Becoming a Non Smoker - Case Study

Abstract

DE is a 53 year old retired mother of 4 grown up daughters and also has 4 grandchildren (ages 6, 5, 3 and 1 years.) She lives at home with her husband.

DE approached me as a volunteer for a case study, to help her become a non-smoker. As a student undertaking this case study, I discussed the ethical implications of our working relationship, and consent was given with regards to submitting the findings as part of my case study, in accordance with respecting client confidentiality. It was also agreed that there would be no fee for the therapy. Having interviewed DE and assessed the information in the Initial Consultation Form (annexe A), I am totally satisfied that there are no presiding medical or ethical issues. We discussed the possibility of DE approaching her doctor for advice to stop smoking, but she stated that she had already done this several times, and she no longer had any confidence in the techniques he was recommending.

DE is keen to try hypnotherapy to become a non-smoker, as several of her friends have been successful in trying this route. We agreed to complete one session of hypnotherapy which would last up to 2 hours, in total, using the guidelines taught to me by my tutor. At the end of the therapy, DE was very motivated, confident, and looking forward to being a non-smoker (she gave me her cigarettes, which I threw in the bin). She gave me a lift in her car and was surprised that, for the first time, she did not feel the urge to light up her cigarette, on entering her car.

Initial Consultation

DE lives at home with her husband, HE, and has 4 grown up daughters, who have all left home. She also has 4 grandchildren, aged 6,5,3 and 1 years. She has retired due to ill-health and spends most of her time looking after her grandchildren, so that her daughters can pursue their careers.

DE's earliest recollection of smoking was at the age of 19 years, when her mother offered her a cigarette to try. DE tried the cigarette, and took this occurrence as a sign of approval from her mother to start smoking. DE continued to smoke socially and has now been smoking for 34 years. All of DE's daughters now also smoke cigarettes.

DE has tried 4 times to stop smoking, and has failed each time. She has been to the doctor for advice 4 times and now, due to the lack of success with patches/inhalators, has lost confidence in seeking further advice from her doctor. Several of her friends have stopped smoking through hypnotherapy, and she is very motivated to undertake this therapy. On a scale of 1 to 10, she gives herself 9 for motivation. Her husband, HE, became a non-smoker 3 years ago through the use of patches, but DE found them ineffective. The last time she tried patches was 6 weeks ago and she failed because

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of lack of belief in the product. Her husband regularly taunts her for not stopping smoking and she is reluctant to stop because her husband has told her to do so; she wants to stop smoking for herself, and not because her husband has told her to. The few times DE has managed to stop smoking for a good length of time, her husband was unsupportive by telling her that it was just a matter of time before she would start smoking again.

DE smokes 20 to 25 cigarettes per day, starting from the moment she wakes up. Causes for smoking seem to be habitual, and she mentioned that she does not smoke to reduce stress or anxiety. She smokes at home and in the car, so she is continually surrounded by the smell. DE continually mentioned that she was aware that non-smokers would notice that she smelt of ash and find it unpleasant.

DE's motivation for stopping smoking is her health and her enjoyment of being with her children and grandchildren. To continue smoking increases the risk of fatal diseases, and may shorten the life she spends with her loved ones. She would also like to save the money she spends on cigarettes; she would spend this money on a holiday to Barbados and the remainder would be spent on her grandchildren.

DE also appears very overweight and expressed concern that she would put on more weight if she became a non-smoker. She finds it very difficult to exercise because she is always looking after the grandchildren, and does not have a lot of time for herself. DE had never undergone hypnotherapy before and seemed apprehensive about what it would involve. Despite the apprehension, DE was very keen to try hypnotherapy and confident that she was motivated enough to make it work.

Through the initial consultation, I ascertained there were no contraindications which may preclude DE from treatment, and I also ensured DE was aware that I was not yet fully trained. I also ensured that there were no ethical issues which may negate hypnotherapy as an appropriate treatment. There was nothing among her medical details which would suggest that hypnotherapy would be unsuitable for her. I informed her that the treatment that I would be using had been taught to me by my tutor and had been approved by Chrysalis. DE was happy to proceed on this basis.

Diagnosis

DE is a long term smoker and, although she has failed several times to stop smoking, she appears very motivated and confident that she will succeed this time. She gives herself 9 out of 10 for motivation. She already has poor health as per her Initial Consultation Form and she is concerned that, if she continues to smoke, she may not be able to enjoy her loved ones for much longer.

Treatment Plan

I would be using hypnotherapy and the system taught to me on the course. Along with suggestions to do with smoking, I would also include suggestions to encourage DE to eat properly and prevent weight gain. I have assessed that DE would react more positively to an authoritive, kinaesthetic screed. I would also give her some advice about how to improve her breathing and, perhaps, increase