Homework Assignment Module 3

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Course Code: MANCH 1 A

Name: Zoe Stux

Phone No: 07801 733775

Email: [email protected]

Title: “Why is the initial consultation so important? What factors will an ethical therapist cover at this time?

Word Count: 2000

Zoe Stux – Year 1 Chrysalis Counselling and Psychotherapy

mailto:[email protected]

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People are complex beings who illustrate complicated intelligence and behaviour patterns which

in turn provide a convoluted element to the individual and the choices they make (Ewan, 2008).

However in as much as people are complex the degree of this is varied from individual to

individual and no two people are identical in both physical and psychological manner (Ewan,

2008).

This said the relationships people form are largely based on their individual personality types

(Ewan, 2008). It is suggested a person is drawn to another because they offer them something

emotionally, love, protection, and friendship. That said it is important to note there are two

primary individuals within the therapy situation and both will differ from each other (Gold,

Strickler, 1993).

However the therapy relationship is conflicted as there exists an illusion of power balance, it will

not be until the relationship is fully formed that the opportunity to contrast the preconceptions

they hold of each other will be enabled (Gold, Strickler, 1993). One would argue within the

therapy relationship that both aspects rely on learning, knowing and understanding (Downing,

2003). Moreover these emotional and functional elements will only complete once initial contact

has been made and the two personalities conclude if they are drawn to each other (Downing,

2003).

There are implications to lack of understanding from both sides of the relationship. In the case of

the client a lack of understanding and full disclosure has the ability to place their physical and

mental health in danger. From the therapists view point there is a duty of care to not endanger the

client knowingly. Thus the dangers from a lack of understanding and unknowing can lead both

the client and therapist into perilous grounds whereby more damage than good can be achieved

(Corey, Corey, 2008).

The aim of this assessment will be to determine the usefulness of an initial consultation in order

to evaluate the importance of full and disclosed understanding. At the same time the assessment

will identify and debate the ethics and code of conduct standards the therapist is bound by in

order to protect both the client and the therapist which are often covered in the initial

consultation.


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Personal change is described as an enormous undertaking for an individual to process (Corey,

Corey, 2008). In essence the individual must accept there is a defect within their personal

physical or psychological makeup that requires changing.

Whilst the use of negative language provides a negative connotation it is important to consider

the individual as they will consider themselves. With an understanding of change therapy the

importance of language is understood, however, in their primary state people tend to adopt the

negative connotations over the positive reaffirming actions as a preference (Ewen, 2008).

Research indicates the primary focus on negativity is proven (Ewen, 2008). This implies a link to

people’s perceptions when they make decisions about changing aspects of their life through self

analysis. The focus on negativity results in a pessimistic view of the issues or personality as

opposed to a realistic or necessarily accurate view of the individual.

Thus one might argue in some cases the self analysis may be unfounded with little basis in the

reality of the individuals need for change, or alternatively provides mis-direction for the change

required (Ewen, 2008). An example of this can be seen within organisational structures when

individuals take part in annual appraisal processes. Research indicates there is a pattern which

aligns some personality types who tend to score themselves lower than their manager because

their view of their own ability is impaired (Mullins, 2007).

This can be supported with primary evidence from the author who recently in a performance

review meeting spent an hour talking about all the problems and mistakes that had been made in

a recent project. In contrast the focus should have been on the positive actions that had followed

the errors as a result of the individuals follow through.

If this were applied to a therapy situation it would indicate the self assessment of the individual

was inaccurate. Therefore the level of mis-direction from the role of the client would have

provided a learning curve as the therapist identified the more accurate view.

However there are contrasting cases whereby the individual may be acutely self aware and able

to make accepted judgements about their attitudes or behaviours to result in driving a degree of

change required (Corey, Corey, 2008).


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As a therapist therefore one would argue it is essential to observe and interact with your client

prior to starting any basis of change therapy. Through training and knowledge the therapist will

be able to assess the client’s needs and desires as two separate issues therefore identifying the

best therapy method for the client.

Important factors to consider here are how the therapist manages the initial consultation theory.

There is a vast amount of assimilation for the client and therapist within a short time of building

this relationship and is relatively intense. For the therapist there is an expectation of their role as

the carer and a degree of personal or previous case detachment is required prior to the initial

consultation beginning. The individual is unique as is their specific situation thus should be

accorded the respect as such.

Whilst for the client the initial consultation is a learning experience and an opportunity to grown

a potentially important relationship for the therapist there are ethical considerations to be

undertaken which place paramount importance on this initial session. In relative terms there is no

actual therapy being practised within the initial consultation which is ethically correct as the

assessment will determine suitability to therapy for the client.

However the therapist faces an ethical dilemma from the start as the session qualifies as working

time thus the debate becomes one of commerciality over ethical consideration. Many therapists

manage this through the offer of a free of charge initial consultation as it only takes at most forty

five minutes.

However whilst the argument would imply value for the client and long term objectivity for the

therapist there is a counter argument to suggest the offer of free time provides a dishonest hook

to the client implying they would feel obliged to pursue therapy further. On the other hand this

can be neither proved nor disproved. One might argue the sincerity of the therapist to explain the

‘what happens next’ stage to the client would reduce the potential for this obligated feeling

provided rapport has been build to a suitable level between the two individuals.


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However it is fundamental to the evaluation of the client and therapist relationship that the initial

induction is carried out regardless of funding and financial consideration. If for the purpose of

this assessment the assumption that the offer of a free initial consultation meets ethical

requirements is accepted the debate is free to further assess the ethical considerations the

therapist must consider.

As previously stated therapists are bound through their actions by a code of conduct driven by a

degree of ethics and standards (Pope, Vasquez, 2007). As such the initial consult with the client

provides the therapist with the opportunity to fulfil their duty of care and understand the client

before they begin any work with them (Pope, Vasquez, 2007).

The basis of the initial consultation will follow both personal and medical pathways; initially the

therapist may seem like an interviewer asking a series of questions. However this should change

with time and exposure to become more like an informal conversation (Stone, 2002). In essence

as long as the therapist is able to ascertain the same degree of information the benefits of this

methodology can aid the client as the rapport and relationship with the therapist is less

formalised in their perception which can lead to a relaxed state of mind which aids the hypnosis

method (Stone, 2002).

In terms of information assessment the therapist is looking to ascertain specific kinds of

information. Personal information regards the individual are important to provide help with

identifying their personality type, likes or dislikes, important people within their lives and fears

which will enable the therapist to tailor and personalise a therapy session thus adding validity for

the client (Palmer, 2000).

They are also looking to confirm the details of the specific problem and how the client is looking

to resolve to a solution. This will be linked to the personal information in order to build a picture

of the client that the therapist can work with. The collection of personal information will also

enable the therapist to identify other underlying issues the client is not consciously aware of.


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From a medical view point there are two aspects for consideration, the therapist needs to be

aware of medical conditions that may be heightened and cause complications under hypnosis.

These can be known to the client or found within the client’s family history (Stone, 2002). In the

case of finding something potentially harmful ethically the therapist would explain the issue and

ask for consent to speak to the client’s doctor for their approval.

Assuming rapport has been created and a trust exists between the two it is the therapists role to

explain this is not sinister simply precautionary, one would assume a client with genuine interest

to pursue would agree whilst if a client becomes agitated there become further ethical

considerations for pursuing the therapy.

Furthermore the therapist is looking for the client to demonstrate sound mind and objectivity in

order to discount serious mental illness or psychosis (Stone, 2002). Ethically the therapist cannot

pursue with a client if they are aware or suspect the client is seriously ill, the consequences of

such actions can result in long term harm to the client even though the therapists intentions are

good (Stone, 2002). If there is a suspicion of such mental health issues the therapist holds a duty

of care to seek the client’s medical doctor’s feedback on their proposed work together before

commencement (Stone, 2002).

However ethics are often linked to the specifics of the individual case and herein lays associated

issues of judgement (Pope, Vasquez, 2007). One would infer from this that should the therapist’s

judgement be impaired there is a potential risk to unethical actions even if the therapist does not

realise they have been negligent. In contrast it could be argued the ethics are clear and well

documented and it should be unlikely the therapist is not conversant with the framework (Pope,

Vasquez, 2007).

However there are several impacts to the therapist that can cause compliancy within the

consideration of ethics. As stated previously each individual is unique thus the ethical

considerations may be unapparent. If the therapist is feeling fatigue or their own independent

stress the lack of concentration provides the distraction. Likewise a sense of routine can result in

complacency and the therapist may miss something within the initial consultation which would

indicate a conflict within the ethical framework (Pope, Vasquez, 2007).


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Furthermore the ideology of perception from the therapist provides a link. The lack of an open

mind and assuming associated behaviours or actions provides the potential to find one’s self

focusing on the merits of a previous client and the similarities without providing the individual in

question with the attention they require (Pope, Vasquez, 2007).

Therefore suggesting the therapist needs to understand and apply self questioning throughout the

initial interview. This seeks to ascertain their own perceptions and validate their theories with

supporting evidence and not assumptions.

For example when using an interview structure to develop questioning skills the author

developed associated medical feelings with the sense of smoking to support assumptions made

about the clients lifestyle. These assumptions were then supported through further probing

questions aligned to the clients family.

Thus in conclusion, it is fair to assert from the information and research the initial consultation

holds a high degree of importance from the view point it provides both people embarking on a

new relationship chance to meet each other and ascertain if a relationship can be bonded.

The therapist must ensure they advocate their duty of care to the client and assess for ethical

issues which would prevent therapy from proceeding, in the main these will be serious medical

problems or extreme mental health issues.

The therapist must ensure from their own view point they are fair and open to the individual with

no attached bias and no sense of compliancy which can result in dulled awareness. Ethics and

responsibility are closely linked together and the therapist is ethically responsible for the client

once a contract is agreed. However it can be argued as a professional therapist there is a duty of

care prior to any contractual obligations from in which if there is a prognosis which requires

additional help there should be aid to find this for the client.


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Bibliography

Corey MS, Corey G, (2008), I Never Knew I Had a Choice; Explorations in personal growth, Cengage Learning

Downing JN. (2003), Between Conviction and Uncertainty; philosophical guidelines for the practising psychotherapist, SUNY Press

Ewen RB, (2008), An Introduction to Theories of Personality, Routledge Taylor and Francis Group

Gold JR, Strickler G, (1993), Comprehensive Handbook of Psychotherapy Integration, Plenum Press

Mullins LJ, (2007), Management and Organisational Behaviour, Pitman

Palmer S, (2000), Introduction to Counselling and Psychotherapy; the essential guide, Sage

Stone J, (2002), An Ethical Framework for Complementary and Alternative Therapists, Routledge


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Homework Assignment Module 3