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
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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."
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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)
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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.
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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
- very limited funding is available for research into hypnosis and its effects,
- 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,
- 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,
- 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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