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SYLVAIN NÉRON AND RANDOLPH STEPHENSON
One recent study (Stalpers et al., 2005) enrolled 69 patients who
were randomized between standard curative radiotherapy (RT) alone
and radiotherapy and hypnotherapy (RTH). Patients in the RTH group
received hypnotherapy at the intake, before RT simulation, before the
first RT session, and halfway between the RT treatments. No statisti-
cally significant difference was found in anxiety or quality of life
between both groups. However, significantly more patients in the RTH
group indicated an improvement in mental and overall well-being. If
anxiety is part of the experience of patients, one might distinguish
between state anxiety and acute anxiety during the procedure itself.
The utilization of a rapid verbal scale (Benotsch, Lutgendorf, Watson,
Fick, & Lang, 2000), which has been validated (Lang et al., 2000) and
used in interventional radiology procedures, might be more appropri-
ate to decrease acute anxiety during such procedures.
A case study done by Bertoni et al. (1999) might provide an idea on
what could be an endpoint measure for radiotherapy situations: immo-
bility (lying still) during all phases of the treatment. Steggles (1999)
described two cases of exacerbated claustrophobic reaction to the
radiotherapy environment. He suggested the use of a comprehensive
cognitive-behavioral approach to treat these reactions in cancer
patients undergoing radiation therapy. Patients require help because
they feel unable to tolerate being immobilized or their discomfort
causes them to interrupt the procedure. We use clinical hypnosis to
reduce overt anxiety and phobic reactions.
Prior Radiotherapy Protocol
Session 1.
General assessment that includes identification of cancer-
related distorted cognitions regarding radiotherapy and immobiliza-
tion using adjuvant psychological therapy for cancer patients (Greer
et al., 1992). This is a “brief, problem-focused, cognitive-behavioral
treatment for patients with cancer” (Greer & Moorey, 1997, p. 240),
which follows an introduction to hypnotic phenomena (myths,
description) and exploration of where the patient would rather be or
do in imagination while undergoing the projected treatment. The need
for individualized imagery in order to increase effectiveness of hyp-
notic technique is strongly suggested by Fick, Lang, Logan, Lutgen-
dorf, and Benotsch (1999). In their study, 56 nonselected patients
referred for interventional procedures were guided to a state of self-
hypnotic relaxation (standardized protocol and script described by the
authors). Patients’ hypnotizability was assessed by the Hypnotic
Induction Profile Test (H. Spiegel & Spiegel, 1978). Patients as a group
had an average distribution of hypnotizability. All patients could
develop specific imagery. Patients who were not initially selected for
hypnotizability can develop imagery in order to produce analgesia
and anxiolysis during a procedure.
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