Does My Hypnotherapy Client Need a Medical Referral?

Do hypnotherapists need a medical referral before working with a client? It’s a common question, and one where the advice can seem confusing, and even contradictory.

When Do Hypnotherapists Need Medical Referrals?

In hypnotherapy, a medical referral usually means advising a client to consult their GP, or contacting a medical professional directly (with consent), before proceeding with treatment.

In this article, I’ll look at the key guidelines around medical referrals in hypnotherapy. We’ll include ethical considerations, professional standards, and UK regulations, to help you decide what’s appropriate in your practice.

Ethical Guidelines on Medical Referrals

Start by checking whatever Code of Ethics you work with, as each one words things slightly differently. If in doubt, drop a line to your professional body (or whoever wrote your Code of Ethics). Ask them what their policy is on getting medical referrals, so you have it from the ‘horse’s mouth’.

Professional Bodies Guidance on Medical Referrals

Your Code of Ethics probably comes from your professional body and each one will express their requirements slightly differently. I’m going to use the General Hypnotherapy Register here as an example. If you’re not a GHR member, you can compare your professional body’s advice with theirs.

The GHR Code of Ethics has two things to say about this topic, which are:

ensure that wherever a client is seeking assistance for the relief of physical symptoms, that unless already having done so, the client be advised to contact a registered medical practitioner. (Clause 8)
never knowingly offer advice to a client which either conflicts with or is contrary to that given by the client’s registered medical advisor/s. (Clause 9)

Firstly, you’ll notice that this clause only applies if the client is ‘seeking assistance for the relief of physical symptoms’. Your first job is to decide what that means. The client is presenting for pain relief or menopausal side effects? I’d say yes, definitely. But what about anxiety? It often has physical manifestations. What about a client who is very overweight? Is that a ‘physical symptom’?

I tend to interpret this one on a case by case basis, using what I like to think of as common sense:

• I ask any client with distinct physical symptoms to get them checked out. (One reported pain in his chest and down his left arm as a symptom of panic attacks, for example, which was worrying). After all, if they do have heart problems, reducing their anxiety is not going to make the problem go away.
• If a doctor is already treating them for the presenting issue, I also advise them to let the doctor know they are working with me. That one is a bit of a stretch, perhaps, but seems like good manners.

The second thing you’ll notice about the GHR guidelines is that they don’t ask you to get a referral or permission from the doctor. You should simply advise the client to contact them. Nor do they say what form that contact should take, or what the client should say. You are left to decide what’s appropriate for the client in front of you.

From this, simply asking the client to inform their doctor they are seeing you should be fine. I recommend you record this in your session notes. Follow up at the next session by checking if they have done so, and record that too. If the client has chosen not to follow your advice you will need to ask why. Then review whether you feel it’s ethical to continue to work with them. If you’re not sure, that’s what your supervisor is for!

Most GPs, in my experience, when told a patient is seeing a hypnotherapist shrug and say something fairly neutral and non-committal (although some are gratifyingly supportive). After all, this is about informing them, not asking for their opinion.

But there is the possibility that the client’s medical practitioner will say ‘Under no circumstances. Don’t do it!’ or words to that effect. You would have to stop working with the client then, under clause 9, so as not to contradict medical advice.  This has only happened to me once since I started my practice in 2003, and under very unusual conditions, so I’d guess it’s rare.

Training Standards

If you choose to work within the UK voluntary regulations, the latest (2024) version of the Training Standards states that if there are “possible contra-indications” hypnotherapists should:

contact client’s GP (always with client permission) or other relevant healthcare professional (such as psychiatrist if patient has been referred or is working ‘in conjunction with’). (para 9)

It says ‘possible contraindications”. I’d imagine this could arise if, for example, you suspect an undiagnosed or undisclosed condition which would be a contraindication for hypnotherapy if confirmed. In this case, you have to take action yourself and not simply advise the client to do so.

You will need the client’s consent in writing, and it should include explicit instructions to the GP or medical practitioner concerned to release information to you. Otherwise, you can contact them, but they can’t respond because of GDPR.

Conditions Contraindicated for Hypnotherapy

The above paragraph doesn’t mention what it considers to be contraindications, of course. Paragraph 20 of the Training Standards says therapists should:

 … [work] within [their] competence, understand their limitations and refer on to another hypnotherapist or healthcare professional if appropriate.

So, working outside of your training is contra-indicated, which seems quite reasonable. This doesn’t prevent you from working with an issue for the first time, just in areas where you have no appropriate knowledge or skills.

Some medical conditions are also widely (though not universally) considered contraindications for hypnotherapy. The list you have will depend on who trained you. But we do have some indicators of what they might be in the next section.

Legal and Advertising Guidelines (ASA, CAP and the Law)

There are also legal and advertising guidelines to consider. In the UK, the Advertising Standards Authority (ASA) oversees advertising regulations and applies the Advertising Codes. The Committees of Advertising Practice (CAP) writes the codes.

Neither ASA nor CAP are legislative bodies but their rules reflect the law and apply to you and your practice. This is true whether you work inside or outside of the voluntary regulations and whichever professional body you belong to.

They have a bit to say about what issues hypnotherapists should and shouldn’t say we work with. Now, admittedly, this is about advertising, but if you can’t advertise that you work with an issue I think there’s a good argument to say you shouldn’t be working with it. For example, the CAP website says:

Claims to offer treatment on conditions for which medical supervision should be sought are likely to be considered to discourage essential treatment unless that treatment is carried out under the supervision of a suitably qualified health professional (12.2).

It seems they are worried that if someone sees you, they will be less likely to seek out conventional medical treatment. Whatever your view on that one, the rules apply anyway. Unless you have medical qualifications or other, specific, training in working with the relevant issue, or a health professional overseeing your work, you should consider any ‘serious medical condition’ contra-indicated.

This leads to a key question: what do they mean by “supervised” by a medical professional? It’s possible that requesting a formal referral from a doctor might tick this box, but I couldn’t find any test cases to confirm that. If this situation comes up in your practice, I therefore strongly advise contacting CAP, your insurance, and/or your supervisor for advice before proceeding.

CAP have more to say on what constitutes a serious medical condition:

Claims to treat depression, addiction*, eating disorders and other serious mental or psychological conditions are likely to be considered claims to treat serious medical conditions and practitioners should not refer to the treatment of these conditions unless that treatment is to be carried out under the supervision of a suitably qualified health professional.

*Just as an ‘aside’, the word addictions here doesn’t seem to include working with smokers, as there are separate and specific rules about advertising to them.

While we are speaking about legal limitations, we also have to bear in mind the Cancer Act 1939. Under Section 4 of this Act, it is a criminal offence to advertise services which claim to ‘treat any person for cancer’. Use of wording that breaches this legislation can lead to enforcement action by Trading Standards, which could result in a fine, or up to three months in prison.

Summary: When Is a Medical Referral Needed?

So where does this leave us regarding doctor’s referrals? There is some flexibility in how you interpret some of these guidelines, especially when they are all taken together, but here are my thoughts.

• Generally speaking, you don’t need a doctor’s referral to work with a client.  
•  If the client has physical symptoms, but you are confident you can work with them safely and ethically, you should advise them to contact their doctor.
  You do not need permission or a formal referral from the doctor, but if, when contacted, they advise against undertaking hypnotherapy, you should not go against their advice.  
• If you suspect contraindications, you are responsible for obtaining permission and contacting the doctor yourself. If there are definite contraindications, you would not work with the client, so this would not be necessary.
• Both the Code of Ethics and the Training Standards say you should only work within your training and competence.    
• The ASA and CAP do not consider hypnotherapists qualified to work with “serious mental or psychological conditions” unless they hold medical qualifications or work under medical supervision.
• The Cancer Act says you cannot claim to ‘treat’ cancer. This doesn’t stop you working with people who have it if you are helping with other issues like stress, anxiety and the like. If you work with pain control it would come under the ‘physical symptoms’ provisions above.

These guidelines combine to provide a kind of minimum standard, but you can always have stricter rules for your practice if you wish. Medical referrals in hypnotherapy are not always required, but they are an important part of safe and ethical practice. When in doubt, taking a cautious approach and seeking advice from your supervisor or professional body, will help protect both you and your client.

Free Download

You can download this file for use in your practice, it contains:

• a flow chart summarising our advice about medical referrals, and
• a template letter for clients to give permission to share medical information.

References:

A.S.A. | C. of A. (2025). Health: Hypnotherapy. [online] www.asa.org.uk. Available at: https://www.asa.org.uk/advice-online/health-hypnotherapy.html. [Accessed April 2026]
CORE CURRICULUM FOR HYPNOTHERAPY. (2024). Available at: https://www.cnhc.org.uk/uploads/asset/file/92/Hypnotherapy-core-curriculum.pdf [Accessed 6 Apr. 2026].
General Hypnotherapy Register (n.d.). The General Hypnotherapy Register’s Code of Ethics. [online] Available at: https://general-hypnotherapy-register.com/code-of-ethics. [Accessed April 2026]

This article is based on my personal interpretations of published codes, and is intended as general guidance. Always check your own professional body’s requirements and seek advice from your supervisor, professional body, insurance, or CAP if you are unsure how to interpret the rules.

Disclaimer
The information and ideas shared on this blog are based on the author’s professional experience, research, and training. They are intended for educational purposes and to support reflection and professional development. Therapists should always apply their own professional judgment and consider the needs of individual clients when using any techniques or suggestions discussed here.
While every effort is made to ensure the information is accurate and helpful, no responsibility can be accepted for any loss, damage, or difficulties arising from the use or misuse of material contained in these articles.