Based Upon MANY CONTACTS AND the Textbook:
MEDICAL HYPNOSIS PRIMER - Clinical and Research Evidence
which was developed by: SCEH - Society of Clinical and Experimental Hypnosis and ISH - International Society of Hypnosis,
DRAFT TO MOTIVATE TESTING
Medical Hypnosis Primer - Clinical and RESEARCH EVIDENCE - TRAINING SUPPORT PROGRAM
2-3 DAY FULL TIME COURSE OR PART TIME IN 10-12 SESSIONS
WORK PACK
(see also GUIDE and DIARY)
ALL IDEAS WELCOME
Version 14 – January 18, 2010
Copyright: RGAB 2009/14 Available on request
SPECIFIC OBJECTIVES
This brief cost effective program provides course members with the opportunity to both understand and practice modern medical hypnosis.
It is training support for the new 2009 textbook - Medical Hypnosis Primer - Clinical and Research Evidence and supporting DVD’s published with SCEH (Society of Clinical and Experimental Hypnosis) and ISH (International Society of Hypnosis)
Training for medical and nursing students can be covered in 10-12 two hour regular course sessions. The program can also be a 2-3 day full time training course for doctors, nurses and primary health care workers.
The specific learning objectives are to:
1. Briefly present the basic concepts of modern
medical hypnosis.
2. Encourage health practitioners to use hypnosis as
an adjunct and reinforcement to medical care.
3. Support the teaching and practice of hypnosis as a
part of the requires syllabus of medical schools,
nursing schools and primary health care training
units.
4. Develop confidence in using basic cost effective
brief hypnosis techniques with patients.
5. Motivate further study in the future with the
courses run by the professionally recognized
national and international hypnosis societies.
SPECIAL NOTE ON THE LEARNING
UP TO 2009:
1. With so many new health care developments and publications to absorb each year, With so many new health care developments and publications to absorb each year, how will and doctors and nurses be motivated to read the Primer on Medical Hypnosis?
2. So many doctors and nurses are skeptical about the validity of medical hypnosis. Many patients are frightened by the word hypnosis.
3. Getting medical hypnosis into the required regular syllabus of medical and nursing schools in 2010 is a severe challenge.
4. The medical school syllabus is already over-flowing with new EBM scientific developments and yet medical hypnosis does not seem to be very scientific.
5. Doctors are concerned about patient anxiety but they simply do not have the time for 30 minutes of psychological care, which belongs more to psychiatrists.
BUT:
1. Medical hypnosis can often reinforce medical care in only five minutes.
2. Self hypnosis helps the patient to help himself, to feel in control of mind and body, and thus to feel like part of the health care team.
3. Medical hypnosis is highly cost effective with no side effects.
4. Self hypnosis can benefit not only the anxious patient but also the stressed doctor, nurse and other members of the health care team.
FROM 2010:
1. A rigorous trial of medical hypnosis is justified.
2. The program presents a new way to learn and practice basic medical hypnosis, in a flexible 2-3 day course for doctors, nurses and primary health care workers, or In 10-12 two hour sessions for medical and nursing students, with special support.
3. The program is based upon the concept that experienced health care professionals will only read and accept the new Primer on Medical Hypnosis, when it is supported by a challenging interactive learning experience.
Based on the Primer, this draft standard basic medical hypnosis training course, is designed to be validated with rigorous testing of relevance, efficiency and effectiveness.
This training can be highly cost effective when it requires only one local professional hypnosis instructor as course Organizer with key resources.
Critical choice of lecture notes, videos and exercises needs to be finalized with testing.
The initial planned brief extracts (about 12-15 minutes) from classic professional hypnosis videos are:
Sugarman – “Therapeutic Hypnosis with Children and
Adolescents” (Crown House) by Professor William
Wester & Dr Laurence Sugarman
Rossi - “Hypnosis techniques” Professor Ernest Rossi
(published by Erickson)
Kuttner (1) - "No Tears, No Fears" (Fanlight
Productions)by Dr. Leora Kuttner
Kuttner (2) - Follow up videotape of the reactions of
same children, ten years later.
with alternatives as decided by the Organizer.
: Medical Hypnosis Primer - Clinical and RESEARCH EVIDENCE TRAINING SUPPORT PROGRAM
INDEX
Unit Page No.
Flexible Course Outline
1. Hypnosis Concepts 6
2. Hypnotic Testing 13
3. Acute pain 19
4. Chronic Pain 24
5. Childhood Problems 31
6. PTSD 39
7. Surgery 45
8. Childbirth 50
9. Sleep 57
10. Depression 62
11. Stress & anxiety & Procedural Hypnosis 68
12. Summary & Review Session 72
Appendix: Olness PHC Training Program 77
Medical Hypnosis Primer - Clinical and RESEARCH EVIDENCE TRAINING SUPPORT PROGRAM
FLEXIBLE COURSE OUTLINE
Required pre-course study: Review the Medical Hypnosis Primer -
Clinical and Research Evidence. Test the supporting DVD Hypnotic Induction Demonstrations (Barabasz & Christensen)
Day 1:
08.00 - 10.00 Unit 1 Introduction & Concepts (MG & SG)
10.00 - 10.15 Break
10.15 - 12.15 Unit 2 Hypnotizability (CSG)
12.15 - 01.15 Lunch
01.15 - 03.15 Unit 3 Acute Pain (new SG)
03.15 - 03.30 Break
03.30 - 05.30 Unit 4 Chronic pain (CSG)
05.30 - 06.00 Discussion & Homework (MG)
Day 2:
08.00 - 10.00 Unit 5 Childhood Problems (new SG)
10.00 - 10.15 Break
10.15 - 12.15 Unit 6 PTSD (CSG)
12.15 - 01.15 Lunch
01.15 - 03.15 Unit 7 Surgery (new SG)
03.15 - 03.30 Break
03.30 - 05.30 Unit 8 Childbirth (CSG)
05.30 - 06.00 Discussion & homework (MG)
Day 3:
08.00 - 10.00 Unit 9 Sleep (new SG)
10.00 - 10.15 Break
10.15 - 12.15 Unit 10 Depression (CSG)
12.15 - 01.15 Lunch
01.15 - 03.15 Unit 11 Stress, Anxiety & Proc. Hypnosis (new SG)
03.15 - 03.30 Break
03.30 - 05.30 Unit 12 Summary and Review (CSG)
05.30 - 06.00 Discussion & Post course Study (MG)
Note:
ThE BASIC Three Day COURSE outline includes ALL TWELVE units.
some UNITS may not be of IMMEDIATE interest or relevanCE to specific learners OR THE COURSE TIME MAY BE TOO INTENSE..
ALTERNATIVE COURSE OUTLINES: Three DAYS with TEN UNITS and TWO UNIT TIMES AS PRACTICE WITH MINICASES; OR THREE DAYS WITH ONLY NINE UNITS AND SHORTER HOURS; OR TWO DAYS WITH ONLY EIGHT UNITS. ANY UNITS NOT SELECTED can be used for post-course/ homework study.
Unit 1 - Hypnosis Concepts (Barabasz/Christensen)
TIME SCHEDULE
Activity Minutes
1. OBJECTIVES 10
2. AGL 5
3. QUIZ 40
4. REVIEW OF PRIMER 10
5. NARRATED LECTURE 15
6. VIDEO 15
7. DEMO/PRACTICE EXERCISE 15
8. SUMMARY 10
120
NOTE:
ALL INSTRUCTIONS ARE GIVEN IN MG FOLLOWED BY CONTINUOUS SG DISCUSSION AND INTERACTION.
Unit 1 - Hypnosis Concepts
1.1 OBJECTIVES OF THE PROGRAM (10 minutes)
a. To stimulate the learner knowledge, skills and attitudes for efficient and effective basic medical hypnosis practice and to motivate further study and practice in the future.
b. Based on the Medical Hypnosis Primer the key pre-learning textbook for the course, to get medical hypnosis training into the required syllabus of every medical/nursing school and PHC training facility in 2010.
c. To use the AGL (Autonomous Group Learning) system to create 24 hours of highly interactive training, in 2 hour units, which can be organized and provided by one qualified hypnosis instructor. Each unit can be adapted to local culture,
d. To give in each unit an inspiring learning mixture of: narrated lecture, group discussion, Primer study, video, practical exercise and quiz
e. To create a website with training materials (with controlled access by code) to encourage free access and translation of the textbook and training materials, into local languages. To use this web site as a resource for post training help, feedback and support of further study.
f. To promote and support the Olness Training program and for primary health care workers in developing counties. See Appendix.
g To use a rigorous alternative choice quiz (80 questions) in the first and last units of
the training, to measure and reward the learning achieved.
h To provide allow alternative scheduling as a 2-3 day course for Doctors, nurses and
primary health care workers, or in 10-12 two hour sessions for medical and nursing
students, with individual support as needed.
1.2 AGL (Autonomous Group Learning)
a. AGL was designed as an intensive highly interactive learning experience with a variety of 2 hour units which may be selected. Some parts may be less challenging for the experienced health worker with many years of experience.
b. AGL creates a very special group learning environment that is new to the group members. It is a highly effective but rather challenging learning experience. Members should therefore try to keep an open mind on their reactions until the second day of the program.
c. Members can and do solve ALL the problems and answer ALL the questions, from the special materials (Workpack, Guide, Diary and DVD) provided and the experience of other members of the group.
Unit 1 - Hypnosis Concepts
d. The Organizer can respond directly to technical questions, but the learning is better when members help each other. The critical skill of the Organizer is to HELP the participants to WORK TOGETHER to resolve successfully, all questions arising. Thus by the end of the program EVERY QUESTION is resolved!
e. In AGL the learning will be done:
IND - Individually, or
SG - Small Group (four members or just partners which change), or
CSG - Combined Small Group (two small groups together), or
MG - Main Group (short lectures with visual aids).
f We hope you too will find the program stimulating, efficient and effective for you in
every unit! The specific objectives Unit 1 are to present and practice:
1. Basic hypnosis concepts.
2. Common evidence-based uses of hypnosis
3. Definitions of hypnosis
4. Hypnotizability
5. Using self hypnosis yourself
6. Examples of a hypnotic-like experiences.
NOW IN SG start the registration form in the diary. Complete it as homework tonight.
Unit 1 - Hypnosis Concepts
1.3 QUIZ (40)
Instructions SG::
1. Individually complete on the answer sheet provided in the Diary, the 80 question alternative choice quiz which is in the GUIDE. Choose questions only the selected units included in the course.
2. Hand your answer sheet to the Organizer who will give you a score of hypnosis learning at the start of the course.
3. The same quiz will be completed in the last learning unit, to give you feedback on your achievement.
1.4 REVIEW OF PRIMER (10)
Instructions SG:
1. Briefly review the Primer – Introduction & Ch. 1.
2. Discuss following questions:
a. What are your reactions?
b. How will your patients react?
1.5 NARRATED LECTURE (15)
A. Overview
Hypnosis is a set of procedures used by health professionals to treat a range of emotional and physical problems. Hypnosis is an altered state of awareness one can enter spontaneously. However, for health care purposes it is attained by an induction procedure.
Most hypnotic inductions engage patients’ imaginative capacities and include suggestions of focused attention, relaxation, and calmness.
Patients respond to hypnosis in different ways. Some describe their experiences as a state of deepened awareness, others as calm state of focused attention.
Prior to using hypnosis, always familiarize the patient with “hypnotic-like” experiences, to reinforce debunking of myths about hypnosis. Self-hypnosis is the key to hypnosis efficiency and effectiveness.
Unit 1 - Hypnosis Concepts
B. Hypnosis defined
A short definition of hypnosis is ‘attentive perception and concentration, which leads to controlled imagination’. Hypnosis operates from one’s latent cognitive ability (hypnotizability).
Social influences such as ‘expectancy’ have only a modest influence on responsiveness. It is altered state of consciousness and an interpersonal relationship of trust.
The initial suggestion can constitute the hypnotic induction.
Clinical hypnotic inductions usually involve progressive phases to reach a depth for a medical or psychotherapeutic purpose.
The hypnotic state is characterized by the patient’s ability to sustain a state of attention, receptive, intense focal concentration with diminished peripheral awareness.
Thus, the hypnotic state involves a contraction of awareness of involvement with other points in space and time, thereby creating a dialectic between focal and peripheral awareness.
C. Common Evidence Based Uses of Hypnosis
Clinical hypnosis has proven useful reinforcement in health care of:
1. Acute and chronic pain (including medical procedures; surgeries, pre-post op)
2. Post Traumatic Stress Disorder (PTSD) with EMDR.
3. Childhood and adolescent problems.
4. Childbirth pain and Trauma
5. Insomnia.
6. Depression
7. Weight control/healthy eating and exercise
8. Psychosomatic Disorders
9. Habit control
10. Irritable Bowel syndrome.
11. Headaches and Migraines
12. Cancer patient care etc.
D. Hypnotizability
Hypnosis is a matter of degree.
Some individuals may enter a deep state and exhibit behaviors such as regression, time distortion, and hallucinations.
Others, however, may reach a plateau, where they are able to experience only simple suggestions..
Unit 1 - Hypnosis Concepts
Some hypnotherapeutic techniques and experimental research responses require deep states (e.g. surgery).
Others can be effectively employed with the patient only lightly hypnotized (e.g. minor medical procedures, irritable bowel syndrome [IBS], many forms of psychotherapy).
Researchers and clinicians alike may first assess the level of hypnotizability and then the level of depth capability.
The scales of hypnotizability, useful as they are, only predict responses to hypnosis about 50% of the time Standardized Tests of Hypnotizability are discussed in UNit 2.
E. Conclusions
Hypnosis is an essentially culturally free adjunctive treatment modality that has been shown to be effective in a wide range of medical and psychological disorders.
It is especially cost effective in contrast to standard medical care, well accepted by patients and adaptable to multi-cultural settings.