Cognitive-behavioural hypnotherapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Donald J. Robertson · 2012 · UK

What it is

Cognitive-behavioural hypnotherapy (CBH) is an integrated psychological therapy that combines clinical hypnosis with cognitive-behavioural therapy (CBT). It is a framework for combining the two, not a single fixed protocol. Robertson presents it as using a research-based cognitive-behavioural model…

Format

• Format. Individual sessions, typically weekly. Hypnosis forms part of a CBT-structured session: agenda, homework review, in-session hypnosis, debrief and new homework. Audio recordings or self-hypnosis practice go between sessions. Lynn et al. note that attention exercises can be delivered by…
• Session count. The sources give no session count for Robertson's manual. Mindful Hypnotherapy is eight weekly one-hour sessions. An example from a related hypnotherapy-versus-CBT depression trial (Tübingen) used 20 individual sessions per arm. Plan about 6–20 sessions, depending on the modules used…

Who practises it, and how they are trained or regulated

• Version followed: Donald J. Robertson, The Practice of Cognitive-Behavioural Hypnotherapy: A Manual for Evidence-Based Clinical Hypnosis (Karnac 2012/2013; Routledge reissue), used for the overall structure (assessment, case formulation, socialisation and hypnotic-skills training, then coping skills, affect, behaviour and cognition modules). The mindfulness-based variant follows Lynn et al.'s mindfulness-hypnosis…
• Steven Jay Lynn and colleagues are cognitive-behavioural and sociocognitive hypnosis researchers. They describe giving hypnotic inductions with mindfulness and attention-training suggestions, with examples for depression and PTSD. This places mindfulness inside a cognitive-behavioural hypnosis frame.

Evidence status, as the guide reports it

• Irving Kirsch co-authored the 1995 meta-analysis of hypnosis as an adjunct to cognitive-behavioural psychotherapy (Kirsch, Montgomery & Sapirstein). With Lynn and Rhue he co-edited clinical handbooks of evidence-based hypnosis. His response-expectancy theory is commonly linked to CBH, but the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Cues that are too vague. Strengthen the link through repetition.
• Performance anxiety. Make it explicit that mistakes don't matter.
• Disagreement with the model. Revise it together before you start hypnosis.
• Generic praise the client rejects. Use the client's real evidence instead.
• The client using labelling to push thoughts away (suppression). Emphasise allowing them.

Problems the guide addresses

• Screening and contraindications
• "Nothing happened" or low responsiveness
• Overwhelm, abreaction or dissociation during hypnosis
• No self-hypnosis practice
• Ambivalence and resistance to change suggestions
• Requests for regression or memory recovery
• Fear of losing control, or stage-hypnosis beliefs
• Hypnosis used as avoidance
• Ruptures and over-attribution to the therapist
• Unwanted after-effects

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.