One-to-one hypnotherapy is expensive, and trained therapists are scarce. That is the main reason an effective treatment such as gut-directed hypnotherapy for irritable bowel syndrome reaches so few of the people who could benefit.
One obvious answer is to treat several people at once. The question is whether hypnosis still works when it is shared.
The IMAGINE trial
The best evidence comes from the Netherlands. In a study published in 2019, researchers recruited 354 adults with IBS, referred by GPs and hospital specialists to eleven hospitals.
They were randomly assigned to one of three groups:
- Individual hypnotherapy: a short course of 45-minute sessions
- Group hypnotherapy: the same programme, delivered to small groups
- Education and supportive care: the control
The hypnotherapy was given by psychologists trained in the method. The main measure was simple: did patients report adequate relief of their symptoms?
What it found
After three months:
- Individual hypnotherapy: 40 per cent reported adequate relief
- Group hypnotherapy: 33 per cent
- Education and support: 17 per cent
After nine months the benefits had held, and the group format had caught up:
- Individual: 42 per cent
- Group: 50 per cent
- Control: 22 per cent
The researchers concluded that group hypnotherapy was as effective as individual treatment. Since one therapist can treat several patients in the same hour, that could make it available to many more people at lower cost.
Points to keep in mind
- The response rates are lower than those from specialist centres, which have reported improvement in two thirds or more of patients. This trial was done in ordinary hospitals, with therapists newly trained in the method and a short course. That probably gives a more realistic picture of everyday practice.
- Symptom severity scores did not differ much between groups, even though more hypnotherapy patients said they had adequate relief. People seemed to cope better and be less troubled.
- Many participants dropped out or did not provide data, which is common in trials of this kind.
Why would groups work?
Hypnosis does not depend on private attention from the therapist. The response comes from each person. Stage hypnotists and researchers have always worked with groups; the standard research test of hypnotizability is given to whole rooms at a time.
Groups may also add something.
- You are not alone. People with IBS, pain or anxiety often feel isolated. Sitting with others who have the same problem is a relief in itself.
- Seeing others respond raises your own expectation.
- Shared tips and encouragement.
- Commitment. People are more likely to turn up and practise.
What is lost
- Tailoring. The script is the same for everyone. If the imagery does not suit you, it cannot be changed on the spot.
- Privacy. Some people do not want to discuss bowel symptoms or personal worries in front of others.
- Pace. The session cannot slow down or stop for one person.
- Individual attention if something difficult comes up.
Where else groups are used
- Hypnobirthing classes
- Stopping smoking, in group sessions
- Stress and sleep workshops
- Chronic pain programmes
- Cancer support, including relaxation and guided imagery groups
- Self-hypnosis training in hospitals
Evidence is best for IBS. For other uses it is thinner, but the principle is the same.
Who can deliver it?
Trials have shown gut-directed hypnotherapy working when delivered by psychologists, and studies from Sweden have reported good results with specially trained nurses. Combined with group delivery, that suggests a route to offering it much more widely in health services than relying on a handful of specialist centres.
Is a group right for you?
A group may suit you if:
- Your problem is common and well defined, such as IBS, stress or sleep
- You are comfortable with others in the room
- Cost or waiting time is a barrier
- You would value meeting people in the same position
One-to-one may be better if:
- Your situation is complex
- You have a history of trauma, or a mental health condition
- You need to talk about things you would not say in a group
- You have tried a group and it did not suit you
Getting the most from a group
- Ask who is running it and what their training is.
- Ask how many people will be there. Small groups work best.
- Ask what you need to share. Usually very little.
- Sit where you are comfortable, with your head supported.
- Adapt the imagery privately. If the script says beach and you prefer a forest, go to the forest.
- Use the recording at home. Practice between sessions mattered in the trials.
- Speak to the therapist privately if something does not feel right.
The options compared
| One-to-one | Group | App or recording | |
|---|---|---|---|
| Tailored | Yes | No | No |
| Cost | Highest | Lower | Lowest |
| Support | Therapist | Therapist and peers | None |
| Privacy | High | Lower | High |
| Evidence for IBS | Strong | Good | Emerging |
The bottom line
For IBS, a large trial found that hypnotherapy in a group worked as well as individual sessions, and the benefit lasted. A group gives up tailoring and privacy, and gains company and lower cost. For a common, well-defined problem, it is a sound option.
Next in the series: Hypnosis for Functional Neurological Disorder
This article is for general information and is not medical advice.