Weaning Patients Off Therapy

Therapy has a snowballing effect.

It is often said that when Patients enter therapy most of the therapeutic work happens in-between the sessions. This is because of a snowballing effect that occurs when a therapist intervenes in a Patient’s life. A hypnotherapist will intervene in such a way as to cause a chain reaction. This chain reaction is therapeutic in that it allows certain cause and effect mechanisms to occur in the person’s life in between therapy sessions and even after therapy has been terminated.

The therapist’s role is not only as a problem solver, the therapist should look upon himself as also a teacher. The Patient needs to learn not only how to solve their problems in the here and now but how to avoid future problems developing. More importantly, the patient needs to learn how to accomplish long-term goals. There comes a time in every Patient’s experience when they have to give up therapy. This isn’t to suggest that therapy has to be a long-term experience. A Patient may only be in therapy for one, two, three or four sessions. Even if therapy is of short duration there usually remains a snowballing effect even after therapy has finished.

It is not unusual to find dramatic changes happening a lot later in a Patient’s life as a result of the therapist’s intervention during the problem phase of the Patient’s life. Sometimes these changes can be perceived as the result of the therapist’s direct intervention, at other times, there seems to be no direct cause and effect relationship, however in retrospect as the therapist or Patient looks back over the life of the Patient it can be seen that certain events or situations may not have occurred if it had not been for the therapist’s intervention.

At some time patients may need to be “weaned” off of therapy.

The last thing that we want is for Patients to become dependent on us. Ideally patients should feel responsible for their own changes while acknowledging the participation of the therapist as part of the process, but no more. When the therapist considers that treatment is nearly over he should start the process of weaning the Patient off of therapy. This is usually done in two stages:

1. Re-framing therapist/Patient relationship.

2. Clearly defining long term goals for the Patient.

Stage 1. The Patient/Therapist relationship should be re-framed.

It is usual for the Patient to consider that the therapist is a least partially responsible for any therapeutic changes that occur in the Patient. Often a friendship of sorts develops over the duration of therapy and while this is useful for building rapport it shouldn’t become so strong that the Patient feels reluctant to finish the therapy. It would be wrong for a Patient to remain in therapy simply because he or she is afraid of losing a friend. So the therapist has to re-frame the particular positions of the therapist and Patient. Ideally the Patient needs to feel confident that the therapist is still going to be available as a support, even if the Patient no longer needs therapy. The Patient should feel responsible for his own recovery while acknowledging the help of the therapist. Knowing that the therapist is available, the Patient can feel more independent and able to leave the therapeutic relationship.

Stage 2. Patients should have clearly defined long-term outcomes.

As part of this weaning process it is important for the therapist to make sure that the Patient knows where they will be going in the future. Clearly defined long-term outcomes are very useful. They are important not only so that the Patient continually moves forward in a positive direction, but also for the Patient to feel they have a “map of their future”. Having this map gives the Patient the confidence to finish therapy.

The decision about when to finish therapy is contingent upon the therapist’s skills in knowing that the Patient is independent enough to be able to progress on his own. Usually this decision will be made after significant changes have occurred in the Patient’s life. These changes will sometimes be directly related to the problem that was first presented when therapy began or related to subsequent changes that have occurred as a result of the therapeutic interaction.

The therapist should already have identified the needs of the Patient, their beliefs, values and criteria and interwoven these with the long-term future goals of the Patient. By integrating the meeting of these needs with the therapeutic goals of therapy, the therapist will motivate the Patient towards feeling more independent and positive about the future after therapy has been terminated.

Future planning criteria:

• The therapist should develop ways of helping the Patient to decrease dependency on the therapist by re-framing the Patient’s perception of the therapist being a therapeutic friend to being a distant support.

The Hypnotherapist should help the Patient plan realistic long-term goals that fit in with the Patient’s positive beliefs, behaviors and values, especially any that have developed during therapy.

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