INTRODUCTION:

Anxiety disorders are among the most prevalent mental health conditions, significantly impacting an individual's daily functioning and overall well-being. While pharmaceutical treatments and cognitive-behavioural therapy (CBT) remain the standard of care, there is growing interest in complementary and alternative therapies, such as clinical hypnotherapy. Despite this interest, clinical hypnotherapy remains underutilized, and its potential effectiveness is not fully recognized.

The term clinical hypnosis or clinical hypnotherapy in this study describes the use of hypnosis in systematic clinical intervention. The techniques involve guiding individuals into a relaxed, trance-like state, during which time a therapist directs targeted suggestions to the subconscious mind to positively influence thoughts, emotions, and behaviours. Emerging evidence suggests that clinical hypnotherapy is particularly effective for addressing anxiety and pain-related disorders. By leveraging this unique approach, clinical hypnotherapy (CHT) offers a promising avenue for enhancing psychological well-being.

This study aims to explore the comparative efficacy of cognitive-behavioural therapy and clinical hypnotherapy in the treatment of anxiety and pain disorders. By examining their strengths and therapeutic outcomes, the research seeks to provide a better understanding of the role for clinical hypnotherapy in the treatment and improvement of psychological health and to foster optimal well-being.

Reviewing cognitive behaviour therapy and clinical hypnotherapy approaches to anxiety and pain

Anxiety disorders represent a significant global health burden, profoundly affecting the well-being and functional capacity of individuals. While pharmacological treatments and cognitive-behavioural therapy (CBT) are well-established as standard interventions, emerging evidence from the literature highlights an increasing interest in complementary and alternative approaches, including clinical hypnotherapy (CHT). However despite its potential, CHT remains underexplored concerning its efficacy and therapeutic scope.

As a therapeutic modality, CHT offers a unique mechanism. Individuals are guided into a state of focused relaxation, and therapists engage with the subconscious mind making targeted suggestions to reach and positively influence cognitive and emotional processes. This paper discusses the under recognised potential of CHT and underscores its role in broadening the spectrum of effective interventions available.

Anxiety disorders represent one of the most prevalent and debilitating mental health conditions globally frequently manifesting with significant psychiatric and physiological comorbidities. As a collective group, anxiety disorders are the most frequently diagnosed mental health disorders¹, with high rates of co-occurrence alongside other psychological and medical conditions.² This highlights the critical need for innovative, evidence-based treatment approaches to enhance therapeutic efficacy and patient outcomes.

CHT has gained growing recognition as a scientifically supported intervention for anxiety management, with an expanding body of controlled research and empirical evidence validating its effectiveness. Clinical case studies from private outpatient practices further highlight its therapeutic utility in addressing anxiety-related conditions reinforcing its potential for broader integration into mainstream mental health care.

Emerging evidence indicates that CHT provides distinct therapeutic advantages, such as the ability for enhanced emotional regulation, cognitive restructuring, and reduced physiological arousal.

But despite its demonstrated efficacy, a critical gap remains in the awareness and adoption of CHT within medical and healthcare settings. Addressing this gap requires targeted educational initiatives to inform healthcare professionals about the clinical applications of hypnosis, particularly as interest in evidence-based complementary therapies continues to rise.

Furthermore, a structured research agenda is essential to identify barriers to integration within mainstream medical practice. By investigating institutional, regulatory, and professional constraints, future research can facilitate the translation of knowledge into clinical application, ultimately enhancing the accessibility and implementation of CHT as a validated therapeutic intervention. ³

Anxiety is a natural human emotion that makes people aware of possible dangers and encourages them to get ready to respond to the upcoming obstacles in life. Anxiety can be a healthy response to a stressful situation, but excessive anxiety can be crippling and counterproductive.⁴

Evidence based practices of CHT as outlined in the narrative reviews in the literature suggest that clinical hypnosis may be useful in treating anxiety and anxiety-related disorders.⁵ This investigation is significant, as anxiety disorders are the most prevalent classified mental health conditions and often co-occur exist with other psychological or medical disorders, including alcohol and substance use disorders.

Individuals with specific phobia are fearful and avoidant of specific objects or situations. And several narrative reviews have suggested that CHT may be effective for treating anxiety and anxiety-related disorders.⁶

OBJECTIVE:

This paper aims to present a compelling case for the integration of CHT as a validated treatment option for anxiety disorders. By examining contemporary techniques, therapeutic methodologies, and supporting empirical evidence, this review highlights the therapeutic efficacy of CHT and underscores its potential to complement or, in some cases, replace traditional approaches.

Furthermore, the author advocates for the therapeutic application of CHT in the treatment of anxiety disorders and introduces the rebranded concept Conscious-State Altered Therapy (C-SAT)³² as a structured approach for understanding how it is employed in anxiety management. The specialised techniques that make up this approach and describe its effectiveness in therapeutic practice are given the name Enhanced Focused Empowering Techniques (EFET).

The present review identifies a range of clinical hypnotherapy (CHT) techniques commonly employed in the treatment of anxiety disorders, including guided imagery, relaxation-based inductions, cognitive restructuring, and ego-strengthening scripts. They are similar to the cognitive-behavioural therapy (CBT) techniques that integrates relaxation techniques and cognitive restructuring as core components in the management of stress, anxiety, and various mental health conditions.

The findings of this review suggest that the integration of these techniques enhances the therapeutic efficacy of both CHT and CBT, optimizing their effectiveness in clinical practice.

Clinical Hypnotherapy (CHT) Procedures in Anxiety Treatment

CHT employs a range of scientifically validated techniques to address anxiety at both the conscious and subconscious levels. The therapeutic process begins with a comprehensive psychological assessment, identifying the patient’s specific anxiety triggers, emotional patterns, and cognitive distortions. This initial evaluation informs the development of a personalized intervention plan, ensuring that therapeutic strategies align with the specific requirements of each individual patient.

It is noted that throughout this study the term patient is used interchangeably with client

1. Hypnotic Induction and Relaxation : The first step in the CHT procedure is hypnotic induction, a process designed to guide the patient into a profoundly calm, trance-like state. Induction techniques commonly include guided imagery, controlled breathing, and imagination led progressive muscle relaxation inductions, all of which facilitate heightened suggestibility and a heightened focused attention. This state of concentrated attention and increased suggestibility facilitates direct access to subconscious processes.

2. Absorption and Focused Engagement : Absorption in CHT refers to the patient’s complete immersion into their internal experience, akin to becoming deeply engaged in a book or film. In this heightened state of focus, receptivity to therapeutic suggestions is enhanced, allowing the clinical hypnotherapist to facilitate cognitive and emotional restructuring. This process serves as a foundation for empowering individuals by unlocking their latent psychological potential.

3. Dissociation and Cognitive Reorientation : A key mechanism in CHT is dissociation, where the mind is encouraged to separates distressing thoughts and mental triggers from conscious awareness. In this state attention is then redirected toward constructive behavioural and cognitive scripts. This approach gradually reduces maladaptive thought patterns by reinforcing adaptive, solution-focused thinking. Hypnosis facilitated dissociation allows the therapist to bypass cognitive resistance, making it easier to restructure anxiety-driven beliefs and introduce behavioural or emotional modifications.

Dissociation is further enhanced by relaxation and suggestion to help individuals concentrate on constructive behaviours and thoughts while progressively reducing negative thought patterns. A state of consciousness known as hypnotic dissociation occurs when the mind is split into several regions, enabling the clinical hypnotherapist to guide behaviour by suggestions or by directly activating specific responses.

4. Suggestion and Cognitive Reframing: The clinical hypnotherapist offers constructive suggestions to the patient while they are in a hypnotic state in order to change or modify unhelpful thought patterns. For example, individuals with social anxiety may receive suggestions that reinforce self-efficacy and calmness in social settings. Through cognitive reframing techniques, these suggestions help rewire automatic negative thoughts, fostering more adaptive and positive cognitive responses.

5. Guided Imagery and Visualization: Clients are assisted in mentally practicing constructive coping mechanisms through imagined mental exercises. For instance, an individual experiencing phobic anxiety may be guided to vividly imagine themselves successfully navigating the fear triggering situation. Regular mental rehearsal of this scenario can gradually reduce sensitivity to anxiety-provoking stimuli, fostering increased confidence and emotional and reducing the anxiety response.

6. Age Regression and Affect Bridge: The therapist may occasionally use age regression techniques to find and treat the underlying cause of anxiety. The patient is assisted in remembering past events that might have contributed to their current anxiety or may provide a resource for managing it. In order to promote emotional release and healing, affect bridge techniques then connect these earlier experiences to present emotional states.

Age progression techniques can be employed to help patients envision a future where they successfully manage anxiety, reinforcing confidence and adaptive coping strategies. Affect bridges may also be constructed to future positive emotional states.

7. Ego-Strengthening and Post-Hypnotic Suggestions: Ego-strengthening scripts aim to enhance emotional resilience and self-confidence. These scripts incorporate affirmations and positive reinforcement, which are embedded in the subconscious mind during CHT session to support long-term psychological well-being and promote adaptive coping mechanisms.

These clinical procedures have been observed in patients at the LCCH Clinic Malaysia, demonstrating the efficacy of self-empowerment in overcoming anxiety-related mental disorders. Sheila Menon refers to the practice and procedures used in CHT as "Enhanced Focused Empowering Techniques (EFET)." While this article primarily focuses on the application of EFET in the treatment of anxiety disorders, the author highlights its broader applicability across various health and mental health conditions.

Enhanced focused empowering techniques (EFET) in treatment of anxiety disorder

The effectiveness of clinical hypnosis in treating anxiety:

An analysis of previous literature, including evidence from randomized controlled trials (RCTs) and meta-analyses, demonstrates that CHT significantly reduces symptoms of social anxiety, generalized anxiety, and phobias. A meta-analysis conducted by Hammond (2018) found that CHT reduced anxiety symptoms by 45% more than standard care alone, highlighting its efficacy as a therapeutic intervention.⁷

A literature review by Valentine et al. (2019) identifies hypnosis as an effective treatment for stress- and anxiety-related disorders. Research published in Neurotherapeutics Expert Review and other studies indicate that CHT provides long-lasting symptom relief, with follow-up assessments demonstrating sustained improvements at six and twelve months post-treatment.⁸ The effectiveness of CHT is attributed to its ability to access and influence the subconscious mind, facilitating emotional and cognitive changes that may be more challenging to achieve through conventional talk therapy.

Furthermore, techniques such as age regression, the Affect Bridge, and post-hypnotic suggestion have been extensively examined, particularly in their neurobiological mechanisms. Studies, including those by Oakley and Halligan (2017) ⁹, highlight the role of key brain regions associated with anxiety, such as the amygdala and prefrontal cortex, in mediating the therapeutic effects of hypnotherapy.

Oakley and Halligan (2017) explore the intersection of cognitive neuroscience and hypnotic suggestion in Cognitive Sciences Trends, 21(8), 589-599. Their findings align with the dual-process hypothesis of hypnosis, which suggests that CHT can circumvent crucial conscious resistance, allowing for direct engagement with maladaptive cognitive patterns.¹⁰

One reviewed literature analysis further supports the efficacy of hypnosis in reducing pain and anxiety in children undergoing anaesthesia and dental procedures. CHT has been shown to enhance cooperation in paediatric patients during tooth extractions while significantly lowering both self-reported and observed anxiety levels (Valentine et al., 2019). ¹¹

Randomized clinical trials (RCTs) have demonstrated that CHT effectively reduces anxiety in children undergoing superficial surgery, and serves as a safe and viable alternative to general anaesthesia. It is seen to provide significant benefits for patients undergoing rigid cystoscopy. Hypnosis is a popular medical treatment because it can affect how pain and anxiety are modulated both sensory and affectively.¹²

While some studies report minor or even negative effects, systematic reviews present encouraging findings, highlighting clinical hypnosis can also be considered a potent and effective technique for reducing anxiety.¹³

CHT is a promising and scientifically supported treatment for anxiety disorders. It utilises an individual's natural capacity to enter altered states of consciousness, and guides patients to make specific emotional and cognitive changes that help them experience long-lasting symptom relief. Current evidence supports the wider use of CHT in psychotherapeutic protocols for anxiety as well as its treatment for anxiety and pain disorders.

While further high-quality randomized clinical trials are needed, existing research underscores its potential as an effective therapeutic intervention the author also suggests that the rebranded term C-SAT will offer an unencumbered opportunity to revisit the efficacy of CHT.

Cognitive Behavioural Therapy approaches to Anxiety Disorders

In cognitive behavioural therapy (CBT), the therapeutic process is structured around empathetic communication and a deep understanding of the patient's interpretations of language that may reinforce maladaptive beliefs. CBT incorporates various behavioural techniques, including progressive muscle relaxation (PMR), to promote physical and psychological relaxation. PMR is a two-step process involving the systematic tensing and relaxing of specific muscle groups, which has been shown to effectively reduce anxiety and alleviate tension headaches.

CBT is a treatment for mental health disorders that focuses on identifying and modifying negative thought patterns and behaviours. The therapeutic process involves recognizing underlying issues, becoming aware of one's thoughts, and discussing identified concerns, including self-talk, situational interpretations, and personal beliefs. CBT helps individuals identify and challenge negative thinking patterns that contribute to their difficulties, ultimately reshaping maladaptive perceptions and fostering healthier cognitive and behavioural responses.

CBT helps individuals develop effective problem-solving skills by identifying challenges, generating potential solutions, evaluating their feasibility, and selecting the most appropriate one for implementation. The process also includes practicing adaptive coping strategies, such as relaxation techniques—including deep breathing, progressive muscle relaxation, and guided imagery. Additionally, CBT encourages individuals to confront fears and anxieties through structured exposure exercises and behavioural experiments, promoting resilience and reducing avoidance behaviours.

In 2020, Mahmoud Shirazi and Hadi Anjomshoaa Reza Snagui Moharer conducted an experiment to compare the effects of Neuro-Linguistic Programming and cognitive behavioural therapy on reducing students' stress, anxiety, and depression. The findings showed that both approaches significantly reduced students' stress, anxiety, and depression.¹⁴

It should be remembered that whilst Neuro-Linguistic Programming (NLP) and CHT share some core mechanisms in influencing subconscious processes, cognitive restructuring, and behavioural modification further randomized controlled trials (RCTs) and neuroimaging studies are necessary to establish NLP’s clinical efficacy and its relationship with CHT.

In another study, Ahmadi Malayeri, G., Rahman, and Pourasghar Arabi, M. (2023) examined the impact of Cognitive Behavioural Hypnotherapy (CBH) on distress tolerance and aggression in women with premenstrual dysphoria, demonstrating the effectiveness of an integrated treatment approach.¹⁵ Their findings highlight the success of CBH in addressing emotional regulation challenges associated with the condition.

Similarly, the present research emphasizes the central role of relaxation techniques across therapeutic frameworks. Sheila Menon has made significant efforts to integrate relaxation techniques within a two-dimensional perspective, combining CBT and CHT based on their foundational principles and reinforcing their complementary therapeutic potential.

Recent studies also highlight relaxation techniques as a fundamental component of therapeutic methodologies. Sheila Menon has worked to integrate relaxation methods from the foundational principles of both CBT and CHT creating an two dimensional framework from both disciplines. This integrated model, is termed "Integrated Relaxation Technique" (IRT), comprises relaxation as a core mechanism for facilitating cognitive and emotional regulation. The author notes that anxiety is a primary symptom of wide range of medical and psychological disorders and has therefore intentionally introduced IRT as a part of C-SAT to enhance its efficacy

This relaxation process forms a procedural part of CHT. The initial suggestions are designed to guide the patient conscious focus in a progressively inward direction. Deeper relaxation takes the patient into hypnotic state (trance state) of relaxation where the therapeutic suggestions are most easily accepted and interference from conscious resistance or defence mechanisms are reduced.

The clinical hypnotherapist work is to facilitate the removal of the patients unhealthy thoughts and emotions and replace them with or install (new) healthier thoughts, emotions and responses. This has a similarity to the way the CBT clinician deconstruct the cognitive structure of emotionally unhealthy, irrational thoughts and then reconstructs them into more rational healthy ones. Both processes are designed to foster long-term psychological resilience.

Generalized Anxiety Disorder (GAD) is characterized by a broad range of physical, emotional, and cognitive impairments. Anxiety about making decisions is a defining feature of GAD and both CHT and CBT are widely employed to alleviate symptoms and enhance patient outcomes. 16 The Daitch C (2020) study highlights that a singular treatment modality may be insufficient for addressing the complexities of anxiety disorders. Emerging research highlights the superior efficacy of integrative treatment protocols, which incorporate CBT, CHT, and mindfulness as complementary interventions. When these methodologies are strategically combined, patients experience significant reductions in anxiety symptoms, enhanced self-regulation, and increased future-orientated optimism. This paper provides a structured framework for clinicians seeking to implement evidence-based integrated treatment models, optimizing therapeutic efficacy in anxiety management.¹⁶

Tukaev R presents an integrative theory of hypnosis and hypnotherapy, commonly referred to as universal hypnotherapy, which synthesizes neurobiological mechanisms and communicative processes to enhance therapeutic outcomes. Empirical findings suggest that universal hypnotherapy demonstrates significant efficacy in the treatment of panic disorder and generalized anxiety disorder (GAD) by leveraging its dual framework of neurological modulation and structured hypnotic communication. This approach underscores the potential for targeted cognitive and emotional restructuring, positioning universal hypnotherapy as a clinically viable intervention for anxiety-related disorders.¹⁷

Public speaking anxiety is a prevalent condition that induces significant psychological distress and may lead individuals to avoid situations requiring public speaking. Such avoidance behaviours negatively impact interpersonal relationships, social interactions, and professional functioning (American Psychiatric Association, 1994). ¹⁸. Current evidence supports CBT as the preferred intervention for phobic anxiety disorders, with a primary focus on in-vivo exposure through a graduated hierarchy of feared stimuli.

CHT has been explored as an intervention for the frequently reported concern of public speaking anxiety. It is noted that this treatment can be readily extended and modified for the treatment of simple phobias, generalized social phobia, and other anxiety disorders, even though it was created to address a specific phobia as stated in Schoenberger NE study.¹⁹

A study by Halsband, U., and Gerhard Wolf, T. (2019) the reviewed literature on brain-plasticity changes during hypnosis using electroencephalography (EEG), positron-emission tomography (PET), and functional magnetic resonance imaging (fMRI) Their findings highlight that hypnosis is a potent and effective technique in modulating the fear circuitry structures preventing maladaptive neural responses to anxiety-provoking stimuli.²⁰The study further examined the impact of brief hypnosis in individuals with severe medical procedure phobia, demonstrating its efficacy in reducing fear responses when they (patients) were directly exposed to anxiety-inducing stimuli. Advances in neuroimaging and physiological research have provided deeper scientific insights into the neural mechanisms underlying CHT, drawing evidence from a variety of technological modalities to elucidate its role in fear regulation and emotional processing.²⁰

A further case study presents an overview of the CHT method to treat anxiety and panic attacks in a male patient, Mr. N, ²² who was referred by his general practitioner. Mr. N sought therapy following a series of panic episodes and persistent social anxiety, which had led to avoidant behaviours that significantly impacted his emotional well-being and overall quality of life.

After an initial psychological evaluation, a therapeutic program was implemented to address these concerns. The Volkovyskaya study indicates CHT was employed as a primary intervention to facilitate goal setting, enhance self-confidence, and reduce anxiety levels. The outcomes were highly favourable, with the patient demonstrating significant symptom reduction and positive initiating of social reintegration. By the conclusion of treatment, panic symptoms had nearly disappeared, underscoring the efficacy of CHT in anxiety management.²¹

Previous literature has evidenced cognitive hypnotherapy as effective in reducing anxiety symptoms in women with generalized anxiety disorder. This study utilised a quasi-experimental design to collect data. The randomized selection process recruited 30 women with GAD from the study population. Findings revealed that cognitive hypnotherapy was effective in lowering the anxiety levels of women with generalized anxiety disorder.^{23, 24}

Another previous literature study indicates that the integration of CHT with cognitive therapy is a successful strategy for addressing anxiety issues. The evidence supports the argument that CHT for somatic disorders should gain broader clinical adoption in the future. The present study examines the impact of cognitive hypnotherapy on anxiety patients by employing an evaluation index, followed by an assessment utilizing a neural network model. The experimental findings demonstrate high therapeutic efficacy of cognitive-hypnotherapy integration in the treatment of anxiety disorders, reinforcing its potential as a scientifically validated intervention used to treat anxiety disorders.²⁵

In addition to discussing the potential and efficacy of C-SAT interventions for treating anxiety disorders, the study aims to develop a model for hypnotherapeutic techniques under the Enhanced Focused Empowering Therapy (EFET) framework, to further demonstrate the efficacy of C-SAT in treating anxiety disorders. Sheila Menon the author of this study articulates that transformation in therapeutic models such as renaming the models, enhancing techniques, integrating and rebranding them signifies their utility, growth and overall evolution. Transformation and evolution of psychotherapies, which combined behavioural and cognitive treatment approaches to create CBT, provide evidence of this position.

The "third wave CBT schema therapy"^26–27, which has now developed into its own therapeutic domain, was the result of independent techniques coming together in anticipation of novel therapies. Additional examples can be derived from the collective focus that resulted in "cognitive behavioural analysis system of psychotherapy" (CBASP)²⁹and "CBT emotion-focused therapy"^28.East Asian influences have contributed to the rise in popularity of "mindfulness cognitive therapy," which, when combined with "acceptance and commitment" therapeutic interventions, is becoming increasingly popular.^{30, 31}

The full benefits of hypnosis as a therapeutic intervention will be better served by a rebranding exercise to place clinical hypnotherapy as a psychotherapy, according to Sheila Menon's (2024) analysis, which is based on the literature insights taken from the reviewed article.³²

The author re-branded hypnosis as Conscious-State Altered Therapy (C-SAT) in the article to enhance users' vision and clarity for this approach. To further enhance this understanding the author of this study now defines and renames the clinical hypnosis techniques used in the C-SAT intervention as Enhanced Focused Empowering Techniques (EFET). EFET includes the techniques : induction and relaxation, absorption, dissociation, suggestion and cognitive reframing, guided imagery and imagery and visualization, age regression and affect bridging, and ego-strengthening and post-hypnotic suggestions

CONCLUSION:

A great many people globally suffer from anxiety disorders. This study provides a comprehensive examination of Cognitive Behavioural Therapy (CBT) and Clinical Hypnotherapy (CHT) in the treatment of anxiety disorders, emphasizing the clinical potential of Conscious-State Altered Therapy (C-SAT) and Enhanced Focused Empowering Techniques (EFET). Findings suggest that integrating CHT with CBT enhances therapeutic efficacy, particularly in modulating emotional regulation, cognitive restructuring, and physiological arousal.

By incorporating Integrated Relaxation Technique (IRT) as a structured relaxation component within C-SAT, this study highlights the importance of relaxation in optimizing patient receptivity to therapeutic interventions. EFET, offers a branded structured therapeutic framework, demonstrating that superior engagement with subconscious processes, offers a competitive advantage over traditional CBT in specific intervention procedures.

The study underscores the scientific validity and clinical relevance of C-SAT, positioning it as an innovative and evidence-based psychotherapeutic framework. Future research should explore comparative randomized controlled trials (RCTs) and neurobiological studies to further substantiate C-SAT’s effectiveness. Ultimately, this research advocates for the broader integration of CHT and EFET into mainstream mental health practices, ensuring greater accessibility and recognition as a psychotherapy-based intervention for anxiety disorders.

CONFLICT OF INTEREST:

There is no conflict of interest between authors.

REFERENCES:

1. Roehr B. American psychiatric association explains DSM-5. Bmj. 2013 Jun 6; 346.

2. Craske MG, Stein MB, Eley TC, Milad MR, Holmes A, Rapee RM, Wittchen HU. Anxiety disorders. Nature reviews. Disease primers. 2017 May 4; 3:17024.

3. Szmaglinska M, Andrew L, Massey D, Kirk D. Exploring the Underutilized Potential of Clinical Hypnosis: A Scoping Review of Healthcare Professionals’ Perceptions, Knowledge, and Attitudes. International Journal of Clinical and Experimental Hypnosis. 2024 Apr 2; 72(2):109-38.

4. Fedoce AD, Ferreira F, Bota RG, Bonet-Costa V, Sun PY, Davies KJ. The role of oxidative stress in anxiety disorder: cause or consequence?. Free radical research. 2018 Jul 3; 52(7):737-50.

5. Reid DB. Hypnosis and anxiety.

6. Milling LS. Evidence-based practice in clinical hypnosis. American Psychological Association; 2023.

7. Hammond, D. C. (2018). Hypnosis in the treatment of anxiety- and stress-related disorders. Expert Review of Neurotherapeutics, 18(2), 89-97.

8. Valentine, K. E., Milling, L. S., Clark, L. J., and Moriarty, C. L. (2019). The efficacy of hypnosis as a treatment for anxiety: A meta-analysis. International Journal of Clinical and Experimental Hypnosis, 67(3), 336-363.

9. Oakley, D. A., and Halligan, P. W. (2017). Hypnotic suggestion and cognitive neuroscience. Trends in Cognitive Sciences, 21(8), 589-599.

10. Rothe A, Rich AS, Li ZW. Topics and trends in cognitive science (2000-2017). InProceedings of the Annual Meeting of the Cognitive Science Society 2018 (Vol. 40).

11. Motallebi A, Fathi M, Mazhari F, Hoseinzadeh M, Parisay I. Hypnosis and nitrous oxide impact on the school aged patients’ anxiety and cooperation candidate for tooth extraction: A randomized clinical trial. Heliyon. 2024 Aug 15; 10(15).

12. Tezcan B, Ademoğlu D, Can M, Kazancı D, Mungan I, Taştemur S, Ceylan C, Turan S. A randomized clinical trial on the effect of hypnosis on anxiety and pain in rigid cystoscopy patients. Journal of Endourology. 2021 Jan 1; 35(1):47-53.

13. Wolf TG, Schläppi S, Benz CI, Campus G. Efficacy of hypnosis on dental anxiety and Phobia: A systematic review and meta-analysis. Brain Sciences. 2022 Apr 20; 12(5):521.

14. Anjomshoaa H, Snagui Moharer R, Shirazi M. Comparing the effectiveness of training cognitive behavioral therapy and neuro-linguistic programming strategies on enhancing resilience of high school students in Kerman, Iran. International Journal of Pediatrics. 2020 Aug 1; 8(8):11877-89.

15. Ahmadi Malayeri, G., Rahmani, M. A., and Pourasghar Arabi, M. (2023). The effectiveness of cognitive-behavioral hypnotherapy on distress tolerance and aggression in women with premenstrual dysphoria. aftj,4(1): 157-171

16. Daitch C. Cognitive behavioral therapy, mindfulness, and hypnosis as treatment methods for generalized anxiety disorder. American Journal of Clinical Hypnosis. 2018 Jul 9; 61(1):57-69.

17. Tukaev R. The integrative theory of hypnosis in the light of clinical hypnotherapy. Hypnotherapy and Hypnosis. London: IntechOpen. 2020 Jun 11:41-72.

18. American Psychological Association. 2024 work in America survey: psychological safety in the changing workplace.

19. Schoenberger NE. Cognitive-Behavioral Hypnotherapy for Phobic Anxiety.

20. Halsband, U., and Gerhard Wolf, T. (2019). Functional Changes in Brain Activity After Hypnosis: Neurobiological Mechanisms and Application to Patients with a Specific Phobia—Limitations and Future Directions. International Journal of Clinical and Experimental Hypnosis, 67(4), 449–474.

21. Volkovyskaya E. The use of clinical hypnotherapy in the treatment of social anxiety and panic attacks: a case study. Contemporary Hypnosis and Integrative Therapy. 2020 Mar 1; 34(1).

22. Pournesaei GS, Pooragha Rodbardeh F, Rabiei F. The Effectiveness of Cognitive Hypnotherapy in Reducing the Anxiety of Women with Generalized Anxiety Disorder. Journal of Modern Psychology. 2023 Jan 1; 3(1):50-60.

23. Fuhr K, Bender A, Wiegand A, Janouch P, Drujan M, Cyrny B, Schweizer C, Kreifelts B, Nieratschker V, Batra A. Hypnotherapy for agoraphobia—Feasibility and efficacy investigated in a pilot study. Frontiers in Psychology. 2023 Aug 10; 14:1213792.

24. Zhang H, Yuan X, Mohd Zain NB, Gao Y. Analysis of therapeutic effect of subliminal cognition combined with hypnotherapy on anxiety disorder via neural network. Biotechnology and Genetic Engineering Reviews. 2024 Nov 1; 40(4):3856-73.

25. Kessler RC, Gruber M, Hettema JM, Hwang I, Sampson N, Yonkers KA. Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychological medicine. 2008 Mar; 38(3):365-74.

26. Churchill R, Moore TH, Furukawa TA, et al. ‘Third waveand#39; cognitive and behavioural therapies versus treatment as usual for depression. The Cochrane Library 2013; 10:1–47.

27. Young JE, Mattila DE. Schema-focused therapy for depression. In: Reinecke MA, Davison MR, eds. Depression: A Practitionerand#39;s Guide to Comparative Treatments, New York: Springer. , 2007:2007, 291–313. 9

28. Greenberg LS, Watson JC. Emotion-focused therapy for depression. Washington: American Psychological Association, 2006.

29. McCullough JP. Treatment for chronic depression: Cognitive behavioral analysis system of psychotherapy (CBASP). J Psych other Integr 2003; 13:241–63.

30. Teasdale JD, Segal ZV, Williams JMG, et al. Prevention of relapse/ recurrence inmajor depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000; 68:615–23.

31. Hayes SC, Luoma JB, Bond FW, et al. Acceptance and commitment therapy model, processes, and outcomes. Behav Res Ther 2006; 44:1–25.

32. Menon S, Bhagat V. Making a Case for Hypnosis: Using the RE-AIM Framework to Recognize Hypnosis as a Stand-Alone Therapeutic Intervention within Healthcare and Educational Systems. Research Journal of Pharmacy and Technology. 2024 Feb 20; 17(2):953-62.

Received on 03.09.2024 Revised on 08.11.2024

Accepted on 13.12.2024 Published on 28.01.2025

Available online from February 27, 2025

Research J. Pharmacy and Technology. 2025;18(2):935-943.

DOI: 10.52711/0974-360X.2025.00137

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Therapies.	CBT	CHT
1. Cognitive Behavioural Therapy (CBT) 2. Clinical Hypnosis Therapy (CHT)	Relaxation techniques and cognitive restructuring techniques used in managing stress, anxiety, and various mental health conditions	Relaxation and cognitive restructuring techniques, Woking with subconscious beliefs and automatic thoughts.
Behavioural or physical symptoms treatment	Progressive muscle relaxation, diaphragmatic breathing: Guided imagery	Guided imagery on progressive muscle restriction and relaxation, diaphragmatic breathing, and guided imagery to establish associations with previous emotional or physiological states, direct suggestions for relax and increase focus attention of thoughts or sensations of relaxation.
Cognitive restructuring	Socratic questioning: to analyse and evaluate actual thoughts Thought records Behavioural experiments: Generating alternatives:	Identifying and challenging negative automatic thoughts. Reframe negative thoughts to line up with reality thus reduce impact of negative emotions. Seeing problem with new and realistic perspectives and revisiting past to bring emotional release by new experiences. Metaphorical suggestions to establish new associations and thoughts replacing previous unwanted thoughts
Procedures	Uses relaxation methods like deep breathing, muscle relaxation, and visualization, practicing adaptive skills, facing fears and anxieties, and participating in behavioural experiments or exposure exercises.	Includes Relaxation, absorption, dissociation, suggestion and cognitive reframing, metaphor, guided imagery, direct and indirect suggestion, imagery, age regression and bridging, ego-strengthening and post-hypnotic suggestions

CBT and CHT similarities	Thought records, Exposure therapy, Invitro followed by exposure therapy Socratic questioning similar to CBT and CHT.
Note: selected two therapeutic intervention above for anxiety, depression, and pain are seen with similarity in their approach but they have difference in their perspectives.