The Secret Ingredient of Effective Hypnotherapy: The Science of Rapport-Building

Effective Hypnotherapy Delivery

Introduction

This work aims to describe the importance of the therapeutic relationship in hypnotherapy, and also to describe the process of building rapport and the significance of this process in the relationship with the client.

1. Relationship in hypnotherapy

Building a relationship between client and therapist is of great, perhaps even the most important, part of therapy. There are many aspects to this process and the main task of the therapist is to establish a trusting contact with the client in order to make the therapy as effective as possible. This contact in therapy is commonly referred to as a rapport.

1.1. What is rapport?

But what is a rapport? Is it a process, an action, a contact or a therapeutic skill? According to Zakaria and Musta’amal (2014, p.2) rapport is defined as “the ability to connect with others in a way that creates a climate of trust and understanding”.

From this, it can be assumed that rapport is a skill or an ability of a person to communicate or come into contact with another person. It is important to note that this contact is not necessarily verbal, as will be discussed in more detail below.

However, Reiman (2007) states that rapport “is a relationship in which the clinician simply clicks with the client and it is a continuous process that must be nurtured during each session”. Firstly, Reiman says that rapport is a process. Secondly, it may seem that rapport is some kind of magic that does or does not occur between client and therapist in the first seconds of contact.

However, if considering that everyone is different, with a different set of characteristics and qualities, with a different culture and background, we can say that the rapport is also the first feeling that arises between two people, and the stronger the rapport the more clear it is to the individual that there is someone they can trust in front of them.

That is, the rapport is also a sense of a kinship, which gives both client and therapist a hint as to whether or not the two people are suitable for each other. In the end the therapist is not just a toolkit for his client, but rather a person first and it is then that the rapport or the level of strength of the rapport plays an important role for both parties to understand the possibility of further progression.

Since rapport is the combination of a first feeling between two people and also the process by which this communication can be established or improved, it can be agreed with Horvath and Greenberg

(1989) who state that rapport is not only every therapist’s objective but also “a therapeutic alliance which is aided by various aspects of the therapist’s behaviour, such as language, facial expression, body language, warmth, etc”. Leach (2005) also supports that “establishing client rapport is the therapist’s first objective” However, before going on to the discussion of why this is so important, it is worth highlighting the responsibility in building the client-therapist relationship.

1.2. Who is responsible for the relationship?

It is important to realize that in any relationship, just as in the client-therapist relationship, there are always two participants, where both are responsible for being involved in the process, namely to be interested in making this communication happen. However, although both participants are 100% responsible on their part, the tools or steps to build rapport are different.

For example, it is enough for the client to be motivated and to express interest in contact with the therapist, while the therapist needs to take a number of conscious actions to make this contact happen. For example, Horvath et al (2011, p.11) state that rapport is “partnership and mutual collaboration between therapist and client.”

2. Building Rapport

2.1. How to build?

The task of the therapist is to establish rapport with his client, and to do this as consciously as possible. However, the therapist’s personality itself is not something that can be controlled or managed, so the natural qualities that the therapist possesses are aids in establishing rapport and do not need to be particularly reinforced. For example, according to a review by Keijsers, Schaap, and Hoogduin (2000), among the factors related to positive treatment outcomes among therapists were “empathy, genuineness, warmth, and positive regard.” It is these qualities that form the base on which one can build the rest of the actions to develop a rapport with the client.

Young (2017) describes different ways to build a rapport with a client and these include maintaining a sense of calm, soliciting client’s opinion, being patient, putting therapist’s ego on the back burner, allowing the client to appear smart and insightful and avoiding behavior that is humiliating to the other person. In this way, the author describes actions that help the client to feel valued and appreciated through the therapist’s actions aimed at emphasising the client’s importance in the therapy process. In addition to the attitude towards the client, the author talks about how important it is to remember to take very specific actions that help to build rapport with the client. For example, making eye contact or choosing the right tone of voice and speed level depending on what is more natural for the client.

Additional methods also include starting with a small talk at the beginning of the therapy or integrating humour into conversation as appropriate. The last is of particular importance because human physics has arranged it so that laughter and humour are only possible where and when one does not feel danger. This biological programme has its roots in an ancient time, because running away from danger or defending against attack, all the systems of the human body are geared towards survival, which means that there is no place for laughter, which is the exact opposite of the defence mechanisms. Laughter is relaxation, it is the body’s response to a safe environment, so through laughter there is an opportunity to influence the body and the psyche and to lower the protective barriers that may hinder the client from going into the therapeutic process.

According to Lonczak (2021) an important point in establishing rapport with the client is also asking the right questions, which allows the therapist to “put the client at ease while also eliciting key information”. The right questions mean thoughtful and well-calibrated questions that not only avoid confusing the client, but also help them to see the answers to their questions as quickly as possible while feeling safe. For example, Young (2017) suggests using open-ended questions because they are the ones that help get as much information from the client as possible.

Among other recommendations that Young (2017) describes, it is also worth mentioning such as “attending to the client’s non-verbal cues”, which means reading how comfortable or uncomfortable the client is depending on their body position, gestures, facial expressions and using this information to eliminate discomfort. For example, if the client is crossing their arms, perhaps it is because the distance between the client and the therapist is insufficient or the temperature and light in the room is disruptive and creates barriers. Of course, the honesty and openness that the therapist can demonstrate can also help to improve rapport. Namely, it is possible to tell the client directly that the therapist wants to do everything possible to make the client feel comfortable, but also to tell them that they can share their feelings and ask for feedback, which in itself helps to establish rapport.

The last but not least important to mention is using reflective listening and paraphrasing as well as engaging in active listening, so the client feels truly heard (Young, 2017).

2.2. How to maintain rapport?

Since rapport is a process of building trust between client and therapist, special care must be taken to ensure that this communication is maintained and, as with any relationship, never assume that rapport is built up only once in the beginning and requires no further effort. Myers (2000) suggests that there are three basic principles to build on in order to maintain rapport, such as “expressing non-judgmental acceptance, listening carefully, which includes remembering details and providing feedback through paraphrasing, questioning, and summarising”. Vincent (2018, p.167) supports the opinion that

non-judgmental acceptance is one of the most important foundations in rapport building, where the client’s reasoning is along the lines of ‘If I am not being judged, perhaps I am not as evil or abnormal as I have thought’.

Because rapport is a communication between two participants, it is important not only to give but also to receive feedback from the client. It makes it possible to maintain trust between client and therapist, and also helps to equalise positions where there is a lack of superiority of anyone in the communication.

The therapists’ self-validation process is another key to maintaining an established rapport. According to Kocabas and Üstündağ-Budak (2017) and Linehan (1997), the therapist is responsible for being in constant work on their own performance, so the authors recommend referring to questions and occasionally reflect on the questions such as “- Am I mindfully listening?”, “Am I accurately reflecting and acknowledging what is being said?” etc.

3. Why is it important?

3.1. Rapport's Impact: Treatment Success, Therapy Duration, and Client Experience

Client’s Motivational Growth

Rogers (2021) states that “by identifying with another person’s situation, the therapist elicits the client’s trust, which is crucial for motivating clients to change”. This means that rapport not only removes protective barriers, but also has a direct impact on how effective the therapy as a whole will be, because without the client’s willingness, it is impossible to achieve any results whatsoever.

Therapy Outcome

It can be argued that rapport is a direct source for therapy to be successful, as Horvath et al (2011) also say in reference to “strong therapeutic alliance is predictive of desirable treatment outcomes”.

Harwood and Eyberg (2004) also support this view, as after examining verbal behaviours among therapists, the researchers found that “supportive therapist verbalizations predicted greater treatment success”.

Another study by Joe et al. (2001) examined the relationship between drug abuse outcomes and rapport between the patient and their therapist and found that a greater degree of rapport resulted in less cocaine use.

Longer stay in therapy

Since rapport affects the client’s motivation and the results of therapy, it can be said that the results become visible and tangible to the client much sooner, which in turn can influence the client’s desire to stay in therapy longer and continue the therapy.

For example, based on a study conducted by Kasarabada et al. (2002), they found that “positive perceptions of counsellors were associated with significantly longer stays in treatment and better psychiatric outcomes”.

Deeper processes in client’s experience

Last but not least, the client’s experience also always depends on the level of rapport.

It is on the basis of trust, understanding and support that the client has the desire and opportunity to share their innermost secrets, feelings and fears (Lonczak, 2021) and “explore the hidden places of their lives” (McMinn, 2021).

3.2. What if rapport is not there?

Lack of trust

It is not hard to predict that without rapport the client may have an even greater resistance to opening up and going to therapy.

For example, Young (2017) says that trust and rapport are inextricably linked in therapy, and that both are “connective tissue for gaining and maintaining healthy relationships.”

Lack of result or desired outcome

Since a lack of rapport can create even more barriers between client and therapist, it is important to note that such therapy is likely to be ineffective and most likely to fail.

Lack of Motivation for further therapy with any therapist

The most unfortunate consequence of a lack of rapport can be the reluctance of the client to try therapy in the future, since a negative experience often has an impact not only on the current decision not to continue, but also on all subsequent decisions. This in turn can also mean that the client is more likely to suffer from the problem with which they have approached the therapist than to give this or another therapist another chance.
Code of Ethics

4. Working within Code of Ethics

Of course, using the HS ethical framework is necessary and very important precisely because it enables the hypnotherapist not only to be a person who wants to help others, but moreover to be a professional and provide this help according to a code where the client’s interests come first, where both parties involved are protected, where there is also confidence that no harm will come to the client.

The point is that the professional hypnotherapist must be a tool for the client, through whom the client in turn receives the necessary results and positive dynamics. This is possible if the therapist is aware of the importance of the fact that his opinion should not exist in the therapeutic process.

This is very important precisely because every opinion is based on prior experience. As such, any desire to advise or help someone through one’s opinion can only be detrimental, because it may be totally inappropriate for the other person. This is why it is so important to remain impartial and neutral when working with clients, like a white paper, where the only objective is for the client to understand for himself what is best for him.

In this way, by relying on a code of ethics, the therapist gives assurance to his clients that he will act professionally within the professional community and based only on the client’s best interests. It is also important because the therapist thereby gives himself a promise of self-improvement and of finding answers to questions such as – where can I get better or what responsibility do I have towards the client?

As for the most important clauses of the code of ethics, every therapist certainly has to have a feeling that he or she complies with each of them. For example, the principles described above fit with such points as justice, where there is no room for judgment in practice, and also with the point of working towards the good of clients. Or, integrity and self-responsibility are the two others to bear in mind all the time. It’s a reminder that you can’t separate your role as a therapist from your role as a person in life, so it’s important to be honest and self-responsible by nature and only then be a therapist.

It is a reminder that integrity and responsibility for your health, your condition, your qualifications and so on is just as important because the quality of communication with potential clients depends on it.

Conclusion

In conclusion, it is important to note that rapport is without exaggeration a key aspect in therapy, on which depend not only the outcome of the therapy itself, but also the depth and experience of the client.

Questions and Answers

Rapport is the ability to connect with others in a way that creates a climate of trust and understanding. It is a combination of a first feeling between the therapist and client, and the process by which this communication is established or improved.

Both the therapist and the client are responsible for building rapport, although their roles and actions may differ. The therapist should take conscious actions to establish trust and communication, while the client should be motivated and express interest in the therapeutic process.

A therapist can build rapport by maintaining a sense of calm, soliciting the client’s opinion, being patient, putting their ego aside, allowing the client to feel smart and insightful, and avoiding humiliating behavior. Maintaining rapport involves expressing non-judgmental acceptance, listening carefully, and providing feedback through paraphrasing, questioning, and summarizing.

Rapport is important because it impacts treatment success, therapy duration, and the client’s experience. A strong rapport can motivate clients to change, result in better therapy outcomes, encourage longer stays in therapy, and allow the client to explore deeper emotional processes.

The Code of Ethics provides guidelines to ensure that a hypnotherapist acts professionally, impartially, and in the best interests of their clients. By adhering to the Code of Ethics, therapists can build rapport with their clients while demonstrating integrity, self-responsibility, and a commitment to self-improvement.

References

Viktoria Nazarov - Hypnotherapist

Viktoria Nazarov

Accredited Hypnotherapist

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