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Running head: HOW I WORK WITH A CLIENT 1
An Example of How I Work With a Client
David Grinstead
NorthCentral University
2007
Author Note
David Grinstead, Psychology Department, NorthCentral University .
David Grinstead is now at Department of Continuing Education, Alamance Community College.
Correspondence concerning this article should be addressed to David Grinstead, Department of Continuing Education, Alamance Community College, P.O. Box 8000, Graham, NC 27253-8000. Contact: dcgrinstead879@access.alamancecc.edu.
More information regarding the author is available at www.linkedin.com/in/livealife.

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HOW I WORK WITH A CLIENT 2
Abstract
Using a case study (the client’s name and other personal details have been altered for identity protection) as an example, this paper provides an overview of how I design and assist a client with a treatment regimen that uses a mixture/combination of clinical hypnotherapy, life coaching, and spiritual counseling/direction.

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In my private practice, I offer three services: life coaching, spiritual counseling/direction, and hypnotherapy. Though each is a distinct discipline and modality of treatment, I often combine them when developing a treatment regimen for my clients. This allows me to use a fluid combination of directive and non-directive techniques. Life coaching by design is directive, goal oriented and outcome based. Hypnotherapy techniques depend on the personality and suggestibility of the client, however, my preferences are to use non-directive techniques as much as possible. Spiritual counseling/direction is usually non-directive by nature and design.
I do not engage in the independent diagnosis and treatment of medical disease. The bulk of my clients are normal people who need assistance in resolving the normal routine problems of living. Both DSM-IV-TR and ICD-9 contain V-Codes that are used to describe routine human problems that are not the focus of a mental or medical disorder. The more common V-Codes a hypnotherapist might use are:
V61.90 Relational Problem Related to a Mental or Medical Condition
V61.20 Parent-Child Relational Problem
V61.10 Partner Relational Problem
V61.80 Sibling Relational Problem
V62.81 Relational Problem Not Otherwise Specified
V62.82 Bereavement
V62.30 Academic Problem
V62.20 Occupational Problem
V62.89 Religious or Spiritual Problem, or a Phase of Life Problem
V62.40 Acculturation Problem
V68.20 Request for Expert Advice (National Guild of Hypnotists)
The only exception is when I do medical hypnotherapy for conditions such as pain control, FMS, IBS, depression, diabetes, etc. which requires a written referral from a licensed medical practitioner.
The prime use of hypnosis concerning bereavement is to assist a client that is stuck and immobilized in one of the stages of grief. Hypnosis is an aid in returning to the natural process of

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grieving, enabling a person to continue to move at a beneficial and healthy pace through all stages of grief and into recovery. When feeling completely overwhelmed and unable to function due to the progression of emotions that accompany bereavement and grief hypnosis reduces the severity thereby empowering the client to return to an acceptable level of functionality and life control.
My role as a life coach is to assist clients in identifying the interference that stands between them and the achievement of their potential and life goals. It is about eliminating obstructions and focusing on the motivation of achievement. I believe that my clients already have all the resources they need to solve their own life challenges. As a life coach I allow my clients to find the answers for themselves and then assist them in applying these answers to the best of their ability.
Using spiritual counseling and direction, a client can reflect on the experiences of their daily life. Gradually, a person may begin to experience God’s presence and grace in their life and come to realize how God’s spirit is truly present every day and everywhere, as close as a person can be to one’s own self. Spiritual counseling is about being invited to draw closer to God. A person is invited into this relationship whether he or she attends a church, mosque, synagogue, temple, or none of these. Spiritual counselors come in all faiths. Clients also use spiritual counseling or direction to let go of worry, fear, sadness, or grief; share struggles, losses, or disappointments; and find encouragement and affirmation.
A 60-year-old male, who I will call John, recently came to me for help. His wife died of cancer. She was an in-home Hospice patient and died in her sleep during the early morning hours while John was asleep in an adjacent room. John was her primary caregiver for 1.5 years. He sleeps one to three hours nightly and has been drinking excessively for the past year during which time he gained 26 pounds. For approximately one year he has worked in a herbal/health food retail store at a low hourly wage and does not practice his profession as a Doctor of Homoeopathy. He

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f recently ound a letter that his wife had written to him prior to her death the contents of which left him feeling that he had abandoned her.
John describes himself as highly spiritual yet not religious. He attends a New Thought Church and believes in divine purpose and reincarnation. There is a psychic/medium that John and his wife consulted jointly on multiple occasions while she was still living. A few months after his wife’s death, John had a session with the psychic/medium during which his deceased wife‘s presence was channeled. He describes the experience as positive and beneficial.
On a private client confidential information intake document, John described his situation as follows:
 If using any medications, list name of each and why. Was using Ambien for insomnia and Xanax for anxiety--discontinued use
 What is your profession? Doctor of Naturopathy
 How can I assist and be of help to you? Is there a problem? What is it? Explain? guilt, anger, grief associated with wife’s death, insomnia stemming from feeling of abandoning her and associated guilt
 When did the problem begin? Shortly after her passing.
 What was going on in your life at the time? Extreme stress and turmoil/emotional loss.
 What have you been currently doing about it? supplements, meditation, then medications which I have voluntarily discontinued.
 How has that been working for you? No!
 How would your life be different if you didn’t have this problem? More rested, clarity of mind with less confusion--more energy--and possibly more enthusiasm.
 Tell me about the times you don’t have this problem. Most of my life prior to the last 2.5 years was not plagued with doubt, fears, depression. Have had depressive periods but usually optimistic.
 What do you want? I need to learn to give myself permission to relax, rest, and sleep. Also, I need to learn to forgive myself and accept myself for who I am, without false expectations. I’ve also lost focus--need to concentrate.
 How will you know when you have what you want? Ultimately, when I can reach a Zen like state of acceptance. More immediately, when I am able to deal with the grief of losing my wife in a more serene state--accepting that which I cannot change.
 What is stopping you from having what you want right now? Emotions of grief, doubt, anger--lack of interest, passion, feeling lost and uncertain. Obviously due to grief, but I believe much more underlies these surface emotions.

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 What have you been currently doing to help yourself? Before and shortly after losing (wife’s name)--using medication to numb myself and sleep. Now, anxiety and uncertainty, without meds, but using diet, supplements, and affirmations to support and restore myself.
 List seven ways your life will be better when you get what you want? When the underlying issues of insomnia and hyper alert state are understood and deactivate. I believe I can restore my concentration, and reduce the feeling of confusion and lack. At this point, possibly I can start to restore my life to living as one, instead of two, with renewed interest I life. Regain enjoyment of life, renew my body as well as mind and spirit. Restore my business by believing in myself again. Ultimately help others with the gifts that (wife’s name) and I both employed in our herb business.
 Are there any other things you would like to deal with or work on even if not done today? As alluded to above, but very important--learn to relax and stop blaming myself.
The first session with a client is generally two hours long during which I do an assessment, test for suggestibility, teach cognitive relaxation techniques, devise a preliminary treatment regimen, and introduce the experience of hypnosis via listening to a pre-recorded generic stress/anxiety/relaxation C.D. while in my office. The client receives a personal copy of the C.D. with explicate instructions to listen to it passively once daily until returning for their next appointment. Often there is other accompanying homework.
After his introductory session, John’s homework was to go on line and take these positive psychology assessment tests at http://www.authentichappiness.sas.upenn.edu/resources.aspx : VIA Signature Strengths Questionnaire that measures 24 character strengths, CES-D Questionnaire that measures depression symptoms, Authentic Happiness Inventory Questionnaire that measures overall happiness, and General Happiness Questionnaire that assesses enduring happiness. In addition, I instructed him to listen to his stress/anxiety/relaxation
C.D. nightly at bedtime, stop all meditation/inner work, perform some weekly volunteer work,
and practice Centering Prayer twice a day.
John’s treatment regime consist of six sessions one week apart using life coaching anchored

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with hypnotherapy and hypnotic topic specific suggestion content.
Session 1 (completed): Goals: deep relaxation, de-stress, reduce sleeplessness, stop self-blame, and get unstuck. Life coaching homework directives: (1) write a brief preliminary business plan to re-establish personal practice as a Doctor of Naturopathy (2) make a life inventory balance sheet listing on one side the current positive aspects of his life situation and on the other side all the current negative aspects of his life situation, transfer the positive aspects or blessings to multiple 3x5 index cards and post them in highly visual places (bathroom mirror, car dash, etc.) where they can be viewed and read often throughout the major portion of the day. Spiritual counseling/direction: VIA Signature Strength assessment ranked forgiveness and mercy as a top five signature strength--instructed to use “forgiveness and mercy” as his phrase/word of intent when practicing Centering Prayer twice daily. Hypnotherapy (This session was recorded live to a cassette tape that was afterwards given to the client with instructions to listen to it once daily until returning for the next appointment): Induced a state of deep relaxation and high suggestibility using progressive relaxation, guided imagery, and deepening techniques; followed by hypnotic trance using a non-directive metaphor for someone who has lost a loved one combined with a directive generic bereavement/grief script retailored to the specific needs of the client.
BURIED TREASURES
A metaphor for those who have lost someone.
I wonder if you have ever seen the small fragile glass figurines that artisans sell at fairs and in shopping malls, made of tiny strands of clear bright glass all carefully laced together to form the shape of a ship or an animal, or even a house or a tree,
that seem to fascinate children with their delicate sparkles and shapes like priceless jewels, valuable possessions, to be carried in velvet cases and protected, kept safe from loss or damage, tiny treasures, a gift to someone, like the treasures carried in ships across the sea.
There was a program on TV several years ago, about a man who spent twenty years searching for such a ship, a lost treasure ship, and one of hundreds that had been lost along the coast because of accidents and disasters and wars. He researched it

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very carefully, and thought he knew exactly what had been lost. He also thought he knew what had happened and where the treasure had sunk. But it was hard to find that ship, it had been lost for so long. It had gotten buried with mud and coral, and there were many other wrecks in the area, any one of which could have been the one, but wasn’t.
So he spent many years searching, and he raised thousands of dollars from investors, because he was convinced there was something of great value down there, lost treasure of immeasurable worth, and he convinced others it was there too, family, friends and the divers who worked with him, searched for it year after year, until finally one day the divers returned to the surface shouting and screaming and holding up gold bars. They had found that ship, and it contained more than you can imagine, tons of gold bars, silver bars, gold coins, precious jewels and elaborate jewelry, priceless objects, treasure untold, things from the past that had gone untouched, that had not been seen for hundreds of years suddenly were there for people to hold and to feel.
And they held them with reverence, touching them gently and silently, as if these things that had been lost for so long, contained some memory of the past, something special to protect, like those tiny glass figures that you see at fairs and malls. They seem to be so fragile, so easily broken by someone rough, but they actually are quite sturdy and can survive for years and years, even when lost or hidden away, like the treasures at the bottom of the ocean, hidden deep down below, something precious and valuable inside, a part of you, before. And the joy of its discovery, the recovery of that buried treasure, the pleasures of knowing it belongs to you, something you can bring back with you that warm good part of the heart of the matter that children sometimes lose for a time, or have taken from them at another time, but it always lies there waiting, waiting to be brought back to the surface where it can be touched and protected and enjoyed and kept close with you forever, now, because it all belongs to you. (Havens & Walters, pg. 110-111)
BEREAVEMENT
A generic hypnosis script for those experiencing grief.
Losing someone we love is the most difficult thing that we have to live through and at this particular time of your life I know you are experiencing many unhappy feelings that are hard for you to bear. We all go through the grieving process in our own way and at the moment you may feel that you are in a dark tunnel to which there is no end.
The emotions that you are feeling may change from day to day, they can range from denial to guilt or blame, from anger to eventual acceptance. Indeed, some people feel no emotion at all - it's as though a part of them has died as well. You may feel at times that you can't go on without the person you lost - but these feelings are perfectly normal. We ask ourselves, why did it happen? What is the point of living?

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What could I have done to prevent this happening? We may feel angry that they left us and again this is part of the grieving process. Only you know what you are feeling right now, but what I do know is that you're not happy with the way that you feel because this is why you are here today.
I also know is that you loved this person, still do, and I'm sure that you always will. No-one can ever take that away from you. In time it becomes easier for you, but if you feel like crying or screaming or shouting then that's what you must do.
Don't bottle those feelings up for they are an expression of your feeling of loss and the love that you have for (name of deceased).
When someone dies we are upset for ourselves. It's our loss that we feel. Your parent (friend, partner or whoever) is at peace, he/she may have been suffering but that suffering is over now and he/she will not have to go through any more. You may have some beliefs of your own that can help you get through this period. I personally believe that the soul never dies but goes back to where it came from - to where, one day, we all will go.
For those who believe in God they may ask, how could He let this happen? They say God moves in a mysterious way. Your loved one may have fulfilled his/her task in this life, and now it's time to move to a higher plane of existence. I'm sure you have your own beliefs but right now you're probably questioning them. One thing is for certain that there is a beginning and an end to our life on this earth. The cycles of nature continue forever, as the buds in spring form on a shrub and unfold into a leaf or a beautiful flower which opens up to the summer sun and turns brown with the autumn breeze before leaving its life and fluttering to the ground. And that leaf or flower will go back to where it came from - the earth.
Do you think all the other leaves and flowers cry as one is carried away? Soon the shrub will be bare; they will all be together again. There is a poignant verse from Winnie the Pooh - "Do not stand at my grave and weep - for I am not there - I am not asleep". Your loved one has transcended the physical life and is pure spirit again.
The memories that you hold in your heart are precious. Although the person you love is not there in a physical sense, none of your past is physical anymore so he/she will be with you forever. And your memories are like beautiful jewels, you can take them out and look at them and feel the spiritual presence of your loved one in you. You can feel that calm acceptance beginning to replace those conflicting emotions and even as you're listening to my voice, you're already beginning to feel better - life is becoming brighter as you see the light at the end of the tunnel. Okay you may still have a little way to go, but the light is there and gets brighter and brighter day by day.
I want you to feel the burden that you have been carrying now lifting away from

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you and feel your heart becoming lighter and lighter, as that calm acceptance begins to spread throughout your body. And every day becomes a little easier for you to bear. Every day you're moving further and further towards the light. You know that one day you'll be together again, but right now it's time to get on with your life. Just like your loved one would want you to do. (HypnoticWorld)
Client feedback: As he was leaving the office John said to me, “I feel lighter--you have a gift.”
Session 2 (scheduled): Focus: Saying Goodbye. Goal: alleviation of
feelings of guilt associated with “not being there” at the time.
Session 3 (scheduled): Focus: Preparing for Change. Goal: accept and work with the
inevitability of change--life’s beginnings and endings.
Session 4 (scheduled): Focus: Thinking for a Change. Goal: positive transformation of
self-sabotaging thoughts, feelings, and behaviors.
Session 5 (scheduled): Focus: Building Self-Confidence. Goal: restoring and empowering
the subtle seeds of self-confidence already present within.
Session 6 (scheduled): Focus: Career Planning. Goal: return to fulfilling work and
professional development.
This is a true-life example of how I incorporate life coaching, hypnotherapy, and spiritual counseling/direction to assist clients seeking help with their bereavement and grieving process.

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References
Havens, R.A. & Walters, C. (1989) Hypnotherapy Scripts: A Neo-Ericksonian Approach to Persuasive Healing. New York: Brunner/Mazel
Hypnotic World. (n.d.) Hypnosis Script: Bereavement and Grief. Retrieved October 10, 2007,
from http://hypnoticworld.com/
National Guild of Hypnotists (n.d.) NGH State Law Guide. Retrieved October 27, 2007 from
www.ngh.net