clients who respond to Meta-questions with “I’d like to try and explore the reasons why”” or “I thought hypnosis might be able to help” or “I’d like to be able stop” are not committed to the change process. By working through the Meta-questioning you can establish what the client really wants and where possible what is stopping the achieving of it. By identifying the blocks holding them back you can change their perspective on how big, bad or difficult these thoughts are in making their lives better and then explain how by making a few changes to their thought patterns these blocks can be removed or overcome. You can then encourage them in or out of hypnosis to produce an image (complete with attached emotion) of them successfully achieving their goal. Q2 RESUMBIT PLEASE. Your answer is good as far as it goes, though is somewhat general. I would like to see you please give a specific example of a client seeking a specific change and follow through with advice on increasing motivation and inspiring change. Taking your example of “I’d like to be able stop” spoken to a smoker, what would your reply be to such a statement? How would you uncover the blocks you speak of and encourage the change? Exploring more as to why they wish to stop smoking followed by the reason they were using the non-committal wording “I’d like” rather than a more empowering “I want”. I would ask what they think is preventing them from actually quitting the habit? Going as far as what would they need to change their answer into a more positive one, making notes for future use in the session. Drilling down into their answers when asked what they actually get from smoking, such as gathering with friends to smoke and gossip or a feeling of stress release felt during smoking. I would also ask is there anything else that might give them the same feelings of being part of the group or releasing of stress? Using a representation of their own relevant aversion images I’d get them to understand how smoking will hurt their future and that of the people they love (family etc.), adding in any other additional motivations discovered during the meta-questioning process, such as living longer and being happier and healthier, allowing them to run around and play with their future grand children rather than a doom and gloom vision of lying in a hospital bed on oxygen with grey skin fighting for breath with their family sat around crying etc. Using the New Behaviour Generator to provide more effective and healthier methods of dealing with stress so they no longer needed cigarettes. Utilising all the information gained in the meta-questioning I would feedback to them the positives they would gain and the negatives they fear could occur if they do not change and re-enforcing the benefits of making the changes along with suitable anchors to ensure they maintain their motivation. CORRECT. Thank you for this resubmission which is exactly what I was looking for. The example and how you would deal with the situation is excellent.

EXAMPLE ANSWERS: Q1

Student answer

1.1: [X] is not a leading question. (LO 1.8 An ability to recognise 'leading' questions.)

1.2 Give three examples of loaded questions and when and why you would use these.

 Learning outcomes: 1.71.2

Loaded questions can be used to infer a statement as fact. Instead of asking ‘do you’ ‘did you’ type questions, the stance that an event has occurred is taken as fact and the rest of the question hinges from this. In order to answer the question, there is agreement that the inferred event did in fact take place

Examples

• “When did you stop making yourself sick after a meal?” This would be used to imply the individual has done this action and also that it has stopped
• “How often did you cheat on your wife without her realising” This would be used to imply the individual has cheated and has not been caught in the past
• “After you stole the purse, where did you go?” This would be used to imply the individual has stolen the purse and then left

(LO 1.8 An ability to recognise 'leading' questions)

1.2 Give three examples of loaded questions and when and why you would use these. Learning outcomes: 1.7

“When did you start to overeat?”- Assumes that the respondent overeats and began to do it at some point that they can remember. We could use this to determine the period or age that a client began over eating and this would help the therapist to cut straight to the point and put pressure on the client to take ownership of their behaviour rather than trying to sugar coat it and not take responsibility. “Do you still blame yourself for your childhood experiences?” - Assumes that the respondent blames themselves for something that happened to them as a child and that there was a specific point at which this behaviour started to occur. We could use this question to help the client to see that they have been blaming themselves for something that was possibly out of their control, and to help us and them to understand that they are still doing this to a certain extent. “Have you quit smoking already then? or do you want to quit now?” – This assumes that the person was or still is a smoker and that if they haven’t already quit then they only have the choice to quit right away. It would e useful in questioning a client who wants to give up smoking and encourages them to make the decision to quit straight away rather than delaying it and having a get-out-clause.

Correct. In leading the client in this manner, it invites resistance and discussion. The client could protest that in fact their weight condition has little to do with the amount of food they eat and perhaps it is their metabolism at fault. Or they could agree that they DO overeat and you can then explore the reasons as to why that occurs. Good answer. Correct. Having suspected that the client does in fact blame themselves in this manner which could be to their detriment this gives the client the opportunity to discount or agree and you can then explore both avenues. Correct. Using the presumption that they may already have quit (in fact, it is a technique to be utilised in that you are drawing attention to the very notion that they are NOT smoking right now, so in actuality, they are sitting in front of you as a non smoker!). They are lead to explore the notion of what being a non smoker would be like and may then volunteer difficulties and restrictions that having given up smoking would present. You are also of course implying that if they have not already given up, they will be doing so now. Well done.

(Further Student answer here) Q1.1 d - Do you want to stop eating chocolate? Q1.2 i) How much more weight are you prepared to put on before you finally decide enough is enough? Loaded questions like this are often a last resort and shortcuts to bring a client to focus on their desired outcome, especially when time is running out in a session. The question assumes that they will have outlined the problems arising from their being overweight but have been prevaricating or showing reticence about taking the final step. Questions like this should be used with care, as they risk breaking the rapport established between client and therapist but are a means of getting to the crux of their problem(s). The question is a reminder that they need to take ownership of their current behaviour NOW and that they have sole responsibility for moving towards the changes they seek. ii) Why did you feel you needed a new plasma TV when you haven’t been able to pay your mortgage for three months? This loaded question is a something of a slap in the face for the client. Here the therapist is trying to establish that a client with an over-spending habit, really understands the position they’re in and the consequences of their continued behaviour.  If they appreciate the negative consequences implied by the question then they are ready for change. Not to accept the consequences or to defend or justify their position would indicate that they are not ready for change. Depending on the stage reached in the session, this could mean calling a halt to proceedings or resorting to a further round of meta-questions to see if the client can be turned around. iii) So will you give up smoking, or risk another stroke? This is an example of a loaded question set in a blame frame context conveying the message that “you’ve had a stroke and if you don’t give up smoking, you’ll have another one and probably die!” It assumes that their smoking habit has a direct connection with their poor health, but is probably a fair assumption given the weight of evidence. The meta-questioning should have revealed that the client does really wish to become a non-smoker. In a case where they subsequently show reluctance to quit, this question presents the client with a dilemma and puts pressure on them to take ownership of their behaviour and control over their health.

FAST PHOBIA CURE - UNITY STYLE

 The Fast Phobia Cure

1. Client thinks of something that causes them to feel fearful - notice their displayed behaviour (ensure that there is a true phobic response and change of state, eg rubbing neck, distaste display (downturned mouth), giggly voice, shudder, elevated breathing etc). Break state.
   
   
2. Stack up positive resources and ANCHOR them at their most intense (touch shoulder, eg). You are looking for true past experiences of the resources they will need, such as confidence, curiosity, humour. Double and intensify. Release anchor.
   
   
3. Instruct them to recall the earliest event they can remember when they had those fearful feelings, though not to go into them YET. In a moment you will ask them to MARK the beginning of the event.
   
   
4. While they have that memory out in front of them run the fast phobia model :
   
   Imagine yourself in a cinema, sitting in front of the blank screen. Relaxed.
   
   Now float out of your body, so that you are looking at the back of your head and go into the projection room, looking at yourself watching the blank screen.
   
   In a moment, you are going to run the film from JUST BEFORE the event occurred, when you KNEW YOU WERE SAFE, and PAUSE the image. MARK THE FILM NOW.
   
   Drain all the colour and sound from the still image.
   
   Now, WHEN I SAY SO, you are going to fast forward the film at lightning speed, though only WHEN I SAY SO, right the way to the end of the film, to the moment JUST AFTER the event, WHEN YOU KNEW YOU WERE SAFE. And you will MARK THE FILM. When you come to the end you will NOD, ok?
   Do it NOW (use anchor) (sing or play silly music like Benny Hill theme) until the nod.
   
   Now, this time you will REWIND the film at double speed from the end of the scene WHEN YOU KNOW YOU ARE SAFE right back to the beginning WHEN YOU KNOW YOU ARE SAFE, with all of the images running backwards, in black and white with no sound at all ok? (make sure you get agreement).
   Do it NOW (hold anchor, play music again and notice change of state)
   
   [do this backwards replay again THREE TIMES, adding sound and colour as necessary, making voices squeaky or funny etc, the idea being to REFRAME]
   
   Float back into the YOU that is watching the film. [suggest this is OLD news]
   
   Float back into the film itself and enjoy experiencing this old worn out movie in a new way, with all the experiences, wisdom and insights the present you has.
   
   
5. Now tell them to come back to the present moment and open their eyes only as quickly as it takes their subconscious to make all the changes it needs to make so that they can be completely free of the past and return feeling confident, calm, positive and relaxed.
   
   
6. When the unconscious is done suggest they open their eyes (remember to TEST!)

c The Unity Principal 2011