Complementary and Alternative Healthcare - Hypnotherapy

Listing of Units and Elements

Unit		Elements of Competence
CH-H1	Assess the needs of the client	CH-H1.1 - Evaluate and process requests for hypnotherapy CH-H1.2 - Prepare to assess the client CH-H1.3 - Assess the client CH-H1.4 - Agree action with the client
CH-H2	Treat the client	CH-H2.1 - Plan the hypnotherapy treatment programme with the client CH-H2.2 - Provide treatment CH-H2.3 - Evaluate the effectiveness of the treatment
CH-H3	Educate the client to adopt self-care procedure(s)	CH-H3.1 - Prepare to advise and educate the client CH-H3.2 - Enable the client to adopt the self-care procedure(s) CH-H3.3 - Evaluate the effectiveness of the self-care procedure(s)

UNIT 

CH-H1 Assess the needs of the client

Elements of competence

CH-H1.1 Evaluate and process requests for hypnotherapy 

CH-H1.2 Prepare to assess the client 

CH-H1.3 Assess the client

CH-H1.4 Agree action with the client 

Information about this unit

Summary
This unit 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. 

Who this unit is aimed at
This unit 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. 

Principles of good practice
This unit 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. 

Relationship to other units 
This unit focuses on the assessment of clients’ needs which affect their health, effective functioning and well-being and the evaluation of how hypnotherapy might meet those needs. 

It is similar in content to unit 11.1 in the National Occupational Standards for Professional Activity in Health Promotion and Care but has been put into the specific context of hypnotherapy. It links with Units CH-H2 and CH-H3 in terms of implementing a hypnotherapy treatment programme.

Note: where “client” is referred to, read also “patient”, “customer”, “pupil” and “learner”,

where “companion” is referred to, read also “representative”, “partner”, “relative”, “friend of the client”, “another healthcare practitioner” and “appointed chaperone”.

Element CH-H1.1 Evaluate and process requests for hypnotherapy 

Performance criteria

You will need to:

(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 

Scope:

1 Requests for services from:
a) potential or current clients
b) someone acting on behalf of the client (e.g. a parent, carer or appointed person)
c) other healthcare practitioners 

2 Particular requirements in relation to:
a) the client’s personal beliefs and preferences and presenting issues 
b) the client’s age, sex and physical condition
c) communication differences
d) physical support and access 
e) emotional, psychological and medical support 

Element CH-H1.2 Prepare to assess the client 

Performance criteria

You will need to:

(1) ensure that the assessment environment is appropriate for the client and their needs 

(2) present a professional appearance and be prepared and fit to carry out the assessment 

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

(4) evaluate the client’s initial approach and manner to assess their needs

(5) introduce the client and any companion to those present and confirm individual roles

(6) communicate effectively and in a manner which maintains client goodwill, trust, confidentiality and rapport 

(7) explain the nature, scope and duration of the assessment and any related interventions

(8) inform the client of the records to be made and their right of access to these

(9) encourage the client to ask questions, seek advice and express any concerns about the assessment

(10) confirm the consent of the client, and where appropriate their companion, to the assessment

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

Scope:

1 Professional appearance:
a) own presentation including appropriate dress/uniform/adornment
b) personal hygiene

2 Work area is suitable in terms of:
a) ventilation 
b) lighting 
c) heating 
d) level of noise 
e) privacy
f) accessibility
g) space
h) cleanliness and orderliness

3 Initial approach and manner:
a) appearance
b) body language
c) behaviour
d) posture and gait
e) oral responses
4 Confirm individual roles in relation to:
a) the client’s identity 
b) the companion’s identity 
c) the role which the client wishes their companion to have and the information the companion should receive
d) the identity and roles of any practitioners present
e) your own role 

5 Communicate using:
a) speech and language 
b) actions, gestures and body language
c) space and position
d) the written word or illustrations

Element CH-H1.3 Assess the client

Performance criteria

You will need to:

(1) respect the client’s privacy and dignity throughout the assessment and ensure they are as comfortable as possible

(2) position the client for effective interaction and to minimise risk of injury to self and discomfort to the client 

(3) conduct the assessment in a manner which encourages the effective participation of the client and meets their particular requirements

(4) support the client to identify significant aspects of their lives and use this to inform the assessment 

(5) where possible determine any contra-indications or restrictions to assessment and take appropriate action

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

(7) systematically establish the client’s needs and draw valid conclusions

(8) 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

(9) halt the assessment at the request of the client or when the information obtained means that it is unsafe to proceed

(10) inform the client when additional information is required and obtain their consent to obtain the information

(11) ensure records meet organisational requirements

Scope:

1 Particular requirements in relation to:
a) the client’s personal beliefs and preferences and presenting issues 
b) the client’s age, sex and physical condition
c) communication differences
d) physical support and access 
e) emotional, psychological and medical support 

2 Aspects of the client’s life to explore:
a) history of the client’s health, effective functioning and well-being (physical, emotional, psychological, spiritual) including any particular conditions, contra-indications, treatments and medication
b) lifestyle including diet, exercise and use of drugs
c) work or academic history
d) social and family history 

3 Assessment methods:
a) suggestibility tests
b) guided interview
c) questionnaire
d) subjective unit of distress (SUDS)
e) observation
f) personality profiles
g) depth scales 

4 Client’s presenting condition:
a) behavioural
b) psychological
c) physical
d) fulfilment
e) habits that predispose to or aggravate the symptoms 

5 Conclusions in relation to:
a) balance across physical, mental, emotional, social and spiritual condition
b) all the client’s signs and symptoms
c) relief and/or alleviation of symptoms
d) symptoms for which treatment is to be applied with caution

Element CH-H1.4 Agree action with the client 

Performance criteria

You will need to:

(1) explain the outcomes of the assessment clearly and in a manner, level and pace appropriate to the client

(2) balance possible successful outcomes with any inherent benefits and risks and the legal duty of care to the client

(3) inform the client of the content, level of risk, duration and projected costs of the proposed action

(4) explain any restrictions to hypnotherapy and advise on unrealistic expectations 

(5) advise the client where hypnotherapy is unsuitable and enable them to seek other healthcare where appropriate

(6) recommend and agree action to suit the client’s condition and identified needs

(7) record the outcomes of the assessment accurately and in sufficient detail to meet professional requirements

(8) store the records securely

Scope:

1 Appropriate explanation in terms of the client’s:
a) current state of health, effective functioning and well-being
b) personal beliefs and preferences 
c) age and level of understanding 
d) cultural and social background 
e) awareness and understanding of their condition 

2 Risk in relation to:
a) the nature of any subsequent hypnotherapy treatment programme 
b) the client and their overall health, effective functioning and well-being 
c) evidence from documented research and the success of the interventions concerned 
d) the setting(s) in which interventions will take place 
e) the practitioners involved

3 Restrictions:
a) human resources
b) cost
c) physical
d) technological 
e) time

4 Action could include:
a) develop a hypnotherapy treatment programme with the client
b) further assessment 
c) refer to another healthcare practitioner
d) no further action

UNIT
CH-H2 Treat the client

Elements of competence
CH-H2.1 Plan the hypnotherapy treatment programme with the client 
CH-H2.2 Provide treatment
CH-H2.3 Evaluate the effectiveness of the treatment 

Information about this unit

Summary
This unit 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. 

Who this unit is aimed at
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. 

Principles of good practice
This unit 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. 

Relationship to other units
This unit links with unit CH-H1 and is similar in content to unit 11.2 in the National Occupational Standards for Professional Activity in Health Promotion and Care but has been put into the specific context of hypnotherapy.

Note: where “client” is referred to, read also “patient”, “customer”, “pupil” and “learner”,

where “companion” is referred to, read also “representative”, “partner”, “relative”, “friend of the client”, “another healthcare practitioner” and “appointed chaperone”.


Element CH-H2.1 Plan the hypnotherapy treatment programme with the client

Performance criteria

You will need to:

(1) ensure information about the client is sufficient to plan the treatment 

(2) explain the treatment options available and methods which meet the client’s circumstances, identified needs and their personal beliefs and preferences

(3) discuss the treatment and potential outcomes with the client, check their understanding and support them to make informed choices

(4) agree the location and timing of the treatment and make the necessary arrangements

(5) explain how the treatment will be evaluated and reviewed 

(6) determine issues of confidentiality with the client and confirm their agreement 

(7) record the agreed treatment accurately, and in sufficient detail to meet professional requirements 

(8) obtain the consent of the client or their companion (where appropriate) to proceed 

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

Scope:

Element CH-H2.2 Provide treatment 

Performance criteria

You will need to:

(1) ensure that the hypnotherapy treatment environment is appropriate for the client and their needs 

(2) present a professional appearance and be prepared and fit to carry out the hypnotherapy treatment

(3) ensure that the equipment, materials, and the surrounding hypnotherapy treatment area meet professional codes of practice, legal and organisational requirements 

(4) position the client for effective interaction and to minimise risk of injury to self and discomfort to the client

(5) reassure the client and encourage them to relax and interact as they wish

(6) carry out the hypnotherapy treatment safely and appropriately 

(7) make appropriate adjustments to the hypnotherapy treatment to meet the client’s changing needs

(8) respond effectively to deal with reactions to the hypnotherapy treatment

(9) check the client’s well-being throughout the hypnotherapy treatment and give reassurance where needed

(10) offer clear and accurate aftercare advice and support to the client where needed

(11) allow the client sufficient time to recover fully before leaving the premises

Scope:

1 Professional appearance:
a) own presentation including appropriate dress/uniform/adornment
b) personal hygiene

2 Treatment area is suitable in terms of:
a) ventilation 
b) lighting 
c) heating 
d) level and nature of noise 
e) privacy
f) accessibility
g) space
h) cleanliness and orderliness

3 Treatment:
a) formal and informal trance
b) direct
c) indirect
d) permissive
e) authoritative
f) mechanisitic

4 Reactions to the treatment:
a) abreactions
b) spontaneous regression
c) spontaneous breach of trance
d) not coming out of trance when instructed
e) dealing with obstacles in trance and out of trance e.g. non response

Element CH-H2.3 Evaluate the effectiveness of the treatment 

Performance criteria

You will need to:

(1) discuss the outcomes of the hypnotherapy treatment and its effectiveness in a manner, level and pace suited to the client

(2) encourage the client to evaluate their hypnotherapy programme and suggest possible modifications

(3) agree future hypnotherapy treatment with the client

(4) encourage clients to take responsibility for their own health, effective functioning and well-being 

(5) advise the client where hypnotherapy is unsuitable and support them to seek other healthcare where appropriate

(6) obtain the client’s written consent to pass on confidential information

(7) record the outcomes of the treatment accurately and in sufficient detail to meet professional requirements

(8) store the records securely

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

(10) evaluate the experience you have gained from treating the client to inform future practice

Scope:

1 Outcomes:
a) improvement of the client’s health, effective functioning and well-being
b) maintenance and stability 
c) palliative 
d) deterioration in the client’s health, effective functioning and well-being

2 Evaluation includes:
a) client’s experience of the programme 
b) extent to which the programme has met the needs of the client
c) the client’s broader needs 
d) other factors which may have affected the programme’s effectiveness

UNIT
CH-H3 Educate the client to adopt self-care procedure(s)

Elements of competence
CH-H3.1 Prepare to advise and educate the client 
CH-H3.2 Enable the client to adopt the self-care procedure(s) 
CH-H3.3 Evaluate the effectiveness of the self-care procedure(s) 

Information about this unit

Summary
This unit describes standards for planning, implementing and evaluating sessions designed to enable the client to adopt self-care procedure(s).

Who this unit is aimed at
This unit applies to any practitioner whose work aims to enable clients to improve and maintain their health, effective functioning and well-being through educating them towards a self-care procedure. 

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. Clients 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. 

Principles of good practice
This unit is based on the premise that to deliver effective hypnotherapy 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. The emphasis is on encouraging the client to take responsibility for their own health, effective functioning and well-being through a process of education and training. 

Relationship to other units
This unit links with unit CH-H1 and is similar in content to Unit 11.2 in the National Occupational Standards for Professional Activity in Health Promotion and Care but has been put into the specific context of hypnotherapy.

Note: where “client” is referred to, read also “patient”, “customer”, “pupil” and “learner”,

where “companion” is referred to, read also “representative”, “partner”, “relative”, “friend of the client”, “another healthcare practitioner” and “appointed chaperone”.

Element CH-H3.1 Prepare to advise and educate the client 

Performance criteria

You will need to:

(1) ensure that information is sufficient to advise and educate the client 

(2) explain the recommended self-care procedure(s) and tailor this to meet the client’s identified needs and preferences

(3) clarify the potential outcomes of using the self-care procedure(s) with the client, check their understanding and support them to make informed choices

(4) discuss and agree the role of the client and any companion(s) in achieving the identified aims

(5) explain how the self-care procedure(s) will be evaluated and reviewed 

(6) agree the location and timing of appointments and make the necessary arrangements

(7) determine issues of confidentiality with the client and confirm their agreement 

(8) obtain the consent of the client or their companion (where appropriate) to proceed 

Scope:

Element CH-H3.2 Enable the client to adopt the self-care procedure(s) 

Performance criteria

You will need to:

(1) ensure that the work area is appropriate for the client and their needs 

(2) present a professional appearance and be prepared and fit to advise and educate the client

(3) clarify and agree the client’s understanding of their role and responsibilities in relation to self-care 

(4) advise and educate the client on appropriate self-care methods and actions 

(5) check the client’s understanding of the recommended self-care procedure(s)

(6) explain the benefits of following your recommendations 

(7) inform the client of the range of possible reactions to self-care 

(8) respond to questions and concerns of the client and offer appropriate advice 

(9) advise the client on the appropriate action to take if they have concerns whilst using the self-care procedure(s) 

(10) acknowledge the rights of the client to choose whether or not to follow your advice

(11) encourage the client to note any effects of self-care in sufficient detail for use in any review

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

Scope:

1 Work area is suitable in terms of:
a) ventilation 
b) lighting 
c) heating 
d) level and nature of noise 
e) privacy
f) accessibility
g) space
h) cleanliness and orderliness

2 Professional appearance:
a) own presentation including appropriate dress/uniform/adornment
b) personal hygiene

3 Self-care methods and actions:
a) self-hypnosis
b) tasking

4 Effects of self-care:
a) physical change
b) emotional change
c) psychological change
d) spiritual change

Element CH-H3.3 Evaluate the effectiveness of the self-care procedure(s)

Performance criteria

You will need to:

(1) encourage the client to evaluate their use of the self-care procedure(s) and suggest possible modifications

(2) discuss the outcomes of the self-care in a manner, level and pace suited to the client

(3) make appropriate adjustments to the self-care procedure(s) to meet the client’s changing needs

(4) advise on and agree further self-care with the client

(5) advise the client where further self-care is inappropriate and support them to seek other healthcare 

(6) obtain the client’s written consent to pass on confidential information

(7) make accurate, legible and complete records of the review process 

(8) store the records securely

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

(10) evaluate the experience you have gained from working with the client to inform future practice

Scope:

1 Outcomes:
a) improvement in the client’s health, effective functioning and well-being
b) maintenance and stability 
c) deterioration in the client’s health, effective functioning and well-being

2 Evaluation includes:
a) client’s experience of the programme 
b) extent to which the programme has achieved the client’s aims and goals 
c) the client’s broader needs 
e) other factors which may have affected the programme’s effectiveness

Knowledge and Understanding

The knowledge and understanding needed to support competent performance of the standards of competence is presented under a number of headings. The headings are as follows:

A Professional standards and codes of conduct

B Legislation 

C Employment and organisational policies and practices

D Communication and the professional relationship

E Work role and practice - reflecting and developing

F Confidentiality 

G Consent 

H Practice management

I Health, effective functioning and well-being

J The scope and methods of complementary healthcare 
K Anatomy, physiology

L Assessing the client’s needs and the appropriateness of hypnotherapy
M Providing treatment 
N Evaluating and reviewing the effectiveness of treatment(s)

Description of knowledge and understanding required for all units
You should know and understand:-

A Professional standards and codes of conduct

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 

B Legislation 

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

2 legislation relating to obtaining, storing and using information and supplying services 

3 the importance of keeping your understanding of legislation up to date

4 how relevant legislation impacts on your own work

C Employment and organisational policies and practices

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

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

3 why it is important to respect the rights of clients

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

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

6 the organisational requirements and restrictions relating to the use of resources

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

D Communication and the professional relationship

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

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

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

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

5 how to position self and client to encourage communication

6 how to recognise and overcome barriers to communication

7 why certain environments can inhibit communication and how to minimise this 

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

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

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

E Work role and practice - reflecting and developing

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

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

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

4 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

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

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

F Confidentiality 

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

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

3 what to take into account when passing on information about clients

4 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

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

G Consent 

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

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

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

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

5 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

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

7 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

H Practice management

1 why it important to protect client confidentiality

2 how to keep records to protect confidentiality and security of information

3 how to keep records so that clinical audit can be undertaken

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

5 who has the right of access to information held of records

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

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

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

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

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

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

I Health, effective functioning and well-being

1 the concept of health, effective functioning and well-being

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

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

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

5 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
6 how the diet, lifestyle, physical, social, emotional and economic context in which people live affects their health, effective functioning and well-being

7 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

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

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

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

J The scope and methods of complementary healthcare 

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

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

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

• hypnotherapy is unlikely to succeed 
• the client does not want to continue with treatment
• you do not wish to provide the treatment

4 the circumstances when you must not treat a client:

• hypnotherapy is contra-indicated
• other healthcare should be sought
• you do not have the requisite experience or expertise

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

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

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

8 how to tailor treatment appropriately for each individual

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

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

K Hypnotherapy science

1 Anatomy & Physiology

a) Conscious and unconscious process

• the functions of the conscious and unconscious process
• the basic neural operation of the brain
• the difference between the analytical and creative functions of the mind
• short and long term memory – how this is stored
• false memory
• the impact of emotion on memory
• how memory corrupts

b) Stress response

• fight or flight
• the endocrine system and how this interacts with the brain
• how psychological response creates physical reaction and vice versa

c) Breathing

• characteristics of breathing
• how to recognise changes in breathing
• utilising breathing as part of the psychological response

d) Psychosis

• functional and organic psychosis
• how to recognise psychosis and the appropriate action to take
• appropriate referral action to take if confronted by psychosis

2 Induction, deepening and reviving techniques

a) Techniques 

• direct, indirect, confusion, eye fixation, fractionalisation, trigger, metaphoric, physical induction techniques
• how to select appropriate technique(s) to suit the client
• how to recognise when not to use certain techniques and the possible consequences of using an inappropriate technique

3 Psychology

a) Theories of psychology

• the main theories of psychology e.g. psychodynamic, humanistic/existential, cognitive and behavioural
• how these influence your own practice
• the importance of keeping your own knowledge up to date

b) The therapeutic process

• how key theories and approaches to treatment can be utilised in therapy
• the difference between hypnosis and hypnotherapy
• how to be aware of and manage transference and counter-transference
• how to develop a working alliance with your client

4 Intervention methods

a) Methods

­ 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)

the correct use of the different methods

b) Contra-indications

• how to recognise conditions that you cannot treat
• when and how to refer clients who are outside the scope of your competence

c) Abreactions

• induced and spontaneous abreactions
• how to manage appropriately both types of abreactions
• how to recognise the potential for hysteria
• how to respond to unexpected reactions

5 Ethical practice

a) Why advertising should be accurate and truthful

b) The importance of holding appropriate professional indemnity insurance

c) Client welfare

• The importance of ensuring the welfare of the client
• 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

d) Continuing professional development

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

6 Interview and assessment techniques

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

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

c) How to keep records securely
d) The importance of fostering a rapport with your client

e) How to utilise appropriate self-disclosure

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

g) The range of assessment methods which may be used:

• suggestability tests
• guided interview
• questionnaire
• subjective unit of distress (SUDS)
• observation
• personality profiles
• depth scales

h) How to select the appropriate assessment method for your client

Knowledge and understanding needed for the standards in Unit CH-H1

L Assessing the client’s needs and the appropriateness of hypnotherapy

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

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

3 how to prepare and present yourself correctly to carry out assessment 

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

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

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

7 how to select and use different assessment methods effectively 

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

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

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

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

12 how to deal with inconsistent information gathered during assessment

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

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

15 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

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

Knowledge and understanding needed for the standards in Units CH-H2 and CH-H3

M Providing treatment

1 the importance of agreeing aims and staged goals to meet those aims with the client 

2 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))

3 how to support the client to make informed choices

4 the importance of agreeing the location and timing of the hypnotherapy treatments with the client and the factors which may intervene and alter plans

5 why evaluation methods should be determined at the planning stage and what the client’s role will be in the evaluation

6 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

7 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 

8 how to evaluate the efficacy and suitability of hypnotherapy for the client and decide when it should be halted and/or discontinued

9 methods and processes for evaluating information as treatment proceeds and using this to inform future practice

10 the potential risks associated with client self-care and the extent of your responsibilities

11 the importance of giving accurate and clear advice on self-care and the consequences of not doing so

N Evaluating and reviewing the effectiveness of treatment(s)

1 what information is needed for the review to be carried out effectively 

2 what methods exist for reviewing the effectiveness of the hypnotherapy with the client and evaluating to what extent their needs have been met

3 how to evaluate the effectiveness of the hypnotherapy treatments as a whole and the importance of doing so 

4 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

5 how the client (and any companion(s)) may indicate concerns in the process without making their concerns clear and explicit

6 the importance of active listening in evaluating the hypnotherapy treatment with the client 

7 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

8 why it is necessary to help and support the client to consider the implications of any changes made to their programme of care

9 how to record the content and outcomes of the review process and what information should be included

10 the variety of reasons there may be for discontinuing the hypnotherapy treatment programme with the client 


GLOSSARY - WORDS USED IN THE HYPNOTHERAPY STANDARDS

Assessment
Evaluation of all the known information about a situation or person, a judgment of the position and what is likely to happen i.e. the collection and evaluation of information and a subsequent judgment.

Clinical audit
A system of evaluation of the efficacy of the therapist’s work. This process should have elements of evaluation performed by the therapist themself, and externally.

Clinical supervision
A supportive and structured framework in which the therapist is able to discuss issues with their peer or senior therapist to ensure the client is given the best possible therapy

Code of Ethics
Guidelines laid down by the professional body which define standards of behaviour and values for practitioners

Consent
Consent may be informed or implied. Implied consent is that which is not explicitly sought or expressed by the client. Informed consent is that where the client has all relevant information and the necessary understanding to decide whether the course of action is the right one or not for them. 

Consultation
Sessions involving both client and practitioner where information is exchanged and explored. Consultations may have a focus on assessment, treatment planning, review or the provision of general support and advice to clients.

Continuing professional development
Means by which the practitioner maintains their current level of expertise in line with best practice and develops this further to extend their skills and understanding. For qualified practitioners of hypnotherapy professional development could include further training and/or qualifications in a related discipline.

Contract
All agreements between practitioners and clients, be they formal or informal, written or oral. Contracts will cover the roles and responsibilities of both parties.

Contra-indications
Factors which indicate that a particular treatment, procedure or material is unsuitable for a client.

Evaluation
Evaluation is the process of determining the effectiveness, value or quality of something based on a careful study of its good and bad features against predefined criteria. Evaluation can take place while something is happening and influence what happens next (formative evaluation) or take place at the end (summative evaluation). 

Evidence-based practice
Integrates individual expertise with the best available evidence from systematic research to assist in decision making about practice. 

Holistic
Recognising that health and social well-being should be considered as a whole and in relation to everything that affects a persons life i.e. that component parts should not be considered in isolation from others.

Intervention
An intervention is any planned action to influence an outcome in a specific way. 

Practitioner competence
Ability to act properly, appropriately and effectively.

Research
A detailed, systematic study of a subject or an aspect of a subject which involves collecting and analysing data and information and synthesising these in new ways to generate new knowledge and understanding, or new approaches which have general application. Action research is one form of research which involves trying things out during the research process, evaluating the process and feeding this into the development of knowledge and practice.

Services
Services are organisations or systems which are intended to provide something which the public, or an individual, needs or wants. Services include those specifically directed at health and social care, but also cover recreation, education, transport etc. 

State of altered awareness
This phrase is used in preference to states of hypnosis or trance states.

Stereotype
A fixed general image that is held to represent a particular type of person or thing. If you stereotype someone, you use this image to assume that they will behave in a particular way. 

SUDS (SUBJECTIVE UNIT OF DISTRESS)
Subjective Unit of Distress is a widely used from of scaling to ascertain how the clients themselves perceive the degree to which they are feeling something, or rate something. For example, “On a scale of 1 to 10 how anxious do you feel ?” repeated after every intervention.

Therapy goals
The aims which the client wishes to achieve through the therapy/treatment process. Goals should be agreed by client and practitioner before therapy/treatment starts, and be subject to ongoing review. (The practitioner may identify a series of short-term goals/aims which have to be achieved in order to achieve the client’s overall goal.)

COMPONENT PARTS OF NATIONAL OCCUPATIONAL STANDARDS

People need to acquire knowledge, understanding and skills to enable them to act – the knowledge, understanding and skills which people need to develop to meet the national occupational standards consistently are identified as part of the standards development process. In a national occupational standard, the knowledge, understanding and skills which support the achievement of the standard are identified – so there is a direct and clear relationship between knowledge and action.

Key role
The occupational functions which have to be achieved in an occupational sector, or particular area of practice.

National Occupational Standards
A specification, agreed nationally, of good practice at work. The standard is presented as performance criteria, the scope of circumstances in which performance should be demonstrated, and the knowledge and understanding required. National occupational standards are presented in Units of Competence.

Units of Competence
Units of Competence provide a description of a work function which has significant value in the occupation and which an individual can hold responsibility for achieving. They describe what needs to be achieved. This description is the result of successful action – it is not the action itself. Units are divided into Elements of competence. Each Element describes a task or action which needs to be performed to a specified standard.

Performance criteria
The most important things which have to be done to achieve the desired outcome. Each criterion in itself is an important performance indicator. Performance criteria include the results of effective action, the way in which things are done - the process; and deal with unusual events or contingencies.

Scope
The scope of circumstances in which performance standards of an Element must be demonstrated. This part of the standard picks up the important variations encountered in routine and non-routine work.