Clinical Hypnosis
Definition
Clinical Hypnosis is the process of (a) deliberately triggering a trance state and then (b) utilizing that state to encourage helpful cognitive, emotional, or physical healing responses. A trance is a natural biological state of inner absorption, concentration and focused attention.
Clinical Hypnosis and Hypnotherapy are not the same as hypnosis.
Hypnosis is the process of triggering a trance state in an individual. It not usually geared towards therapeutic change, but just for relaxation or increasing compliance. Without a clinician using additional tools to cause change while the person is in trance, there rarely is lasting benefit to hypnosis beyond relaxation and temporary stress reduction.
Clinical Hypnosis and Hypnotherapy are advanced skills in which a trained professional uses hypnosis to cause specific change. Clinical Hypnosis and Hypnotherapy are used extensively in the medical and Mental Health fields.
Background and Policy on in VA
Clinical Hypnosis (or Hypnotherapy) is one of the evidence-based complementary and integrative health (CIH) approaches covered by the Veterans medical benefits package when deemed clinically necessary by their care team per VA Directive 1137 — Provision of Complementary and Integrative Health (recertified December 2022). Based on literature review these approaches were found to be safe and have sufficient evidence of benefit to be recommended as appropriate components of care for the Veteran population.
Clinical Hypnosis Safety and Effectiveness
An evidence map of Guided Imagery, Biofeedback, and Hypnosis was developed by VA’s Health Services Research & Development. This evidence map limited itself to meta-analysis studies.
Conditions with evidence of positive effect include: anxiety disorders, anxiety related to medical procedures, insomnia, Irritable Bowel Syndrome. High-confidence evidence that clinical hypnosis is effective for anxiety in cancer patients, breast cancer care, obesity and weight loss.
A summary of double-blind studies suggests Clinical Hypnosis as a tool to consider as possible efficacious or better for additional areas: pain management, headache and migraine, asthma, sleep disorders, depression, dermatological conditions, anxiety, procedural pain and anxiety, and other areas.
Occupational Guidance
Standards for VA Providers
- The provider has adequately passed requirements for basic instruction in clinical hypnosis in a class meeting the standards for a major certification body.
- The provider maintains his/her license in their appropriate field.
- The provider is using clinical hypnosis within their scope of practice.
Standards for Community Providers
All hypnotherapy providers external to the VA must be Licensed Independent Practitioners (LIPs) in their field of practice. Examples include but are not limited to: Psychology, nursing, physical therapy, social work, counseling, etc. Additionally, external providers must carry certification in Clinical Hypnosis from one of the major certification bodies (Internal VA providers do not need outside certification).
Treatment Guidance
Most frequently clinical hypnosis is used for stress related disorders and pain management. Evidence informed clinical decision making is recommended. Subject matter experts have developed guidance for both internal and external provision of clinical hypnosis.
Internal: Frequency and duration of clinical hypnosis is determined by the local clinical hypnosis provider based on patient needs and the provider’s scope of practice.
External: Under certain circumstances clinical hypnosis will be delivered in the community. When care is delivered outside the VAMC, the clinical hypnosis Standard Episodes of Care (SEOC) are used to inform treatment. NOTE: must be clinical hypnosis (not hypnosis).
Telehealth: Most clinical hypnosis protocols are initiated with in-person sessions. Depending on the site and location, clinical hypnosis is appropriate for delivery via telehealth. Preliminary research support hypnosis delivered through telehealth to be well-received and effective.
