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CH H1 Assess the needs of the client (Hypnotherapy)

Overview

This standard describes the role of the practitioner in assessing clients’ needs which affect their health, effective functioning and well-being. This involves evaluating requests for hypnotherapy and the initial information received on the client, whether it is provided by the client him/herself or comes from another source, such as a referral. In doing this the practitioner needs to consider whether it is appropriate to work with the client or not. The evaluation will include determining the urgency of the client’s needs and the overall caseload of the practitioner, together with making the necessary arrangements for the assessment to take place. If the decision is made to see the client, the nature and purpose of the assessment is agreed with them and their needs identified. Some clients may be accompanied by a companion(s). Where this occurs the practitioner is expected to interact with the companion(s) in ways that are appropriate to the needs of the client and the needs of the practitioner. The subsequent assessment aims to determine the nature and extent of the client’s needs and to agree a course of action with them. This may be to refer the client to another healthcare practitioner or to develop a hypnotherapy treatment programme or to decide that hypnotherapy is not appropriate for the client. This standard applies to any practitioner whose work aims to enable clients to improve and maintain health, effective functioning and well-being through hypnotherapy wherever they practise. The clients may be seeking to improve and maintain their health, effective functioning and well-being. Equally, they may have no particular health needs or may have acute or chronic conditions, or be terminally ill. They may be new to hypnotherapy, new to the practitioner, established in that the practitioner has been working with them for some while or returning to the practitioner after a period of absence. This standard is based on the premise that for effective assessment to take place, the practitioner needs to understand the clients’ personal, cultural and social situation and the holistic nature of health, effective functioning and well-being. The practitioner must be able to communicate effectively with clients and any companion(s) and balance the information obtained initially with information gained during the assessment. As the assessment process often acts as a gateway to services, there is also a particular requirement for practitioners to monitor clients and evaluate the extent to which services are meeting the needs of the broad community. Where particular issues or incidents cause concern the practitioner is expected to alert their professional body, their employing organisation, or other relevant organisation. Users of this standard will need to ensure that practice reflects up to date information and policies.Version No 1

Knowledge and Understanding

You will need to know and understand:

1.      the professional standards and code of conduct for your therapy

2.      the role of the professional body setting the rules and ethics of your therapy

3.      how the rules and ethics of professional practice and codes of conduct apply to your own practice

4.      why it is important to keep your understanding of professional rules and codes of conduct up to date

5.      how to balance your own responsibilities as a professional with any organisational and contractual requirements

6.      current relevant health and safety legislation and how it applies to your own work role

7.      legislation relating to obtaining, storing and using information and supplying services

8.      the importance of keeping your understanding of legislation up to date

9.      how relevant legislation impacts on your own work

10.  the roles and functions of the principal agencies within the health and social care sector

11.  sources of information within the health and social care sector and how to access them

12.  why it is important to respect the rights of clients

13.  the extent of your own remit as a practitioner and the limits of your responsibilities

14.  how your own role relates to other health and social care practitioners

15.  the organisational requirements and restrictions relating to the use of resources

16.  the range of resources and options available to meet the client’s needs

17.  how to achieve effective communication through observation, sensitive questioning and listening

18.  how to adapt vocabulary, pace and tone of speaking to meet the needs of the client

19.  what forms of verbal and non-verbal communication are available and how to use these positively

20.  how to check understanding with the client by reading and using a variety of signals

21.  how to position self and client to encourage communication

22.  how to recognise and overcome barriers to communication

23.   why certain environments can inhibit communication and how to minimise this

24.  why it is important to encourage the client (and any companion(s)) to ask questions, seek advice and express any concerns

25.   the nature of a professional therapeutic relationship and how to develop it with clients

26.  how to respond to conflicting advice which clients may receive from different practitioners

27.  why it is important to reflect on your own practice and identify any development needs

28.  how to evaluate the effectiveness of your own actions and learn from experience

29.  the information available on effective complementary healthcare and how to evaluate and use this information within your own practice

30.  how the models and concepts in your area of practice have evolved and developed, how these tend to change with time and the similarities and differences between different versions

31.  how to develop links with other healthcare providers and the protocols for doing this

32.  the extent of your own knowledge and competence and how and when to refer the client to another practitioner

33.  the importance of recognising and maintaining the client’s right to confidentiality

34.  how to balance the client’s rights against your responsibility to others

35.   what to take into account when passing on information about clients

36.  what the procedures and requirements on confidentiality, security and transmission of information are for your organisation and for any organisation that you may need to contact regarding a client

37.  ways in which confidentiality may be breached and how to prevent this occurrence

38.  what is meant by “implied” and “informed” consent and the circumstances in which these may arise

39.   the guidance given by your professional body on implied and informed consent and when written consent should be obtained

40.   why it is important to ensure that clients have been given sufficient information to give or refuse consent

41.   who holds responsibility for gaining consent and when this should be done

42.  how informed consent may be obtained from clients who are unable to give the consent themselves and who has the right to give this consent

43.  how to confirm that the agreements reached are likely to be in the clients’ best interest

44.  what the policies on consent, including any specific requirements under contractual agreements are for your organisation and for any organisation that you may need to contact regarding a client

45.  why it important to protect client confidentiality

46.  how to keep records to protect confidentiality and security of information

47.  how to keep records so that clinical audit can be undertaken

48.  why it is important to record all the necessary information in a format suitable for further use

49.  who has the right of access to information held of records

50.  why it is important to acknowledge and respect an individual’s rights and dignity and ways of doing this

51.  what circumstances may indicate a need for an escort/presence of a third party

52.  who may act as a companion for the client and how to interact with them

53.  what your legal and ethical responsibilities are in relation to the client’s health and safety

54.  how to maintain your practice in line with health and safety legislation

55.  how to be supportive to the client (and any companion(s)) whilst managing time effectively

56.  the concept of health, effective functioning and well-being

57.  why it is important to recognise that the client’s previous and present care may affect their health, effective functioning and well-being

58.  how the psychological and emotional balance of the client may affect their health, effective functioning and well-being

59.  the nature of illness and the impact this may have on a client’s health, effective functioning and well-being

60.  how signs and symptoms may be suppressed or altered by other factors such as medication, exercise, diet, drugs and how to obtain information on these

61.  how the diet, lifestyle, physical, social, emotional and economic context in which people live affects their health, effective functioning and well-being

62.  the importance of recognising conditions which may pose a serious risk to the client and when to seek immediate help or advice from other professional sources

63.  how personal beliefs and preferences affect how clients live and the choices they make

64.  the nature of disability and your role in working with those who have disabilities

65.  how an individual’s abilities and disabilities may affect the nature and form of support needed

66.  the history, principles and development of hypnotherapy and its relationship to other healthcare

67.  how to recognise those occasions when hypnotherapy may complement other treatments which the client is receiving

68.  the circumstances when you may choose not to accept a client:

a)      hypnotherapy is unlikely to succeed

b)      the client does not want to continue with treatment

c)      you do not wish to provide the treatment

69.  the circumstances when you must not treat a client:

a)      hypnotherapy is contra-indicated

b)      other healthcare should be sought

c)      you do not have the requisite experience or expertise

70.  the range, purpose and limitations of different methods which may be used for different clients with different needs

71.  how to determine the most appropriate method(s) for different clients and their particular needs

72.  how to recognise conditions for which hypnotherapy is incomplete in itself and for which the client should seek advice from other sources

73.  how to tailor treatment appropriately for each individual

74.  how to judge whether self-care is appropriate for the client

75.  the importance of giving clear and accurate instructions on self-care

76.  Conscious and unconscious process

a)      the functions of the conscious and unconscious process

b)      the basic neural operation of the brain

c)      the difference between the analytical and creative functions of the mind

d)      short and long term memory – how this is stored

e)      false memory

f)        the impact of emotion on memory

g)      how memory corrupts

77.  Stress response

 

a)      fight or flight

b)      the endocrine system and how this interacts with the brain

c)      how psychological response creates physical reaction and vice versa

78.  Breathing

a)      characteristics of breathing

b)      how to recognise changes in breathing

c)      utilising breathing as part of the psychological response

79.  Psychosis

a)      functional and organic psychosis

b)      how to recognise psychosis and the appropriate action to take

c)      appropriate referral action to take if confronted by psychosis

80.  Techniques

a)      direct, indirect, confusion, eye fixation, fractionalisation, trigger, metaphoric, physical induction techniques

b)      how to select appropriate technique(s) to suit the client

c)      how to recognise when not to use certain techniques and the possible consequences of using an inappropriate technique

81.  Theories of psychology

a)      the main theories of psychology e.g. psychodynamic, humanistic/existential, cognitive and behavioural

b)      how these influence your own practice

c)      the importance of keeping your own knowledge up to date

82.  The therapeutic process

a)      how key theories and approaches to treatment can be utilised in therapy

b)      the difference between hypnosis and hypnotherapy

c)      how to be aware of and manage transference and counter-transference

d)      how to develop a working alliance with your client

83.  Methods

a)      the range of intervention methods which may be used, for example

-       direct suggestion

-       indirect suggestion

-       metaphor

-       neuro linguistic programming

-       eriksonian

-       analytical

-       cognitive behavioural

-       regression

-       mechanistic

-       self help (including self-hypnosis and tasking)

b)      the correct use of the different methods

84.  Contra-indications

a)      how to recognise conditions that you cannot treat

b)      when and how to refer clients who are outside the scope of your competence

85.  Abreactions

a)      induced and spontaneous abreactions

b)      how to manage appropriately both types of abreactions

c)      how to recognise the potential for hysteria

d)      how to respond to unexpected reactions

86.  Why advertising should be accurate and truthful

87.  The importance of holding appropriate professional indemnity insurance

88.  Client welfare

a)      The importance of ensuring the welfare of the client

b)      How to recognise and guard against client exploitation through improper use of information gained, extending the treatment unnecessarily, overstepping the boundary in the professional relationship

89.  Continuing professional development

a)      The importance of maintaining your own development and keeping up to date with current practice in your profession

90.  The importance of recording client information accurately and in sufficient detail to use for assessment purposes

91.  Why certain information should be obtained before treatment e.g. family history, medical history, personal details

92.  How to keep records securely

93.  The importance of fostering a rapport with your client

94.  How to utilise appropriate self-disclosure

95.  The different questioning techniques which may be used – open questioning and closed questioning, direct and non-direct

96.  The range of assessment methods which may be used:

a)      suggestability tests

b)      guided interview

c)      questionnaire

d)      subjective unit of distress (SUDS)

e)      observation

f)        personality profiles

g)      depth scales

97.  How to select the appropriate assessment method for your client

98.  how to provide an appropriate assessment environment for the client and the importance of doing so

99.  how to select, prepare and use a range of equipment and materials that are needed to assess the client

100.       how to prepare and present yourself correctly to carry out assessment

101.       why it is important to introduce everyone present and confirm their role within the assessment process

102.       how to clarify and confirm the client’s (and any companion’s) understanding of the assessment process

103.       how to interpret the client’s initial approach and manner and identify their needs

104.       how to select and use different assessment methods effectively

105.       the amount of time which each assessment method is likely to take to establish the client’s needs

106.       the importance of respecting the client’s privacy and dignity and affording them as much comfort as possible during assessment

107.       how to establish valid and reliable information about the client, determine its importance and formulate your initial hypothesis

108.       the information which would confirm or deny your initial hypothesis and the reasons for this in particular cases

109.       how to deal with inconsistent information gathered during assessment

110.       the potential risks of various courses of action for the client and how to assess these realistically in terms of priority of need

111.       the range of resources and options available to meet the client’s needs

112.       why it is important to acknowledge your own limitations and when there may be a need to refer the client on to other healthcare practitioners

why it is important to explain the reasons for any delay between requests and assessment

Performance Criteria

You must be able to do the following:

1.      evaluate requests for services for their appropriateness

2.      suggest alternative service providers to clients, where appropriate

3.      communicate verbally or in writing in a manner, and at a level and pace appropriate to the individual

4.      establish the client’s particular requirements through sensitive questioning

5.      determine the severity of the client’s needs or the risk of their condition deteriorating

6.      ensure that any fee structures, charges and different methods of payment are clearly understood

7.      explain possible outcomes, charges and duration of services to the client

8.      arrange a suitable time and location for the assessment and agree those who should be present

9.      explain clearly the reasons for any delay between requests and assessment

10.  record arrangements made for the assessment fully and accurately

11.  ensure that the assessment environment is appropriate for the client and their needs

12.  present a professional appearance and be prepared and fit to carry out the assessment

13.  ensure that the equipment, materials, and surrounding work area are prepared and meet professional codes of practice, legal and organisational requirements

14.  evaluate the client’s initial approach and manner to assess their needs

15.  introduce the client and any companion to those present and confirm individual roles

16.  communicate effectively and in a manner which maintains client goodwill, trust, confidentiality and rapport

17.  explain the nature, scope and duration of the assessment and any related interventions

18.  inform the client of the records to be made and their right of access to these

19.  encourage the client to ask questions, seek advice and express any concerns about the assessment

20.  confirm the consent of the client, and where appropriate their companion, to the assessment

21.  interact with any companion(s) of the client in ways that are appropriate to the needs of the client and to your needs

22.  respect the client’s privacy and dignity throughout the assessment and ensure they are as comfortable as possible

23.  position the client for effective interaction and to minimise risk of injury to self and discomfort to the client

24.  conduct the assessment in a manner which encourages the effective participation of the client and meets their particular requirements

25.  support the client to identify significant aspects of their lives and use this to inform the assessment

26.  where possible determine any contra-indications or restrictions to assessment and take appropriate action

27.  use assessment methods which are safe, appropriate to the client’s presenting condition and comply with professional and legal requirements

28.  systematically establish the client’s needs and draw valid conclusions

29.  seek advice and support from an appropriate source when the needs of the client and the complexity of the case are beyond your own remit or capability

30.  halt the assessment at the request of the client or when the information obtained means that it is unsafe to proceed

31.  inform the client when additional information is required and obtain their consent to obtain the information

32.  ensure records meet organisational requirements

33.  explain the outcomes of the assessment clearly and in a manner, level and pace appropriate to the client

34.  balance possible successful outcomes with any inherent benefits and risks and the legal duty of care to the client

35.  inform the client of the content, level of risk, duration and projected costs of the proposed action

36.  explain any restrictions to hypnotherapy and advise on unrealistic expectations

37.  advise the client where hypnotherapy is unsuitable and enable them to seek other healthcare where appropriate

38.  recommend and agree action to suit the client’s condition and identified needs

39.  record the outcomes of the assessment accurately and in sufficient detail to meet professional requirements

40.  store the records securely

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):Dimension: HWB2 Assessment and care planning to meet people's health and wellbeing needs
CH H1 Assess the needs of the client (Hypnotherapy)
Final version approved June 2010 © copyright Skills For Health,
For competence management tools visit tools.skillsforhealth.org.uk