CH H2 Treat the client (Hypnotherapy)


This standard describes standards for planning, implementing, monitoring and reviewing hypnotherapy treatment programmes for clients. The actions which the practitioner takes should be planned and evaluated with the clients concerned.

This unit applies to any practitioner whose work aims to enable clients to improve and maintain their 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 treatment planning and implementation to take place, the practitioner needs to understand the context of the client 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) of the client and integrate their work with that of other practitioners. Throughout the process, clients and any companion(s) are encouraged and supported to take an active part and this is enhanced by the practitioner using, as far as is possible, interventions which are sustainable by the client in their own context.

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. how to achieve effective communication through observation, sensitive questioning and listening
  17. how to adapt vocabulary, pace and tone of speaking to meet the needs of the client
  18. what forms of verbal and non-verbal communication are available and how to use these positively
  19. how to check understanding with the client by reading and using a variety of signals
  20. how to position self and client to encourage communication
  21. how to recognise and overcome barriers to communication
  22. why certain environments can inhibit communication and how to minimise this
  23. why it is important to encourage the client (and any companion(s)) to ask questions, seek advice and express any concerns
  24. the nature of a professional therapeutic relationship and how to develop it with clients
  25. how to respond to conflicting advice which clients may receive from different practitioners
  26. why it is important to reflect on your own practice and identify any development needs
  27. how to evaluate the effectiveness of your own actions and learn from experience
  28. the information available on effective complementary healthcare and how to evaluate and use this information within your own practice
  29. 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
  30. how to develop links with other healthcare providers and the protocols for doing this
  31. the extent of your own knowledge and competence and how and when to refer the client to another practitioner
  32. what to take into account when passing on information about clients
  33. 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
  34. ways in which confidentiality may be breached and how to prevent this occurrence
  35. the guidance given by your professional body on implied and informed consent and when written consent should be obtained
  36. why it is important to ensure that clients have been given sufficient information to give or refuse consent
  37. who holds responsibility for gaining consent and when this should be done
  38. 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
  39. 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
  40. why it important to protect client confidentiality
  41. how to keep records to protect confidentiality and security of information
  42. how to keep records so that clinical audit can be undertaken
  43. why it is important to record all the necessary information in a format suitable for further use
  44. who has the right of access to information held of records
  45. what circumstances may indicate a need for an escort/presence of a third party
  46. who may act as a companion for the client and how to interact with them
  47. how to maintain your practice in line with health and safety legislation
  48. how to be supportive to the client (and any companion(s)) whilst managing time effectively
  49. the concept of health, effective functioning and well-being
  50. how the psychological and emotional balance of the client may affect their health, effective functioning and well-being
  51. 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
  52. how the diet, lifestyle, physical, social, emotional and economic context in which people live affects their health, effective functioning and well-being
  53. 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
  54. how personal beliefs and preferences affect how clients live and the choices they make
  55. the nature of disability and your role in working with those who have disabilities
  56. the history, principles and development of hypnotherapy and its relationship to other healthcare
  57. how to recognise those occasions when hypnotherapy may complement other treatments which the client is receiving
  58. the circumstances when you may choose not to accept a client:
    1. hypnotherapy is unlikely to succeed
    2. the client does not want to continue with treatment
    3. you do not wish to provide the treatment
  59. the circumstances when you must not treat a client:
    1. hypnotherapy is contra-indicated
    2. other healthcare should be sought
    3. you do not have the requisite experience or expertise
  60. the range, purpose and limitations of different methods which may be used for different clients with different needs
  61. how to determine the most appropriate method(s) for different clients and their particular needs
  62. how to recognise conditions for which hypnotherapy is incomplete in itself and for which the client should seek advice from other sources
  63. how to tailor treatment appropriately for each individual
  64. how to judge whether self-care is appropriate for the client
  65. the importance of giving clear and accurate instructions on self-care
  66. conscious and unconscious process
    1. the functions of the conscious and unconscious process
    2. the basic neural operation of the brain
    3. the difference between the analytical and creative functions of the mind
    4. false memory
    5. the impact of emotion on memory
    6. how memory corrupts
  67. stress response
    1. fight or flight
    2. the endocrine system and how this interacts with the brain
    3. how psychological response creates physical reaction and vice versa
  68. breathing
    1. characteristics of breathing
    2. how to recognise changes in breathing
    3. utilising breathing as part of the psychological response
  69. psychosis
    1. functional and organic psychosis
    2. how to recognise psychosis and the appropriate action to take
    3. appropriate referral action to take if confronted by psychosis
  70. techniques
    1. direct, indirect, confusion, eye fixation, fractionalisation, trigger, metaphoric, physical induction techniques
    2. how to select appropriate technique(s) to suit the client
    3. how to recognise when not to use certain techniques and the possible consequences of using an inappropriate technique
  71. theories of psychology
    1. the main theories of psychology e.g. psychodynamic, humanistic/existential, cognitive and behavioural
    2. how these influence your own practice
    3. the importance of keeping your own knowledge up to date
  72. the therapeutic process
    1. how key theories and approaches to treatment can be utilised in therapy
    2. the difference between hypnosis and hypnotherapy
    3. how to be aware of and manage transference and counter-transference
    4. how to develop a working alliance with your client
  73. methods
    1. the range of intervention methods which may be used, for example
      1. direct suggestion
      2. indirect suggestion
      3. metaphor
      4. neuro linguistic programming
      5. eriksonian
      6. analytical
      7. cognitive behavioural
      8. regression
      9. mechanistic
      10. self help (including self-hypnosis and tasking)
        1. the correct use of the different methods
        2. contra-indications
          1. how to recognise conditions that you cannot treat
          2. when and how to refer clients who are outside the scope of your competence
        3. abreactions
          1. induced and spontaneous abreactions
          2. how to manage appropriately both types of abreactions
          3. how to recognise the potential for hysteria
          4. how to respond to unexpected reactions
        4. why advertising should be accurate and truthful
        5. the importance of holding appropriate professional indemnity insurance
        6. client welfare
          1. the importance of ensuring the welfare of the client
          2. 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
        7. continuing professional development
          1. the importance of maintaining your own development and keeping up to date with current practice in your profession
        8. the importance of recording client information accurately and in sufficient detail to use for assessment purposes
        9. why certain information should be obtained before treatment e.g. family history, medical history, personal details
        10. how to keep records securely
        11. the importance of fostering a rapport with your client
        12. how to utilise appropriate self-disclosure
        13. the range of assessment methods which may be used:
          1. suggestability tests
          2. guided interview
          3. questionnaire
          4. subjective unit of distress (SUDS)
          5. observation
          6. personality profiles
          7. depth scales
        14. the importance of agreeing aims and staged goals to meet those aims with the client
        15. the role which the client (and others) may take, and may need to take, if the hypnotherapy treatment is to be successful and how to explain and agree them with the client (and any companion(s))
        16. how to support the client to make informed choices
        17. the importance of agreeing the location and timing of the hypnotherapy treatments with the client and the factors which may intervene and alter plans
        18. the importance of encouraging the client to be as actively involved as possible and the relationship of this to the promotion of their health, effective functioning and well-being
        19. how to monitor and evaluate changes in the client, assess which changes are related to the hypnotherapy and use this information to inform future practice
        20. how to evaluate the efficacy and suitability of hypnotherapy for the client and decide when it should be halted and/or discontinued
        21. methods and processes for evaluating information as treatment proceeds and using this to inform future practice
        22. the potential risks associated with client self-care and the extent of your responsibilities
        23. the importance of giving accurate and clear advice on self-care and the consequences of not doing so
        24. what information is needed for the review to be carried out effectively
        25. what methods exist for reviewing the effectiveness of the hypnotherapy with the client and evaluating to what extent their needs have been met
        26. how to evaluate the effectiveness of the hypnotherapy treatments as a whole and the importance of doing so
        27. how and why you should encourage the client (and any companion(s)) to take a full and active part in the review process and to offer their views
        28. how the client (and any companion(s)) may indicate concerns in the process without making their concerns clear and explicit
        29. the importance of active listening in evaluating the hypnotherapy treatment with the client
        30. the range of different ways in which hypnotherapy treatments can be altered to meet the needs of the client and the ways in which their needs may have changed
        31. why it is necessary to help and support the client to consider the implications of any changes made to their programme of care
        32. how to record the content and outcomes of the review process and what information should be included
        33. the variety of reasons there may be for discontinuing the hypnotherapy treatment programme with the client

Performance Criteria

You must be able to do the following:

  1. ensure information about the client is sufficient to plan the treatment
  2. discuss the treatment and potential outcomes with the client, check their understanding and support them to make informed choices
  3. agree the location and timing of the treatment and make the necessary arrangements
  4. explain how the treatment will be evaluated and reviewed
  5. determine issues of confidentiality with the client and confirm their agreement
  6. record the agreed treatment accurately, and in sufficient detail to meet professional requirements
  7. obtain the consent of the client or their companion (where appropriate) to proceed
  8. interact with any companion(s) of the client in ways that are appropriate to the needs of the client and to your needs
  9. ensure that the hypnotherapy treatment environment is appropriate for the client and their needs
  10. present a professional appearance and be prepared and fit to carry out the hypnotherapy treatment
  11. ensure that the equipment, materials, and the surrounding hypnotherapy treatment area meet professional codes of practice, legal and organisational requirements
  12. position the client for effective interaction and to minimise risk of injury to self and discomfort to the client
  13. reassure the client and encourage them to relax and interact as they wish
  14. carry out the hypnotherapy treatment safely and appropriately
  15. respond effectively to deal with reactions to the hypnotherapy treatment
  16. offer clear and accurate aftercare advice and support to the client where needed
  17. allow the client sufficient time to recover fully before leaving the premises
  18. discuss the outcomes of the hypnotherapy treatment and its effectiveness in a manner, level and pace suited to the client
  19. encourage the client to evaluate their hypnotherapy programme and suggest possible modifications
  20. agree future hypnotherapy treatment with the client
  21. encourage clients to take responsibility for their own health, effective functioning and well-being
  22. advise the client where hypnotherapy is unsuitable and support them to seek other healthcare where appropriate
  23. record the outcomes of the treatment accurately and in sufficient detail to meet professional requirements
  24. store the records securely
  25. interact with any companion(s) of the client in ways that are appropriate to the needs of the client and to your needs
  26. evaluate the experience you have gained from treating the client to inform future practice

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: HWB5 Provision of care to meet health and wellbeing needs
CH H2 Treat the client (Hypnotherapy)
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk