In talking with other hypnotherapists and psychotherapists it’s clear that many have only a small range of techniques and interventions to draw upon. We believe it’s important that hypnotherapists and psychotherapists have a wide range of interventions (treatment elements) to draw upon to create tailored and flexible treatment plans for each client.
Here’s the current list of evidence-based interventions covered in our Diploma in Cognitive Behavioural Hypnotherapy – please note that for each intervention there maybe several different imagery techniques that can be used.
Each technique falls within the “Cognitive Behavioural” approach – and so while what you learn is “technically eclectic” (a wide range and number of different techniques) they are all “theoretically coherent” (i.e. the techniques fall within the same sort of theory of human experience, how we get stuck and how we can get “unstuck”).
1.Psycho-Education about hypnosis, CBT, or the nature of the problem.
Educating clients about hypnosis and the therapeutic approach of Cognitive Behavioural Therapy. The idea in CBT is that therapist and client work together so that the client becomes their own therapist; this involves the client understanding how the mind and body work, how thoughts, sensations and emotions are different but related, how the client might be instrumental in bringing their anxiety about and what they can do to change it. The focus is on empowering the client with both knowledge (psycho-education) and skills (coping skills training).
Helping clients understand their problem better is very empowering. For example, for panic attacks we might say “in a way your brain has developed an intense fear of anxiety sensations, in your case a fear of the heart rate increasing, even though that isn’t dangerous and is actually a really healthy and safe response to real dangers. So instead of being scared of the spider you are now scared that something is terribly wrong with your heart, your brain is focused on checking on that…. which makes it beat faster. Of course your heart beating fast isn’t really dangerous, it is designed to do that. So the emotional-response part of the brain, that monitors for threats, has made a mistake and is taking something quite normal and healthy as a threat“.
2. Self-awareness Exercises (from Gestalt Therapy/Mindfulness-based CBT)
Helping clients become more aware of their thoughts, emotions, sensations and behaviour.
3.Cognitive Insight / Identification of Negative Cognitions or Beliefs
How to identify and uncover the negative (unhelpful) beliefs that are maintaining the problem
4. Cognitive Disputation & Restructuring (Beck/Ellis)
– how to dispute, weaken and “sow doubt” about negative beliefs and thoughts using Socratic Questioning, distancing, Behavioural Experiments, Evidence Evaluation, Imagery Techniques and Thought Experiments.
5. Hypnotic Skills Training & Self-Hypnosis (Sensory Recall & Mood Induction)
How to train the client in self-hypnosis and increase their responsiveness to hypnotic suggestions through special skills training exercises and sensory recall methods
6. Post-Hypnotic Suggestion – for symptom removal/habit change/treatment adherence
Positive suggestions that continue to create change AFTER the hypnosis session has finished, continuing to influence/change the client’s symptoms, thoughts, feelings and behaviour after the hypnosis session.
7. Relaxation Techniques: Meditation (Benson) and Breathing Techniques
How to activate the “relaxation response” through simple meditation as developed by Herbert Benson, Professor of Physiology at Harvard University.
Also understanding the principles of the relaxation response (parasympathetic nervous system) and the relationship to breathing style. How to conduct breathing relaxation skills training – and integrate breathing relaxation principles into hypnotherapy.
8. Tension-Release Progressive Muscle Relaxation/PMR (Jacobson)
The classic muscle relaxation system developed by the father of all relaxation methods, Edmund Jacobson. This is taught in-depth and with many key elements and techniques that have been forgotten in modern versions of PMR. This has a wide range of application from working with anxiety, unhelpful tension in performance situations, to insomnia, pain control, musculoskeletal issues, psychosomatic disorders and overall self-management by consciously reducing unnecessary tensions in the musculature.
Moreover the integration of tension release, for example with cognitive therapy, accelerates the processes of therapy (due to increased cognitive flexibility, weakening of habit strength and reduced validity of anxious thoughts when muscles are relaxed).
9. Cue-Controlled Relaxation & Emotional Self-Regulation
How to relax rapidly “on cue” in any given situation, or how to regulate how you feel anytime you want using an emotional self-regulation technique.
10. Systematic Desensitisation (Wolberg/Wolpe)
The most evidence-based method in psychotherapy – how to treat phobias and anxiety (or anything that unnecessarily disturbs the client). The method in essence is to simply train the client thoroughly in a relaxation technique and then have them gradually face their feared situation in small doses while stayed relaxed (you can’t feel anxious and relaxed, they are opposite emotions, the relaxation thus “inhibits” the anxiety. This “reconditions” the nervous system to associate the previously feared situation or stimulus with relaxation (rather than with anxiety).
11. Imaginal Exposure Therapy (Graded Exposure to Pure Exposure/Emotional Flooding)
Rather than actually facing the real stimulus, how to use the client’s imagination to face feared situations (exposure therapy) to bring about change – ranging from systematic desensitisation to graded exposure to high intensity flooding techniques.
12. Covert Sensitisation (Aversion Therapy)
How to create in the client an automatic strong aversive response to a stimulus or situation (e.g. chocolate, gambling, cigarettes)
13. Negative Practice & Paradoxical Intention (Dunlap)
How to bring about change by having the client deliberately increase their symptoms (e.g. stop sweating by deliberately trying to sweat as much as you can or cure insomnia by trying to stay awake for as long as possible). Remarkably powerful and effective technique if done properly.
14. Covert Behavioural Rehearsal (Imaginal Rehearsal of Coping Skills)
How to use the client’s imagination (typically in hypnosis) to rehearse new behaviour, new more effective ways of coping with and handling challenging situations or performance opportunities.
15. Goal Visualisation & Self-Image (Maltz/Susskind)
How to use goal visualisation imagery to increase motivation and problem solving ability.
How to work with the client to create a new, positive image of themselves and how to use imagery to help them see themselves changing, in practical steps and stages, into the person they want to become
16. Solution-Focused Therapy (de Shazer & Berg) and Strengths Focused Approaches (Meichenbaum)
Having the client focus on their desired outcome and begin to develop imagery and narrative around the desired outcome (the solution) rather than their symptoms (problems).
Focusing on client strengths (rather than weaknesses) and “the other half of the story”, what they’ve managed to accomplish in spite of their situation and other issues.
17. Coping Statements and Self-Instruction (Meichenbaum/Vygotsky)
How clients can use the principles of how children learn complex tasks (by talking aloud to themselves) to self-instruct themselves on what to do in challenging situations. The use of self-talk that helps clients handle situations in a more effective way. (e.g. asking clients “What would be a more helpful thing to say to yourself in that situation?”)
18. Cognitive Rehearsal
How to rehearse and embed, using hypnosis, the new beliefs, self-talk and positive thoughts that the client wants to have in situations that previously activated negative, unhelpful thoughts, in order that these more helpful thoughts become more accessible and ultimately become underlying (unconscious) positive assumptions about the situation and the client’s ability to handle the situation.
19. Mood Induction & Rational Emotive Imagery (Ellis)
How to use rapid self-hypnosis to change mood by changing thoughts. How to recognise the “feeling” of a negative thought and then switch it to a positive thought.
How to use imagery to understand how you create your issue (e.g. anxiety) and therefore how to uncreate that issue.
20. The Use of Operant Conditioning (Skinner)
The principles of reward and punishment by which behaviours are reinforced or weakened. How to integrate these into every element of therapy and how to teach the client to use rewards to strengthen the new skills and positive habits the client wants to develop
21. Positive Regression Hypnotherapy
The use of regression to recall, access and re-vivify positive experiences from the client’s past. Rather than using a neo-Freudian model to regress the client to their originating and sensitising negative event – the focus is on using hypnosis to recall previous strengths, experiences, positive emotions and beliefs – and then access and use those in the present moment.
(e.g. regressing a client with recent erectile dysfunction to previous positive sexual experiences in order to re-vivify the neurophysiological pathways of positive sexual response.)
22. Hypnotic Relaxation Therapy and Soviet Sleep Hypnotherapy
A key feature of hypnosis is the ability to induce extraordinarily deep states of relaxation (many people think that this IS hypnosis – however we can also induce high states of alertness and excitability with hypnosis). The use of deep hypnotic relaxation is essential in some therapy approaches and with some client issues. In addition the Soviet approach to hypnosis was to make particular use of “suggested sleep” to allow for great healing, learning and balancing of the organism.
23. Habit Reversal (Nunn & Azrin)
How to deliver an effective Habit Reversal Training in a single two hour session to stop basic repetitive habits (e.g. hand to mouth habits like nail biting and eyebrow pulling), a highly effective and well-evidenced protocol.
24. Thought-Stopping (Alexander/Wolpe)
How to stop a chain of strong negative thoughts and switch into more helpful thoughts (for clients that say “I can’t stop thinking” or “my thinking is out of control” or who suffer from strong negative automatic or pop-up thoughts)
25. Stimulus Control /Positive stimulus reconditioning (Pavlov, Skinner, Bootzin)
How to work with the client to create an automatic positive response to situations and stimuli that have built up a negative association (e.g. the bed for insomnia clients)
26. Assertiveness & Authenticity Training (Salter/Wolpe)
How to train clients to be more assertive, expressive, authentic, natural and stand up for themselves and their rights, interests and values. Also known as “Social Skills Training”, for example how to initiate, sustain and terminate conversations, how to make requests of others and how to refuse requests yourself (“No” is a complete sentence!)
The approach particularly draws on the original and dynamic work of the behaviour therapist, Andrew Salter, which is still highly relevant today both in terms of it’s connections to mindfulness based approaches, the focus on the expression of basic emotions and the understanding of neuroplasticity.
27. Role-Modelling, Social Learning and Principles of Self-Efficacy (Bandura)
Understanding how to increase self-efficacy and learning through the use of role-modelling, examples, story-telling etc. Albert Bandura showed that we learn by observing others (social learning theory). Moreover, he showed that developing the confidence (self-efficacy) to handle situations can be done in various levels of “potency” which he listed in decreasing order; from direct experience (the most potent), to vicarious learning (observing others, or using the imagination), to verbal persuasion, to emotional self-regulation (the least potent).
These principles are then integrated through the therapy.
28. Hypnotic Suggestion & Autosuggestion
How positive suggestions work, how to write and use positive suggestions both therapeutically with clients and also for use in self-hypnosis (auto-hypnosis).
29. Stress Inoculation Training (Donald Meichenbaum)
A well-evidenced, transdiagnostic stress training model (this mean it can work across all issues without needing to know the diagnostic categories) which is focused primarily on training clients in coping skills and then rehearsing those coping skills in stressful situations; first by “inoculating” them to small doses of stress and then increasing the stressful aspects as the client builds their skills until they can handle highly stressful situations with confidence.
30. Problem Solving Hypnotherapy (Nezu, Nezu & D’Zurilla)
Learning the approach of Problem Solving Therapy and then how to integrate this with hypnotherapy to create a very practical, effective and efficient method of helping clients become better at recognising and solving problems in their everyday life (e.g. paying bills, handing arguments, dealing with a headache, getting a date, dealing with a difficult boss, getting a new job etc etc). Stress, anxiety and depression arise because clients don’t recognise and handle problems in effective ways.
31. Mindfulness & Acceptance Based Approaches
Learning the principles of mindfulness based approaches, how to introduce them and when to introduce them to the client. When and how to shift the client from struggling to change something towards accepting and being with an issue, situation, thought, emotion or sensation.
(e.g. struggle to fix the tinnitus or learn to accept and get on with life inspite of the tinnitus)
32. Attention Training (narrow, stuck vs flexible & open)
The critical role that attention plays in our experience. How to train the client to use and control their attention: how to switch attention, how to be more focused on the present moment environment, how to widen attention, how to attention gets stuck and how to loosen up the attention so it is no longer stuck on negative issues. Teaching clients how to use of spatial awareness training to reduce discomfort and enhance relaxed integration of mind and body.
33. Cognitive Distancing & Delusion & De-hypnosis (Beck, Hayes, Robertson/Davis)
How to gain some distance from our thoughts, observe them (rather than react from them), how to let them pass by, how to no longer respond “hypnotically” to our negative thinking.
34. Behavioural Activation and Values Based Living
Helping clients to switch their attention from their symptoms onto activity that has real value in their life. Too often clients are generating too much behaviour and effort to reduce their symptoms (e.g. chronic pain), rather than accepting the symptoms and shifting the focus and efforts on to valued activities they can do inspite of their symptoms (in doing so giving less attention, value and meaning to their symptoms).
35. Undoing and Unlearning Self-Consciousness
How to train the client’s awareness so they no longer focus on how they look to others (self-consciousness) but rather become more aware of how others appear to them, in doing so remove the burden of self-consciousness from their social interactions and life. Self-consciousness (processing ourselves as a social object) is an unnecessary habit that can be brought under control.
In addition a wide-range of imagery techniques and hypnotic suggestions are covered which support many of the interventions above: