Basic HTML Version
EFFECTIVENESS OF HYPNOTHERAPY WITH CANCER PATIENTS 347
Session 2.
Hypnosis is induced by eye fixation and by eye-roll
induction (Lang et al., 2000) in a private office. The treatment is
rehearsed and the patient’s chosen imagery is utilized to produce
immobilization and anxiolysis. Suggestion is made to patient to prac-
tice self-hypnosis.
Session 3.
One day prior to the treatment, there is an in vivo expo-
sure in which an eye-roll induction rehearsal in a radiotherapy suite is
done. On the treatment day, there is an eye-roll induction in the radio-
therapy suite immediately prior to treatment, and deepening during
treatment.
Measures of hypnotizability will be performed prior to hypnosis
training. A three-armed study is planned: (1) hypnosis; (2) treatment as
usual; (3) treatment as usual with attention (from the manualized treat-
ment in Lang et al.’s 2000 study). The outcome measures will include
the level of acute anxiety, state of immobilization, frequency of treat-
ment interruptions (endpoint), staff rating of patient’s distress level,
and duration of treatment.
D
ISCUSSION AND
C
ONCLUSIONS
Pinell and Covino’s (2000) review indicated that clinical hypnosis
might be useful in the treatment of nausea and emesis. However, the
“larger studies with fully elaborated procedures” (p. 243) envisioned
by Lynn et al. (2000) have not yet been published. Regarding acute
pain, recent critical reviews (Richardson, Smith, McCall, & Pilkington,
2006) concluded that hypnotherapy is potentially a clinically valuable
intervention for procedure-related pain and distress even if studies
reviewed are of unequal quality (Rajasekaran et al., 2005; Wild &
Espie, 2004). Methodologically, the three papers published during the
1999–2006 period (Liossi & Hatira, 1999, 2003; Liossi & White, 2001), to
some extent, meet the recommendations proposed by Lynn, Kirsch,
and Koby (2000), at least concerning reporting and design (see Table 4).
In those studies, the intervention was manualized and adherence to
the clinical protocol monitored.
In the well-designed noncancer studies of Lang et al. (2000) and
Schupp et al. (2005), even though hypnotizability was not measured,
the interventions were assessed on an intent-to-treat basis. This is real-
world clinical practice tested in effectiveness-focused research. As
such, it does place greater emphasis on ecological validity rather than
internal validity. The Lang et al. study places an emphasis on symp-
tom reduction (pain and anxiety) and on patients taking an active role
in their comfort during their procedure. Hypnosis is a unique way to
accomplish these two goals rapidly and without side effects. It is such
objectives that we would like to test in a proposed study on achieving
Downloaded by [ ] at 02:21 27 March 2012