Client management case study for overweight client
2nd September, 20140 Comments
Written by: Susan Boggon-Smith MAPHP Accredited
John (Client name changed to protect his true identity) was a 51 year old, happily married gentleman, working as a bus driver, who came to see me first on the 31st of March 2011 asking for help to lose weight. He was a 5’10” man and weighed just over 19 stone 5lbs at the first consultation. He was clinically obese, and was experiencing breathlessness on exertion. John believed that he could not feel any worse about himself at that time
General principles of the first interview
‘You only get one chance to make a first impression.’
I believe that creating a good image building rapport at the first consultation is paramount to success. I endeavour to create a relaxing environment for my clients, taking in to account, diversity, equality, the scene, lighting, sound, etc. As some of my clients are obese I have to think about stair access and the type of chair to accommodate them.
Personal comfort is also important as I believe this is reflected in my voice and manner, and when I am relaxed and comfortable I am more efficient.
John’s first interview
Following a weigh in, at 19 stone 5lbs for his height of 5’10”, it was clear that John was obese. He was a little bit red in the face and breathless, but had been riding a bike. He did not appear particularly anxious, but told me that he was very keen to lose weight and often suffered from breathlessness. He appeared to be friendly and easy to get along with.
He said that he now felt ‘fat and ugly’. He said that his friends were saying, "You’re not yourself, not smiling as much". His goal/s were to get down to 16 stone, to feel ‘back on track’, to hear people telling him how good he looked now, and to feel healthier and less breathless. John said that he wanted good control of his diabetes.
On a daily basis he tended to avoid breakfast saying he was too busy, he ate fast generally and always cleared his plate. He said he was trying hard and was ‘stuck’ and now could not lose weight. I had identified some bad eating habits and more importantly his beliefs that he could not lose weight and that nothing seemed to work. Now I was going help him learn how he could change his beliefs and his old programmed way of eating to date, as well as his thoughts and feelings.
The first hypnotherapy session
I’d established John’s goal, motivation, beliefs and some key barriers in his mind, and that he could be described as a ‘Settler type’ with some ‘Warrior’ tendencies but little of the ‘Nomad’ (using principles from the books and training on Warriors, Settlers and Nomads, by Terence Watts). He was auditory and kinaesthetically strong, but visually weaker visually. He was also an ‘external’ type of person, none procedural, but still liking a process, with some ‘sameness’ qualities (words that change minds). He accessed the past in the right hand side of his brain. As a general rule he liked to keep everybody happy, and please others, or a typical ‘people pleaser’.
The pre-talk was about gaining agreements, and a discussion about how I would teach him self- hypnosis and I wanted to help him establish new eating patterns and understand the importance of this. I used some conscious teaching methods, to help him understand what was happening when he went to place food in his mouth, and what influences both internal and external and programmed habits were at work with his problem with overeating. We discussed our ancestral genes, hormones, comfort eating, eating habits from childhood, modern food marketing, and the physiology of eating. I then moved on to use traditional hypnotherapy, and he came to see me for three initial sessions.
John returned to see me in mid April 2011. He now weighed 18 stone 7lb, he had lost 12lb. This time we went straight in to hypnosis using the same induction and deeper and I applied the hypnotherapy script tailored to him. I re-enforced his goal, and placed the emphasis on what he would hear and feel in the future as his goal was reached, and even beyond. His old belief was, "I’ve always lost weight in the past but gained again later".
I wanted to get him beyond thinking or believing in this way and to realise he could, not only lose weight, but be in a position to maintain the new slimmer self, for ever.
Initially John had a good outcome, but then he hit a couple of problems caused by a domestic situation and then revelations that family members and his diabetic nurse were displaying anxiety about his initial rapid weight loss. I used a variety of therapies helping him to manage his weight loss and his diabetes in a more practical and positive way, whilst gaining full support from his family
August 2013, John was more relaxed, confident, and felt healthier, and he had managed to reduce his daily insulin. John now weighs 15 stone 8lbs, which is below his initial target of 16 stone he set for himself in March 2011. He is contemplating reducing his weight to 14 stone now.
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