Comparison of hypnosis and distraction in severely ill children undergoing painful medical procedures
Abstract
An ethnically diverse sample of high and low hypnotizable children (N = 27) suffering from cancer or blood disorders and their parents were trained to use both distraction and hypnosis to reduce pain and anxiety. Measures of pain and anxiety were obtained from the children and their parents. Independent raters also judged participants' video-taped distress responses. Data were collected during painful medical procedures, for baseline, distraction, and hypnosis conditions. Supporting E. R. Hilgard's (1977, 1992) neodissociation theory, hypnotizable children showed significantly lower pain, anxiety, and distress scores in response to hypnosis in contrast to the low hypnotizable children. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children.
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There is some evidence that self-hypnosis may be helpful with chronic conditions in children.
“Several studies highlight the utility of self-hypnosis with pediatric procedural pain [30,31] and there is some evidence that it may be helpful with chronic conditions as well [32].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [32]
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“Factors influencing clinical hypnosis outcomes 1st Author Child HS Other Factors Potentially Influencing H OutcomesTest and Scores Relation to H Outcomes Baaleman [81] NR NR NR (clinical assumptions) Boggia [84] NR NR NR Butler [108] 0–10 HIP • Weak q to distress (r ¼ 0.22) • 2 dropouts had low HS (2.5 and 4.5) < grou…”
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“The few studies contrasting hypnosis against simple distraction from a pain stimulus have produced contradictory findings (Smith et al., 1996; Spanos, McNeil, Gwynn, & Stam, 1984; Tenenbaum, Kurtz, & Bienias, 1990; Zeltzer & LeBaron, 1982).”
BackgroundResultInfluentialPaediatric Pain Management: Using Complementary and Alternative Medicine
Evans, S., Tsao, J. C. I., & Zeltzer, L. K. (2008) · Reviews in Pain · doi:10.1177/204946370800200104 · Cited by 20 · see citing works
“Hypnosis has been used in children to alleviate a number of painful medical procedures, including bone marrow aspirations (33), venipuncture and lumbar punctures (34), although its therapeutic benefits may be reduced in children of preschool age and younger (35).”
BackgroundJong, M. C., Boers, I., van Wietmarschen, H., Busch, M., Naafs, M. C., Kaspers, G. J. L., & Tissing, W. J. E. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-019-05058-8 · Cited by 28 · see citing works
Procedural Pain Management in Pediatric Oncology: A Review of the Literature
Conte, P. M., Walco, G. A., Sterling, C. M., Engel, R. G., & Kuppenheimer, W. G. (1999) · Cancer Investigation · doi:10.3109/07357909909021437 · Cited by 17 · see citing works
Tan, S.-Y., & Leucht, C. A. (1997) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207149708416140 · Cited by 17 · see citing works
Aramideh, J., Ogez, D., Mizrahi, T., Charest, M.-C., Plante, C., Duval, M., & Sultan, S. (2020) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2020.102426 · Cited by 16 · see citing works
Aramideh, J., Mizrahi, T., Charest, M.-C., Plante, C., Duval, M., & Sultan, S. (2017) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2017.11.013 · Cited by 15 · see citing works
Ogez, D., Aramideh, J., Mizrahi, T., Charest, M.-C., Plante, C., Duval, M., & Sultan, S. (2020) · British Journal of Pain · doi:10.1177/2049463720932949 · Cited by 15 · see citing works
Uman, L. S., Chambers, C. T., McGrath, P. J., & Kisely, S. R. (2008) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.239 · Cited by 14 · see citing works
The Effectiveness of Complementary Therapies on the Pain Experience of Hospitalized Children
Lassetter, J. H. (2006) · Journal of Holistic Nursing · doi:10.1177/0898010106289838 · Cited by 14 · see citing works
“, 2000; Pederson, 1995, 1996), hypnosis and distraction (Smith et al., 1996), hypnosis and cognitive-behavioral (CB) training (Liossi & Hatira, 1999), and art therapy (AT; FavaraScacco et al.”
BackgroundInfluentialEfficacy of Self-hypnosis on Quality of Life For Children with Chronic Pain Syndrome
Delivet, H., Dugue, S., Ferrari, A., Postone, S., & Dahmani, S. (2018) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207144.2018.1396109 · Cited by 13 · see citing works
Hypnosis as a lens to the development of attention
Raz, A. (2012) · Consciousness and Cognition · doi:10.1016/j.concog.2012.05.011 · Cited by 10 · see citing works
De la neurophysiologie à la clinique de l’hypnose dans la douleur de l’enfant
Wood, C. H., & Bioy, A. (2005) · Douleurs Évaluation - Diagnostic - Traitement · doi:10.1016/s1624-5687(05)80287-2 · Cited by 10 · see citing works
“[46] ont comparé l’hypnose et la distraction dans la réduction de la douleur et de l’anxiété lors de ponctions veineuses, de AMO et d’autres actes médicaux chez 27 enfants entre 3 et 8 ans.”
BackgroundCasini, F., Scaltrito, F., Grimaldi, M. T., Pop, T. L., Calcaterra, V., Zuccotti, G., Pettoello‐Mantovani, M., Ferrara, P., Corsello, G., & Fabiano, V. (2023) · The Italian Journal of Pediatrics/Italian journal of pediatrics · doi:10.1186/s13052-023-01554-0 · Cited by 9 · see citing works
Efficacy of Complementary and Alternative Medicine Approaches for Pediatric Pain
Tsao, J. C. I., Meldrum, M. L., & Zeltzer, L. K. (2006) · Humana Press eBooks · doi:10.1007/978-1-59745-125-3_6 · Cited by 9 · see citing works
“On the other hand, Smith et al. ( 72 ), using a crossover design, found hypnosis to be significantly more effective than distraction in reducing distress, pain, and anxiety during venipuncture, BMA, and LP in “highly hypnotizable” children (aged 3–8 years).”
MethodAramideh, J., Ogez, D., Rondeau, É., Duval, M., & Sultan, S. (2022) · British Journal of Pain · doi:10.1177/20494637221103170 · Cited by 9 · see citing works
Clinical hypnosis as an effective adjunct in the care of pediatric inpatients.
Barnes, A. J., & Kohen, D. (2006) · Jornal de Pediatria · doi:10.1016/j.jpeds.2006.05.048 · Cited by 9 · see citing works
Recent developments in the study of hypnotic pain reduction: a new golden era of research?
Milling, L. S. (2008) · Contemporary Hypnosis · doi:10.1002/ch.362 · Cited by 7 · see citing works
“Moreover, consistent with Smith et al. (1996), the three studies by Liossi and her colleagues (Hawkins et al., 1998; Liossi and Hatira, 1999; Liossi and Hatira, 2003) showed that hypnotic suggestibility was associated with greater response to the hypnotic interventions.”
ResultLeBaron, S., Fanurik, D., & Zeltzer, L. K. (2001) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207140108410080 · Cited by 7 · see citing works
Preferences for Descriptors of Hypnosis:The International Point of View
Munson, S. O., Trenkle, B., & Gallawa, R. (2015) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207144.2015.1031536 · Cited by 6 · see citing works
“…support for the use of hypnosis with children and reviewed literature including the American Psychological Association (APA) award-winning paper of Smith, Barabasz, and Barabasz (1996), who compared hypnosis versus distraction for the reduction of pain and anxiety in children who were repeatedly…”
BackgroundCruce, M. K., & Stinnett, T. A. (2006) · American Psychological Association eBooks · doi:10.1037/11435-003 · Cited by 6 · see citing works
THE EFFECT OF A HYPNOTIC-BASED ANIMATED VIDEO ON STRESS AND PAIN REDUCTION IN PEDIATRIC SURGERY
Arnon, Z., Hanan, H., & Mogilner, J. G. (2018) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207144.2018.1421353 · Cited by 7 · see citing works
Baaleman, D. F., Vriesman, M. H., Koppen, I. J. N., Osborne, K., Benninga, M. A., Saps, M., Yacob, D., Lu, P. L., Woodley, F. W., & Lorenzo, C. D. (2022) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm20274 · Cited by 6 · see citing works
“18 It records the presence or absence of 13 operationally-defined behaviors with scores ranging from 1 to 4, which indicate discomfort at 15-second intervals throughout the procedure.”
The Future of Professional Hypnosis: Comment on Kirsch, Mazzoni, and Montgomery
Frischholz, E. J. (2007) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2007.10401578 · Cited by 6 · see citing works
Guest Editorial: The Need for Clinically Relevant Research
Hammond, D. C. (1998) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.1998.10404180 · Cited by 6 · see citing works
Procedimientos psicológicos para el afrontamiento del dolor en niños con cáncer
Orgilés, M., Espada, J. P., & Méndez, F. X. (2009) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.5209/rev_psic.2009.v6.n2.16002 · Cited by 5 · see citing works
“Los resultados de un estudio que comparaba la eficacia de la hipnosis con la distracción para reducir el dolor y la ansiedad frente a procedimientos médicos invasivos en niños de 3 a 8 años teniendo en cuenta su nivel de sugestionabilidad mostraron que los niños altamente sugestionables en la condición de hipnosis inf…”
BackgroundThe Future of Professional Hypnosis: Comment on Kirsch, Mazzoni, and Montgomery
Frischholz, E. J. (2014) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2015.967075 · Cited by 5 · see citing works
Effects of hypnosis in the treatment of residual stump pain and phantom limb pain
Rickard, J. A. (2004) · Cited by 4 · see citing works
Liossi, C., Kuttner, L., Wood, C. H., & Zeltzer, L. K. (2013) · Oxford University Press eBooks · doi:10.1093/med/9780199642656.003.0054 · Cited by 4 · see citing works
Psychosocial Issues in Children with Cancer: The Role of Patient Advocacy and Its Impact on Care
Sardi-Brown, V. A., Kupst, M. J., Brown, P., & Wiener, L. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-43121-5_18 · Cited by 4 · see citing works
Hypnotherapy of a Pain Disorder:A Clinical Case Study
Artimon, H. M. (2015) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207144.2015.1002704 · Cited by 3 · see citing works
Ullán, A. M., Fernández, E., Badía, M., Lorente, F., Malmierca, F., & Zapatero, I. (2013) · Anales de Pediatría · doi:10.1016/j.anpedi.2012.12.003 · Cited by 2 · see citing works
The effects of hypnosis on flow and in the performance enhancement of basketball skills
Vasquez, B. L. (2005) · Research Exchange (Washington State University) · Cited by 2 · see citing works
Post‐White, J., & Ndao, D. H. (2012) · Pediatric oncology · doi:10.1007/978-3-642-04201-0_7 · Cited by 1 · see citing works
Hypnotherapeutic Advances in Pain Management
(2001) · CRC Press eBooks · doi:10.1201/9781420093193-85 · Cited by 1 · see citing works
Santana, L. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9781107375338.018 · Cited by 1 · see citing works
Attitudes and Perceptions Regarding Complementary Therapy Interventions for Radiology
Bates, S. E., Meyer, E. A., Ott, M. J., Wornham, W. L., & Dean‐Clower, E. (2005) · Journal of Radiology Nursing · doi:10.1016/j.jradnu.2005.01.001 · Cited by 1 · see citing works
Hypnosis in Cancer Patients: Can We Do Better?
Kwiatkowski, F. (2012) · InTech eBooks · doi:10.5772/37630
Psychologic management of cancer pain
Meyers, C. A. (1997) · Current Review of Pain · doi:10.1007/bf02938400
“Smith et al. [ 16 ] compared the degree of pain reduction among ‘‘high'' and ‘‘low'' hypnotizable children with distraction (ie, playing with a toy) and hypnosis (ie, imagining traveling to a favorite place as an induction).”
BackgroundHypnosis in Clinical Social Work Practice: What Contributes To Its Under-Utilization?
Olson, A. M. (2012) · UST Research Online (University of St. Thomas - Minnesota)
Levesque, R. J. R. (2018) · Springer eBooks · doi:10.1007/978-3-319-33228-4_437
Social Workers’ Ideas on Health Promotion among Older Adults
Olson, K. (2012) · UST Research Online (University of St. Thomas - Minnesota)
Adjunctive Hypnotic Management of Acute Pain in Invasive Medical Interventions
Salazar, G., Faintuch, S., & Lang, E. V. (2008) · Humana Press eBooks · doi:10.1007/978-1-59745-344-8_10
“However, a 13% rejection rate was also described ( 65 ), and because of the lack of a therapist-patient relationship, videos and audiotapes may not be as powerful in preventing adverse effects such as vomiting (62).”
BackgroundHarnessing clinical hypnosis to improve paediatric pain management
Liossi, C. (2026) · British Journal of Pain · doi:10.1177/20494637261419225
Nontraditional Pain Management in Interventional Radiology
Faintuch, S., Salazar, G., Collares, F. B., & Lang, E. V. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511547331.020
- Authors
- Smith, J. T., Barabasz, A., & Barabasz, M.
- Affiliations
- Primary Children's Hospital (US)
- Venue
- Journal of Counseling Psychology
- Published
- 1996-04
- Volume
- 43
- Issue
- 2
- Pages
- 187-195
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W2141340103
- Cited by
- 97
- References
- 47
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 4 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 5 · 2014: 2 · 2013: 5 · 2012: 7
- FWCI
- 4.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Counseling Psychology (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
- Keywords
- hypnosis, distraction, hypnotic susceptibility, pediatric pain, anxiety, painful medical procedures, childhood cancer, hematologic disorders, parent training, analgesia
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