As a Registered Nurse and Cognitive Hypnotherapist, I have an ethical duty to keep anyone I see professionally as safe as I possibly can, as well as to deliver effective therapy.
That's why I didn't rush to re-open My Hypnotherapy Works too quickly and why I have taken the decision to go back to all sessions being online - everyone's safety is paramount and there isn't much point in working on resolving one issue with a client and causing them to become infected with a - potentially - deadly virus.
Perhaps selfishly, having been a Senior Sister on a busy Intensive Care Unit, I have absolutely no desire to find myself - nor anyone I care about - as a patient in intensive care.
Risk Assessments for Face to Face Consultations
Standard Virus Transmission Risks
Existing transfer points gate latch and gate, lightwell railings, consulting room door handles and surround, client seating, adjacent table, tissue boxes and any pencil/ballpoint pen, or any documentation handled by both client and therapist, any water glass or jug, any contactless or other card payment using the erpos terminal. Use of any handwashing, sanitising or toilet facilities and associated access routes and spaces not designated for exclusive client use.
Existing transmission risks - airborne droplets, airborne virus, hand contact.
Are there any particular facets of face to face Hypnotherapy that increase any of these risks? Provided social distancing of 2 metres is maintained there is no increased risk associated with My Hypnotherapy's normal practise.
Location Specific Risks
Client route between parking area and consulting room - no specific risks relating to route which is 100% in the open air.
Consulting room specific risks - The consulting room is sited within a listed building which has a narrower than standard doorway. The consulting area is compact, and maintaining consistent 2 metre separation is not possible. Ventilation of the room is limited to leaving the door open - where possible - but this does not lead to any through air currents dispersing any breathing droplets away from either client or therapist.
Mitigation for Identified Risks
Provision of dedicated client Hand Sanitising Station under cover in the lightwell - non contact dispenser for alcohol sanitiser sited on a small table.
Risks mitigated - transmission of virus by hand contact by the client into the consulting room on the way in, transmission from the consulting room to the client's car.
Cleansing and sanitising with alcohol sanitiser of all identified points for virus transmission by contact - before and after each client visit.
Use of online session for Initial Consultations and Extended Client First Appointments - All Initial consultations will take place online or by phone call. There is no additional benefit for either client or therapist to conducting these in-person.
First Appointments will take place on-line. Because these sessions are, typically, longer the exposure of both therapist and client to an enhanced viral load - should either be infected with Covid-19 - and because a great deal of the session is spent going through paperwork, signing forms, passing paper based material between client and therapist, gleaning client specific verbal construct information in conversation and exploring and analysing their issue in some detail, there are enhanced risks of transmission in this particular session which outweigh any benefit to either client or therapist.
Regular Client 60 Minute Sessions - provision of PPE and PPE use by client and therapist. The basic requirement for Hypnotherapy is that the therapist has clear sight of the client's face and, ideally, upper body and hands - in order to read non-verbal communication cues. Accordingly, to minimise airborne and droplet borne transmission, both therapist and client will wear clear visors throughout the session. Facemasks cannot be used as these conceal important visual cues.
Teenagers - All sessions will be organised as per adult sessions - the risks can be adequately communicated to this group - so are not enhanced. On-line sessions will be used where parental presence is required or requested by the teenager.
Children - In most cases, for the present these will be held as on-line sessions only.
There are some quite significant advantages to online therapy for children which parents might not at first appreciate.
Zoom offers the ability for both parents to be observers in the session regardless of their location.
Most children are far more screen savvy than adults - it is a natural arena for them.
As a therapist, it is easier for me to see the point at which a child 'detaches' from therapy online and I can more easily change 'tack' to re-engage their attention.
Because many of these younger clients (Ages 6 to 11) feel it is important to have their parents with them during Hypnotherapy, the enhanced potential viral load caused by 2 adults and a child in My Hypnotherapy Works consulting room enhances risk to all beyond any acceptable level. Additionally, social distancing and avoiding touching anything unnecessary are more difficult to control with children and, because, so many of the face to face techniques My Hypnotherapy uses rely on closer contact than would be necessary or natural with adults, for the moment, children's sessions (ages 6 to 11) will be held on-line.
Additional Mitigation Strategies - under review. Provision of gloves as an additional measure to avoid contamination by hands within the consulting room.
Annie Winfield-Shearer