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SYLVAIN NÉRON AND RANDOLPH STEPHENSON
Liossi and Hatira (2003) randomly assigned 80 pediatric cancer
patients undergoing regular lumbar punctures to one of four groups:
direct hypnosis, indirect hypnosis, attention control with standard
medical treatment, and standard medical treatment alone. Results
indicate that hypnosis is effective in preparing pediatric oncology
patients for lumbar puncture. The authors utilized measures of pain
and anxiety at baseline (behavioral observation and self-reports), pro-
vided a treatment manual describing all hypnotic procedures, and ses-
sions were randomly rated for adherence. The impact on pain and
anxiety diminished as patients switched to self-hypnosis.
Butler, Symons, Henderson, Shortliffe, and Spiegel (2005) random-
ized 44 children undergoing a procedure called voiding cystourethrog-
raphy (VCUG) to hypnosis and routine-care groups. The hypnosis
group was systematically trained to induce self-hypnosis. There were
significant benefits (moderate to large effect size) for the hypnosis
group compared with the routine-care group: (a) parents reported that
the procedure was significantly less traumatic for their children; (b)
distress levels during the procedure were significantly lower; (c) staff
reported less difficulty in conducting the procedure; and (d) total pro-
cedural time was significantly shorter, by almost 14 minutes. Results
are clinically meaningful to cost-effective patient care. Nevertheless,
generalization of results is limited by the small sample size and the fact
that children were previously exposed to the procedure.
Rajasekaran, Edmonds, and Higginson (2005) reported that there is
a paucity of results supporting hypnosis in palliative care. However,
subjects who received hypnosis in Liossi and White’s (2001) study
reported a significant alleviation of their pain and psychological dis-
tress. Although there is only a small number of subjects in that study,
the authors developed a manualized treatment and used validated
measures. Such methods are in line with Lynn, Kirsch, Barabasz,
Cardeña, and Patterson’s (2000) recommendations as it ensured repli-
cation of the study.
From these studies, we learn that: (1) Hypnosis compared to atten-
tion or standard treatment control showed positive results (see Table 2).
Self-hypnosis in comparison to hypnosis seems to have a lesser impact
on pain and anxiety (Liossi & Hatira, 2003). (2) Hypnosis compared to
CBT is as efficacious to decrease both pain and anxiety levels (see
Table 2) (Liossi & Hatira, 1999; Nash & Klyce, 2005). (3) Wild and Espie
(2004) concluded that there is not enough evidence-based research to
substantiate the efficacy of hypnosis in the management of procedural
pediatric pain. At best, it requires “further research into the effective-
ness and acceptability of hypnosis” (see Table 3) (Richardson, Smith,
McCall, & Pilkington, 2006, p. 82). (4) There is a paucity of results sup-
porting utilization of hypnosis in palliative care (Rajasekaran et al.,
2005). And (5) hypnosis has been shown useful in reduction of pain,
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