This article may present fringe theories, without giving appropriate weight to the mainstream view, and explaining the responses to the fringe theories. (September 2017) (Learn how and when to remove this template message)
Hypnotherapy is a type of complementary medicine in which hypnosis is used to create a state of focused attention and increased suggestibility during which positive suggestions and guided imagery are used to help individuals deal with a variety of concerns and issues.
The United States' Federal Dictionary of Occupational Titles describes the job of the hypnotherapist:
"Induces hypnotic state in client to increase motivation or alter behavior patterns: Consults with client to determine nature of problem. Prepares client to enter hypnotic state by explaining how hypnosis works and what client will experience. Tests subject to determine degree of physical and emotional suggestibility. Induces hypnotic state in client, using individualized methods and techniques of hypnosis based on interpretation of test results and analysis of client's problem. May train client in self-hypnosis conditioning."
The form of hypnotherapy practiced by most Victorian hypnotists, including James Braid and Hippolyte Bernheim, mainly employed direct suggestion of symptom removal, with some use of therapeutic relaxation and occasionally aversion to alcohol, drugs, etc.
In the 1950s, Milton H. Erickson developed a radically different approach to hypnotism, which has subsequently become known as "Ericksonian hypnotherapy" or "Neo-Ericksonian hypnotherapy." Erickson made use of an informal conversational approach with many clients and complex language patterns, and therapeutic strategies. This divergence from tradition led some of his colleagues, including Andre Weitzenhoffer, to dispute whether Erickson was right to label his approach "hypnosis" at all.
The founders of neuro-linguistic programming (NLP), a method somewhat similar in some regards to some versions of hypnotherapy, claimed that they had modelled the work of Erickson extensively and assimilated it into their approach. Weitzenhoffer disputed whether NLP bears any genuine resemblance to Erickson's work.
In the 2000s, hypnotherapists began to combine aspects of solution-focused brief therapy (SFBT) with Ericksonian hypnotherapy to produce therapy that was goal-focused (what the client wanted to achieve) rather than the more traditional problem-focused approach (spending time discussing the issues that brought the client to seek help). A solution-focused hypnotherapy session may include techniques from NLP.
Cognitive behavioural hypnotherapy (CBH) is an integrated psychological therapy employing clinical hypnosis and cognitive behavioural therapy (CBT). The use of CBT in conjunction with hypnotherapy may result in greater treatment effectiveness. A meta-analysis of eight different researches revealed "a 70% greater improvement" for patients undergoing an integrated treatment to those using CBT only.
In 1974, Theodore X. Barber and his colleagues published a review of the research which argued, following the earlier social psychology of Theodore R. Sarbin, that hypnotism was better understood not as a "special state" but as the result of normal psychological variables, such as active imagination, expectation, appropriate attitudes, and motivation. Barber introduced the term "cognitive-behavioral" to describe the nonstate theory of hypnotism, and discussed its application to behavior therapy.
The growing application of cognitive and behavioral psychological theories and concepts to the explanation of hypnosis paved the way for a closer integration of hypnotherapy with various cognitive and behavioral therapies.
Many cognitive and behavioral therapies were themselves originally influenced by older hypnotherapy techniques, e.g., the systematic desensitisation of Joseph Wolpe, the cardinal technique of early behavior therapy, was originally called "hypnotic desensitisation" and derived from the Medical Hypnosis (1948) of Lewis Wolberg.
David Lesser (1928 - 2001) was the originator of what is today known by the term "curative hypnotherapy". It was he who first saw the possibility of finding the causes of people's symptoms by using a combination of hypnosis, IMR and a method of specific questioning that he began to explore. Rather than try to override the subconscious information as Janet had done, he realised the necessity- and developed the process- to correct the wrong information. Lesser's understanding of the logicality and simplicity of the subconscious led to the creation of the methodical treatment used today and it is his work and understanding that underpins the therapy and is why the term "Lesserian" was coined and trademarked. As the understanding of the workings of the subconscious continues to evolve, the application of the therapy continues to change. The three most influential changes have been in Specific Questioning (1992) to gain more accurate subconscious information; a subconscious cause/effect mapping system (SRBC)(1996) to streamline the process of curative hypnotherapy treatment; and the 'LBR Criteria' (2003) to be able to differentiate more easily between causal and trigger events and helping to target more accurately the erroneous data which requires reinterpretation.
Hypnotherapy expert Dr Peter Marshall, former Principal of the London School of Hypnotherapy and Psychotherapy Ltd. and author of A Handbook of Hypnotherapy, devised the Trance Theory of Mental Illness, which provides that people suffering from depression, or certain other kinds of neuroses, are already living in a trance and so the hypnotherapist does not need to induce them, but rather to make them understand this and help lead them out of it.
Clinicians choose hypnotherapy to address a wide range of circumstances; however, according to Yeates (2016), people choose to have hypnotherapy for many other reasons:
The hypnotherapy has in terms of smoking cessation a greater effect on six-month quit rates than other interventions, nevertheless, another conclusion says there was no evidence available from randomised controlled trials to assess the effectiveness of hypnosis during pregnancy, childbirth, and the postnatal period for preventing postnatal depression.
Hypnotherapy is often applied in the birthing process and the post-natal period, but there is insufficient evidence to determine if it alleviates pain during childbirth and no evidence that it is effective against post-natal depression.
Literature shows that a wide variety of hypnotic interventions have been investigated for the treatment bulimia nervosa, with inconclusive effect. Similar studies have shown that groups suffering from bulimia nervosa, undergoing hypnotherapy, were more exceptional to no treatment, placebos, or other alternative treatments.
Modern hypnotherapy is widely accepted for the treatment of certain habit disorders, to control irrational fears, as well as in the treatment of conditions such as insomnia and addiction. Hypnosis has also been used to enhance recovery from non-psychological conditions such as after surgical procedures, in breast cancer care and even with gastro-intestinal problems, including IBS.
A 2003 meta-analysis on the efficacy of hypnotherapy concluded that "the efficacy of hypnosis is not verified for a considerable part of the spectrum of psychotherapeutic practice."
In 2005, a meta-analysis by the Cochrane Collaboration found no evidence that hypnotherapy was more successful than other treatments or no treatment in achieving cessation of smoking for at least six months.
In 2007, a meta-analysis from the Cochrane Collaboration found that the therapeutic effect of hypnotherapy was "superior to that of a waiting list control or usual medical management, for abdominal pain and composite primary IBS symptoms, in the short term in patients who fail standard medical therapy", with no harmful side-effects. However the authors noted that the quality of data available was inadequate to draw any firm conclusions.
In 2016, a literature review published in La Presse Medicale found that there is not sufficient evidence to "support the efficacy of hypnosis in chronic anxiety disorders".
In 2019, a Cochrane review was unable to find evidence of benefit of hypnosis in smoking cessation, and suggested if there is, it is small at best.
The laws regarding hypnosis and hypnotherapy vary by state and municipality. Some states, like Colorado, Connecticut and Washington, have mandatory licensing and registration requirements, while many other states have no specific regulations governing the practice of hypnotherapy.
In 2002, the Department for Education and Skills developed National Occupational Standards for hypnotherapy linked to National Vocational Qualifications based on the then National Qualifications Framework under the Qualifications and Curriculum Authority. NCFE, a national awarding body, issues level four national vocational qualification diploma in hypnotherapy. Currently AIM Awards offers a Level 3 Certificate in Hypnotherapy and Counselling Skills at level 3 of the Regulated Qualifications Framework.
The regulation of the hypnotherapy profession in the UK is at present the main focus of UKCHO, a non-profit umbrella body for hypnotherapy organisations. Founded in 1998 to provide a non-political arena to discuss and implement changes to the profession of hypnotherapy, UKCHO currently represents 9 of the UK's professional hypnotherapy organisations and has developed standards of training for hypnotherapists, along with codes of conduct and practice that all UKCHO registered hypnotherapists are governed by. As a step towards the regulation of the profession, UKCHO's website now includes a National Public Register of Hypnotherapists who have been registered by UKCHO's Member Organisations and are therefore subject to UKCHO's professional standards. Further steps to full regulation of the hypnotherapy profession will be taken in consultation with the Prince's Foundation for Integrated Health.
Professional hypnotherapy and use of the occupational titles hypnotherapist or clinical hypnotherapist are not government-regulated in Australia.
In 1996, as a result of a three-year research project led by Lindsay B. Yeates, the Australian Hypnotherapists Association (founded in 1949), the oldest hypnotism-oriented professional organization in Australia, instituted a peer-group accreditation system for full-time Australian professional hypnotherapists, the first of its kind in the world, which "accredit[ed] specific individuals on the basis of their actual demonstrated knowledge and clinical performance; instead of approving particular 'courses' or approving particular 'teaching institutions'" (Yeates, 1996, p.iv; 1999, p.xiv). The system was further revised in 1999.
Australian hypnotism/hypnotherapy organizations (including the Australian Hypnotherapists Association) are seeking government regulation similar to other mental health professions. However, the various tiers of Australian government have shown consistently over the last two decades that they are opposed to government legislation and in favour of self-regulation by industry groups.