Research Evidence

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• Case studies report that hypnotherapy and training in self-hypnosis can help persons achieve remarkable success in alleviating anxiety, not only in anxiety disorders, but also in any problem involving anxiety. The author describes the role of hypnosis in the treatment of several disorders and provides clinical examples illustrating treatment of generalized anxiety, phobias, and posttraumatic stress disorders. He concludes that because hypnosis exploits the intimate connection between mind and body, it provides relief through improved self-regulation and also beneficially affects cognition and the experience of self-mastery. [W H Smith, Hypnosis in the treatment of anxiety, Bull Menninger Clin. 1990 Spring;54(2):209-16.]

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•  The efficacy of clinical hypnosis with headaches and migraines has been reviewed by the 12-member National Institute of Health Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia (1996). It reviewed outcome studies on hypnosis with cancer pain and concluded that research evidence was strong and that other evidence suggested hypnosis may be effective with some chronic pain, including tension headaches. This paper provides an updated review of the literature on the effectiveness of hypnosis in the treatment of headaches and migraines, concluding that it meets the clinical psychology research criteria for being a well-established and efficacious treatment and is virtually free of the side effects, risks of adverse reactions, and ongoing expense associated with medication treatments. [D Corydon Hammond, University of Utah School of Medicine, Salt Lake City, Utah 84132-2119, USA. D.C.Hammond@utah.edu]

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• The potential benefits of hypnotherapy were investigated with 32 patients suffering from chronic combat-related post-traumatic stress disorder (PTSD). The patients were already being treated with anti-depressants and supportive psychotherapy and were randomised into two groups. Fifteen patients in the first group received Zolpidem 10 milligrams nightly for 14 nights, and 17 patients in the hypnotherapy group were treated by symptom-orientated hypnotherapy, two 1.5-hour sessions each week for 2 weeks. All patients completed the Stanford Hypnotic Susceptibility Scale, Beck Depression Inventory, Impact of Event Scale and Sleep Quality Questionnaire prior to and post-treatment. It was found that there was a significant main effect of condition in the hypnotherapy group on PTSD symptoms as measured on the Post-traumatic Disorder Scale, and this effect was maintained at a 1-month follow-up. No such effects were reported in the non-hypnotherapy group either during the main data collection period or at the 1-month monitoring. The hypnotherapy group experienced additional benefits: decreases in intrusion and avoidance reactions and improvement in all sleep variables assessed. This investigation demonstrates the beneficial effect of hypnotherapy with positive results achieved in a 2-week period. The methodology is robust as it uses a number of different scales and incorporates a control group. [Abramowitz EG, Barak Y, Ben-Avi I, Knobler HY. Hypnotherapy in the treatment of chronic combat-related PTSD patients suffering from insomnia: A randomised, Zolpidem-controlled clinical trial. International Journal of Clinical and Experimental Hypnosis. 2008;56(3):270-280]

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• An investigation into the treatment of headaches and migraines provided an update of the literature first reviewed in 1996 by the National Institute of Health Technology Assessment Panel on the Integration of Behavioural and Relaxation Approaches into the treatment of chronic pain and headaches. It concluded that hypnosis is very effective and virtually free of side effects and adverse reactions and it meets the clinical psychology research criteria for being a well-established treatment. The research further drew attention to the ongoing expense associated with medication treatments. [Hammond DC. Review of the efficacy of clinical hypnosis with headaches and migraines. International Journal of Clinical and Experimental Hypnosis. 2007;55:207-219]

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• Recent research was conducted into MPA with 46 advanced pianists where participants were randomly assigned to a cognitive hypnotherapy (CH), eye movement desensitisation and reprocessing (EMDR) or non-treatment group and given two sessions only of the allocated therapy. They were tested in two concert performances pre- and post-intervention. Significant decreases in performance anxiety (the cognitive, physiological and behavioural aspects of performance) were found in both the therapy groups but not in the control group [66]. This research was extended when trait levels of anxiety (an individual’s general anxiety level) were tested at 4 months and 1 year post-intervention. Statistical evidence at both monitoring points demonstrated a significant reduction in trait anxiety levels below baseline, showing the effectiveness of both CH and EMDR over time. [Brooker E. Cognitive hypnotherapy and EMDR: The longitudinal effects on trait anxiety and music performance in advanced pianists. Advances in Complementary & Alternative medicine. 2019;5(4):ACAM.000616.2019]

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• Nine case studies documenting performance anxiety in different domains have recently been published (five in music, two in the sports arena and two in the workplace) where CH was one of the interventions adopted. The effects of CH were recorded immediately post-intervention and longitudinally, and shown to be beneficial in a short space of time for the reduction of negative, psychological perceptions in a performing situation. [Brooker E. Transforming Performance Anxiety Treatment Using Cognitive Hypnotherapy and EMDR. London and New York: Routledge; 2019]

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• Post-treatment scores were available for 83 of the 106 clients reaching caseness (above the clinical cut-off on either or both measures) on their pre-treatment scores. Totally, 59 clients had moved to recovery, representing 71 per cent of cases where post scores were available and 56 per cent of the intent to treat (ITT) population (106 clients). Additionally, including all cases (both above and below cut-offs) 118 clients had post-treatment measures. In total, 86 (73 per cent) clients improved reliably. The mean number of treatment sessions was between three and four. This compares favourably with 2012-2013 IAPT findings using the same measures.

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• A pilot investigation of Quest Institute Cognitive Hypnotherapy services using Improving Access to Psychological Therapies as the benchmark has been undertaken to investigate the treatment effects of Quest cognitive hypnotherapy (QCH) on anxiety and depression, and make comparisons with published data from the Improving Access to Psychological Therapies (IAPT) project. Post-treatment scores were available for 83 of the 106 clients reaching caseness (above the clinical cut-off on either or both measures) on their pre-treatment scores. Totally, 59 clients had moved to recovery, representing 71 per cent of cases where post scores were available and 56 per cent of the intent to treat (ITT) population (106 clients). Additionally, including all cases (both above and below cut-offs) 118 clients had post-treatment measures. In total, 86 (73 per cent) clients improved reliably. The mean number of treatment sessions was between three and four. This compares favourably with 2012-2013 IAPT findings using the same measures. [Andrews, W.P., Parsons, A.A., Rawle, H. and Gibbs, J. (2015), "A pilot investigation of Quest Institute Cognitive Hypnotherapy services using Improving Access to Psychological Therapies as the benchmark", Mental Health Review Journal, Vol. 20 No. 3, pp. 199-210. https://doi.org/10.1108/MHRJ-08-2014-0030]

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