Client Care & Facilitation Skills for EHPs...client-care ethics, relationship dynamics, facilitation...

Client Care Skills & Resources for EHPs: Online Module 12 & Workshop Manual © 2006 Association for Comprehensive Energy Psychology

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ACEP Certification Module 12: Client Care Skills & Resources for Certified Energy Health Practitioners Rationale: Many ACEP Energy Health Practitioner Certification Candidates have a good understanding of the energy technique(s) they utilize, but may have little or no training in basic psychological principles of client care and facilitation. This course is designed to help ACEP C.EHP Candidates gain psychological understanding and skills needed for being an effective Certified Energy Health Practitioner who provides high quality services in a legal and ethical way, within his/her scope of expertise and training, and who knows when and how to seek consultation and make referrals.

Online & Workshop Combined Learning Objectives for This Module On completion of the online and live workshop portions of this module, ACEP Energy Health Practitioner Certification Candidates will be able to demonstrate competency in the following areas: • Name three essential dimensions of “right relationship.”

• Name five essential dimensions of building rapport and trust.

• Describe the four elements of the GIHFT assessment process

• List the four steps in deepening the client’s experience and self-efficacy through using Focusing to elicit non-conscious information from the body

• Name five practitioner issues that interfere with rapport and create impasses

• Name five client factors that can create impasses

• Describe three courses of action when rapport is disrupted or impasses arise

• Define seven essential professional boundary dimensions that EHPs must address.

• Name your personal strengths, limitations and decisions about what to do regarding those limitations in order to develop a definition of your scope of practice.

• Describe five main areas of liability in offering an innovative modality.

• Commit to five essential risk management practices.

How the Online Module & Live Workshop Are Connected As you can see, this module covers A LOT of ground! The live workshop primarily focuses on experiential application of the conceptual material covered in this online module. In as much as the workshop is only one day long, it is absolutely VITAL that you come to the workshop well-acquainted with the conceptual material presented in this online module in order for you to be able to complete the workshop experiences within the allotted times. Please be clear that this is mandatory, not optional. PRINT THIS MODULE & BRING IT WITH YOU TO THE WORKSHOP BECAUSE YOU WILL DEFINITELY NEED TO REFER TO IT THERE!


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Module Unit Overview (online and in-vivo combined) This information is offered to you so that, as you are reviewing this online module, you will be able to see how the online learning material integrates with the exercises in which you will be participating during the live workshop. You will need to be quite familiar with the material in this manual in order to benefit from attending the workshop. Again, be sure to print this manual and bring it to the workshop.

Unit 1: Introduction to Right Relationship Between Energy Health Practitioners and Their Clients Unit 2: The Heart of Rapport: Facilitating Being Led Unit 3: Assessment: The GIHFT Assessment Process (Goal, Interference, History, Focus of

Treatment) Unit 4: Workshop Practicum: Practice “Facilitating Being Led” While Conducting a GIHFT

Assessment Unit 5: Deepening the Process & Expanding Client’s Experience & Self-Efficacy Though Accessing

Non-Conscious Information From the Body Unit 6: Workshop Practicum: Deepening the Process Using Eugene Gendlin’s “Focusing” method Unit 7: Dealing With Impasses & Rapport Disruptions Unit 8: Professional Boundaries for Energy Health Practitioners Unit 9: Risk Management for Energy Health Practitioners: Unit 10: Workshop Practicum: Professional Boundaries & Risk Management

Module Credits The Ethics & Risk-Management sections of this module were produced by Dorothea Hover-Kramer, Ed.D., CNS. The Facilitation sections of this module were produced by David Gruder, Ph.D. The module was edited by Gregory Nicosia, Ph.D. and all information herein is provided by permission of these authors for the express purpose of being utilized in ACEP’s Certification Program.


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Unit #1: Introduction to “Right Relationship” Between Certified Energy Health Practitioners and Their Clients In this module, you will learn about the psychological and interpersonal dimensions to be aware of in using Energy Psychology methods as a Certified Energy Health Practitioner. We will cover client-care ethics, relationship dynamics, facilitation skills and dealing with trauma.

Client-care begins with “Right Relationship.” This term pertains to the form the relationship between you and your client takes in order to serve your client’s goals in ways that are honorable to both of you. Three aspects of Right Relationship to be especially clear about are: • Right Relationship With Our Own Capabilities & Limitations • Right Relationship With Seeking Assistance • Right Relationship With Our Clients

RIGHT RELATIONSHIP WITH OUR OWN CAPABILITIES & LIMITATIONS In order to serve our clients’ highest interests, it is imperative that we, as helping professionals, have conscious relationships with our capabilities and our limitations. Having limitations is not a crime – it is part of being human. Every helping professional has his/her own set of limitations. The “crime”, if any, is being unaware of our limitations or our gifts.

Our capabilities as helping professionals include our ability to: • Establish, deepen and maintain rapport • Empathize without being drained or sucked in • Know how to draw out the client and get to the bottom of an issue • Know when to let the client lead and when it is time for us to lead • Have a set of intervention tools on our tool belt – and know the limits of our technical

expertise • Know how to use those tools with different kinds of issues – and avoid attempting to treat the

issues we are not sufficiently trained to address • Maintain clean and healthy boundaries and business practices • Know our ethical and legal responsibilities

Exercise 1. Make a list of your capabilities and gifts as a helping person. If you have difficulty accepting

yourself with all your gifts, strengths and/or ability to love, consider treating that block using Energy Psychology (or other) methods.

2. Make a list of your limitations. If you have difficulty accepting yourself with all your faults, problems and/or limitations, consider treating that block using Energy Psychology (or other) methods.

3. Make a list of those of your current limitations about which you choose to obtain further training during the coming year, and describe specifically how you will do that with each item you select.


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RIGHT RELATIONSHIP WITH SEEKING ASSISTANCE As part of being responsible for our limitations, helping professionals know how to accurately recognize when to seek assistance, the form of assistance to seek and from whom to seek it.

We seek assistance whenever we bump up against our own professional limitations, whenever we develop a strong emotional charge toward a client (positive or negative) and when any ethical, boundary or business question arises.

The four main forms of seeking assistance to be aware of include: 1. Consultation: We seek consultations when we have treatment questions, when we have a

strong positive or negative emotional reaction toward a client, or when we have boundary, ethical, legal or other practice management questions.

2. Training: We seek training when we need more in-depth information or skills to deal with a particular issue involving a client, when we need to deepen our ability to utilize a method in which we are already trained in order to better serve a client, or when we need to add new tools to our tool belt in order to serve a client. When necessary, we refer such clients until we have obtained the supplemental training we need in order to continue working with these clients, should we decide we want to keep working with clients with those particular issues or needs.

3. Referral: We refer our client when his/her needs exceed our current ability to provide a level of assistance the client needs. The referral may be temporary in order to address a specialized issue (such as complex non-polarization issues, for example) in ongoing work with someone. Or the referral may be permanent because the client’s needs are not sufficiently matched with either our expertise or our boundaries.

4. Psychotherapy: We refer ourselves for psychotherapy when doing a Consultation proves insufficient to “clear” a strong negative or positive emotional charge we have with a client, or when we become aware of any “person” issue we have with a client that could interfere with our ability to work cleanly, effectively and ethically as a helping professional and maintain integrity with our own personal boundaries.

Exercise 1. Think about the clients with whom you’re currently working. 2. Identify those in which you need some sort of assistance. 3. Identify precisely why you need the assistance. 4. Determine which of the four forms of assistance best fits the need. 5. Select a professional you believe can best assist you with this need.

RIGHT RELATIONSHIP WITH OUR CLIENTS This involves establishing, building, and maintaining rapport, especially during impasses or other difficult times during your work with a client, as well as being able get to the bottom of the real issue, and knowing how to “Facilitate Being Led.” In this module, you will learn more about these dimensions.


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Unit #2: The Heart of Rapport – “Facilitating Being Led” “Rapport” is a shorthand word for the experience of attunement between two people. Attunement is of particular importance in the helping arts, and is arguably of even greater importance when helping using energy-oriented methods.

There are three keys to rapport. The client brings one. The helper brings the other two. The rapport key that clients bring is “willingness” or “teachability,” which is an alchemical blend of self-responsibility and openness to learning. The rapport keys that helpers bring are a compassionate heart and facilitation skills.

In this module, we are assuming that you have a compassionate heart or you would not be enrolled in this Certified Energy Health Practitioner Candidate course. So, we won’t cover that here other than to say that if you have blocks standing between you and compassion, it is vital that you do whatever you need to do to remove them, even if that requires seeking professional assistance.

Helping clients as a Certified Energy Health Practitioner also requires that we become good facilitators. Facilitation is a blend between being led and leading, and knowing when and how to do which. “Facilitating Being Led” is shorthand for helping our clients help us help them. In this unit, we will cover five key aspects of “Facilitating Being Led.”

COLLABORATIVE INTENTION Collaborative Intention means joining with your client to discover what serves your client’s highest interest in his/her work with you. It means neither assuming you know what the client’s problem is or how to “fix” it, nor ignoring your hunches about these things. Begin each session by joining with your client to discover together what serves his/her highest interests today in the context of what you are able to provide him/her. Intention is a profoundly powerful energy – arguably the most powerful energy in the universe. So, even if you have not yet evolved your particular style for helping establish Collaborative Intention with your clients, simply holding a strong intention to evolve a style that works for you with virtually everyone you meet will be enough to make your style become more apparent to you. And remember to use your Consultations with ACEP Certification Consultants to help you with this, if needed.

EMPATHIC TEACHABILITY It is not only a client’s teachability that is necessary for rapport to develop. It is yours as well.

One of the key skills all relationships require is the ability to accept influence. “Accepting Influence” in a helping relationship means being authentically open to learning from your client, particularly about him/herself and about your impact on him/her. It does not mean ignoring your own hunches or boundaries and it is the opposite of arrogantly assuming that your perceptions are accurate. “Accepting Influence” is the key to teachability.

Empathy is the ability to compassionately see and feel another as that person sees and feels him/herself. Empathy therefore requires two things, in addition to deep heartfelt compassion. The first is that we are so secure within ourselves that we are unafraid of permanently losing ourselves when we temporarily enter another’s world. The second is that we are so clear in our gut about the sovereignty of the other person that, as we temporarily visit our client’s world, we


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don’t take responsibility, energetically or otherwise, for that person’s life experiences, for having to solve their life riddles, or for having to heal their pain.

COMPASSIONATE LEADING WHILE INTERVIEWING AND WHILE INTERVENING There are essentially two functions we have as facilitators (in addition to listening to our own inner and higher guidance). One is interviewing and the other is intervening. We interview in order to facilitate our client in accessing both his/her best understanding of his/her issues and his/her deepest wisdom as to their source and their remedy. We intervene in order to facilitate our client’s effectiveness in implementing the remedy to the issue the two of you agreed to address.

Compassionate Leading requires great humility (that is, not assuming we as the helping person know the client’s answers), deep trust in the client’s ability to discover his/her own answers, and an ability to elicit that wisdom from our client. Another term for this kind of humility and trust is Enlightened Stupidity. The best posture we as helping professionals can take with our clients is Enlightened Stupidity.

Facilitating Being Led While Interviewing involves inviting the client deeper into what he/she knows about: 1. His/her most precious or important goals 2. The blocks he/she has that stand between him/her and fully manifesting a goal 3. The most important source(s) of the block to successful intervention 4. The most effective way to address a block 5. The progress being made during an intervention

Facilitating Being Led While Intervening involves getting the client’s agreement about which intervention to use and that now is the time to use it. It also entails asking the client throughout the process to share what is unfolding within him/her so that the process can be customized to fit the client’s here-and-now needs during the intervention.

The key to “Facilitating Being Led” is not technique but intention. While there are many things you can offer that can help deepen the process (such as Active Listening and inviting the client out of his/her head and more deeply into noticing and learning from his/her body sensations), it is most important to hold strong intention around an attitude of Facilitating Being Led. Your unique ways of speaking up while you are embodying this attitude will naturally emerge over time and practice.

That said, here are a few general guidelines for facilitating a client to lead you where he/she most needs you to help him/her go:

Maintain An Attitude of Enlightened Stupidity: Certainly notice your own hunches or intuitions but, as a general guideline, wait to offer these until after you’ve done your best to elicit your client’s deepest truth.

Questions to Ask & Not Ask: See the GIHFT Assessment section for specific suggestions about questions to ask. The most important question NOT to ask is “Why?” Also, any other question that invites a client to justify him/herself or answer from his/her head should be avoided.

Answers to Not Accept & What to Do Instead: Don’t accept the answer, “I don’t know.” Maintain your inner intention to draw out your client’s inner knowing. Ask something like,


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“What if you did know?” or “Take your best guess” or “How would a wise and loving presence who knew all about you answer?” If you maintain your inner intention to draw out your client’s inner knowing, you might be surprised by the creative questions that will come out of your mouth!

Invite the Client Deeper Within: Reorient your client from his/her head (intellectual theorizing) to his/her body. Inquire about body sensations in response to a particular issue or question: Where is the sensation located? What is the sensation itself? What is it wanting to communicate to you? For further information on this, see the “Deepening the Process” unit in this module.

Observe: Take the heat off yourself to figure out for your client what the issue is, what the source of the problem is or even what the intervention needs to be! If you stay in your head like that, so will your client! Instead, simply observe to your client his/her noticeable body responses or slips of the tongue when he/she says something or he/she responds to something you say. Don’t interpret the meaning of what you notice – ask the client to interpret this him/herself. With practice, you will be able to sense when a client’s body response to something he/she or you say is a “truth” response, a “close but not quite” response, or a “doesn’t fit” response. You’ll also become increasingly aware of when a client is moving into his/her head or deeper into body. Generally speaking, heading toward the head tends to take clients off track while deepening attention to body sensations tends to more reliably take clients in directions that end up helping them the most. The “Deepening the Process” unit in this module will discuss this further.

When Offering a Hunch or Your Client Offers a Tentative Possibility: Invite the client deeper within by asking something like, “Does your body or intuition confirm that this ‘fits?’”

THE INTERPLAY BETWEEN LEADING & BEING LED (WHAT THE CLIENT AND PRACTITIONER EACH PROVIDE) Keep in mind that one of the underlying tenets effective helping professionals maintain is to help their clients learn to listen better to themselves. Under most circumstances (except when the client is in crisis or truly doesn’t have access to an answer), anything you offer from that intention is likely to help your client learn to listen more carefully and caringly to him/herself.

That said, the interplay between leading and being led is that you want to lead your client into leading you toward your client’s truth. What you provide your client after each response, is an invitation to explore inwardly in increasingly deep and self-trusting ways. What your client, in turn, provides to you is information you would never have figured out yourself. This can help you facilitate your client toward clarifying what most needs intervention right now and what method might best assist. Then you get to lead your client through the execution of that method. Your client provides the willingness to transform and you provide a safe and compassionate “container” in which your client participates in the intervention that grows out of his/her inner wisdom.

The elegance of Facilitating Being Led is that it is much less work for the helper while providing a much richer and empowering experience for the client!

APPROPRIATE BOUNDARIES: PROFESSIONAL AND PERSONAL LIMITS We all have limits, personally and professionally, to how far we can Facilitate Being Led. Our obligation as helpers is to be aware of our limits and to remain in integrity with them. When you reach a limit in which you don’t know how to go further in facilitating your client, often the most


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powerful intervention is to confess this with humility but without shame, and then authentically ask your client where to go from here. Surprisingly, this often turns out to be precisely the invitation the client needs to access a deeper level of inner wisdom. When this does not occur, it simply means you are in a situation that requires you to seek assistance. Consult the relevant sections in this module for reminders on how to do that (see page 4 and Unit 8).

EXERCISE: FACILITATING BEING LED (ACTIVE LISTENING-ON-A-PAGE SUMMARY) Practice the following with clients:

• Consciously conduct a handful of client sessions with the intention of embodying a “Facilitating Being Led” Attitude and notice what happens compared to when you don’t do this

• Add to this the following key “active listening” habits, in moments when doing so could help deepen your client’s inner discovery process. Notice what happens when you try this!

1. Repeat a key word/phrase the client says OR Paraphrase the essence of or the intention behind a client’s word/phrase without interpreting or adding your own “spin” to what your client said (remember: your job is to facilitate your client into a deeper experience of him/herself not to dazzle or divert him/her with your brilliance). OR Observe & Inquire about something your client’s body is expressing (e.g., a sigh or a smile or your client pointing to/touching someplace on his/her body). “Observe” is a form of “repeating” to your client something he/she is doing physically without interpreting or adding your own spin to it. “Inquire” means asking your client to allow his/her body to teach both of you what it is trying to express.

2. How to Select Key Words/Phrases to Repeat or Paraphrase: Select those which: a) Seem to have the strongest emotional charge for your client b) Refer to a sensation in your client’s body c) Express your client’s experience as a metaphor (e.g., “It’s as though I’m trying to push a heavy boulder uphill”) d) Anchor a new self-discovery your client just made.

3. Timing for Repeating, Paraphrasing or Observing/Inquiring: This is likely to occur at moments when you sense your reflection will assist your client in moving even more deeply into his/her inner exploration process. There are four situations in which your reflection is most likely to help your client deepen his/her inner exploration: a) Company-Keeping: When you sense your client needs to experience that you’ve empathically connected with him/her and that you’re also tracking him/her accurately b) Reinforcing: When you sense your client has not fully absorbed something he/she has just discovered c) Deepening: When you sense your client is ready to take his/her exploration to the next deeper level d) Impasses: When your client seems stuck in his/her inner exploration process. Otherwise, remain silent while remaining compassionate, open to learning from your client and holding an inner “Facilitating to Be Led” Attitude. Trust your client to go


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where he/she needs to go, remembering that you don’t need to be a hero and figure anything out for him/her! (also see the section on Impasses in this module)

4. Inquire About Omissions: When a client is talking purely from his/her head and the repeating/paraphrasing you offer is not assisting in shifting attention to his/her feelings, sensations or deeper knowing, ask directly questions such as “What feelings or sensations) are you having as you say that?” or “What does your deepest wisdom say about that?” etc. Simply observe the omission and ask about it – don’t interpret.


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Unit #3: Assessment – The GIHFT Assessment Process (Goal, Interference, History, Focus of Treatment) Only licensed health professionals are legally allowed to “diagnose” within their scope of licensure. However, all helping professionals need ways to assess the nature of the work that would best serve their client, within the scope of their training and expertise. This section provides a straightforward format for doing this assessment as a Certified Energy Health Practitioner. Please be aware that it is not the only way to do an assessment, only one way. Feel free to modify it to fit your particular style and needs.

The GIHFT Assessment Process has four parts to it: Goal, Interference, History and Focus of Treatment. It can be used as a guide taking you from “beginning with the end in mind” (as Stephen Covey so famously puts it), to identifying the most useful things to address in order to help your client get where he/she wants to go, as well as identifying the most useful intervention to accomplish this.

Use the “Facilitating Being Led” guidelines throughout the conduct of the GIHFT Assessment Process.

1. GOAL (BEGIN WITH THE END IN MIND) • Ask the client what the top priority result he/she is seeking (wording this question is up to

you). Continue to assist your client in refining his/her wording, using the “Facilitating Being Led” guidelines, until he/she confirms that the wording fits just right without further additions, deletions or modifications.

• Questions to draw this out from a client who has difficulty identifying such a top priority result:

o What if you did know?

o What would a wise and loving presence who knows all about you say?

• What to do if a client cannot identify his/her top priority result/goal, even with your assistance:

o Propose that, in light of this, the top priority goal can be to identify and remove the blocks that stand between his/her vision/dream/mission/purpose or his/her ability to identify a top priority goal in a given moment in time

o Find out from your client if he/she intuits that there is something even more important to focus on than this, in light of his/her difficulty identifying his/her top priority goal. (If so, go with that instead.)

2. INTERFERENCE (BEGIN FINDING THE PRIORITY TREATMENT FOCUS) Elicit from your client information about which of the following dimensions is/are interfering with a full manifestation of his/her top-priority goal:

q Self-Defeating Thoughts/Beliefs

q Emotions: indulged, overwhelming, blocked access to specific emotions

q Inner Critic: blocked access to inner or higher input


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q Self-Defeating Automated Habits

q Physiological Imbalances

q Severe Trauma or Other Severe Psychological Dysfunction

3. HISTORY (FURTHER NARROW DOWN THE PRIORITY TREATMENT FOCUS) Once a picture of the interference has emerged, explore the history of this interference, including:

q Origins: When did these interferences first begin emerging? (This establishes the time frame when either the roots of this issue emerged or the pattern first coalesced, as well as potentially revealing root causes of traumas that may need to be addressed.)

q Related Events: What else was going on in the person’s life at that time? (This information often reveals what birthed the goal or contributed to the person’s inability to manifest that goal, as well as any additional traumas that may need to be addressed.)

q Repetitions: In what prior-life situations has this interference pattern repeated itself? (This information further clarifies the nature of the interference pattern, as well as any subsequent traumas that also may need to be addressed.)

q Attempts to Rectify: What has the client done previously to try to achieve his/her top priority goal and/or become free from this interference pattern? How did it work or not work? (This information tells you what interventions to avoid trying again and/or what to do more of.)

q Other: General medical and trauma history

4. FOCUS OF TREATMENT (FINALIZE WHAT IS THE FOCUS OF THE INTERVENTION) Select the Priority Treatment Focus: You and your client will base this decision on the intersection between what emerged as most important to your client when you explored Interferences and History, and what your scope of practice and areas of expertise empower you to help your client address. The Priority Treatment Focus will likely fall into one of the following three general categories:

q A specific piece of internal work

q Social/Relational change or intervention

q Environmental change or intervention

Decide How to Best Support Your Client: The VERAS Support Method Menu provides one way to determine how to assist your client with this issue. VERAS is an acronym for Validate, Educate, Remove Blocks, Amplify Intention, and Develop Skills. Identify the form(s) of support that your client feels he/she would most benefit from that also falls within your scope of practice and expertise:

q Validate: Most clients need and benefit greatly from permission for them to know what they know, honor the true boundaries that they have, and live in integrity with their deepest sense of purpose. Validation is therefore a very important form of support that you will want to become effective in being able to provide as a Certified Energy Health Practitioner. The “Facilitating Being Led” guidelines in this module provide a particularly powerful way to Validate your clients!


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q Educate: Helping professionals possess what is archetypally called “secret knowledge.” As an archetypal term, this does not mean knowledge meant to be kept secret, but rather the term signifies specialized knowledge that those with specialized training tend to have that others tend not to have. We are meant to share that specialized knowledge with clients when we reasonably believe or intuit it would serve their highest interests to know. The point here is not to assume that just because you know something, everyone knows it! Often, clients are helped simply because they are provided with new knowledge that fits their current needs. An example of helpful knowledge is that when an unresolved trauma is stored within us, it can cause psychological distress or even physical symptoms even decades after the trauma occurred. Be generous in offering education to your clients, but a general guideline is to not do this while facilitating a client through a self-exploration process (during assessment, for instance) or while your client is in the midst of an experiential intervention. Also, be aware that providing education is sometimes more useful after a block has been cleared rather than before. At best, premature insight is worthless to people and damaging at worst! When in doubt, ask your client whether it is easier to be immersed in such an experiential intervention after he/she has insight, or whether it works better to be offered education after such an intervention. (By the way, experiential interventions are ones that focus more on doing something rather than talking about them. Energy Psychology methods are examples of experiential interventions.) That all said, Educate your clients!

q Remove Blocks: This is perhaps the most commonly selected support category, and a wonderful one it is! Helping professionals get in trouble with this intervention category, however, when they try to assist a client in removing blocks when: 1) The helping professional has insufficient training in the dynamics and treatment of specific kinds of problems (for instance, unresolved trauma); 2) The helping professional’s proficiency level in using a specific intervention (such as an Energy Psychology method) is not sufficiently advanced to effectively assist a client with a specific block; and 3) The client is not ready for the intervention. Stay in conscious relationship with your gifts and your limitations (expertise-wise, technique-wise and regarding scope of practice). Whenever indicated, get the appropriate kind of assistance for yourself or your client, as described elsewhere in this module. Also, refrain from assuming that you know which block to address or which method to use. Remain in your “Facilitating Being Led” attitude and you are unlikely to go wrong.

q Amplify Intention: This is one of the most enjoyable of the support categories! However, helping professionals sometimes make the mistake of trying to embed a goal or amplify an intention prior to removing interference that needs to be addressed before the amplification can succeed as effortlessly as possible. Here’s the bottom line: placing pretty intentions on top of crap only creates pretty-smelling crap! When you or your client wonder whether he/she is ready to amplify his/her desired intention or embed a desired goal, explore together and find out whether this hesitancy is a clue that a block (or an additional one!) needs to be addressed before this can occur successfully and easily!

q Develop Skills: Just because we have helped a client remove blocks on a goal and/or amplify that goal/intention, it doesn’t necessarily follow that he/she has the skills to prevent a block from recurring or the skills to fully manifest his/her goal. Therefore, after


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you finish addressing an issue, ask your client what skills he/she needs to develop or upgrade in order to easily and successfully manifest his/her goal. An example of a helpful skill would be teaching a client how to use Energy Psychology Self-Help methods. (This would include educating the client about how to recognize, while using these methods on his/her own, when he/she has gotten to a place where it is important to seek professional facilitation.) Self-efficacy is one of the greatest gifts we can give our clients. Gift your client with new skills whenever appropriate!

Select the Specific Intervention to Use: In Whose Repertoire is the Intervention? Once you have identified the issue to be addressed first (or next) and how you might best support your client at this time, given your expertise and scope of practice, the next thing to consider doing together is to discover whose repertoire the intervention itself is in! What you want to find is the top-priority intervention (that is, the most useful, highest leverage intervention) for this issue under these circumstances. One particularly fun and useful way to begin the process of identifying the top-priority intervention is to use your “Facilitating Being Led” skills to help your client discover who knows and/or will implement the intervention of choice. Check the following four categories to find out the answer:

q Client: The client him/herself knows and/or can implement the intervention of choice.

q Spirit: The client’s spiritual resources know and can implement the intervention of choice.

q Practitioner: You, the Certified Energy Health Practitioner, know and/or can implement the intervention of choice.

q Referral Source: The intervention of choice can be best provided by a referral source.

Once you have identified whose repertoire the intervention of choice is in, and what it is, you’re ready to actually implement the intervention! Are you seeing from all this that there is much more to providing an Energy Psychology treatment than simply following the Energy Psychology protocol itself?

A NOTE ABOUT MUSCLE TESTING If you are properly trained and proficient in muscle testing (or any other subtle ideomotor cueing assessment method), consider cross-verifying the answers you get during each step in the GIHFT Assessment Process to find out if the client’s unconscious and/or energy system agrees with what the two of you are discovering together on a more conscious level. (See the Muscle Testing section in the next unit for more comments about this.)

EXERCISE: COMBINING THE GIHFT ASSESSMENT METHOD & FACILITATING BEING LED 1. Try implementing with some clients the GIHFT Assessment Method using the “Facilitating

Being Led” guidelines. Notice how your session unfolds. 2. Compare and contrast how your sessions unfold when you do them in your more usual way. 3. Based on what you learn, decide how to modify either what you usually do or how you will

modify the GIHFT Assessment Method, in order to better serve your clients.


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Unit #4: Deepening the Process and Workshop Practicum: Practice “Facilitating Being Led” while Conducting a GIHFT Assessment

Unit #5: Deepening the Process and Expanding Client’s Experience & Self-Efficacy though Accessing Non-Conscious Information From the Body

SUBTLE IDEOMOTOR CUEING & INTUITION Part of why, in Energy Psychology, we make use of SUDs ratings and Muscle Testing is that we appreciate that self-report from a client’s conscious mind provides only a small fraction of the inner wisdom a client holds about him/herself. There are many ways to access this inner wisdom. Ways of doing this that a client can learn to use him/herself are highly endorsed, because part of what we want to engender in clients is an increasing resourcefulness in finding within themselves their deepest truth.

There is a family of methods that help clients learn how to do this, and that we as practitioners can also use to more fully assist our clients. This family is referred to as Subtle Ideomotor Cueing (SIC) methods. Let’s break down the word “ideomotor.” “Ideo” means imagery or metaphor. “Motor” means movement. Imagery and metaphor are used because if direct linear concrete language could be used to express what our motor cues are trying to teach us, we would already have conscious awareness of those messages and would not need our bodies to communicate with us at all! “Ideomotor cues” are a combination of body movements and imagery or metaphor that put into words what these body movements are trying to express. Subtle Ideomotor Cues are motor cues that may be so subtle that we often overlook them and therefore don’t take the time to learn from them.

Learning to recognize and learning from our own and our clients’ Subtle Ideomotor Cues provides us with doorways into the vast pool of wisdom that lies beyond our conscious mind, and linear logical language system’s ability to express.

MUSCLE TESTING AS BUT ONE SUBTLE IDEOMOTOR CUEING METHOD Muscle Testing is one example of Subtle Ideomotor Cueing. Like all forms of SIC, Muscle Testing results are fallible, even in the hands of the best trained practitioners. It is also but one form of Subtle Ideomotor Cueing. It can be extremely valuable, nevertheless, and can serve for many people as a particularly elegant form of intuition training, a sort of intuition-on-training-wheels.


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EUGENE GENDLIN’S “FOCUSING:” ANOTHER RECOMMENDED SIC METHOD “Focusing” is another Subtle Ideomotor Cueing method. It provides a powerful step-by-step format for accessing non-conscious information through subtle bodily-felt sensations that any Certified Energy Health Practitioner can become truly masterful with, given the proper training. For that reason, it is highly recommended that C.EHPs consider receiving training in this method.

Gendlin said, “Focusing is a mode of inward bodily attention that occurs at the interface of the body-mind. It consists of specific steps for getting a body sense of how you are in a particular life situation. The body sense is unclear and vague at first, but if you pay attention it will open up into words or images and you experience a felt shift in your body. In the process of Focusing, one experiences a physical change in the way that the issue is being lived in the body. We learn to live in a deeper place than just thoughts or feelings. The whole issue looks different and new solutions arise.”

The Six Steps of “Focusing”

1. Clearing a Space: Make Room to Do a Piece of Work.

a. Get physically comfortable and take a couple of full cleansing breaths as you move your attention inwardly into your torso, between your neck and your pelvic floor.

b. Continuing to pay attention to the middle of your body, ask yourself something like, “How is my life going?” or “Everything’s fine right now, right?” or “What is the main thing for me right now?” Sense your body’s response to these questions. Let the answers come slowly from this sensing, one at a time.

c. When you become aware of the first concern, acknowledge its presence without going inside it, by inwardly saying to that concern something like, “Yes, that’s there. I can feel you, there.” And then let there be a little space between you and that.

d. Now again ask yourself something like, “How is my life going?” or “Everything’s fine right now, right?” or “What is the main thing for me right now?” Allow the next thing to bubble up from the center of your body. When it does, acknowledge its presence without going inside it, by inwardly saying to that concern something like, “Yes, you’re there too. I feel you.” And then let there be a little space between you and that.

e. Repeat “d” above until you have finished putting a little space between you and the last thing that comes up in response to your question. Usually there are several things.

f. You have now cleared a space in your body for you to do a piece of exploration or work.

2. Felt Sense: Select One Issue & Notice Your Initial Vague Fuzzy Bodily Sense of That Issue as a Whole.

a. From among the items that came up during Step 1, select one personal issue to focus on during this Focusing session. DO NOT GO INSIDE IT. Stand back from it.

b. There may be many parts to that one thing you selected – too many to think of each aspect individually. For the moment, allow yourself to feel all of these aspects together.


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c. Pay attention to the place in your body where you most feel this issue, getting a sense of what all of the problem feels like. Let yourself feel that vague, fuzzy, unclear bodily felt sense of all of that.

3. Handle: Let the Felt Sense Generate a Rough Draft of What It is Called as a Sensation.

a. Focusing your attention on that initially vague, fuzzy, unclearly felt sense, imagine that you’re asking it what the quality of that felt sense is.

b. Let a word, a phrase, or an image come up from the felt sense itself. It might be a quality-word, like tight, sticky, scary, stuck, heavy, jumpy or a phrase, or an image.

c. When a word, phrase or image comes up, go to step 4.


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4. Resonate: Find the Word, Phrase or Image That Resonates Perfectly with the Felt Sense

a. Focus on the word, phrase or image that came up and imagine asking the felt sense, “Is that it?” Your body will respond with one of three sensations. One will register in you as letting you know, “No that’s not it.” Another will register in you as letting you know, “That’s on the right track, but it’s not yet a bulls eye.” And yet another will register in you as letting you know, “Yes! That fits just right! The felt sense and this word, phrase or image are a real match!”

b. If you didn’t get a “fit,” re-focus on the felt sense as you experience it now, and allow another word, phrase or image to arise from it. Return to “a” to check whether what came is still a rough draft or is the “real thing” (that is, until you get the third response described in “a” above). Keep going back and forth between the felt sense and the word (phrase, or image), checking how the felt sense and the word, quality or image resonate with each other.

c. You will know you have arrived at what “fits” because when the “handle” for the felt sense is “spot on,” your body’s sensations will shift in an unmistakable way, like the bodily felt shift you experience when you’re trying to remember something and you finally remember what it is.

5. Ask: Discover What Your Felt Sense is Conveying

a. As you continue to feel into this bodily felt sense, imagine asking it, “What is it about this whole problem that makes this quality (which you have just named or pictured)?” or “What brings you now?” or “What’s the most [felt sense quality] about you?” or “What makes this whole problem so [felt sense]?” As you ask, make sure you are re-sensing the felt sense quality freshly and vividly at this moment (not just remembered from before).

b. Patiently, compassionately and with genuine curiosity, keep the felt sense company, allowing it just close enough to feel but not so close that it engulfs you, as it reveals its answer to you. Notice your bodily response to the answer. As with when you were searching for the accurate “handle” for your felt sense, it will again feel one of three ways: “Nice try but no cigar,” or “That’s heading in the right direction but you’re not quite there yet” or “That’s exactly it!” And again, you will know when you’ve got a “That’s it” response because it will be accompanied by a bodily felt shift in the felt sense. Until you get that response, keep returning your attention to your body and freshly find the felt sense again. Then patiently, compassionately and with genuine curiosity, ask your felt sense your question again.

c. Continue to keep company with the felt sense until something comes that is accompanied by a bodily felt shift, a slight "give" or a bodily sense of release. This “felt sense shift” confirms that you have accurately grasped the message your felt sense was trying to convey to you.


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6. Receive: Accept the Gift Your Felt Sense Reveals to You

a. Receive in a friendly, appreciative way whatever information was accompanied with the bodily felt sense shift. Give yourself a few moments to bask in the shift and the information, even if the shift only feels like a slight release.

b. Bear in mind that this may be only one shift among many, as you repeat step 5 to find out if there is anything else the felt sense wants to convey to you.

Even if you don’t hit pay-dirt at each step in this process, if you even spent a short time sensing into and touching your bodily felt sense of this issue, you have begun to learn how to do “Focusing.” It doesn't matter whether a bodily felt sense shift came or not. These shifts come when they are ready. We don't control that. What we control is the extent to which we are willing to learn how to pay attention to and learn from our Subtle Ideomotor Cues. The rest will take care of itself with time and practice.

As with Muscle Testing, “Focusing” is also a profoundly elegant way to help clients develop their access to their intuition. This kind of “radical” listening is a vital life skill. Any opportunity we have to incorporate it into what we do with our clients not only helps deepen the facilitation we are offering them, but also helps them develop a skill that will serve them for the rest of their lives.

To find a Certified Focusing Trainer near you, or for a schedule of Focusing Training Workshops, visit the Focusing Institute’s website: www.focusing.org.

EXERCISE 1. Try doing the Six Steps of Focusing described above a few times with yourself. Notice how

your Focusing abilities grow each time you do this.

2. When you feel ready, begin trying to facilitate Focusing with others, especially when working with a client who needs to deepen his/her ability to access inner information beyond his/her conscious mind. This may help you deepen the facilitation you are able to offer them.

3. When you get excited about mastering Focusing, get some formal training in it (www.focusing.org).

Unit 6: Workshop Practicum: Deepening the Process Using Eugene Gendlin’s “Focusing” method

http://www.focusing.org/

http://www.focusing.org/


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Unit #7: Dealing With Impasses & Rapport Disruptions An “Impasse” is said to have occurred when, in the midst of doing an assessment or an intervention, the process grinds to a halt and seems unresponsive to all attempts to get back on track and start moving forward again.

It is important to be aware that impasses are part of the terrain of being a helping professional. In other words, there is nothing particularly weird or unusual about them cropping up. So, don’t bother feeling like there is something wrong with either you or your client if this should occur. Impasses are simply specialized forms of self-protection (defense mechanisms) that are capable of arising when a client is working on an issue that is particularly “charged…” for EITHER the client or the helping professional (or both)!

A number of factors affecting both the practitioner and the client can help create impasses. It is incumbent upon the Certified Energy Health Practitioner to know:

1. How to recognize when an impasse has occurred

2. How to identify the source of the impasse

3. How to address any such sources

4. How to know when it is time to seek assistance.

PRACTITIONER ISSUES THAT INTERFERE WITH RAPPORT & HELP CREATE IMPASSES There is nothing like relationships to bring us into powerful contact with that which remains unhealed in us. Helping relationships are not exempt from this relationship dynamic! Practitioner contributions to rapport disruptions and other impasses tend to fall into two main categories: emotional charge and arrogance. Whenever you cannot both pinpoint and “clear” your contributions to an impasse, seek a Consultation and be open to the possibility that, with some issues, psychotherapy may be needed in order for you to resolve your contribution. Rest assured, though, that if you have these issues, your client will pick up on and be reactive to your “countertransference,” whether consciously or unconsciously!

q Emotional Charge is exactly how it sounds: we have a stronger-than-helpful or stronger-than-situation-appropriate reaction to our client. The most common reason this happens is our own unaddressed issues. So, look for your own emotional charges when you are helping others because you’ll find a personal gold mine there. Common forms that emotional charge takes in helping professionals include: o Projection: We mistake our past experiences, issues, emotions, evaluations, behaviors

etc., for what our client must be experiencing or thinking or feeling or intending. o Loss of Compassion: We notice ourselves becoming judgmental or resentful toward a

client. o Boundaries Invasion: We notice ourselves taking our client’s issues home with us. o Attachment to an Outcome: We believe it is our responsibility to figure out what a

client’s problem is, what the solution should be, or how to do the healing in order for that solution to occur. We forget that we are a facilitator not a fixer, and that in order to be an


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effective facilitator we must be a clean vessel, devoid of emotional charge or arrogance (see below) regarding a client or an issue with which a client is dealing (or not dealing).

q Arrogance in this context is shorthand for assuming you know what’s best for your client. Arrogance frequently grows out of having an unacknowledged or un-dealt-with emotional charge with a client. Common forms that practitioner arrogance can take include: o Unteachability: The practitioner is paying more attention to his/her own interpretations

of what the client’s issue is, what the intervention needs to be or how the intervention needs to unfold, than to Facilitating Being Led by the client. This is a form of being over-boundaried.

o Exceeding Your Expertise: Trying to assess or intervene with an issue that is beyond your training to know how to handle or scope of practice to be allowed to handle. This is a form of violating your own professional boundaries.

o Working Harder Than Your Client: Trying to compensate for the client’s blocks in moving forward by putting more energy into the process than the client is doing. This is a form of being under-boundaried and will make you frantic at first, resentful later and ultimately will burn you out.

o Determining Your Client’s Pace of Progress: It is not up to you to figure out or decide for your client the pace at which he/she moves forward. If you feel the urge to do so, your over-zealousness will become a boundary violation of your client. If you become aware that you want to push your client to move forward more quickly, and you truly believe this is not because of your own issues, ask your client if he/she is comfortable with the pace. If he/she is, ask her/him how this pace serves him/her. For instance, maybe he/she is by temperament a slow processor.

In summary, the helping professional’s primary contribution to impasses is one form or another of boundary issues. And these issues are frequently the tip of the iceberg into an important piece of personal growth work the helping professional needs to do for his/her own sake as much as for the sake of his/her clients!

CLIENT FACTORS THAT INTERFERE WITH RAPPORT & HELP CREATE IMPASSES Here are some of the more common sources of client contributions to rapport interference and other impasses:

q Complex Readiness Issues: The more a client suffers from pervasive energetic non-polarization, the less he/she will be able to collaborate to help create the outcome he/she seeks.

q Unaddressed or Complex Objections to Succeeding: The more a client suffers from unaddressed or severe psychological reversals, the less he/she will be able to collaborate to help create the outcome he/she seeks.

q Interfering Physiological Factors Requiring Medical Diagnosis or Treatment: There are a lot of physiological imbalances, such as severe or even moderate hormonal imbalances, that may need to be diagnosed and treated before a client will be able to fully collaborate with you to help create the desired outcome.

q Significant Trauma Requiring a Trauma Treatment Expert: When a client carries significant or complex trauma, he/she may be terrified to reconnect with that experience, and will thus put on the brakes in any number of possible forms (from passive resistance to


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getting ugly with you), if you get too close to helping him/her touch that experience. If you are not well trained in dealing with significant or complex trauma, or with child abuse trauma, you will likely need to refer this client to an expert for at least this part of the work.

q Transference: This is a technical term describing the “projection” a client makes on a helping professional in which the latter becomes just like someone from the client’s past with whom he/she still has important “unfinished business.” Negative Transference can result in a client seeming as though he/she is resisting your help. Positive Transference can result in a client not progressing beyond a certain point because if he/she does, your work together will be complete and the client does not want your relationship to end.

q Moderate to Severe Psychological Disorders: Those clients who suffer from moderate to severe psychological conditions require treatment by a mental health professional who has advanced training in dealing with such conditions. This is not an attempt to be elitist or exclusionary. There are simply certain psychological conditions that are so complex and potentially dicey to treat that without some in-depth and specialized diagnostic and treatment expertise, a well-intentioned helping professional runs a quite severe risk of doing more harm than good. The following is a list of just some of the conditions that fall outside a Certified Energy Health Practitioner’s scope of training to handle (don’t feel bad: many of these fall outside many licensed psychotherapists’ scope of training to handle too!): Borderline Personality Disorder, Narcissistic Personality Disorder, Paranoid Personality Disorder, Unipolar or Bipolar Disorder (Major Depression, Mania or Manic-Depressive Disorder), Dissociative Identity Disorder (Multiple Personality Disorder), Sociopathy, Attention Deficit Disorder, Intermittent Explosive Disorder, Obsessive-Compulsive Disorder, Severe PTSD (Post-Traumatic Stress Disorder), Eating Disorders, Alcohol or other Chemical Dependency, Autism, and Schizophrenia. These are just some of the kinds of conditions that fall outside a Certified Energy Health Practitioner’s scope of training to handle. If you want the complete list of the disorders you should not treat, as well as a profile for each, consult the latest version of the Diagnostic & Statistical Manual of Mental Disorders ( DSM-IV as of 2006) published by the American Psychiatric Association.

WHAT TO TRY FIRST WHEN THE WORK FEELS STUCK OR NOTHING APPEARS TO BE HELPING… AND THIS IS NOT DUE TO YOUR OWN ARROGANCE OR EMOTIONAL CHARGE Now that we have covered all this complexity for reasons of ethical client care, let’s come back to a level of elegant simplicity when there is a rapport disruption or an impasse and you have ruled out (preferably after doing a Consultation) that your own arrogance or emotional charge has contributed to this. When an impasse seems unresponsive to all interventions, and you have ruled out your own possible contributions to this, consider making the unresponsiveness itself the Priority Treatment Focus. Observe to your client that you’re noticing that no matter what you both try to do, nothing appears to be helping. Ask your client if he/she is noticing this too. When he/she says “yes,” ask how this pattern of “trying hard with little or no success to show for all the effort” is reflected in his/her life. Use this response as the beginning of a GIHFT Assessment Process around this pattern. This will likely result in the two of you identifying the issue that needs to be addressed first before it will become possible to address those issues the client thought he/she wanted to address.


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GET HELP WHEN RAPPORT IS DISRUPTED OR IMPASSES ARISE In summary, impasses and other rapport disruptions are not weird in the helping professions. Your job is to be conscious of when these arise, explore them with your client, and seek assistance when needed.


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Unit 8: Professional Boundaries for Certified Energy Health Practitioners And Unit 9: Risk Management for Certified Energy Health Practitioners These two module units are designed to emphasize ethical issues and concerns that may be less familiar to non-mental-health practitioners but can be crucial in achieving success in an integrated practice.

To facilitate this, please review the ethics online module that you have already studied with special emphasis on Section II.B “Areas in which ethical violations may occur” and II.F “Sources of liability and risk management practices.” As further discussed at the workshop course for all certification candidates, you need to be very familiar with ACEP’s Code of Ethics and Standards of Care (available on ACEP’s website) and, if you hold a license in healthcare, be able to report what the state licensing board holds as its policy regarding new and innovative practices.

Also, for the Workshop Practicum, be prepared to present your Informed Consent Process (as discussed in the ethics module showing how you address risks, benefits, client choice, etc.) and a Statement of your Scope of Practice (see page 24.)

Unit 8: Professional Boundaries for Certified Energy Health Practitioners Defining Your Scope of Practice

It is essential that you know who you are, what you know, and what you don’t know in a practice of an innovative modality such as EP. This self-understanding is required of an ethical practitioner who does not claim to be all things to all people or make exorbitant claims for these new techniques.

Think of every item of publicity—how you speak about your integrated practice (EP plus your other discipline), what you put on your brochure or cards, how you identify yourself to colleagues, clients, or at community meetings—as a form of public contract. It is the agreement that will shape how you are seen and how energy concepts are understood. Clarity about who you are will, of course, also attract people in need to you.

Exercise: Self-Awareness & Scope of Practice

1. List your current personal strengths 2. List personal weaknesses or limitations, dislikes, worries, etc. 3. List your professional strengths—ex. I am helpful with ___types of patients or clients


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4. List your professional limitations—ex. I have ___time as a practitioner of EP; I am good with _____clients; I am not effective with ___ types of clients/patients; I need to have more _________

Based on your self–survey, write down a brief description of your scope of practice to present at the workshop training especially for C.EHPs. For example, “I am a nurse with 10 years experience in outpatient clinics. I see the need for trauma intervention with some of the patients in this setting. I can help to reduce the intensity of their emotions around a traumatic event by using biofield balancing techniques, EFT, or TFT with which I am comfortable. I would not be able to help someone with severe childhood trauma that has affected the entire personality. Someone with those needs might well need medication prescribed by an MD and/or psychotherapy, neither of which is in my scope of practice. Therefore, I would make sure I have good referral resources in those areas.”

Selection of Clients/Patients Appropriate for EP Just as we cannot be all things to all people, we recognize that not all clients/patients are ready to benefit from EP. First, of course, we have to consider willingness and interest from the person; your informed consent process will help to determine this. However, willingness and interest in EP are not enough. You need to ask yourself:

1. Is the person ready for EP? 2. Is his/her biofield balanced? Does proper polarization exist? If an intervention to restore

proper polarization is done, does it ‘hold’? 3. Does the person have sufficient ego strength to experience an unusual, innovative modality? 4. Is there a strong trust relationship between the client and the practitioner? 5. How does the person respond when I teach one simple element of EP? 6. Does the person use that element between sessions to help their self? Is there a sense of

commitment to trying out the EP method?

Briefly stated, the fallout from good techniques administered at the wrong time or place, or to the wrong person can be considerable (enough to keep many, many attorneys very busy). People who are suspicious, rigid, unsure of their relationship with you, caught in a lifetime of distresses or with personality disorders are not good candidates for your beginning practice. However, you may teach relaxation exercises or stress management to give them some useful tools.

If there are extensive physical problems, you will want to insure conventional medical care and document that you have done so. If there are deep-seated emotional problems, you will want to make sure that there is a competent psychotherapist involved. Always, you will want to have consultation available for yourself to handle complex cases, and a list of referral resources to bring the best care to those who seek your help.

You will know your present skills are insufficient to meet the client’s needs when you repeatedly feel stuck, unable to answer the client’s questions, are uncomfortable with the terrain both of you have entered, are wondering what is the best course of action, or are unable to project a treatment plan for each session. Initially, the unease would give you cause for consultation with a trusted


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professional and, ultimately, you may want to make a referral to a more skilled professional, even if it is for a brief time or a limited specific issue.

Unit 9: Risk Management for Certified Energy Health Practitioners

Making Referrals: Legal and Ethical Considerations As you consider your scope of practice, take into account the areas which you do not cover. If you have skills in counseling or coaching, you will want to make sure that you have good medical back-up and several good psychotherapists available for in-depth counseling involving issues that have been held for a long time in the energy system. If your orientation is as a medical physician, you will definitely also want available good resources for body work and deeper therapies.

For various reasons, clients/patients receiving energy work often have unusual sensory phenomena. In the likely event of encountering clients that have non-ordinary states of consciousness—ranging from brief states of reverie to out-of-body experiences, past lives, intense reliving of trauma or biographical information—you will want to know therapists who have solid experience in working with such phenomena. Non-ordinary states may be indicative of a “break through” or spiritual emergence for the individual. On the other hand, they may signal a loosening of client ego boundaries and possible widening of pathology.

It is good to prepare your clients for the possibility of a referral as you discuss informed consent to help maximize the care they get from you. It is also ethical to make sure that clients understand that you will seek consultation with qualified professionals to augment your care for them and that you will make every effort to guard privacy and confidentiality in doing so. Bringing these possibilities up at the beginning of your relationship will show that you are looking out for the client’s welfare and that you are respectful of his/her needs and your limitations. Seeking consultation and making referrals as needed are the hallmarks of professional, ethical practitioners.

Although highly desirable, referral-making is serious business in the eyes of the law. Direct liability occurs if you make a referral without due care, possibly resulting in client injury. For example, such direct liability would exist if you refer someone to a self-taught holistic health practitioner who recommends mega doses of vitamins that affect the client adversely. Another form of concern is vicarious liability, incurred if you do not know the practitioner’s credentials or hear of incompetence in his/her dealings. Aiding or abetting a crime could be charged if you refer to someone engaged in unauthorized medical or psychotherapeutic practice who, in some way, harms a client. Some capable, but unlicensed, practitioners of alternative health methods may be accused of practicing medicine without a license. Others who are licensed may exceed their scope of practice by suggesting supplements or devices that are not in their standard of care.

It is best to know any referral sources you wish to use very well, if possible experience their care directly, and to do careful follow-up with the client and the referral source to evaluate for future reference.


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Exercise: Your Referrals List

1. Make a list of the professionals in your area that you now know for making referrals. 2. Make a list of the areas that you still need to have covered, including specialties in your

chosen field as well as allied healthcare resources. 3. Make a list of the colleagues, leaders, teachers on whom you could call for non-biased

consultation.

Liabilities for All Certified Energy Health Practitioners, Licensed and Non-Licensed There are two main liabilities for all of us – licensed or unlicensed, experienced or inexperienced, young or old: charges of malpractice or negligence. Some clients are “bad apples.” Some are predators looking to victimize the practitioner, some are inappropriately needy, and some suffer from particularly problematic interpersonal psychopathology, such as Borderline Personality Disorder.

It is therefore important to understand that no practitioner is guaranteed to be immune from the possibility that these kinds of charges could be brought against him/her. For this reason, all of us in private practice should have some kind of liability insurance. Low-cost programs are available in the United States through most professional associations such as the American Nurses Association, National Association of Social Workers, International Coaching Association, etc. If you work outside the United States, check into the programs available in your country through organizations similar to those listed above.

Malpractice occurs whenever you exceed your defined scope of practice. If you are licensed, this is defined by the respective state or national licensing board. For an unlicensed person, malpractice has to do with overstepping publicly sanctioned boundaries. It covers anything that has to do with the sale of supplements or devices, strong recommendations of vitamins or drugs, careless referrals as noted above, and especially anything that connotes practicing medicine without a medical degree or doing in-depth psychotherapy without a publicly sanctioned education.

Negligence is a bit more nebulous as standards of care can be quite variable in different fields and locations.

If you are unlicensed and someone with ‘darkness’ crosses your path and makes charges against you, the law could compare your practice to that of someone with the same skill level who is fully licensed. As a minimum, you need to do everything to protect and help your client that a licensed professional would also do.

The more clarity you have about your defined scope of practice using EP and the careful selection of clients that are appropriate to your skill level and training in dealing with specific issues and populations, the better you will fare. An ounce of prevention is worth a pound of pain.

HIPAA Law Patient privacy and confidentiality have always been hallmarks of professional practice. However, living in an electronic age brings special challenges, as intensely personal information


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may pass to insurance carriers and non-therapeutic personnel, be transmitted via cell phones or e-mails, overheard in elevators, etc. The national Health Insurance Portability and Accountability Act (HIPAA) was passed in the United States in the last few years to guard patients’ rights to know what is reported to insurance carriers and to choose to restrict the flow of personal information about themselves.

The Act has been interpreted widely to mean that personal privacy should be understood when, for example, standing in line at a pharmacy or when describing a particular client disorder or circumstance in a book or educational setting. Certified Energy Health Practitioners must make every effort to respect client rights in the “information age.” We, as guardians of hope for persons in need, must be especially vigilant in this area as well as to recognize the circumstances that we must report to appropriate agencies (see sample information sheet on page 28), to whatever extent is required by law in our particular locale.

Professional Practice Issues The sample document on the next page covers many of the basics for an effective private practice. Please note the exceptions to confidentiality that apply to all practitioners, licensed or unlicensed, in the United States, and which are generally similar to those in other countries (if you practice outside the United States, consult with someone from your country regarding the specifics that apply to you).

In the United States, you must report to appropriate family members and/or agencies if: • Your patient/client is in danger of hurting self or others (i.e., suicidal or homicidal) • You have evidence of, or even simply strongly suspect, your client is the victim of child or

elder abuse, or is the perpetrator of child or elder abuse – or your client has identified someone else as a perpetrator of child or elder abuse with someone specific

• There is a legitimate court order, such as a subpoena or other writ, requiring you to divulge otherwise confidential information about your client/patient.

Other practical issues cover the confidentiality of your meeting place (a rented professional-looking office is best, your home or other public settings are not as desirable unless privacy can be guaranteed), transference of sounds (sound-proofing), payment of fees, agreements about sessions and in-between telephone calls, length of sessions, privacy of answering machine, where and when to leave messages for the client, etc.

Use of “touch” is a delicate issue, as many clients have had negative experiences involving touch due to a history of abuse or a fear of intimacy. You are responsible for creating an environment of trust and respect by carefully asking client permission before you offer any form of touch, no matter how pure or well-intended. Similarly, you need to evaluate whether touch, such as a hug, is appropriate—it is not, in some circumstances, such as those mentioned earlier in this paragraph.

Dual or complex relationships exist when a person is not only your client but you also know him/her in some other capacity. Examples include a relative, friend, landlord, neighbor, a fellow member of your house of worship, someone with whom you do business, or someone with whom you have other financial dealings such as loaning or being loaned money.


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In small rural communities, complex relationships can be particularly difficult to avoid. When this is the case, you must address the possible implications of these issues, and your resulting boundaries, prior to agreeing to work with a client. There are three basic rules of thumb covering these circumstances: 1 Avoid dual relationships to the greatest extent possible. 2 Discuss with your client unavoidable dual relationships to see if you can create mutually

honorable agreements about how the two of you will handle these. 3 If you cannot serve your client’s highest interests without violating your own boundaries or

damaging the “other” relationship the two of you have, don’t do it!

It has been said that “God is in the details”—the details of your practice can help make your career a venue of learning and expansion or one that is contaminated by unneeded stress and disappointment. You Create It!


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SAMPLE INFORMATION SHEET courtesy of J. Patricia Thatcher, LCSW

This is information that you may find useful about my office policies.

CONFIDENTIALITY: Your work here is confidential and protected by HIPAA & state statutes. I will not release any information about you without a written release signed by you. The legal exceptions to this are: if you are in danger of hurting yourself or others; child/elder abuse; legitimate court orders; signed authorization to legitimate insurance carriers; emergency coverage during my absences; or failure to pay for services requiring action to collect fees due. Utilizing energy techniques may also alter or change memory of a traumatic event that may affect legal proceedings.

FEES/PAYMENT: Payment of agreed-upon fee is due at time of appointment. If a check is returned there will be a $10 charge. If the bank increases its charge, this fee will be increased.

INSURANCE: I am glad to give you an insurance acceptable receipt for fees paid. In accordance with HIPAA, we will discuss any diagnosis that is required in order for you to get reimbursed by your insurance carrier. It is important for you to know that HIPAA now regulates how information about you needs to be protected. No claim will be filed electronically from my office. I do not have any relationship with any insurance carrier. You are responsible for using your insurance in any way that serves you.

CANCELLATIONS: Your time is set aside just for you. If you need to change your appointment please give me as much notice as possible. There will be a charge for any missed appointment with less than 48 hours notice. I will make every attempt to give you as much notice as possible if I need to change our appointment.

REACHING ME: You have probably met my trusty answering machine, which is available 24 hours a day. I typically call in once/twice a day when I am not in the office. I make every attempt to return calls as soon as possible. It is helpful if you give me several alternate times to call you back.

I do not have 24 hour coverage and if you need such coverage we will need to decide how to handle it. In case of an emergency, please leave a message stating the emergency on my answering machine, call your other supports, hotlines, community mental health center or go to your local emergency hospital if you cannot wait for a call back from me.

PHONE CALLS: I am glad to answer short calls (5-10 minutes) in between sessions. If we need to spend more time to handle a difficulty that has arisen, I will be glad to do so and there will be a charge at the usual rate (currently $2.33/minute).

USE OF TOUCH: There may be times when appropriate touch is asked for. This may include touching the arm or hand for muscle testing, holding the head for TAT or frontal/occipital holding (a kinesiology technique) or when you ask for a hug at the end of a session. It is important for you to know that permission is always asked at the time of the touch and you always have the right to refuse. Hugs are only given if you ask for them and we always create time to discuss the understandings you have about any touching that may happen in the therapy.


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Additional Bibliography for C.EHP Certification Candidates

Carkhuff, R.R. & Pierce, R.M. (1995) The Art of Helping. Amherst, MA: Human Resource Development Press.

Cohen, M.H. (2003) Future Medicine: Ethical dilemmas, regulatory challenges, and therapeutic pathways to health care and healing in human transformation. Ann Arbor, MI: University of Michigan Press. www. Camlawblog.org

Chu, J. (1998) Rebuilding Shattered Lives: The responsible treatment of complex post-traumatic and dissociative disorders. New York: John Wiley & Sons.

Fleming, T. (1999) You Can Heal Now. Redondo Beach, CA: TAT International, Tel. 310-375-3628, www.tatlife.com

Gendlin, E. (1996) Focusing-Oriented Psychotherapy. New York: Guilford Press.

Herman, J.L. (1992) Trauma and Recovery, New York: Basic Books.

HIPAA information websites: www.hrsa.gov/hipaa.htm; www.hep-c-alert.org/links/hippaa.html

Hover-Kramer, D. with Murphy, M.(2006) Creating Right Relationships, A practical guide to ethics in energy therapies. Cave Junction, OR: Behavioral Health Consultants, P O Box 406, Cave Junction, OR 97523; also available from www. Midgemurphy.com

Lee,L. (2000) Listen Up: How to improve relationships, reduce stress, and be more productive. New York: Bantam.

Lewis, B. & Pucelik, F. (1982) Magic Demystified, a Pragmatic Guide to Communication and Change. Lake Oswego, OR: Metamorphous Press.

Pennebaker, J. (1990) Opening Up: The healing power of confiding in others. New York: William Morrow.

Plante, T.G. (2004) Do the Right Thing: Living ethically in an unethical world. Oakland, CA: New Harbinger publications.

Siegel, D.L. (1999) The Developing Mind. New York: Guilford Press.

Snow, C. & Willard, D. (1989) I’m Dying to Take Care of You. Redmond, CA: Professional Counselor Books.

Taylor, K. (1995) The Ethics of Caring: Honoring the web of life in our professional healing relationships. Santa Cruz, CA: Hanford Mead.

Wright, S.G. & Sayre-Adams, J. (2000) Sacred Space: Right relationship and spirituality in healthcare. New York: Churchill Livingstone.

http://www.tatlife.com/

http://www.hrsa.gov/hipaa.htm

http://www.hep-c-alert.org/links/hippa.html


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Client Care & Facilitation Skills for EHPs...client-care ethics, relationship dynamics, facilitation...

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