International Handbook of Clinical Hypnosis - E-Lib FK UWKS

106 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
and their clients to understand the latter's problems in the same way; also,
clinicians should always consider alternative hypotheses to account for clients'
problems, and should be especially careful not to ®xate on one of those
hypotheses. McConkey's 1997) consideration of the available statements and
guidelines underscored general agreement that: a) childhood abuse is a reality
that may have devastating consequences; b) the existence of particular problems
in adulthood is not a reliable indicator of the occurrence of abuse in childhood;
c) memories may be unreliable, and inaccurate memories can be held strongly;
d) the existence of repression should not be rejected, but it cannot be accepted
without question; e) recovered memories of childhood abuse may or may not be
accurate, and independent corroboration is the only way of determining this; f)
clinicians' responsibilities to their clients are best met through a cautious
approach to the assumptions they make and the techniques they use; and g)
clinicians' professional and ethical responsibilities are best met by avoiding an
excessive encouragement or discouragement of reports of childhood sexual abuse.
In a more concrete way, Knapp & VandeCreek 1996) commented on risk
management procedures for psychologists treating individuals who recover memories
of childhood abuse. They argued that `effective treatment included maintaining
appropriate boundaries, developing an accurate diagnosis that is based on a
collaborative relationship with the patient, using intervention techniques that have
been empirically derived or in other ways have received the profession's endorsement,
obtaining informed consent from patients when using experimental techniques,
and showing concern for the patients' long-term relationship with their
families of origin. Consultation in dif®cult cases and careful documentation are
also essential' Knapp & VandeCreek, 1996, p. 455).
These comments highlight that clinicians need to know how to work in a setting
of ambiguity, uncertainty, and differential demands. Moreover, to engage in competent
practice clinicians must have a knowledge of memory research, an understanding
of trauma and memory loss, and must develop speci®c intervention skills
and practices to work with clients who may recover memories. In terms of
hypnosis, clinicians need to be alert that its use can be potentially problematic; in
particular, hypnosis can offer no guarantee of the veracity of the reports that it may
elicit, and the memories that are recovered during hypnosis may be very dif®cult to
corroborate independently. Moreover, Pope & Brown 1996) set out speci®c
questions that should be addressed by clinicians considering the use of hypnosis to
recover memories: `a) Am I competent in the clinical uses of hypnosis as demonstrated
by my education, training, and experience? b) Have I adequately considered
alternative approaches that do not involve hypnosis? c) Have I consulted with
a quali®ed attorney to ensure that I understand the ways that using hypnosis may
affect the client's legal rights e.g., admissibility of claims, testimony, or other
evidence based on hypnotically refreshed recollection)? d) Am I adequately aware
of the research and theory about the use of hypnosis for this population in this
situation? and e) Have I accorded the client full informed consent or informed