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April 2000 - English PDF Print E-mail


The International Journal of Clinical and Experimental Hypnosis
Volume 48, Number 2 - April 2000 - English
Special Issue: Epirical Validation of Hypnotic Interventions

 

The Status Of Hypnosis As Empirically Validated Clinical Intervention: A Preamble To The Special Issue
Michael R. Nash

In his introductory remarks to this Journal's Special Issue on the status of hypnosis as an empirically supported clinical intervention, the Editor briefly describes the dawn of clinical hypnosis research, the logic of the natural science model, the importance of an inspired but tough-minded clinical science, and the auspicious confluence of practice and research purpose in this enterprise. The progenitor of this effort was indeed the Report of the Royal Commission co-authored by Benjamin Franklin and Antoine Lavoisier over 215 years ago-a report which has been noted as one of the most important documents in the history of human reason. The ethos and logic of this Special Issue is grounded on the legacy of that document. Eschewing the conflicting mental health agendas of managed-care, governmental, patient rights, and professional guild interests, this Special Issue seeks to present a frank, even-handed, informed, and dispassionate assessment of what we know, and what we do not know about clinical hypnosis.

 

Clinical hypnosis with children: First steps toward empirical support
Leonard S. Milling and Christine A. Costantino

A review of controlled studies on the efficacy of clinical hypnosis with children reveals promising findings, particularly for reduction of acute pain, chemotherapy-related distress, and enuresis. However, no child hypnosis interventions currently qualify as "efficacious" according to criteria for empirically supported therapies (EST). A major limitation of the existing literature relative to EST guidelines is the lack of treatment specification via a manual or its equivalent.

 

A meta-analysis of hypnotically induced analgesia: How effective is hypnosis?
Guy H. Montgomery, Katherine N. DuHamel, and William H. Redd

Over the past 2 decades, hypnoanalgesia has been widely studied. However, no systematic attempts have been made to determine the size of hypnoanalgesic effects or establish the generalizability of laboratory findings to patient samples. This study examines the effectiveness of hypnosis in pain management, compares studies that evaluated hypnotic pain reduction in healthy volunteers vs. those using patient samples, compares hypnoanalgesic effects and participants' hypnotic suggestibility, and determines the effectiveness of hypnotic suggestion for pain relief relative to other nonhypnotic psychological interventions. Meta-analysis of 18 studies revealed a moderate to large hypnoanalgesic effect, supporting the efficacy of hypnotic techniques for pain management. The results also indicated that hypnotic suggestion was equally effective in reducing both clinical and experimental pain. The overall results suggest broader application of hypnoanalgesic techniques with pain patients.

 

Research on hypnosis as an adjunct to cognitive-behavioral psychotherapy
Nancy Schoenberger

There is a growing body of research evaluating the use of hypnosis with cognitive-behavioral techniques in the treatment of psychological disorders. The central question for research is whether the addition of hypnosis enhances the efficacy of cognitive-behavioral treatments. Overall, studies demonstrate a substantial benefit from the addition of hypnosis; however, the number of published studies is relatively small, and many of them have methodological limitations. For cognitive-behavioral hypnotherapies to be recognized as empirically supported treatments, a number of well designed, randomized clinical trials are necessary. Currently, the efficacy of hypnosis as an adjunctive treatment remains unresolved.

 

Empirical support for the use of hypnosis in medicine: A review
Cornelia Mare Pinnell and Nicholas A. Covino

Recent changes in health care have been characterized by an increased demand for empirically supported treatments in medicine. Presently, there is moderate support for the integration of hypnotic techniques in the treatment of a number of medical problems. This critical review of the research literature focuses on the empirical research on the effectiveness of hypnotic treatments as adjuncts to medical care for anxiety related to medical and dental procedures, asthma, dermatological diseases, gastrointestinal diseases, hemorrhagic disorders, nausea and emesis in oncology, and obstetrics/gynecology. Wider acceptance of hypnosis as an intervention to assist with medical care will require further research.

 

Hypnosis and suggestion-based approaches to smoking cessation: An examination of the evidence.
Joseph P. Green and Steven Jay Lynn

This article reviews 56 studies of hypnosis and smoking cessation as to whether the research empirically supports hypnosis as a treatment. Whereas hypnotic procedures generally yield higher rates of abstinence relative to wait list and no treatment conditions, hypnotic interventions are generally comparable to a variety of nonhypnotic treatments. The evidence for whether hypnosis yields outcomes superior to placebos is mixed. In short, hypnosis cannot be considered a specific and efficactious treatment for smoking cessation. Furthermore, in many cases, it is impossible to rule out cognitive/behavioral and educational interventions as the source of positive treatment gains associated with hypnotic treatments. Hypnosis cannot, as yet, be regarded as a well-established treatment for smoking cessation. Nevertheless, it seems justified to classify hypnosis as a "possibly efficacious" treatment for smoking cessation.

 

Hypnosis for the treatment of trauma: A probably, but not yet fully supported efficacious intervention
Etzel Carde–a

Hypnotic techniques for the treatment of posttraumatic conditions were often used by the clinical pioneers of the end of the 19th century and by military therapists treating soldiers during this century's conflagrations. More recently, hypnosis has also been used with survivors of sexual assault, accidents, and other traumas, and with various groups including children and ethnic minorities. Nonetheless, there have been almost no systematic studies on the efficacy of hypnosis for posttraumatic disorders. This state of affairs is especially disappointing considering that: hypnosis can be easily integrated into therapies that are commonly used with traumatized clients; a number of PTSD individuals have shown high hypnotizability in various studies; hypnosis can be used for symptoms associated with PTSD; and hypnosis may help modulate and integrate memories of trauma. Hypnotic techniques may indeed be efficacious for posttraumatic conditions, but systematic group or single case studies need to be conducted before reaching that conclusion.

 

Hypnosis as an Empirically Supported Clinical Intervention: The State of the Evidence and a Look to the Future
Steven Jay Lynn, Irving Kirsch, Arreed Barabasz, Etzel Cardena & David Patterson
Drawing on the literature reviews of a special issue of the International Journal of Clinical and Experimental Hypnosis (2000), this article summarizes the evidence for the effectiveness of hypnosis as an empirically supported clinical intervention. As a whole, the clinical research to date generally substantiates the claim that hypnotic procedures can ameliorate some psychological and medical conditions, as judged against the Chambless and Hollon methodological guidelines. In many cases, these clinical procedures can also be quite cost-effective. It is probable that with some key empircial refinement a number of other hypnosis treatment protocols will have sufficient empirical documentation to be considered as "well-established." But it is noted that the the Chambless and Hollon guidelines are not particularly well-suited for assessing hypnosis' impact when used adjunctively with other interventions. The article concludes with recommendations regarding the efficacy questions that need to be more fully addressed empirically and offers methodological guidelines for researchers and practioners.

 
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