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GORDON COCHRANE AND JOHN FRIESEN
effectiveness o f hypnotherapy for weight loss. We hypothes ized
t ha t the two exper iment a l groups would reveal significantly
greater weight loss immed i a t e l y after t r ea tmen t and after a 6-
mon t h fol low-up than the cont rol group, and that the exper i -
mental group using audiotapes would show significantly greater
weight loss than the group no t using audiotapes.
A secondary object ive o f this study was to ident ify cl ient char-
acteristics that cont r ibut e to var iabi l i ty in weight loss. Da t a
f rom the fol lowing cl ient var iables were recorded and analyzed:
suggestibility, self-concept , qual i ty o f fami ly origin, age o f obe-
sity onset, educa t ion level, and soc i oeconomi c status.
In test ing the efficacy o f hypnosis as a t r ea tmen t for weight
loss, care was exercised to establ ish m i n i mum t r ea tmen t condi -
tions. Wi th the increas ing evidence on nonspeci f ic t r ea tmen t
factors such as expectancy, mot ivat ion, and therapist character-
istics, it has become evident that some therapeut i c ou t comes
may be at t r ibutable to these factors rather than to specific t reat -
men t componen t s (Kazdin, 1979). In order to max imi ze t reat -
men t fidelity, the present study sought to cont rol for these fac-
tors as much as possible.
Me t h o d
Subjects
The subjects were 60 females between the ages of 20 and 65 who were
at least 20% above ideal weight according to Metropolitan Life (1960)
actuarial data. They were without medical problems contraindicating
weight loss and were not enrolled in any other weight loss programs.
The subjects were secured through the use of a newspaper advertise-
ment that listed the aforementioned criteria for participation.
Treatment
The treatment program was conducted by Gordon Coehrane, who
had obtained extensive formal training in the practice of hypnosis and
was supervised in this study by an experienced hypnotherapist. The
content, time, induction procedures, and imagery activities were estab-
lished in script form prior to initiating the treatment, and these were
adhered to in detail. Two experienced dieticians assisted with data col-
lection and logistics during the treatment program.
The rationale of the hypnotic treatment was explained to treatment
groups at the outset. Group inductions were used with a combination
of direct and indirect suggestions for dissociation and deepening (Kline,
Coleman, & Wick, 1976). Each subject was also inducted individually
to accommodate unique response patterns (Coupar & Kennedy, 1980).
The scripted treatment program consisted of three basic components.
Group hypnosis was used to present specific therapeutic stories and
metaphors designed for ego enhancement, motivation, and decision
making (Hartland, 1971). Individual hypnosis (Cheek & LeCron, 1968)
was used to facilitate the identification of unconscious weight-related
issues. Group hypnosis was again used for specific weight loss and main-
tenance suggestions following the uncovering activities (Kline et al.,
1976).
(Fitts, 1964) prior to treatment. This scale consists of 10 self-description
items. A Total Positive Self Concept score is derived from these items
and reflects the overall level of self-esteem. Test-retest reliability
coefficients with a 2-week interval between testings average in the
high .80s.
The Family History of Distress Scale (FAM), a subtest from the Mari-
tal Satisfaction Inventory (Snyder, 1975), was also administered to each
subject prior to treatment. The scale is based on the premise that ele-
vated scores indicate either unresolved conflicts stemming from the
family of origin or the absence of adequate parental models. These con-
ditions could contribute to current relationship difficulties and emo-
tional problems. Snyder (1975) reports a test-retest reliability coeffi-
cient of.94 for the FAM with an interval of 6 weeks between testings.
The Representational Systems Inventory (RSI) was developed by Co-
chrane as a means of measuring the subjects' degree of absorption in
imagery activities selected from the treatment program. The inventory
consists of 30 Likert-type items that purport to measure the degree of
imagery absorption experienced by the subject in three selected activi-
ties from the hypnotherapy programs. Item content is organized around
visual, auditory, and kinesthetic experiences. The minimum score is 40
and the maximum score is 120; higher scores represent greater imagery
absorption. A test-retest reliability coefficient of .92 was obtained by
the author with a 4-week interval between tests. Whereas the RSI has
content validity, it is not yet possible to establish the construct validity
that is established over time and based on many studies. The RSI was
administered to each subject in the two experimental groups immedi-
ately following the 4-week treatment program. The control group did
not participate in the imagery activities of the treatment program and
therefore could not respond to the treatment-specific questions of
the RSI.I
The data on age of obesity onset, education, and economic status were
obtained on an intake form prior to treatment.
Procedure
The subjects were randomly assigned to three groups: hypnosis treat-
ment utilizing audiotapes (Hy-T), hypnosis treatment without audio-
tapes (Hy), and wait-listed control group (Cont). Prior to treatment, the
subjects presented a medical clearance. Each subject was weighed on
the same scale, without shoes, wearing indoor clothing. The pretests
were completed and intake forms were collected at this time. The data
from the RSI were obtained from the two experimental groups following
the treatment program.
Subjects in the two experimental groups then met with the therapist
for a total of 24 hr (two 3-hr group sessions per week for 4 weeks). At
the end of the treatment period, the experimental and control group
subjects were weighed. Prepared audiotapes were given to the Hy-T sub-
jects. The tapes were 15 rain long, and the subjects were instructed to
use the tapes daily, if possible, and to record the frequency of tape use
until the follow-up meeting. There was no contact with the members of
the three groups until the designated 6-month follow-up date when tape
usage by Hy-T was recorded and when all subjects were weighed. Ad-
junctive therapies were not provided during the follow-up period to any
of the groups.
Re s u l t s
Instrumentation
The Barber Suggestibility Scale (BSS) was administered to each sub-
ject prior to treatment using standard procedures (Barber, 1969). The
BSS is significantly correlated with the Stanford Susceptibility Scale,
Form A, at .62 and.78 for objective and subjectiveportions, respaetively
(Ruth, Morgan, & Hilgard, 1974).
Each subject also completed the Tennessee SelfConcept Scale (TSCS)
A s umma r y o f means and standard deviat ions for ini t ial
weight and pos t t rea tment weight loss is provided in Table I. It
1A more detailed description of this study, including the treatment
script and the RSI, is available from UniversityMicro Films, 300 North
Zeeb Road, Ann Arbor, Michigan 48106, or from Gordon Cochrane,
2095 W. 45th Avenue, Vancouver, British Columbia, Canada V6M 2H8.