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HYPNOTIC ANALGESIA IN PERSONS WITH DISABILITIES
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treatment gains in pain intensity were maintained up to 3 months post-
treatment.
To our knowledge, this study is the largest series of patients with
chronic pain and a disability that have been offered hypnotic analgesia.
The results support the efficacy of this treatment for a subset of these
patients. Further study and clinical use of hypnosis in this population
is warranted.
The positive findings are particularly encouraging given the fact
that the intervention was standardized and read to participants from a
script. Usual clinical applications of hypnotic analgesia involve tailoring
the induction and the specific analgesia suggestions to the patient (e.g.,
Barber 1996, 2004; see also Jensen & Barber, 2000). Further support for the
benefits of tailored suggestions was noted by Barabasz and Christensen
(in press), who found that tailored inductions were significantly more
effective than scripted inductions among 20 volunteers assigned to
alternative induction procedures. In the current study, which focused
on using the same induction strategy for each patient, such tailoring
was not a part of treatment. Similarly, different patients respond to dif-
ferent types of hypnotic-analgesia suggestions (Erickson, 1980). One
way to address this idiosyncratic response is to provide patients with a
variety of suggestions, under the assumption that at least one of these,
and perhaps more, will be effective (Crasilneck, 1995), and then to tailor
subsequent sessions to include only those suggestions that the patient
responds to well (Jensen & Barber, 2000). In the current study, all of
the participants heard all suggestions, even if they consistently
reported no benefit from some of the suggestions. For example, one of
the participants in the current study repeatedly stated that suggestions
for deep relaxation were enjoyable and were consistently associated
with increases in comfort. On the other hand, symptom substitution
suggestions had little effect on this patient’s experience of pain. The
research protocol, however, required that the latter be included in each
treatment session. In the clinical setting, these suggestions would have
likely been dropped in favor of additional time spent with the admin-
istration of more detailed and comprehensive relaxation suggestions.
It is likely that hypnotic-analgesia research studies that employ stan-
dardized treatment protocols underestimate the effects that could be
obtained in clinical settings when suggestions are efficiently matched
to patients. Future research could test this hypothesis by including a
treatment arm where individualized treatment is administered by an
experienced clinician, allowing comparison of the response in this con-
dition to the effects of the standardized intervention.
Change in Secondary Outcome Variables with Hypnotic-Analgesia Treatment
One of the strengths of the current study was the inclusion of
secondary measures that assessed important outcome domains in