Psychotherapy | Counselling | Hypnotherapy
E.mail: namita@alignedmindset.co.uk
Phone: 07305595603
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Case Studies
Chemotherapy-related nausea support using hypnotherapy (2 sessions) (All identifying details have been changed to protect confidentiality.) Client: Woman in her 50s Format: Online sessions (Zoom) Presenting concern The client was undergoing chemotherapy and reached out a few days before her next cycle. Following her previous treatment, she experienced severe nausea, leaving her unable to eat or drink adequately for several days. She described feeling emotionally overwhelmed and worried about coping with upcoming treatments. After reading evidence online that hypnotherapy may support chemotherapy-related nausea, she contacted me for urgent support prior to her next round. Goals Together we focused on: Reducing the intensity and duration of nausea during and after chemotherapy Supporting her ability to eat, drink and rest more comfortably Increasing calm and confidence by addressing anticipatory anxiety around treatment Intervention We worked across two sessions Session 1 – Relaxation and nervous system support A stabilising hypnotherapy session designed to reduce stress and settle the body’s threat response, with calming imagery and an “anchor” she could use between sessions. Session 2 – Nausea-focused hypnotherapy A targeted hypnotherapy session using nausea-reduction suggestions, mind–body imagery, and conditioning techniques to help strengthen a calmer physical response during chemotherapy. Following each session, the client received a personalised audio recording to use in the days leading up to treatment, during chemotherapy (where appropriate), and afterwards. Outcome (client-reported) The client reported a dramatic reduction in nausea during her next chemotherapy cycle - describing the improvement as “tremendous” and noting that she barely experienced nausea at all. She also reported that the nausea did not return in subsequent cycles, and that she felt more able to cope with the remainder of her treatment. Client feedback “The difference was tremendous, I barely had any nausea at all… I now have only one treatment to go and have not been troubled with any more nausea. I am so grateful for finding this solution and will definitely consider hypnotherapy if needed in the future.” Note Hypnotherapy is offered as a complementary support alongside medical treatment, not a replacement. Outcomes vary, and clients should always follow guidance from their oncology team.
Supporting mild grief after bereavement (4 sessions) Client profile An adult client seeking short-term counselling support following the death of her mother during the Covid period. All identifying details have been changed to protect confidentiality. Presenting issue Although the client felt she was “fine” about the loss, she described still breaking down into tears and noticing a “no care attitude,” alongside reduced focus/motivation and feeling less guided without her mum. Relationship strain (particularly with her husband) was also emerging, as her mother had previously been a key source of emotional and cultural support. Goals Together we agreed to focus on: Regaining focus, motivation and a sense of purpose Making sense of ongoing tearfulness and emotional overwhelm Exploring the impact of grief on mood, stress symptoms and relationships Approach In the initial consultation, I completed a brief grief screening (Complicated Grief Questionnaire) to ensure the presentation was appropriate for short-term work and within my scope of competence, and we agreed a clear contract and four-session structure. The sessions were primarily person-centred, using active listening, reflection and Socratic questioning, alongside simple mapping tools to help the client identify patterns and make meaning. Session focus Session 1: Assessment + stabilising the work Contracting, rapport-building, and clarifying what the client wanted to achieve. Session 2: Linking grief to day-to-day wellbeing Exploring how grief was showing up in mood, sleep and physical stress symptoms (e.g., headaches/heartburn), and how reduced support in her relationship was affecting coping. Session 3: Mapping patterns + widening emotional awareness Using a “vicious cycle” style map to identify emotions underneath anger/low mood (e.g., feeling humiliated, suffocated, frustrated, out of control), and exploring where she felt she was within her grief process. Namita Bhatia -SSP1 including c… Session 4: Relationships + next steps Exploring family dynamics and strengthening self-advocacy needs, while identifying what further support would be most helpful beyond the brief intervention. Namita Bhatia -SSP1 including c… Outcome (client-reported) The client described gaining clarity and perspective, and feeling more at peace. In feedback, she described the work as helping her “unknot” and understand how grief had been affecting her. Next steps After the sessions, the client requested couples counselling and was signposted to local options and Relate (including additional signposting via the National Counselling Society website). Key clinical reflections Brief grief work can benefit from earlier psychoeducation and clear session structure. Namita Bhatia -SSP1 including c… Maintaining time boundaries while staying emotionally attuned is important, especially when clients become tearful. Namita Bhatia -SSP1 including c… Normalising emotional expression (e.g., reassurance that it’s okay to cry) can reduce shame and support safety in the room. Namita Bhatia -SSP1 including c… Important note This support was offered as short-term counselling for mild grief within scope of practice, with appropriate screening and supervision. Grief support is individual, and some clients may benefit from longer-term or specialist input depending on need.
Supporting mild grief after bereavement (8 sessions) Client profile An adult client seeking short-term counselling support following the death of her mother during the Covid period. All identifying details have been changed to protect confidentiality. Presenting issue Although the client felt she was “fine” about the loss, she described still breaking down into tears and noticing a “no care attitude,” alongside reduced focus/motivation and feeling less guided without her mum. Relationship strain (particularly with her husband) was also emerging, as her mother had previously been a key source of emotional and cultural support. Goals Together we agreed to focus on: Regaining focus, motivation and a sense of purpose Making sense of ongoing tearfulness and emotional overwhelm Exploring the impact of grief on mood, stress symptoms and relationships Approach In the initial consultation, I completed a brief grief screening (Complicated Grief Questionnaire) to ensure the presentation was appropriate for short-term work and within my scope of competence, and we agreed a clear contract and four-session structure. The sessions were primarily person-centred, using active listening, reflection and Socratic questioning, alongside simple mapping tools to help the client identify patterns and make meaning. Session focus Session 1: Assessment + stabilising the work Contracting, rapport-building, and clarifying what the client wanted to achieve. Session 2: Linking grief to day-to-day wellbeing Exploring how grief was showing up in mood, sleep and physical stress symptoms (e.g., headaches/heartburn), and how reduced support in her relationship was affecting coping. Session 3: Mapping patterns + widening emotional awareness Using a “vicious cycle” style map to identify emotions underneath anger/low mood (e.g., feeling humiliated, suffocated, frustrated, out of control), and exploring where she felt she was within her grief process. Namita Bhatia -SSP1 including c… Session 4: Relationships + next steps Exploring family dynamics and strengthening self-advocacy needs, while identifying what further support would be most helpful beyond the brief intervention. Namita Bhatia -SSP1 including c… Outcome (client-reported) The client described gaining clarity and perspective, and feeling more at peace. In feedback, she described the work as helping her “unknot” and understand how grief had been affecting her. Next steps After the sessions, the client requested couples counselling and was signposted to local options and Relate (including additional signposting via the National Counselling Society website). Key clinical reflections Brief grief work can benefit from earlier psychoeducation and clear session structure. Namita Bhatia -SSP1 including c… Maintaining time boundaries while staying emotionally attuned is important, especially when clients become tearful. Namita Bhatia -SSP1 including c… Normalising emotional expression (e.g., reassurance that it’s okay to cry) can reduce shame and support safety in the room. Namita Bhatia -SSP1 including c… Important note This support was offered as short-term counselling for mild grief within scope of practice, with appropriate screening and supervision. Grief support is individual, and some clients may benefit from longer-term or specialist input depending on need.
Supporting low motivation and procrastination with CBT-informed counselling (4 sessions) Client profile A woman in her 50s in a high-pressure full-time role, balancing work, family life and a work-based coaching course (in-person sessions). All identifying details have been changed to protect confidentiality. SSP2 Presenting issue The client sought support for low motivation and procrastination after feeling overwhelmed by workload alongside course demands. She noticed increased anxiety, tiredness/fatigue, feeling constantly rushed, and feeling “snappy,” alongside a growing sense she wasn’t enjoying work as she used to. SSP2 Goals Together, we agreed to focus on: Reducing procrastination and improving follow-through with coursework Strengthening time management and daily structure Understanding and easing anxiety triggers (including perfectionistic pressure) SSP2 Approach Following an initial assessment (including PHQ-9 and GAD-7 screening) and clear contracting, we worked over four sessions using a person-centred foundation with CBT-informed tools. This included activity monitoring, a thought/trigger diary, Socratic questioning, and practical time-management strategies to reduce overwhelm and increase a sense of control. SSP2 Session structure (overview) Session 1: Assessment + clarity and planning Explored the pressure points (work demands, course expectations, responsibility at home) and agreed home practice using activity monitoring and a thought/trigger diary. SSP2 Session 2: Identifying triggers + practical structure Reviewed monitoring sheets, identified anxiety triggers (self-doubt, overthinking, fear of others’ opinions), and introduced a simple timetable and the Pomodoro technique to reduce avoidance and improve momentum. SSP2 Session 3: Strengthening routines + cognitive skills Consolidated what was working (e.g., protected morning focus time) and introduced psychoeducation on cognitive distortions to help the client spot unhelpful thinking patterns. SSP2 Session 4: Consolidation + relapse prevention Practised identifying thinking patterns from real examples, linked thoughts–feelings–behaviours, and reviewed a realistic ongoing plan the client could sustain independently. SSP2 Home practice plan Between sessions, the client used: Activity monitoring (to track energy, motivation and time use) Thought/trigger notes (to identify patterns and reduce overthinking) A weekly timetable + Pomodoro intervals for coursework Brief breathing breaks and short rest periods to support fatigue and regulation SSP2 Outcome (client-reported) By the end of the four sessions, the client reported improved time management, increased focus, and reduced procrastination. She also developed clearer insight into how perfectionism and self-pressure were driving anxiety and avoidance. SSP2 Client feedback (excerpt) “I had a clear direction… I felt less anxious and more self-aware of situations.” SSP2 Key clinical reflections Combining practical structure (timetabling/Pomodoro) with thought-based work can be especially helpful when procrastination is fuelled by anxiety. SSP2 Monitoring tools supported change by grounding sessions in real examples, not assumptions. SSP2 In future, I would consider introducing an ABC-style framework earlier to strengthen understanding of beliefs and emotional responses, and review client worksheets in more depth prior to sessions. SSP2 Important note This was brief, structured counselling support for motivation/anxiety difficulties and is not a substitute for medical or specialist mental health care. If symptoms are severe, persistent, or worsening, additional support (e.g., GP/mental health services) may be recommended. SSP2 Sources
Processing trauma-related guilt, anxiety and a need for control (22 sessions) Client profile An adult woman who began online counselling to explore how past experiences were affecting her present-day wellbeing and relationships. All identifying details have been changed to protect confidentiality. Namita Bhatia Year 3 SSP Includ… Presenting issue The client described a history of domestic abuse and significant early responsibility as a young carer for her mother. She reported ongoing anxiety, low mood at times, people-pleasing patterns, social anxiety, and a strong need for control and “hypervigilance.” A key theme was persistent guilt and self-blame connected to her mother’s illness and death, alongside difficulty tolerating uncertainty and fear of judgement. Namita Bhatia Year 3 SSP Includ… Goals Together, we agreed to: Increase understanding of how past experiences shaped present emotions and reactions Reduce anxiety-driven behaviours (overthinking, hypervigilance, fear of judgement) Work with guilt and self-blame, building a kinder and more balanced perspective Namita Bhatia Year 3 SSP Includ… Approach We agreed a structured block of weekly 50-minute online sessions with a review point partway through. The work was primarily person-centred, with carefully introduced, trauma-informed integrative tools to support insight and change. This included: Timeline work (to organise key life events and identify patterns) CBT-informed techniques (Socratic questioning and a thought record) Simple experiential exercises to reduce self-consciousness and strengthen confidence Namita Bhatia Year 3 SSP Includ… Session structure (overview) Session 1: Assessment + stabilising the work Building safety and clarity around what the client wanted from counselling, and identifying the main themes (anxiety, guilt, control, fear of judgement). Namita Bhatia Year 3 SSP Includ… Session 2: Timeline work + linking past to present Creating a timeline of significant events to help the client notice how earlier experiences continued to shape current coping strategies. Namita Bhatia Year 3 SSP Includ… Sessions 3–4: Understanding control, hypervigilance and overthinking Exploring how the client’s need for control and “what if” thinking connected to earlier experiences of not feeling safe or in control. Namita Bhatia Year 3 SSP Includ… Sessions 5–6: Reducing fear of judgement + building confidence Introducing a practical, repeatable exercise to help the client step out of self-consciousness and experiment with being more visible and confident. Namita Bhatia Year 3 SSP Includ… Sessions 7–8: Working with guilt, grief and complex emotions Exploring self-blame and guilt related to her mother’s illness and death, including acknowledging underlying anger and sadness—especially around an anniversary period—while supporting emotional regulation and self-compassion. Namita Bhatia Year 3 SSP Includ… Home practice plan Between sessions, the client used: Ongoing timeline reflections (adding significant events and noticing themes) A CBT-style thought record to challenge self-blame and unhelpful assumptions A confidence-focused exercise to reduce self-judgement in social/work situations Namita Bhatia Year 3 SSP Includ… Outcome (client-reported) Over the course of the sessions, the client reported improved self-understanding and an increased ability to link present reactions to earlier experiences. She described the work as helpful because it was tailored to her needs, and noted growing confidence in situations she would previously have avoided. Namita Bhatia Year 3 SSP Includ… Client feedback (summary) The client reported finding it particularly helpful to “see the connections” between childhood experiences and current patterns such as people-pleasing, control, and fear of judgement. Namita Bhatia Year 3 SSP Includ… Key clinical reflections Early, gentle identification of core themes (guilt, anger, fear of judgement) can help pace the work and reduce overwhelm. Namita Bhatia Year 3 SSP Includ… Structured psychoeducation and behavioural experiments introduced earlier may strengthen momentum for clients with anxiety and avoidance. Namita Bhatia Year 3 SSP Includ… When grief and trauma overlap, creating space for “mixed feelings” (sadness, anger, unfairness, loss of control) can support deeper processing and self-compassion. Namita Bhatia Year 3 SSP Includ… Important note This is an anonymised example of counselling support for trauma-related difficulties. Counselling can be a helpful step, but everyone’s needs differ. If someone is currently experiencing domestic abuse or feels unsafe, specialist support and safeguarding help should be prioritised.
Reducing Trichotillomania Using Habit Reversal + the COMB Model ( 6 sessions) Client Profile: Female, mid-20s Presenting issue: Trichotillomania (hair pulling) with noticeable bald patches on the scalp Duration: ~10 years Sessions: 6 sessions + 3-month follow-up Outcome: Hair pulling stopped by session 6; no pulling reported at 3-month follow-up Presenting Difficulties The client sought support for longstanding trichotillomania that had resulted in bald patches and significant distress. At the start of therapy, she reported: Pulling for up to ~5 hours per day An estimate of 50+ hairs per day A strong sensory drive (seeking hairs that felt “just right,” often longer hairs) Pulling with both hands, especially when one hand was “free” Emotional impact including anxiety, stress, frustration, and a sense of being out of control Reduced confidence and increased self-consciousness due to visible hair loss Before starting sessions, her longest period without pulling had been around two weeks. Goal The client’s primary goal was to stop hair pulling and feel more in control of urges, particularly during periods of stress and anxiety. Assessment & Formulation We completed a thorough assessment and behavioural conceptualisation, including: Pulling patterns (timing, location, intensity, sensory cues) Emotional and physiological triggers (stress/anxiety states) Environmental/contextual factors (automatic vs. focused pulling) Maintaining loops (relief/soothing + sensory reinforcement) A key formulation point was that pulling was not only anxiety-linked—it also met a strong sensory/physical need, particularly through the hands and fingertips. This guided treatment toward strategies that addressed both emotional regulation and sensory substitution. Intervention Approach We used an evidence-based behavioural framework combining: 1) Habit Reversal Training (HRT) Awareness training (noticing early cues, positions, contexts) Competing responses (physically incompatible actions) Stimulus control (reducing opportunity and automaticity) 2) The COMB Model (Comprehensive Behavioural Model for BFRBs) Interventions targeted multiple drivers of pulling, including: Sensory: tactile input needs Cognitive: beliefs/attention patterns around “finding the right hair” Affective: stress/anxiety states Motor: hand movements and automatic reaching Place/environment: contexts that increased likelihood of pulling Treatment Progress (6 sessions) Each session included structured monitoring of what had changed since the previous session, allowing us to refine strategies quickly. Early sessions: Increased awareness, mapped urge patterns, introduced stimulus control and initial competing responses Middle sessions: Strengthened sensory replacements and hand-based strategies (since both hands were involved), tailored competing responses to high-risk moments Later sessions: Consolidated skills, problem-solved setbacks, and reinforced maintenance strategies for stress spikes Outcomes By the end of six sessions, the client reported: No pulling Increased sense of control and confidence Reduced distress around urges and triggers A clear plan for maintaining change during stressful periods Follow-up: At 3 months, the client reported no pulling during the entire follow-up period—an improvement from her previous pattern of relapsing within two weeks. Key Factors That Supported Success A detailed behavioural conceptualisation (not just “stop pulling,” but why it happens) Addressing the sensory need directly (not treating pulling as purely anxiety-based) Frequent monitoring and rapid iteration of strategies Skills tailored for both hands and “free hand” moments A structured relapse-prevention plan to protect progress beyond sessions Clinical Note (Ethical Disclaimer) This case study is anonymised and shared for educational purposes. Outcomes vary between individuals depending on many factors, including severity, triggers, and context. This is not a guarantee of results.