What are the core skills of a hypnotherapist and psychotherapist?

What are the core skills of a hypnotherapist and psychotherapist?

So you are considering consulting a hypnotherapist or psychotherapist for the first time. What are the core skills a practitioner needs to demonstrate? The following are things I believe a therapist needs to be able to do.

BASIC EMPATHY

A response which demonstrates that the therapist has perceived accurately what the client is feeling now and the source of that feeling (facts and feelings) often demonstrated by the formula ‘you are feeling x, because of y’.

ADVANCED EMPATHY

As above, but capturing the exact nuance of what the client is feeling; articulating what the client has implied as well as what has been said. Often demonstrated by the therapist picking up ‘the music behind the words’. Not what was said, but how it was said; tonality, expression, gesture, etc.

REFLECTING

Repeating back or re-stating to the client a word, phrase or sentence the client has spoken. The purpose is to show continuing attention; to validate; to invite clarification or more detail; to allow the client to hear the words they have used; to regulate pace; to check intentions.

PARAPHRASING

Communicating as briefly as possible the meaning understood in a key client message. The purpose is to build trust; to clarify and test meaning; to communicate respect and acceptance; to communicate empathic understanding.

MIRRORING

To mirror back to the client the non-verbal communication. The purpose is to mirror back to the client the power of the message; the consistency and inconsistency; the congruency of the message; to emphasise the holistic nature of the engagement.

SUMMARISING

Gathering together a client’s statements so as to identify specific thoughts and feelings; to reinforce patterns, connections and themes described from the client’s perspective (e.g., past and present or polarisation) etc.

The purpose should be to ‘paragraph’ rather than ‘parrot’ the complexity and multiplicity of the client’s problems; facilitating movement towards other areas of exploration and a focus on the central problem.

OPEN QUESTIONING

The use of the what, where, who, when and how of questioning. Closed questions can be answered ‘yes’ or ‘no’. Open questions engage the client in deeper exploration and introspection. Though therapists will elicit helpful information it is important that all questions are framed for a therapeutic purpose. Equally important is the understanding of how each prefix will engage in a specific avenue of exploration.

What questions engage the client in the experience of behaviour or her/his perceptual experience of what was happening.

When questions engage client in relation to time.

Where geographically locate experiences.

How questions engage the client in feelings and how she/he relates to the what of the experience.

Who questions engage the client in exploration of people and sub-personalities.

FOCUSING

The use of other core skills to sustain or restore a client’s exploration of a specific issue.  The purpose: to encourage thorough exploration; to increase concreteness; to give permission for exploring difficult or uncomfortable material; to counter avoidance.

CONCRETENESS

Focusing on and naming the client’s specific thoughts, feelings, behaviours and experiences rather than deal with vagueness and generalisations.  The additive purpose is to encourage client ownership and differentiate between fantasy and reality.

SILENCE

The engagement of silence is to enable the clients to introspect and get in touch with their own material, particularly emotions in the here-and-now.  Managing silence is important and the therapist must respect it is the clients’ silence.  It is also important that therapists understand the quality of their own responses lies in the therapy that this was done during silence.  All therapeutic responses are conducted in the silence of the therapist and that the response must be seen as an interpretation of the silence.

CHALLENGING

Offering new perspectives and frames of reference to be tested by the clients.  The alternatives are offered as gifts enriching the clients’ realities rather than as attacks.

Purpose – stimuli for examination and modification of habitual patterns of thought, or for re-evaluation of feelings, behaviour and experiences.  A part of reality-testing freeing clients from responses, perceptions and expectations acquired as a result of earlier experience.

CONFRONTATION

An invitation to a client to look at current behaviour and its consequences.  Offered as a gift – not an attack.

Purpose – to engage with discrepancies, distortions, ‘games’.  To point our unused strengths and encourage action.  To lead the client to search for new perspectives and the beginnings of goal setting.

Formula – ” On the one hand you say that you want …., on the other hand you ..(act/fail to act)..”

IMMEDIACY

To putting into words, by the counsellor, of the behaviours and feelings evident in the counselling room in the here-and-now:  making explicit features of the counsellor – client(s) interaction.

Purpose – clients often act-out, in the counselling room, the very behaviours and feelings which cause them difficulties in other settings.  This may take the form of setting up the kind of relationship with the counsellor that is stressful in their everyday lives.  The counsellor is thus offered the opportunity to highlight those behaviours and feelings to show what responses they produce in others, and to offer interpretations and alternative responses they produce in others, and to offer interpretations and alternative responses and interactions.

Formula – “At this moment you are … (saying, behaving) …”

GOAL SETTING

Negotiating with the clients what they want for themselves and each other, behaviour, feelings, closeness, etc.

Purpose – making specific the changes desired by the clients, individually and jointly, which they are motivated to achieve.

Qualities of Goals – they should be REALISTIC, WITHIN THE CLIENTS’ RESOURCES, APPROPRIATE, MEASURABLE, WORTHWHILE, BEHAVIOURAL and TIME LIMITED.

SELF-SHARING

Disclosure of the counsellor’s personal experience as an illustration of another individual’s response to a set of circumstances.  (NB.  This difficult skill should be used infrequently and with great caution.)

Purpose – to assist clients to build a realistic understanding of the impact of particular events and situations on themselves and each other.  To assist a re-assessment of their responses to those happenings.

Example – “Yes, I have found it a real struggle to handle discoveries about myself like those you are speaking about” (ie. The counsellor’s response to a specific issue).  NB. – Involved accounts of the counsellor’s handling of complex situations – “me too” stories – shift the focus away from the clients’ lives and seldom contribute to the work.  Personalising becomes the name of the game.

STRENGTHENING

Facilitating factors:

-       affirming decisions about goals

-       confirming that the benefits of change are greater than the costs

-       demonstrating the effectiveness of personal resources by use in preliminary actions

-       phasing change so as not to overstretch resources

-       choosing best times for action

-       readying and testing external resources

-       recording progress made

-       finding self-rewards which clients will use to mark their own and each other’s progress

-       counsellor’s rewarding behaviour: interest, encouragement, praise.

KNOWLEDGE AND RESOURCES

Making available the counsellor’s knowledge – of the clients, their relationship, their family setting, family, friends, and of technical resources – specialist services, treatment, support groups, crisis centres, etc.

Purpose – maximising clients’ knowledge and access to the resources they may need for  change

These are the skills that therapists should have and things that you can look for when consulting a therapist for your personal issues.

Shaun Brookhouse