This is one of the most basic and primary therapeutic competency required by the therapist. Here the therapist would facilitate the client with the basic idea of therapy and the norms attached to it. This helps in creating strong therapeutic alliance and rapport.
Once the foundation of the therapy session is set, it becomes easier for the client to flow smoothly with the session. Within this therapeutic competency, there are a few sub-competencies which are essential. These include:
Establishing the therapeutic agreement:
This competency is about understanding the purpose of the therapeutic interaction and to come to an agreement with the prospective client about the therapy process and relationship.
This includes understanding and effectively discussing the guidelines, specific parameters of the therapeutic relationship, reaching agreement about what is and is not appropriate in the therapeutic relationship, what is and is not being offered, what are the responsibilities of the therapist and the client.
Meeting Ethical Guidelines and Professional Standards:
This competency is about understanding the professional standards and guidelines that therapists must abide by. Some of these guidelines are legally binding while others are considered best practices. Following these guidelines and standards ensure that the therapist is able to safeguard their legal interests.
- Meeting Ethical Guidelines and Professional Standards
- Establishing the Therapeutic Agreement
Therapy is not a one-session event. Generally, it extends over a period of 8 to 12 sessions depending on the clients current problem and the desired outcome. For this, the therapist needs to foster a friendly and warm yet professional relationship with the client. This competency is all about establishing a relationship that is most conducive to the therapeutic process. Sub-competencies within this include:
Using a flexible approach that is client-centric:
Not every client is the same. So, it is beneficial for the therapist to identify which approach to use for whom. A therapist may be equipped with multiple tools and techniques to help clients deal with their challenges and achieve their desired outcome.
However, it is essential to identify which tool/model would best suit the client and require the least amount of effort and time. A therapist needs to have the competency to not just identify and select the right approach for the client but also to modify the approaches in the most appropriate ways.
Managing self and maintaining coaching presence:
Whilst in a therapy session, the therapist must be fully aware of what the client is saying and respond accordingly. The therapist’s response will help set a direction/path for the client’s desired outcome.
The therapist should also be aware of his/her biases and not let these biases influence the therapy process. This can completely derail the session and hamper the process. The therapist must also be competent to demonstrate confidence in himself/herself and in the process that they are planning to use with the client.
Establishing a trust-based relationship with the client:
This competency is all about creating a safe/supportive environment for the client which would ensure trust and mutual respect between the individuals involved. The therapist should also demonstrate genuine concern for the client’s personal welfare and future.
This should be done in a way that does not seem forced and yet effective for the client. This will also help the therapist develop a strong rapport with the client thereby ensuring the therapeutic process goes smoothly.
- Using Structured yet Flexible Client-Centered Approach
- Managing self and maintaining therapeutic presence
- Establishing trust-based relationship with the client
One of the key tools/skills used by the therapist is communication. The entire process of therapy is dependent on this one tool without which it will be difficult for the client to understand and work towards his/her desired outcome.
This requires the therapist to be aware of different aspects of communication that can influence a client’s style of communication. And that is why this particular competency becomes important. Sub-competencies within this includes:
This competency is about the ability to effectively listen, encourage, accept and explore what the client is saying. Listening is completely different from hearing; it means listening not just through your ears but through your eyes and other senses.
Whilst listening, the therapist should also observe the body language of the client, the changes in tonality of the voice, summarise, paraphrase, reiterate what the client is saying, mirror the client and ensure that there is clarity in understanding the client.
Through engaged listening, the therapist would be able to make out a lot of the things about the client. It will ensure that the therapist uses the right kind of tools and processes on the client for him/her to reach the desired outcome.
This competency is about the ability to ask questions that will uncover the information needed for greatest benefit to the therapeutic relationship and the client, by posing questions that are open-ended to create greater clarity, possibility or new learning.
It’s important for therapist to question not to confront but to understand the client. These questions are meant to help the client explore their thoughts, perceptions, and behaviours in a way that the client can understand him/herself better and the therapist can assist them overcome their challenges and achieve their outcome.
This also enables the therapist to collect specific details so that they can work on facts and not personal biases.
Flexible/Person centric communication:
While engaged listening and powerful questioning are important competencies, another thing to keep in mind is that different people communicate differently. It is important for a therapist to be able to identify and use the style of communication preferred by the client.
This requires the therapist to be aware of different aspects of communication (suggestibility, love language, representation system, level of expressiveness, meta programs…) that can influence a clients style of communication. Based on how the client understands and communicates, the therapist needs to be flexible and communicate accordingly.
While this therapeutic competency is closely associated with the person-centric approach, it also helps the therapist build a trust-based relationship.
- Engaged Listening
- Powerful Questioning
- Effective Communication
Clients may present with a large variety of problems when coming for psychotherapy. In psychotherapy, these are known as presenting problems and include clients’ perceived symptoms, emotional disturbances or difficult behaviours that lead them to seek therapy. Understanding the clients’ issues is important to help the client define goals and expectations, and for the therapist to design a therapy plan.
When you are training to be a Cognitive Hypnotic Psychotherapist, you not only learn to identify the symptoms the client presents with but also train to find the root cause (Secondary gains, beliefs, identity, past experiences), wherever applicable.
The clients do not come to you with a precisely defined problem or issue, rather a story of their lives. It is often difficult to filter out significant symptoms or issues in order to formulate a therapy plan for a specific client. The therapist should be able to cut through the clutter and objectively identify the key symptoms that are important to help the client reach the desired outcome.
Finding Root Cause (Secondary gains, beliefs, identity, past experiences)
The client’s problem may have several layers and broadly, the symptoms or surface issues or presenting problem and the root cause or the deeper issue. These layers may include lack of clarity, skills and resources, ongoing thoughts and emotions, beliefs, values, positive intentions or secondary gains, identity, suppressed emotions, past experiences and repressed memories. The therapist should be able to identify each layer and resolve the problem at the specific layers while ensuring that therapy remains a seamless experience for the client.
- Identifying Symptoms
- Finding Root Cause (Secondary gains, beliefs, identity, past experiences)
The client is able to truly create and sustain change, in other words, undergo a transformation when they can overcome the conscious as well as unconscious hindrances that stop them from creating changes.
These hindrances may include ongoing thoughts and emotions, beliefs, patterns of behaviour, secondary gains, past experiences, suppressed emotions and repressed memories.
Cognitive Hypnotic Psychotherapists can help clients restructure thoughts, release and replace emotions, develop skills, modify behaviours, change underlying beliefs, address secondary gains with harmless or productive behaviours, resolve trauma, work with repressed memories and reframe or re-imprint past experiences. They are not only able to help the client resolve all these but also do it in a manner that is sustainable and effortless, without creating an internal conflict.
Automatic thoughts can stop the client from doing a task or making the change in the direction of their desired outcome. Since these thoughts are automatic, the therapist should be able to help the client identify and replace these thoughts naturally and automatically, without confrontation or inner conflict.
Releasing and Replacing Emotions
Emotions are another source of unconscius hindrances. Effective therapy may require facilitating the release of suppressed emotions that may lead the client to a breakdown. In addition, there may be current emotions that may be stopping the client from making desired changes in their lives. A therapist should be able to help the client identify the emotion and replace it with an effective emotion that can support the change.
While thoughts and emotions can help the client develop a resourceful mental state to achieve the outcome, it is equally important for the client to be able to develop the skills required to take the necessary action towards their goals. The therapist should be able to help the client identify the skills they need and then access a resourceful mental state to develop those skills.
Sometimes, patterns of behaviour the client is stuck in are preventing the client form changing. In addition to resolving thoughts and emotions, the therapist should also be able to work with behaviours directly, disrupt unproductive patterns and install ones that are useful for the client.
Often referred to as limiting beliefs, underlying beliefs or rules may lead to hindering thoughts, emotions and behaviours that are creating a problem in the client’s life. These beliefs may show up in multiple behaviours or multiple areas of a client’s life. The therapeutic process should include diagnosing such beliefs and changing them into ones that will help the client reach the desired outcome.
Handling Secondary Gains
Behind every behaviour is a positive intention, which may be conscious, but is usually hidden in the unconscious. Without fulfilling that positive intention or secondary gain with an alternate, harmless or productive behaviour, it is difficult to create sustainable change. And even if change happens, the likelihood of relapse is really high. To prevent relapse and to enable the client to change naturally and effortlessly, the therapist should be able to work with these secondary gains.
Past emotional trauma can show up as seemingly unrelated symptoms and problems in the client’s present life. In such cases, trauma resolution becomes extremely necessary to help the client get rid of the unnecessary emotional baggage and suppressed emotions, as well as move forward in life. However, an effective therapist should be able to do so swiftly, without exposing the client to the risk of reliving the trauma during the course of therapy.
Working with repressed memories
When repressed memories are causing problems in the client’s life, it is vital to access and resolve repressed memories to relieve those symptoms. The Cognitive Hypnotic Psychotherapist can help the client access the memory, resolve the stored emotion, learn from the memory and move forward.
Re-framing / Re-imprinting Past Experiences
It’s usually not things, events and situations that create a problem in the client’s life, rather the perception of those events and situations. The therapist should be able to help the client reframe past experiences in order to move past Tham and start creating the life they want to live, unhindered by that past experience.
- Restructuring Thought
- Releasing and Replacing Emotions
- Developing Skills
- Modifying Behaviors
- Changing Beliefs
- Handling Secondary Gains
- Trauma Resolution
- Working with repressed memories
- Re-framing / Re-imprinting Past Experiences
Once the process of therapy is initiated, it is important to ensure that there are visible or measurable results. These results will help the therapist identify the effectiveness of the therapeutic tool/model used and decide whether to continue or change the process/model.
This competency also helps the client understand the therapists effectiveness and skill set or decide if he/she wants to continue therapy with the same therapist.
Raising awareness and insights:
This therapeutic competency is about the ability to integrate, accurately assess and interpret various information to help the client gain awareness and achieve agreed-upon results. The client will be equipped to identify facts from the interpretation and distinguish between behaviours that need to be worked on to ensure the desired outcome is met.
Insights play a very important role during therapy. They can act as a seed which when nurtured during the therapeutic process can lead to client overcoming their challenges and achieving the desired outcomes.
Since insights are spontaneous and come from the unconscious mind, a therapist’s ability to work with the unconscious can be very handy. While therapist can use processes to help the client tap into his/her unconscious, the therapist also enables the client to develop mindfulness leading to increased awareness about themselves and their lives.
The therapist should have the competency to ensure that the client is open to all possibilities. At times certain thoughts, emotions, beliefs, past traumatic experiences lead to the client not being open to things that may be beneficial for overcoming the challenges and achieving the desired outcome. The therapist would help the client restructure these things that are essential for a better tomorrow in life.
This also inculcates a sense of hopefulness within the client thereby looking at things in the rawest form possible and not interpreting them with his/her own biases.
Ecological goal setting:
Since therapy is about helping clients overcome their challenges and achieve desired goals, goal setting becomes an extremely important part of the therapy process. Having said that, there are times when one goal can negatively influence other goals which may be more important from the point of view of the clients unconscious.
In such cases, the unconscious doesn’t support the accomplishment of these goals which can lead to self sabotaging. Ecological goal setting ensures that goals are set in a way that they do not negatively affect any other goals.
This competency is about the ability to co-create opportunities for ongoing learning and for taking new actions that will most effectively lead to agreed-upon therapeutic results. This can be achieved through brainstorming and assisting client define actions that will enable them to demonstrate, practice and deepen new learning.
Challenging client’s assumptions, helping them to evaluate options, focus on alternative ideas and solutions, and explore specific concerns and opportunities vital to the therapeutic outcome is equally important whilst designing action plans for them.
After helping clients create ecological goals it is necessary for the client to also ensure specific steps to take them from where they are to move to desired goals. In order to understand these steps, a therapist helps the client explore and evaluate different ways, options, ideas and solutions.
Managing Progress and Accountability:
This coaching competency is about the ability to hold attention on what is significant for the coachee and to leave the responsibility with him/her by clearly requesting the coachee to stick to the agreed plan of actions that will move the coachee toward his/her stated goals.
Following through – by asking about those actions that the coachee is committed to in previous session(s), and acknowledging the lessons learned, what was done and what wasn’t along with keeping the coachee on track by holding attention to the coaching plan and the desired outcome – is important.
- Raising Awareness & Insights
- Inviting the possibility
- Ecological Goal Setting
- Designing Actions
- Managing Progress and Accountability