Hypnosis in the alleviation of procedure related pain and distress in paediatric oncology patients

Abstract

The aims of this study were: (1) to evaluate two different therapeutic approaches, namely direct versus indirect suggestions, in reducing pain during lumbar punctures; and (2) to explore the relationship between hypnotizability and outcome. Thirty children with leukaemia and non‐Hodgkin's lymphoma who were undergoing regular lumbar punctures were randomly allocated to two groups. In one group, children were hypnotized and given direct suggestions associated with pain relief whilst undergoing lumbar puncture. In the second group children were given indirect hypnotic suggestions associated with pain relief. After hypnotic intervention, there was a statistically significant reduction over baseline for pain and anxiety during lumbar punctures in both groups. Direct and indirect methods were found to be equally effective. The level of hypnotizability was significantly associated with the magnitude of treatment outcome. Copyright © 1998 British Society of Experimental and Clinical Hypnosis

Hypnosis in Cancer Patients: Can We Do Better?

“…Hypnotisability, or susceptibility to hypnosis, is often supposed to limit the efficacy of hypnosis (Smith, 1996;Hawkins, 1998;Butler, 2009). Although Erickson claimed that 100% of normal people can be hypnotized and that most unsuccessful protocol failed because a too short time is reserved for the induction (Erickson, 1980;1982), some studies have questioned if the power of suggestions coud vary with the subject's sensitivity to hypnotic induction.…”

“…In these studies, patients age ranged from 3 to 15 and sample size of the trials was around 30. In children, the magnitude of the result depends on hypnotizability of these young patients, and switching to selfhypnosis is less efficient than hypnosis induced by a therapist (Hawkins, 1998;Smith, 1996). Butler (2005) tested an interesting hypnosis strategy against pediatric pain when he trained children as well as their parents, observing a significant reduction of pain, procedural time and thus overall costs thanks to hypnosis.…”

Recent developments in the study of hypnotic pain reduction: a new golden era of research?

“…As for comparisons of different kinds of hypnotic analgesia suggestions, Hawkins, Liossi, Ewart, Hatira and Kosmidis (1998) evaluated the relative effectiveness of direct and indirect hypnotic suggestions in reducing the pain associated with lumbar punctures. Participants were 30 children, age 6 to 16, with leukemia and non-Hodgkin's lymphoma.…”

Management of paediatric procedure-related cancer pain

“…However, in many studies the inter-rater reliability is satisfactory. 21,22 Observational Scale of Behavioral Distress The OSBD 20 is a model of careful scale development. It is an eight-item modification of the PBRS, which introduces two important refinements into the PBRS procedure.…”

“…Hawkins et al 21 examined the differential effectiveness of direct versus indirect hypnotic suggestions. Thirty children (age 5-15 years) with leukaemia and non-Hodgkin's lymphoma, who were undergoing regular LPs were randomly allocated to two groups.…”