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North Ayrshire Health & Social Care Partnership submission of 25 October 2021

PE1873/F: Provide hypnotherapy for the treatment of mental health, psychosomatic disorders and chronic pain

Our local pain service informed me that the National Advisory Committee for chronic pain are going to explore the role of integrative and complimentary medicine as part of the planned chronic pain framework. Until that time, they would not advocate for the use of such approaches as they are not aware of any evidence for their use. Furthermore, until such times as there is robust evidence available, they have some concerns about the use and governance of such approaches and would advise against their use.

From a psychology perspective, we deliver psychological therapies that are evidence based to support patients experiencing symptoms of chronic pain. NICE guidelines (2021) 'Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain [F] Evidence review for psychological therapy for chronic primary pain are relevant here - "Hypnosis: The evidence, which was based on one small study, showed no clinically important difference in quality of life between hypnosis and usual care. Evidence showed no difference in psychological distress at the earlier time point and a mixture of no difference and a benefit of hypnosis with some uncertainty at the later time point. There was no difference in sleep at the earlier time point and a benefit of hypnosis to sleep and pain reduction after 3 months. There were fewer study discontinuations in the hypnosis group. The committee noted that the evidence was based on a study in which the intervention included an element of self-hypnosis, which they considered may explain the apparent delayed benefit, as this is a technique that requires practice. The committee considered that there was insufficient evidence of benefit, the lack of evidence for several critical outcomes, the low to very low quality of the evidence and decided not to make a recommendation for or against hypnosis. The committee decided not to make a research recommendation because the results of the evidence available were not promising enough to warrant further research as a priority and in their opinion, hypnosis is not widely used to manage chronic primary pain in current clinical practice."

Until there is a clearer evidence base regarding the use of hypnosis in supporting individuals with symptoms of chronic pain, we should continue to deliver other psychological therapies that have an evidence base for people with persistent and chronic pain. 

There is a lack of good quality evidence to support the effectiveness of hypnotherapy in the treatment of mental health conditions. This being the case we do not offer this as a treatment for mental health conditions and would not advocate for this in discussion with patients.