*Cognitive Hypnotherapy DOI: http://dx.doi.org/10.5772/intechopen.91327*

*Hypnotherapy and Hypnosis*

that existing studies demonstrate substantial benefits by the use of hypnosis as an

A large-scale study was conducted with pianists looking at the effect of hypnotherapy on music performance anxiety (MPA) [65]. Using two groups, it was found that the hypnotherapy group but not the control group showed a significant reduction in MPA post-intervention, which was still evident 6 months later. At that time, there were no definitive protocols and procedure for the adoption of CH as an intervention for MPA but these have now been recently documented, giving guidelines and clear directives for the process of integration in this domain [47]. Recent research was conducted into MPA with 46 advanced pianists where participants were randomly assigned to a cognitive hypnotherapy (CH), eye movement desensitisation and reprocessing (EMDR) or non-treatment group and given two sessions only of the allocated therapy. They were tested in two concert performances pre- and post-intervention. Significant decreases in performance anxiety (the cognitive, physiological and behavioural aspects of performance) were found in both the therapy groups but not in the control group [66]. This research was extended when trait levels of anxiety (an individual's general anxiety level) were tested at 4 months and 1 year post-intervention. Statistical evidence at both monitoring points demonstrated a significant reduction in trait anxiety levels below

adjunct to CBT, supporting the meta-analysis conducted in 1995 [52].

baseline, showing the effectiveness of both CH and EMDR over time [67].

perceptions in a performing situation [68].

recently been published (five in music, two in the sports arena and two in the workplace) where CH was one of the interventions adopted. The effects of CH were recorded immediately post-intervention and longitudinally, and shown to be beneficial in a short space of time for the reduction of negative, psychological

Nine case studies documenting performance anxiety in different domains have

The findings from the above studies indicate that the addition of hypnosis to CBT protocols for the treatment of a variety of disorders is an effective remedy. It brings positive change rapidly in cognitive perceptions and physiology which impacts on subjective behaviour. However, there appear to be few guidelines for an integrative procedure and the assimilation of hypnotic techniques for the treatment of diverse medical conditions, and this needs to be addressed in future research. As hypnosis influences behavioural and psychological responses, it is difficult to assess whether a placebo effect is operative here and, if it is, the extent to which it plays a role. For a number of individuals, hypnosis may act as a placebo due to positive expectations. There is evidence that hypnotic trance inductions are beneficial for those patients who believe in their efficacy [13, 69] and there is further evidence that patients' attitudes and beliefs can have a profound therapeutic effect on both medical and psychological conditions [70]. This effect may be difficult or impossible to control but if it enhances suggestibility and positive therapeutic outcome, then it can be beneficial and add to the impact and strength of the therapy.

This chapter has reviewed the evidence and given the rationale for the assimilation of hypnotic techniques with CBT and has documented the effects of CH treatments in a number of different domains. There is a growing body of scientific literature attesting to the fact that hypnosis enhances CBT, and a plethora of research suggesting that combining CBT with hypnosis is effective for a variety of psychological, behavioural and medical disorders. It has been shown that the addition of hypnosis shortens the number of sessions required to effect beneficial, rapid change, which is long-lasting. One-dimensional procedures have their

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**6. Conclusion**

limitations; however, a multi-modal approach integrating hypnosis and CBT offers an effective alternative. A weakness of CBT therapies is the number of sessions required and there appears to be a paucity of research in the general domain using comparative interventions of CBT with CH [9, 52, 63]. This needs to be addressed in future studies so that comparisons of symptom effects and number of therapy sessions required can be assessed. There is case formulation, including guidelines and protocols, in the domains of PTSD, the management of depression and in music performance anxiety. However, there appears to be little empirical research with case formulation pertaining to the use of CH for the treatment of diverse medical conditions or the management of anxiety per se. An assimilative integrative model that can be understood and undertaken by therapists in the field is required. This will increase and verify the credibility of CH and help both scientific researchers and clinical therapists have a greater understanding of this psychodynamic therapy.
