Atlas›Domain XII · Complementary, energy & biofield›Guide 149
Guide XII-149

Off-label hyperbaric oxygen

A 29 · L 58 · M 1310 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: hyperbaric oxygen therapy (HBOT) as described by regulators (US FDA, Health Canada), the Undersea and Hyperbaric Medical Society (UHMS) indication list as published by a UHMS-accredited hospital unit, and Mayo Clinic patient information; "off-label" here means use for conditions outside that accepted list, typically sold by wellness or private centres. This guide sets out the psychotherapist's own work alongside the method: the psychotherapist never performs, sells, prescribes or recommends HBOT for any condition.

What it is. HBOT means breathing pure oxygen inside a chamber pressurised above sea-level pressure; breathing oxygen at normal pressure, or being in a pressurised chamber without breathing oxygen, does not count as HBOT. In a single-person (monoplace) chamber the whole chamber is filled with oxygen; in a multi-person (multiplace) chamber the room is pressurised with air and patients breathe oxygen through a mask or hood. [source: Duke Hyperbaric Medicine; Mayo Clinic]

Accepted medical uses (attributed). UHMS lists accepted indications including air or gas embolism, carbon monoxide poisoning, decompression sickness, gas gangrene, crush injury and acute traumatic ischaemia, selected problem wounds, severe anaemia, intracranial abscess, necrotising soft-tissue infection, refractory osteomyelitis, delayed radiation injury, compromised grafts and flaps, acute thermal burns, sudden sensorineural hearing loss and (since 2022) osteonecrosis. [source: Duke Hyperbaric Medicine] Counts differ by body and date: FDA was reported in 2013 as having cleared 13 uses; Health Canada in 2026 described hard-shell chambers as proven for 14 specific conditions. [source: Disability Scoop on the 2013 FDA warning; Health Canada advisory 2026]

Off-label claims (attributed to sellers, not established). Regulators and advertising bodies have recorded HBOT marketed for autism, cerebral palsy, cancer, AIDS, Alzheimer's disease and hepatitis (FDA warning, 2013), and for long COVID, multiple sclerosis, stroke, osteoporosis, respiratory conditions, hearing loss, peripheral neuropathy and sciatica (UK advertising rulings). In a 2025 fatal case, a child was reported to be receiving sessions for sleep apnoea and ADHD. [source: Disability Scoop; ASA guidance; News4Jax/AP 2025] "Anti-ageing" and wellness marketing is also reported [uncertain: not verified]. Soft-shelled "mild" chambers are increasingly found in wellness centres; Health Canada has authorised none. [source: Health Canada advisory 2026]

Core idea of change, as sellers present it (attributed). Sellers present extra oxygen under pressure as healing or restoring tissue, the brain or general wellness. The FDA stated the therapy is not clinically proven for these other uses and that such claims may lead patients to "delay or forgo proven medical therapies". [source: Disability Scoop quoting FDA, 2013]

What a client experiences (medical setting). Change into approved clothing; no lighters, heat-generating battery devices, lotions, lip balm, make-up or hair spray; lie in a clear tube or sit in a room-like chamber; feel ear fullness and clear it by yawning or swallowing; staff monitor throughout and check ears, blood pressure and pulse afterwards; tiredness or hunger is common. [source: Mayo Clinic] Clients may describe wellness-centre sessions differently (soft chambers, no physician present). [source: Health Canada 2026; News4Jax/AP 2025]

Who practises it. Hospital units staffed by physicians board-certified in hyperbaric medicine, with facility accreditation from UHMS [source: Duke Hyperbaric Medicine]; also for-profit private and wellness centres, some without a doctor on site or licensed technicians (as alleged by prosecutors in Michigan) [source: News4Jax/AP 2025].

Regulation (one line each).

  • United States: HBOT chambers are Class II medical devices cleared through 510(k) (product code CBF); FDA warns about serious injuries and deaths including fires. [source: FDA letter to health care providers, 2025]
  • Canada: chambers are regulated medical devices; no soft-shelled chamber is authorised and importing, selling or advertising them is illegal. [source: Health Canada advisory 2026]
  • United Kingdom: advertisers need robust evidence for treatment claims and may not refer to conditions needing medical supervision unless treatment is supervised by a suitably qualified professional (CAP Code rule 12.2). [source: ASA guidance] Care-quality registration and device-regulator rules for UK HBOT centres [uncertain: not verified].

Evidence status (one line). Established hospital use for accepted indications; for autism a Cochrane review found "no evidence" that HBOT improves core or associated symptoms, with more side effects than sham; UK advertising regulators have seen no convincing evidence for alternative-therapy uses. [source: Cochrane 2016; ASA guidance]

2. Framework

This is the psychotherapist's framework alongside a medical procedure, not a framework for HBOT. It has no fixed session count; it runs inside ongoing therapy and is revisited whenever HBOT comes up. [synthesis]

  1. Notice and ask. Goal: learn that HBOT is used or considered, by whom, where, for what and for whom (client or child). Move on once use and context are recorded.
  2. Understand. Goal: the client's hopes, explanatory model, costs, pressures and what they would count as success. Move on once you can summarise the client's reasoning in their words and they agree.
  3. Safety screen. Goal: identify immediate risks: delayed medical care, a child undergoing it, absent medical oversight, physical warning signs, financial strain. Any red flag moves straight to step 5 or safeguarding.
  4. Support an informed decision. Goal: the client weighs options against their values with accurate information from the treating doctor; the therapist neither pushes nor endorses. Move on once a decision (including "undecided") is recorded.
  5. Coordinate and report. Goal: with consent, share concerns with the doctor or pharmacist; make safeguarding or regulatory reports where duties apply.
  6. Follow up. Goal: review outcomes, disappointment, injury, cost, bereavement or regret; return to step 2 if plans change. [synthesis]

Format: individual or family sessions; parents of an autistic or disabled child usually seen with their consent, with the child's assent and voice included where possible. [synthesis]

3. Guiding principles

  • Stay in scope. Never perform, sell, prescribe or recommend HBOT for any use; medical questions go to the treating doctor. [synthesis; APA Ethics Code]
  • Ask without judgement. The client must feel safe telling you; disclosure matters more than agreement. [synthesis]
  • Respect autonomy, protect children. Adults decide for themselves; for children, the child's welfare comes first and safeguarding duties apply. [synthesis; APA Ethics Code]
  • Attribute claims. Say "the centre says" or "the FDA says"; do not present healing claims as fact or ridicule them. [synthesis]
  • Accurate safety facts only from authoritative sources. Where you mention risk, name the source (FDA, Health Canada, Mayo Clinic) and route the detail to the doctor. [synthesis]
  • No conflicts of interest. No referrals, commissions, products, or shared business with HBOT providers. [APA Ethics Code, Standard 3.05]
  • Cooperate with medical colleagues. With consent, coordinate with the doctor or pharmacist. [synthesis; APA Ethics Code]
  • Consent and confidentiality. Explain what you will record and share, and the limits of confidentiality around child protection. [synthesis; APA Ethics Code]
  • Medically indicated HBOT is supported, not questioned. When a client's doctor has prescribed HBOT for an accepted indication, your role is helping them complete it (for example claustrophobia work). [synthesis]
  • Record carefully. Note what was used, for what, by whom, advice given and actions taken. [synthesis]

4. Intervention inventory

All interventions below are the psychotherapist's own work alongside HBOT. Steps are [synthesis] unless a source is tagged; factual content is tagged to the source it comes from.

4.1 Routine, non-judgemental inquiry and recording

  • Purpose / when: At intake and at reviews, and whenever a client mentions "oxygen", "chambers", "hyperbaric", "pressure therapy" or a wellness centre; also when parents describe treatments for an autistic or disabled child.
  • Steps: (1) Ask about all health approaches in one neutral list (medical, complementary, wellness). (2) If HBOT is named, ask: for what, for whom, where (hospital unit or private/wellness centre, hard or soft chamber), who supervises, whether the treating doctor knows, cost and how it is funded. (3) Reflect without comment. (4) Record facts in the client's words, and the date.
  • Example language (illustrative): "Lots of people use treatments alongside their medical care. Is there anything like that for you or your family at the moment, including things like oxygen chambers?" / "Where do you go for it, and who's there with you during sessions?"
  • Watch for: Minimising or guardedness (a sign the client expects disapproval); a child as the recipient (go to 4.7); no doctor involved; soft chambers at home or in a wellness centre, which Health Canada warns about (fire, suffocation, infection, ear, eye, sinus, lung and dental damage, blood-sugar changes). [source: Health Canada advisory 2026] It is working when the client volunteers updates later.

4.2 Exploring meaning, hopes, expectations and explanatory model

  • Purpose / when: After disclosure, to understand what draws the client to HBOT: hope after a long illness, control, distrust of medicine, a community of parents or patients, identity, or a recommendation from a trusted person.
  • Steps: (1) Ask what they understand HBOT does and where they heard it. (2) Ask what they hope will change and how they would know. (3) Ask what they fear if they do not try it. (4) Explore who else is involved in the decision. (5) Summarise their model back and check accuracy. (6) Note grief, exhaustion or desperation underneath the hope.
  • Example language (illustrative): "What's your understanding of how the oxygen sessions are meant to help?" / "If this worked as you hope, what would be different in three months?" / "It sounds like you've been fighting for answers for a long time."
  • Watch for: Hopes tied to curing a developmental condition or chronic disease; promises of guaranteed results; testimonials as the main evidence; sunk-cost reasoning ("we've paid for the package"). Working when the client reflects on their own reasons rather than defending them.

4.3 Supporting an informed, values-based decision

  • Purpose / when: The client is weighing starting, continuing or stopping off-label HBOT; you support thinking, not a verdict.
  • Steps: (1) Clarify the decision and the deadline (often sales pressure). (2) Elicit the client's values (safety, hope, cost, the child's experience). (3) Help them list questions for their doctor, and for the provider: Is a physician on site? Is the facility accredited (in the US, UHMS publishes an accredited-facility list)? Is the chamber a licensed device? What do regulators say about this use? [source: News4Jax/AP 2025 on UHMS list; Health Canada 2026 on checking the licence listing] (4) Help them find the regulator's own page rather than giving your opinion of HBOT. (5) Explore consequences each way, including the cost of not trying, and any risk of delaying proven care. (6) Record the decision and that it was theirs.
  • Example language (illustrative): "I'm not the right person to say whether this is medically safe for you, but I can help you get clear on what matters most and what to ask your doctor." / "Would it help to write down the questions before you go back?"
  • Watch for: Your own bias leaking in either direction; the client asking you to endorse ("just tell me it's fine"); a decision made to placate a partner or group. No validated decision aid specific to off-label HBOT is cited here [uncertain: not verified]. Working when the client can state their reasons and the information they still need.

4.4 Coordinating with the doctor or pharmacist (with consent)

  • Purpose / when: The client has a medical condition, takes medication (especially insulin), is pregnant, has a child receiving HBOT, or reports physical symptoms after sessions.
  • Steps: (1) Ask consent and agree exactly what will be shared. (2) Encourage the client to tell their doctor first; offer a joint letter or call. (3) Share facts (what is used, where, for what), not judgements. (4) Route any physical symptom or medication question to the prescriber or pharmacist; never advise on medicines. (5) Record consent and the communication.
  • Example language (illustrative): "Would it be OK if I let Dr X know you're having these sessions, so your care fits together?"
  • Watch for: Symptoms Mayo Clinic lists as HBOT risks, such as ear pain, eardrum injury, sinus pain or nosebleeds, temporary changes in sight, low blood sugar in people on insulin, and the rarer lung collapse and seizures from oxygen toxicity; these need medical, not psychological, assessment. [source: Mayo Clinic] Working when the medical team is informed and the client feels the care is joined up.

4.5 Supporting a client through medically indicated HBOT (confinement anxiety)

  • Purpose / when: A client has HBOT prescribed for an accepted indication (for example a non-healing wound or radiation injury) and is anxious about the enclosed chamber. Mayo Clinic notes anxiety in enclosed spaces as a known issue. [source: Mayo Clinic]
  • Steps: (1) Coordinate with the hyperbaric team first: they decide what is medically possible, including any medication and the use of a multiplace chamber. (2) Assess claustrophobia and panic using standard CBT formulation. (3) Teach paced breathing and attention-shifting; agree a signal with staff, as the team advises. (4) Plan graded imaginal exposure and, only if the team offers it, a visit to see the chamber. (5) Review after each session. [synthesis]
  • Example language (illustrative): "Let's find out from the team what you'll see and hear, and how you can tell them if you need something."
  • Watch for: Panic, dissociation, trauma reminders (confinement, medical trauma); exposure is graded and consented and stops if distress escalates beyond the agreed plan. Working when the client attends and completes the prescribed course with tolerable distress. Cross-ref Domain II for panic and specific phobia protocols.

4.6 Risk recognition and response

  • Purpose / when: Throughout, whenever off-label HBOT is in use or planned.
  • Steps: (1) Screen for: stopping or delaying medical care (the FDA's central concern); a child as recipient; pregnancy or serious illness without the doctor's knowledge; absent medical oversight; unlicensed or soft-shell chambers, home oxygen concentrators used with chambers; financial strain (packages, loans, crowdfunding); pressure from a group, seller or relative. [source: Disability Scoop quoting FDA 2013; Health Canada 2026; synthesis] (2) Grade urgency: physical symptoms go to medical care the same day (emergency services for seizure, breathing difficulty or burns); child-protection concerns go to safeguarding (4.7). (3) Discuss concerns openly with the client, naming the source of the safety information. (4) Document the risk, discussion and action.
  • Example language (illustrative): "The FDA has warned that people sometimes put off proven treatment because of these claims. Has anything about your usual treatment changed since you started?" / "Health Canada has warned about fire risk with soft chambers, especially with oxygen machines. Can we let your doctor know you're using one at home?"
  • Watch for: Secrecy from the doctor; escalating spending; isolation from sceptical relatives; testimonials replacing medical review. Working when risks are known to the people who need to know and the client remains engaged.

4.7 Parents considering or using HBOT for a child (autism, ADHD, cerebral palsy, sleep problems)

  • Purpose / when: A parent or carer is seeking or using off-label HBOT for a child. Autism and cerebral palsy were among the conditions the FDA warned about; a 5-year-old died in 2025 in a chamber fire while receiving sessions reportedly for sleep apnoea and ADHD. [source: Disability Scoop 2013; News4Jax/AP 2025]
  • Steps: (1) Acknowledge the parent's love, effort and hope. (2) Ask what the child experiences (fear, ear pain, distress) and what the child says, in age-appropriate terms; include the child's assent and voice wherever possible. (3) Share the attributed evidence plainly if asked: the Cochrane review found no evidence of benefit for autism and more side effects than sham. [source: Cochrane 2016] (4) Encourage, with consent, a conversation with the child's paediatrician. (5) Assess safeguarding: whether the child is being deprived of necessary medical care or exposed to a harmful procedure; consult your safeguarding lead and follow local child-protection procedures; report where thresholds are met. (6) Document. [synthesis]
  • Example language (illustrative): "You're clearly doing everything you can for her. Can we think together about how she finds the sessions, and what her doctor thinks?" / "I have a duty to make sure children are safe, so I need to talk with you about the chamber centre."
  • Watch for: Framing autism as damage to be fixed (support neurodiversity-respectful understanding without shaming the parent); the child's distress being overridden; absence of a doctor on site; multiple other unproven interventions at once. Never name the child in any external communication beyond what the safeguarding process requires. Working when the child's welfare is protected and the parent stays in contact with you.

4.8 Health anxiety, somatic symptom presentations and post-viral illness

  • Purpose / when: The client pursues HBOT for persistent, medically unexplained or post-viral symptoms (long COVID was one advertised use) and shows health anxiety, repeated reassurance-seeking or treatment-shopping. [source: ASA guidance on 2023 ruling]
  • Steps: Use established approaches: validate symptoms as real; build a shared formulation of the symptom cycle; reduce checking and reassurance-seeking; set values-based goals; coordinate with the GP so one medical clinician holds the plan. Cross-ref Domain II for health-anxiety and somatic-symptom protocols. [synthesis]
  • Example language (illustrative): "Your symptoms are real and exhausting. Alongside whatever you decide about treatments, can we look at how the worry and the searching are affecting you day to day?"
  • Watch for: Hopelessness after each failed treatment; suicidal thinking (assess using standard practice); escalating spending. Working when time spent searching drops and valued activities return.

4.9 Reporting routes

  • Purpose / when: Injury, a dangerous facility, misleading advertising, illegal device sales or a child at risk.
  • Steps (encourage the client to report, or report yourself where duty or consent allows):
    • United States: adverse events and suspected adverse events to the FDA through MedWatch; FDA Division of Industry and Consumer Education for questions. [source: FDA letter 2025] State consumer-protection or medical boards [uncertain: not verified].
    • Canada: health complications or sales of unlicensed devices to Health Canada through MedEffect Canada. [source: Health Canada 2026]
    • United Kingdom: misleading HBOT advertising to the Advertising Standards Authority. [source: ASA guidance] Device and service regulators [uncertain: not verified].
    • Everywhere: professional boards for a registered clinician's conduct; child-protection services under local procedures. [synthesis]
  • Example language (illustrative): "If you'd like, we can look at the regulator's reporting form together; you decide what goes in it."
  • Watch for: Fear of retaliation or of being judged; protect confidentiality and record what was reported and when.

4.10 Aftermath: injury, bereavement, regret and financial loss

  • Purpose / when: A client or family has been injured, bereaved, out of pocket, or feels guilt after choosing off-label HBOT.
  • Steps: Trauma-informed assessment (burns, witnessing a fire, medical trauma); screen for PTSD, complicated grief and depression; separate responsibility from guilt; support any legal or regulatory processes they choose; refer to financial and legal advice. Cross-ref Domain II for trauma and grief treatments. [synthesis]
  • Example language (illustrative): "You made the choice you did out of love and with the information you had. We can hold both the grief and the anger."
  • Watch for: Self-blame, family blame and conflict, intrusive memories of the event, media attention. Working when the client can speak about the event without being overwhelmed and blame is less consuming.

5. Handling problems

All guidance in this section is [synthesis] unless tagged.

  • Client asks you to recommend or approve HBOT. Decline clearly and warmly; explain it is outside your role; offer to help them prepare questions for the doctor. "(illustrative) I can't advise on whether it's right medically, but I can help you think it through."
  • Client asks you to refer them to a centre, or a centre offers you referral fees. Decline; any financial link is a conflict of interest. [APA Ethics Code, Standard 3.05]
  • Client becomes defensive or stops disclosing. Repair the rupture: name that you may have sounded judgemental, restate respect for their choices, and return to their goals.
  • Client keeps HBOT secret from the doctor. Explore fears about the doctor's reaction; rehearse the conversation; offer a joint letter; respect refusal unless a safety duty overrides.
  • Stuck in a cycle of trying treatments. Shift focus from the treatment to the pattern (hope, disappointment, next purchase); use health-anxiety work (4.8).
  • Family conflict over a child's treatment. Hold separate and joint sessions; keep the child's welfare and voice central; avoid taking sides on HBOT itself; escalate safeguarding where needed.
  • Group or community pressure (parent networks, online groups). Explore belonging and fear of being judged; support the client's own decision-making; recognise high-control dynamics.
  • Physical symptoms disclosed in session. Stop and route to medical care immediately; for seizure, breathing difficulty or burns use emergency services. [synthesis; risks per Mayo Clinic]
  • Client in medically indicated HBOT wants to quit because of claustrophobia. Coordinate with the hyperbaric team and use 4.5; do not advise stopping or continuing treatment yourself.
  • Overwhelm after injury or bereavement. Stabilise first (grounding, safety, sleep), then trauma or grief work per Domain II.
  • Your own reactions. Notice frustration, rescuing or contempt; take it to supervision.

Harm account

What was actually done

  • Florida, Lauderdale-by-the-Sea (Ocean Hyperbaric Center), 2009 [date: uncertain: not verified]. A 4-year-old boy from Italy with cerebral palsy had travelled to South Florida for chamber treatment, accompanied by his grandmother, aged 62. Both were inside an old chamber (built in 1967 and refurbished in 1984) when a fire broke out; investigators believed static electricity started it. It took nearly two minutes to free them. The grandmother died the next day and the boy a few weeks later. After an investigation of nearly three years, the Broward Sheriff's Office charged the technician and safety director and the medical director with manslaughter. Investigators reported burned and soldered exposed wiring, dusty chambers, extension cords taped together, broken indicator lights, missed annual inspections, chambers not properly grounded, patients not in proper attire, staff unaware of emergency decompression procedures and inadequate supervision; a 2008 letter had warned the centre about age-related problems with the chambers. [source: CBS Miami] The outcome of those charges [uncertain: not verified].
  • Michigan, Troy (The Oxford Center), 31 January 2025. A 5-year-old boy died when a pressurised oxygen chamber caught fire; Michigan's Attorney General said a single spark caused a fire that killed him within seconds, and his mother was burned trying to save him. According to the family's attorney he had received multiple sessions for sleep apnoea and ADHD. In March 2025 the founder and chief executive, the facility manager, the safety manager and the chamber operator were charged (second-degree murder, involuntary manslaughter, and in the operator's case placing false information in a medical record); they pleaded not guilty. The Attorney General alleged that no maintenance check was done that day, no doctor was on site, the operator was not a licensed technician, chambers were run beyond their expected service life, safety measures were ignored, and the business was run for cash flow with treatments that were medically unsound for these conditions. The centre was not on the UHMS accredited-facility list. [source: News4Jax/AP 2025] Charges are allegations; outcome [uncertain: not verified].
  • Marketing for unproven uses. In 2013 the FDA warned that HBOT was being promoted for more than a dozen uncleared conditions, including autism, cerebral palsy, cancer, AIDS, Alzheimer's disease and hepatitis. [source: Disability Scoop; MD+DI 2013] UK rulings found claims for hearing loss, peripheral neuropathy, sciatica and long COVID unsubstantiated and claims for MS, stroke, osteoporosis and respiratory conditions likely to discourage essential treatment. [source: ASA guidance]
  • Soft-shelled chambers in wellness centres. Health Canada reported several complaints about unauthorised soft-shelled chambers in Canadian wellness centres, sometimes used with oxygen concentrators. [source: Health Canada 2026]
  • Continuing fires. In August 2025 the FDA told providers it was aware of reports of serious injuries and deaths, including recent fires, with root causes unknown. [source: FDA letter 2025]

How it caused harm

  • Fire. Oxygen-rich environments make ignition easier and fire faster; a spark or static discharge can be fatal within seconds, and occupants of a closed chamber cannot escape quickly. Risk rises with ageing or poorly maintained equipment, missing grounding, prohibited items or wrong clothing (wool and synthetics generate more static), and untrained staff. [source: FDA letter 2025; CBS Miami; News4Jax/AP 2025; Mayo Clinic]
  • Pressure injury (barotrauma). Ear pain, eardrum rupture, middle-ear fluid, sinus pain and nosebleeds; uncommonly lung collapse. Minor ear barotrauma was recorded in the autism trial, with more side effects than sham. [source: Mayo Clinic; Cochrane 2016]
  • Oxygen toxicity. Seizures from too much oxygen in the central nervous system (uncommon); short-term reduced lung function; temporary vision changes and cataract with long courses. [source: Mayo Clinic]
  • Other medical risks. Low blood sugar in people on insulin; with soft chambers, suffocation, cross-infection and damage to ears, eyes, sinuses, lungs and teeth. [source: Mayo Clinic; Health Canada 2026]
  • Indirect harm. Delaying or forgoing proven treatment [source: Disability Scoop quoting FDA]; cost; for families, burns, bereavement, witnessed death and guilt [source: News4Jax/AP 2025; synthesis].
  • Who was most at risk. Young children (who cannot consent or report symptoms), disabled children whose families travelled far for hope, clients in unaccredited centres with no doctor present, and home users of unlicensed soft chambers. [synthesis from the cases above]

Recognising it today

  • Phrases and claims: HBOT offered for autism, ADHD, cerebral palsy, sleep apnoea, long COVID, MS, stroke, dementia, cancer, "brain healing", "detox" or "wellness"; packages of many sessions sold upfront; testimonials in place of evidence; "used in hospitals, so it's proven" (the ASA states routine hospital use does not support alternative-therapy claims). [source: ASA guidance; Disability Scoop; synthesis]
  • Setting red flags: no physician on site; operator not a licensed technician; facility not accredited; old or poorly maintained chambers; soft-shelled chambers (unauthorised in Canada); oxygen concentrators with chambers; no screening of clothing and items; staff unable to explain emergency procedures. [source: News4Jax/AP 2025; CBS Miami; Health Canada 2026; FDA letter 2025]
  • Red flags in a colleague's practice: recommending chamber centres to clients, especially for children; receiving referral fees; hosting or co-selling sessions; presenting HBOT as treating a mental-health or developmental condition. [synthesis]
  • How legitimate use differs: an accepted indication diagnosed by a doctor; physician-supervised hospital or accredited unit with board-certified physicians; trained staff monitoring throughout; fire and clothing rules; checks before and after each session. [source: Duke Hyperbaric Medicine; Mayo Clinic; FDA letter 2025]

What to do instead and how to help those harmed

  • Instead: for the underlying concern, the client's doctor and evidence-based services: paediatric and developmental services and neurodiversity-affirming support for autism, ADHD assessment and care, sleep medicine for sleep apnoea, rehabilitation services for post-viral illness [synthesis]. If HBOT is medically indicated, a physician-supervised, accredited unit [source: Duke Hyperbaric Medicine]. Psychologically: decision support, health-anxiety work and family support (4.2-4.8).
  • Assessment of affected clients: medical review of any physical symptoms first; then screen for PTSD, complicated grief, depression, guilt and financial harm; ask about other children in the family and any ongoing unproven treatments. [synthesis]
  • Treatment: trauma-focused and grief-focused therapies per Domain II; family work where blame divides the family; support around legal proceedings and media attention. [synthesis]
  • Ethical, reporting and legal duties: safeguarding referral when a child is exposed to a harmful procedure or deprived of needed care; report injuries and unsafe devices (FDA MedWatch; Health Canada MedEffect) and misleading advertising (ASA); report professional misconduct to the relevant board; avoid conflicts of interest and harm, and cooperate with other professionals. [source: FDA letter 2025; Health Canada 2026; ASA guidance; APA Ethics Code 3.04, 3.06, 3.09]

Sources

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