Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome

Abstract

Individual gut-directed hypnotherapy (HT) is effective in pediatric irritable bowel syndrome (IBS) and functional abdominal pain or functional abdominal pain syndrome (FAP[S]). It is, however, unavailable to many children.OBJECTIVE To compare the effectiveness of HT by means of home-based self-exercises using a CD with that of individual HT (iHT) performed by qualified therapists. DESIGN, SETTING, AND PARTICIPANTSThis noninferiority randomized clinical trial with a follow-up of 1 year after the end of treatment was conducted from July 15, 2011, through June 24, 2013, at 9 secondary and tertiary care centers throughout the Netherlands. A total of 303 children were eligible to participate. Of those, 260 children (aged 8-18 years) with IBS or FAP(S) were included in this study. Children were randomized (1:1 ratio) to home-based HT with a CD (CD group) or iHT performed by qualified therapists (iHT group). No children withdrew from the study because of adverse effects. INTERVENTIONSThe CD group was instructed to perform exercises 5 times per week or more for 3 months. The iHT group consisted of 6 sessions during 3 months. MAIN OUTCOMES AND MEASURESPrimary outcomes were treatment success directly after treatment and after 1-year follow-up. Treatment success was defined as a 50% or greater reduction in pain frequency and intensity scores. The noninferiority limit was set at 50% treatment success in the CD group, with a maximum of 25% difference in treatment success with the iHT group after 1-year follow-up. Modified intention-to-treat analyses were performed.RESULTS A total of 132 children were assigned to the CD group and 128 to the iHT group; 250 children were analyzed (126 in the CD group and 124 in the iHT group) (mean [SD] age, 13.4 [2.9] years in the CD group and 13.3 [2.8] years in the iHT group; 94 female [74.6%] in the CD group and 85 [68.5%] in the iHT group). Directly after treatment, 46 children (36.8%) in the CD group and 62 (50.1%) in the iHT group were successfully treated. After 1-year follow-up, the 62.1% treatment success in the CD group was noninferior to the 71.0% in the iHT group (difference, −8.9%; 90% CI, −18.9% to 0.7%; P = .002). CONCLUSIONS AND RELEVANCELong-term effectiveness of home-based HT with a CD is noninferior to iHT performed by therapists in pediatric IBS or FAP(S). Treatment with hypnosis using a CD provides an attractive treatment option for these children.

Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study

“…Previous studies have demonstrated the effectiveness of HT in children with functional abdominal complaints and irritable bowel syndrome, with adequate relief in more than 80% of the children at 1-year follow-up [27, 34]. The relatively high treatment success of HT in children with abdominal pain, compared to the results in this study in children with primary headache, may possibly be explained by different characteristics of these two types of chronic pain.…”

“…However, no study has specifically investigated the effect of TM on headache in paediatric patients. It has been reported that hypnotherapy is also an effective method for reduction of chronic pain, stress and anxiety [10, 19, 27, 28]. One observational study reported that HT in children may positively contribute to the reduction of headache complaints, with a lasting effect, but good randomised clinical trials (RCTs) are lacking [14].…”

Die Rolle Der Psychotherapie Beim Reizdarmsyndrom

“…Diese variieren teilweise zwischen fünf und 12 Sitzungen und einer Dauer von einer halben bis ganzen Stunde [97]. Allerdings zeigte eine aktuelle Studie bei Kindern mit RDS-Symptomatik die Nichtunterlegenheit einer CD vermittelten Hypnotherapie im Vergleich zur Hypnotherapie im therapeutischen Einzelsetting [99], sodass diese Therapie auch ressourcensparend angeboten werden könnte.…”

Functional abdominal pain disorders in children: An update on treatment

“…To overcome this problem, researchers experimented with alternative forms of delivering treatment such as homebased hypnotherapy. Rutten et al have shown that home-based therapy using audio CDs was not inferior to treatments by a hypnotherapist 43 . A systematic review comparing hypnotherapy performed by a therapist with studies that used self-exercises on an audio CD concluded that any form of hypnotherapy is beneficial to improve abdominal pain in children 1 .…”