Sunday, 7 May 2017

EXAMPLE ANSWERS: Q10

10. By reference to the following article and further research, appraise, in a professional, factual and non-emotive manner, the claim that hypnotherapy could save the NHS money.

Hypnotherapy 'can help' irritable bowel syndrome
Greater use of hypnotherapy to ease the symptoms of irritable bowel syndrome would help sufferers and might save money, says a gastroenterologist.

Dr Roland Valori, editor of Frontline Gastroenterology, said of the first 100 of his patients treated, symptoms improved significantly for nine in 10.
He said that although previous research has shown hypnotherapy is effective for IBS sufferers, it is not widely used.
This may be because doctors simply do not believe it works.
Widely ignored
Irritable bowel syndrome (IBS) is a common gut problem which can cause abdominal pain, bloating, and sometimes diarrhoea or constipation.
Dr Valori, of Gloucestershire Royal Hospital, said the research evidence which shows that hypnotherapy could help sufferers of IBS was first published in the 1980s.
He thinks it has been widely ignored because many doctors find it hard to believe that it does work, or to comprehend how it could work.
He began referring IBS patients for hypnotherapy in the early 1990s and has found it to be highly effective.
"To be frank, I have never looked back," he said.
He audited the first 100 cases he referred for hypnotherapy and found that the symptoms stopped completely in four in ten cases with typical IBS.
He says in a further five in 10 cases patients reported feeling more in control of their symptoms and were therefore much less troubled by them.
"It is pretty clear to me that it has an amazing effect," he said.
"It seems to work particularly well on younger female patients with typical symptoms, and those who have only had IBS for a relatively short time."
Powerful effect
He believes that it could work partly by helping to relax patients.
"Of the relaxation therapies available, hypnotherapy is the most powerful," he said.
He also says that IBS patients often face difficult situations in their lives, and hypnotherapy can help them respond to these stresses in a less harmful way.
NHS guidelines allow doctors to refer IBS patients for hypnotherapy or other psychological therapies if medication is unsuccessful and the problem persists.
Dr Valori thinks that if hypnotherapy were used more widely it could possibly save the NHS money while improving patient care.
Dr Charlie Murray, Secretary of the British Gastroenterology Society, said: "There is no doubt that hypnotherapy is helpful for some patients, but it depends on the skill and experience of those practising it.
"But the degree to which it is effective is not well defined.
"I would support using it as one therapy, but it is no panacea."


Learning outcomes: 3.4
Student answer
In the current political climate, the NHS and funding is a political ‘hot potato.’ At a time when budgets are overspent and being cut and the preference for traditional medication is losing some of its dominance, alternatives are being sought and persuasive arguments being made. One of these arguments can be made for the treatment of Irritable Bowel Syndrome (IBS). NHS.uk defines this as
A common long term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation.” Figures from NHS.uk and the IBS network (www.theibsnetwork.org) indicate that up to one in five people may experience IBS at some point in their lives. There is a greater incidence for women than men (twice as many) with an onset of between 20 and 30 years old. Symptoms can be managed by making changes to diet (avoiding trigger food/drinks and increasing fibre levels) or lifestyle (reducing stress and increasing exercise) or symptomatic relief via medication can be provided, but there is no cure. The impact of not knowing when a bout may occur and the embarrassing nature of the symptoms often leads to an increased risk of depression and anxiety. These in turn have an impact on the economy and NHS- The Centre for Economic Performance’s
Mental Health Policy Group report –How Mental Illness Loses Out In The NHS (2012) suggests figures of over £14 billion each year spent by the NHS on Mental Health (for all services/conditions) and extra physical healthcare for conditions caused or exacerbated by mental illness at an extra £10 billion/year. The report suggests for patients with anxiety conditions (roughly half of all mental illness) and for depression a series of CBT sessions with an approximate total cost of £750, has a result of a 50% recovery (mostly permanently for anxiety but depression has a higher relapse rate). When one adds the additional cost savings of being in employment, payment of taxes and contribution to spending, these figures are considered very cost effective and National programmes are and have been rolled out.

However not all cost saving treatments are considered equal; whilst many people experiencing IBS have reported relief by using hypnotherapy, and published research supporting this has been available since the 1980s, the scientific community are not widely supportive of its use as a treatment. Dr Roland Valori, editor of Frontline Gastroenterology, is unsure as to why but suggests scepticism and lack of knowledge may be the reasons for the reluctance. In the BBC article “Hypnotherapy 'can help' irritable bowel syndrome” Dr Valori reports having referred patients for hypnotherapy since the early 1990s. He has conducted his own research where he has observed a 90% success rate; broken down as 40% having symptoms cease and 50% experiencing increased control over symptoms and reduction in anxiety about them. In particular he reports the greatest benefit for younger female patients and when treatment occurs sooner after symptoms occur than for those who have experienced them for a longer duration.

With comparable savings and a growing body of support, perhaps its time the scientific and medical community took another look at using hypnotherapy to provide effective and cost efficient services for its patients. And perhaps the current economic climate might inspire this to take place sooner rather than later.
(LO 3.4 An ability to critically appraise, in a professional, factual and non-emotive manner, claims made in the media, including digital media such as websites, or those made by colleagues, supervisors and trainers)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table)

Correct, a well balanced and well put together answer detailing in a professional, factual and non-emotive manner your response to the article, thank you.





Further Student Example Answer:  The doctor’s view that his small-scale study of 100 patients falls short of what is widely accepted as a controlled scientific experiment. A larger controlled study including double blind testing of many more patients with measurable levels of IBS discomfort and exactly what style of hypnosis as well as which standard interventions are used verses the current standard treatment of medication would be needed to provide conclusive proof of the doctors’ claims.

Any claim to save money would need clarification as to the duration of such relief, the number of hypnosis sessions and a comparison of the typical cost of drugs consumed for the same period of relief.

The medical profession has a long held suspicion of Alternative Health Treatments, mainly due to the limited scientific evidence as to their effectiveness, hypnosis as well as several other alternative treatments have been shown to assist some suffers but as each individuals response to these sessions has been wide ranging from excellent to no help it is difficult to produce consistent repeatable empirical data on which to make an informed judgement.

IBS is often regarded a stress related illness which should respond well to hypnosis, however some IBS is not and to add to the problem some IBS is of unknown origin. Each person responds differently to stress so its impact on their particular episode of IBS is virtually immeasurable due to the wide range of variables.

Whilst many clients have stated hypnosis has helped sometimes when medicine has been unable or has stopped being effective, the scientific research and therefore data is not available due to
  1. very limited funding is available for research into hypnosis and its effects,
  2. medicine has a ready made ‘got to’ for illnesses in medication with a huge range of empirical data to support its use with strong marketing from the pharmaceutical companies,
  3. this illness can present with differing triggers, different degrees of symptoms and discomfort making a scientific test of effectiveness of any different form of treatment difficult and costly,
  4. hypnosis is not an exact science and as such not measurably repeatable in a range of people, it works very well for some and not so well if at all on others leading to an inability to reproduce acceptable scientific tests and therefore the necessary data to produce a good case for hypnosis as an acceptable broad treatment plan for IBS


The consultant responsible for developing the treatment plan for each individual patient would have to take into account a huge range of information about the patient including suggestibility testing to decide if hypnosis was a viable treatment requiring further training and understanding beyond that already held by medical consultants.

Q10. Correct. You have made some important points here and have recognised the difficulties presented, giving a balanced and detailed assessment.


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