EXAMPLE ANSWERS: Q19

Q19. Give the advantages and disadvantages of a hypnotherapy treatment that is not supported by scientific research.

Learning outcomes: 3.8

Student answer Alternative therapies or approaches such as hypnotherapy often lack scientific validation, and as a result their effectiveness is considered either unproven or disproved. "There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking- P.B. Fontanarosa, Journal of the American Medical Association (1998). Scientific research has many advantages to bestow upon the treatments which fall within its remit. In order to qualify as scientific, or ‘evidence based,’ research must include a range of specifically designed scientific studies. Ideally performance on a given test or measure is taken before and after the intervention and participants randomly assigned to control or experimental groups. There must be measurable, sustained improvements in a defined area and with a large sample size – defined from past research and statistical analysis. An independent variable should be identified – one which is able to be manipulated in order to measure the effect on the dependent variable. External variables are controlled so that the relationship between the independent and dependent variable can be observed. The overall intention is to increase control and make accurate measurements of variables with an aim to increase objectivity and the ability to replicate. There are advantages of hypnotherapy research attempting to comply with the scientific methodology even on a small scale. By doing so each study contributes to a body of research to build upon and develop; it is granted the ‘approval’ of the scientific community and is therefore easier to defend in terms of validity and ‘reliability. But people are not reliable and their effects are less easy to replicate - they vary from day to day, from moment to moment and session to session, especially if they know they are being observed. To avoid the participant effect, some scientific research is conducted as case study or case review in retrospect which in turn have their own disadvantages of memory and bias. These methods can be used just as easily for hypnotherapy research although with the same disadvantages. In the same way it is possible to measure effects before and after a hypnotherapy intervention, albeit via subjective responses- for example rating of pain before and after a session. Even if one took the most cynical attitude that hypnotherapy is a placebo- the fact that change exists is often the most important for the client, not what enabled it. However even in tightly controlled scientific experiments, not all variables can be completely controlled. The creation of a scientific experiment can cause an artificial environment where people behave as they are expected to and these are then difficult to expand to be able to generalise to reality. Many hypnotherapists may argue that this is in fact similar to hypnotherapy – creating a condition to enable the participant to be open to suggestion. And as a wise psychology teacher of mine once drilled into us during statistics classes – correlation does not infer cause and effect. Her favourite example was the scientific causality link between eating ice cream and drowning; much more likely to be caused by sunshine behaviour at the beach than the ice-cream itself. This is a great example of the nature of the human condition – a factor which can be lost by using scientific research alone. There are also advantages of not using pure scientific methodology, one of which is that if by doing so we prevent hypnotherapy from happening. Every session we conduct cannot contribute to research but it can contribute to the net total of knowledge. Whilst a session may not meet the criteria, it will still have the practice methodology and can have hypotheses – although not ones that can be tested for statistical error. But we can use the principals for new and exciting trials; subjective experience can be observed and recorded in the way in which it was experienced; small numbers (as small as one) can be part of something greater- for the client and hypnotherapy as a whole. In addition costs to administer and develop may be smaller without the scientific constraints and from here the only limitation is imagination as to what hypnotherapy could be used for… Hypnotherapy has no recorded side effects, there are no disadvantages for trying it to assist new or less understood illnesses and unlike many medical or scientific ‘treatments’ the administration of the intervention is as therapeutic as the after effects. Whilst it is true that without the backing of the scientific research it is harder for hypnotherapy to de-bunk the de-bunkers; there are many who will never accept alternative treatments with or without hard scientific ’proof’. It is also difficult to refute any accusations of harm caused – how can one prove you didn’t cause something if one cannot prove what you did do? But it is also important to remember that aspects of medical science such as surgery or anatomical dissection were once considered an abomination against nature – every part of a new science must start somewhere and build the mass of evidence which one day will reach a critical mass of acceptance. There is a balance to be struck between empirical evidence and scientifically principal led hypnotherapy; some things are so individual they are hard to express let alone to capture in a way that can be subjected to statistics. Any hypnotherapist who has had a client who cannot express how they feel after a session other than ‘yes’ will know the value of the smile that is lighting up the person’s face, or the lightness that appears throughout their body upon waking. It just doesn’t show up on a graph (unless it’s an inverted bell curve). (LO 3.8 A demonstrable and respectful appreciation of both the advantages and disadvantages of interventions that have, or have not, been scientifically researched)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct. A detailed and comprehensive response to this question Anna, thank you. The criteria has been well fulfilled here and I appreciate the detail provided and the thought behind your answer.

(Further student work goes here if requested through feedback)

Further Example Student Answer:  The disadvantages are:

Not empirically proven to assist with clients issue, may generate false hope which may in turn cause the client to discontinue all treatments both medical and alternative health.

May actually mask symptoms and/or affect medical treatments by disguising changes in their condition, possibly leading to a worsening of the condition without the client being aware,

Having no corroborating evidence to support use of hypnosis, having provable support helps the client believe in the process increasing the potency of the treatment, the placebo effect,

Without research the medical profession is unlikely to support or promote the benefits and therefore the future use of hypnosis.

Without research there is little information to guide the hypnotist as to the best way to assist the client and/or the doctors.

Hypnosis is dependent on the practitioner being good at their job and the clients have to be good subjects for the best results, these are not measurable qualities using scientific methods.

The Advantages are:

Hypnosis is free from side effects,

Hypnosis at the least effective level can lift the spirits of the client allowing self healing to take place which will speed up recovery and reduce problems,

Hypnosis can be holistic and treat the client as a whole, your energy levels are increasing, whilst when you need to, you can relax and sleep peacefully in one carefully worded suggestion,

Hypnosis could also if necessary be targeted where as medication rarely has only one effect, so for example pain killers whilst reducing pain makes the client sleepy and lethargic, hypnosis can relieve pain without sedating the client.

Hypnosis is almost instant in taking effect and if it doesn’t work for this client/condition it can be stopped immediately, again no side effects,

The anecdotal list of conditions for which hypnosis has helped is growing daily, there is nothing to lose in trying hypnosis for any and all conditions you come across, if it fails the client has lost nothing if it works they have gained everything.

Q19. Correct. A good clear answer outlining your respectful appreciation of both the advantages and disadvantages of interventions that have, or have not, been scientifically researched, just as the learning outcomes dictate. A thoughtful and well delivered answer.