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Course Code: MANCH 1 A

Name: Zoe Stux

Phone No: 07801 733775

Email: zoestux@hotmail.com

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

Word Count: 2000

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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

Zoe Stux – Year 1 Chrysalis Counselling and Psychotherapy