Case Study 00191 – 30 Assessment Questions for Customized Healing Program

Date: 3 January 2026
Program Focus: Self-love, Self-worth, Self-esteem, Self-doubt, Relationships, Creating a new life story and new identity using Hypnotherapy

Purpose

These questions are designed for a hypnotherapist to understand the client’s unique patterns, beliefs, and emotional needs. Responses guide the creation of a personalized 6-week hypnotherapy healing program.

30 Key Questions

Self-Love & Self-Acceptance

1. How would you rate your current level of self-love from 0 to 10?
2. When do you notice that you struggle to accept yourself?
3. What inner messages do you hear when you feel self-critical?
4. How do you usually respond when you make a mistake?
5. Can you recall early experiences that may have influenced your ability to love yourself?

Self-Worth & Self-Esteem

6. How do you define your self-worth?
7. Are there situations where you feel unworthy or inadequate?
8. Do you link your self-esteem to achievements or external approval?
9. Which past experiences do you believe have affected your self-esteem the most?
10. How would your life be different if your self-worth were unconditional?

Self-Doubt & Inner Critic

11. How often do you experience self-doubt?
12. What triggers your inner critic the most?
13. How does self-doubt affect your decisions and actions?
14. Can you identify specific beliefs that reinforce self-doubt?
15. When do you feel most confident and self-assured?

Relationships & Attachment Patterns

16. How would you describe your current relationships?
17. Are there recurring patterns in your relationships (e.g., over-giving, fear of abandonment)?
18. How comfortable are you setting boundaries with others?
19. What is your greatest fear in relationships?
20. Can you recall past experiences that shaped your attachment style?

Creating a New Life Story & Identity

21. How would you describe your current life story?
22. Which aspects of your past identity do you feel ready to release?
23. What qualities or traits do you wish to embody?
24. How do you envision your ideal life in 1–3 years?
25. Which limiting beliefs do you feel are holding you back?

Emotional & Somatic Awareness

26. How do you typically experience stress or anxiety in your body?
27. Are there physical sensations linked to self-criticism or shame?
28. What helps you feel emotionally safe and grounded?

Goals & Motivation for Change

29. What motivates you most to work on self-love, self-worth, and relationships?
30. What would success look like for you at the end of a 6-week hypnotherapy program?

Instructions for Practitioner: Use these questions in the intake session to explore subconscious patterns, early life experiences, relational habits, and emotional triggers. Responses will guide the customized hypnotherapy plan, including session focus, visualizations, anchors, and post-hypnotic suggestions.

Practitioner: Gerald Crawford
Specialization: Hypnotherapy | Identity Healing | Emotional Mastery