The questions every sound healer should ask before a first session

Sound facilitation has almost no regulated entry bar. Anyone can buy a set of bowls, learn three patterns from YouTube, rent a yoga studio, and start a practice this week. Most of the people who do this are sincere. Some are skilled. A few are reckless. The single thing that separates the reckless from the careful is whether they ask the intake questions.

This is the short list of questions that every facilitator — full-time, weekend, just-starting — should be asking before a first session, in the order they matter, and the reason each one matters.

1. Are you pregnant, or trying to conceive?

The honest position from the sound-therapy field (Academy of Sound Therapy Ireland and parallel bodies) is that the first trimester is a period of caution. Many practitioners decline first-trimester sessions outright, not because there is firm evidence of harm but because critical fetal development is happening and elective intense-vibration interventions have no published safety data. The conservative move, and the one most reputable training programmes teach, is: thank, decline politely, invite back after week 12.

Second and third trimester: a gentle, ambient session is generally fine. The non-negotiable rule is no bowls or instruments placed directly on the body, especially the abdomen. Avoid sustained low-frequency vibration close to the torso. Avoid drum work in close proximity. Suggest a side-lying position with bolsters from second trimester onward. Sit closer to the door so departure is easy.

The question to ask, calmly, on the intake form: “Are you currently pregnant, or planning to be in the next few months?” The answer is almost always volunteered if asked. People do not usually lie about it.

2. Do you have any cardiovascular condition, an implanted device, or take blood-pressure or heart medication?

The headline issue is the pacemaker / ICD / implanted device. Modern devices are well shielded, but the manufacturer guidance is consistent across vendors: keep strong magnetic sources and intense sustained vibration at least 20 cm from the device, and never place instruments directly over it. Singing bowls placed on the chest are off the table for this group. Gongs in close proximity are off the table.

The secondary issue is arrhythmia and uncontrolled hypertension. Sound baths are sympathetic-system-calming for most people, which is fine for hypertension on medication; but for someone with active arrhythmia, very low resting heart rates, or recent cardiac events, the calling-card move is to refer back to their cardiologist and ask for explicit clearance. “My cardiologist said it’s fine” is a perfectly good gate.

Ask: “Any heart conditions, pacemaker, defibrillator, or heart medication?” And follow up: “When were you last cleared by your doctor for relaxation activities?“

3. Do you have tinnitus or any current ear condition?

Tinnitus is the contraindication people are most surprised to see on the list. The truth is that sound healing’s relationship to tinnitus is complicated. Notched sound therapy and broadband relaxation can help; sustained high-frequency tones can aggravate.

The safe default is to avoid sustained high-pitched bowls and crystal pyramids close to the head for a client with active tinnitus, and to seat them where they can leave without disrupting the room. Recent ear surgery (last 6 months), perforated eardrum, active middle-ear infection, severe Ménière’s disease: these mean defer, not adapt. Wait until cleared by an ENT.

Ask: “Do you experience tinnitus, hearing loss, or any current ear infection or recent ear surgery?“

4. Have you ever had a seizure, or are you photosensitive?

Sound baths themselves rarely trigger seizures, but they are sometimes paired with low light, strobing candles, or LED installations. Photosensitive epilepsy is sensitive to flickering light, especially in the 3–60 Hz range. Avoid strobing visuals. Avoid flickering candles directly in the client’s visual field.

The deeper concern with seizure history is that some clients have had seizures in altered states. A drowsy, deeply parasympathetic body is not a higher-risk state than ordinary sleep, but it is worth knowing in advance. The intake answer is a flag, not a refusal.

Ask: “History of seizures, or known sensitivity to flickering lights?“

5. Are you currently working with a mental-health professional? Have you been in acute psychiatric care recently?

Sound facilitators are not therapists. We do not diagnose, treat, or take responsibility for mental-health conditions. But we hold rooms in which strong emotion arises, and we need to know whom we are holding space for.

The contraindication that matters here is active untreated psychosis, recent psychiatric hospitalisation (within the last six months), active eating-disorder care, and suicidality. None of these absolutely bar a session — well-supported clients in stable care often benefit — but they require communication with the existing care team and, often, declining to be the primary support.

The opposite end: trauma history is not a contraindication. Most people who walk into a sound bath are processing some form of held distress. The trauma-informed adjustments — clear consent, choice, exits, language — are universal and should be how you run every session anyway (Hopper et al., 2010 is the foundational framework).

Ask: “Are you currently in mental-health care or recently treated for a mental-health condition you’d like me to know about?” Calmly. As a question of context, not gatekeeping.

6. Are you on any psychoactive substance today, including alcohol, prescription sedatives, or recreational drugs?

This is the question most facilitators avoid asking because it feels intrusive. Ask it anyway. Sound baths are not safe to attend on active intoxication. The combination of suppressed motor reflexes (alcohol, sedatives) plus deep parasympathetic activation can produce nausea, vomiting, or unsafe loss of consciousness.

Cannabis is its own conversation. Many people use it before sessions and find the experience deeper. Many also find it produces racing anxiety in the sustained-tone room and want to leave immediately. There is no universal answer; flag it, ask once, let the client choose. If they show up impaired, you can decline that session.

Psilocybin, ayahuasca, MDMA, ketamine, or other plant medicines in the previous 72 hours is also worth knowing. Not because it bars the session, but because integration is a real thing and a sound bath in the immediate aftermath of plant work can be exactly the right container — or the wrong one — depending on the client. Asking signals that you understand the landscape.

Ask: “Anything that affects how your body is responding today — alcohol, sedatives, recent plant medicine, anything you’d want me to know?”

What to do with the answers

The point of the intake is not to compile a refusal list. It is to adapt the session. Almost everyone is welcome. Some people get a slightly different version of the practice — closer to the door, no bowl on the chest, gentler instruments, a quiet word at the start that they can leave whenever they need.

Write the intake down. Keep it for as long as the client is active. Encrypt it. Re-check verbally at the start of each session (“Anything different from what you told me last time?”) because conditions change.

The other purpose of the intake is signal. A facilitator who takes thirty seconds to ask about pacemakers and pregnancy is a facilitator who has been trained, has been mentored, and probably also notices what is happening in the room. That signal is felt by clients in the first minute. They will tell their friends.

What to try this week

If you are a facilitator without an intake form, write one. Two pages, plain language, the six questions above plus your contact info and cancellation policy. Send it as a PDF or Google Form with the booking confirmation. It pays for itself by the third client. You will catch one pacemaker before you put a bowl on someone’s sternum. That alone makes the practice worth it.

If you are starting a practice and want a template, write to the directory — we’ll send you a sample one based on what working facilitators on this list use. It is not a credential, but it will save you from the small mistakes that the field’s history has taught us the hard way.