Attitudes and Beliefs of Hypnosis amongst Mental Health Professionals and the Impact on the Availability of Hypnosis Training in Counseling Training Programs
Abstract
Nine out of ten general practitioners are approached by their patients for information regarding alternative and complementary therapies, including hypnotherapy, and three out of four GPs provide referalls for hypnotherapy (Hall & Giles-Corti, 2000). A minority of healthcare providers, however, has ever received formal education and training in hypnosis, and a majority relies on lay information from the media and other non-authoritative sources to form its opinions about the merits or demerits of hypnotherapy. Mental healthcare standards dictate that clinical referrals must be based on the most up-to-date knowledge about best practices in mental health, and doctors who remain uninformed about the services they provide referrals for place their patients’ health at risk. Thus, it is important for hospitals and medical schools to offer training in hypnosis and hypnotherapy. This research endeavors to determine the degree to which professional attitudes regarding hypnosis have an impact on the availability of hypnosis training in counseling training programs. The study sample includes program chairs for doctoral programs at various medical schools throughout the United States, and clinical directors of mental health services at psychiatric hospitals throughout the country. The study design implements questionnaires to gauge participants’ attitudes toward hypnosis, and uses statistical methods to determine their correlation to hypnosis training outcomes.
Past studies (Thomson, 2003) have shown that a majority of healthcare professionals refer their patients to alternative and complementary therapies that include hypnosis, without personally having received any formal education or training in the subject of hypnosis itself. When professionals rely on lay knowledge to provide patients with advice on hypnotherapy, they may lose their credibility, and put their patients’ health at risk by inadvertently referring patients to unqualified and unlicensed care providers. Mental health standards dictate that referrals must be based on the most current knowledge of best practices. Thus, it is important to understand how hypnosis training as a part of counseling training programs may be affected by the attitudes and beliefs of mental health professionals.
Purpose and Significance of Proposal
The purpose of this study is to determine the prevailing trend in professional attitudes toward hypnosis, and to evaluate its impact on the integration of hypnosis training into counseling training programs. This study will have implications for how hypnosis training will be implemented in holistic training programs for mental health professionals in the future.
Research Question
The research question is, “how do professional attitudes towards hypnosis correlate with the inclusion of hypnosis training in counseling training programs?”
Hypothesis
Favorable attitudes toward hypnosis amongst program chairs and clinical mental health directors will be found to correlate positively with the availability of hypnosis training in doctoral programs and hospitals. Conversely, unfavorable attitudes toward hypnosis amongst program chairs and clinical mental health directors will be found to correlate negatively with the availability of hypnosis training in doctoral programs and hospitals.
Literature Review
Hypnosis is a beneficial therapeutic practice that is widely misunderstood by both health providers and laypeople. Misperceptions about hypnosis are common amongst the general public, whose understanding is often inaccurately shaped by the media, presentations of hypnosis in films and TV shows, and stage performers. According to multiple studies (Echterling & Emmerling, 1987; Large & James, 1991), people whose understanding of hypnosis has been shaped by these sources are more likely to view hypnosis in a negative light. Conversely, when people have been given accurate information about hypnosis, they are more likely to have a positive opinion about the practice, and are subsequently more receptive to the idea of trying hypnosis therapy (Echterling & Whalen, 1995). Furthermore, those who have been educated about hypnosis by medical and psychological clinicians were found to have the most willingness to try hypnotic therapy (Johnson & Hauck, 1999).
A review of the available literature indicates that although the vast majority of medical healthcare professionals recommend alternative therapies, including hypnotherapy, to patients, few providers have ever received professional education on the subject of hypnosis. Hall and Giles-Corti (2000) examined the attitudes and referral patterns of general health practitioners in Australia regarding hypnosis. They found that 90% of GPs had been requested by patients to advise on complementary therapies including hypnosis, and 75% had provided referrals for complementary therapies, with hypnosis therapy being the most common. However, less than half of the physicians surveyed had ever studied about the complementary therapies they provided advice on, and three out of five stated a desire for further training on the subject. In a 1996 survey of physicians and residents in Central Texas, four out of five physicians and 2 out of 3 residents reported interest in further education in hypnotherapy (Elkins & Wall, 1996). A study by Pirotta et al. (2000) further determined that only 20% of GPs had training in hypnosis, despite 80% of them providing referrals for hypnosis, acupuncture, and meditation. Among allopathic physicians, meanwhile, current research (Borkan, Neher, Anson, and Smoker, 1994) indicates that physicians’ knowledge of hypnosis has no bearing on the likelihood that they will refer patients for complementary therapies including hypnosis.
Hypnosis therapy appears to be poorly accepted and underutilized in academia as well. Walling, Baker and Dott (1998) looked at the attitudes of program chairs toward hypnosis training in doctoral programs. Out of 170 programs, only forty-four (or 25%) were found to offer hypnotherapy course work. In an investigation of nurse practitioner programs, Rauckhorst (1997) found that slightly more than one in three, at 37%, included training in alternative therapy courses.
Research Method and Design
The research methodology will be retrospective in nature, and will include both qualitative and quantitative research methods. It will involve the collection and analysis of qualitative survey data from study subjects from various medical schools throughout the United States. Statistical analysis methods will be used to determine the correlation between subjective attitudes and beliefs towards hypnosis amongst mental health professionals and objective rates of integration of hypnosis training into counseling training programs.
Target Population and Sampling Technique
The target population will include program chairs from doctoral programs at various medical universities throughout the United States. In the US, there are 141 accredited MD-granting educational institutions. Invitations to participate in this study will be sent out to the program chairs of the clinical mental health counseling programs at each of these institutions where mental health counseling training and certification is offered. The clinical directors of mental health services at each of the 403 psychiatric hospitals in the United States will also be contacted. As such, this study utilizes a non-random sampling design in the recruitment of subjects. The study subjects will not receive compensation for their participation. The sample size has not been set, but it is expected to include between 300 and 500 participants across both sources (hospitals and medical schools).
Instruments Used
The instruments used in the data collection process will include questionnaires, to be distributed electronically over the internet, using an online survey development software called SurveyMonkey. The instruments used in the data analysis process will include statistical analysis software such as Microsoft Excel.
Data Collection Procedures
The collection of data in this study will be accomplished with the use of questionnaires. Each questionnaire will consist of demographic questions, as well as multiple-choice questions designed to gauge participants’ attitudes towards and understanding of hypnosis and hypnotherapy. The questionnaires will include questions regarding participants’ beliefs about the place of hypnosis in mainstream medicine, about the usefulness of hypnotherapy as a relaxation technique, about the usefulness of hypnotherapy as a self-regulation technique, and about perceptions of employee interest in hypnosis training courses. These questions will implement a Likert-type scale (Thomoson, 2003) to allow participants to measure their beliefs and attitudes along a continuum. Finally, the questionnaire will inquire to the degree of availability of hypnosis courses and training program at the study subjects’ associated institutions.
Data Analysis Procedures
The method of parametric statistics known as the analysis of covariance, or ANCOVA, will be used to show the type of relationships among the variables, that is, the answers to the demographic questions and multiple-choice questions, and the relative strengths of those variables in relation to the availability of hypnosis training at the institutions from which the participants are drawn. Analysis of covariance is thought to be an appropriate method because the research will examine objective and subjective variables for the purpose of predicting outcomes. The study will code two types of variables. The first type, nominal, will include information about participants’ location, title, and duration of their career. The second type of variable that will be coded is ratio, for the dependent variables of scores on the Likert-type scale.
Definition of Terms
Hypnosis: hypnosis is defined as the act of inducing a state of consciousness in people, in which they appear to lose the power to act according to their own free will, and in which they are highly receptive to the suggestion of the person hypnotizing them. The technique of hypnosis is often used in psychiatric therapy to modify patients’ behavior by suggestion.
Hypnotherapy: hypnotherapy is defined as the use of hypnosis in therapy.
Likert-type scale: A psychometric scale frequently used in research that involves the use of questionnaires, named after its inventor, Rensis Likert. On the Likert-type scale, answers are scored along a range, generally from 1 to 5 or 1 to 10. The range is meant to elucidate the intensity of answerers’ feelings toward a given question of interest.
Assumptions
The successful implementation of the study design will require that certain assumptions will be met. The first assumption is that enough study participants will be available for recruitment for the study to be considered representative of the population from which the participants are selected. This has implications for the external validity of the research. External validity refers to the generalizability of the conclusions reached. If the sample size is too small, then the research will have low external validity, and the conclusions reached will not be generalizable to the healthcare profession as a whole. The second assumption involves the validity of the chosen statistical method used in the analysis of the data. The use of ANCOVA requires that the relationship between the independent variable and the covariate is linear. In the case of this study, the independent variable is study subjects’ answers to the Likert-type questions on the questionnaire. The covariate is the degree of availability of hypnosis courses and training programs at associated institutions.
Limitations
This study will be subject to certain influences that will be outside of the researchers’ control. The study will be subject to at least one study design limitation. The purpose of the research is to determine how professional attitudes toward hypnosis have an impact on the incorporation of hypnosis training into counseling training programs. As such, the purpose of the study is to infer a cause-effect relationship between an independent variable and a dependent variable. As it is currently designed, the study cannot lead to conclusions about cause and effect. Rather, it can only demonstrate a correlation between the independent variable of professional attitudes, and the dependent variable of the degree of availability of hypnosis training programs at associated institutions.
Expected Outcome
The research will be carried out successfully, and the results will lead to the conclusion that the hypothesis is proven.
References
Borkan, J., Neher, J. O., Anson, O., & Smoker, B. (1994). Referrals for alternative therapies. Journal of Family Practice, 39(6), 545-551.
Echterling, L. G., & Emmerling, D. A. (1987). Impact of stage hypnosis.American Journal of Clinical Hypnosis, 29(3), 149-154.
Echterling, L. G., & Whalen, J. (1995). Stage hypnosis and public lecture effects on attitudes and beliefs regarding hypnosis. American Journal of Clinical Hypnosis, 38(1), 13-21.
Elkins, G. R., & Wall, V. J. (1996). Medical referrals for hypnotherapy: Opinions of physicians, residents, family practice outpatients, and psychiatry outpatients. American Journal of Clinical Hypnosis, 38(4), 254-262.
Hall, K., & Giles-Corti, B. (2000). Complementary therapies and the general practitioner. A survey of Perth GPs. Australian Family Physician, 29(6), 602-606.
Johnson, M. E., & Hauck, C. (1999). Beliefs and opinions about hypnosis held by the general public: A systematic evaluation. American Journal of Clinical Hypnosis, 42(1), 10-20.
Large, R. G., & James, F. R. (1991). Public expectations of hypnosis.Australian Journal of Clinical & Experimental Hypnosis.
Pirotta, M. V., Cohen, M. M., Kotsirilos, V., & Farish, S. J. (2000). Complementary therapies: have they become accepted in general practice?.Medical journal of Australia, 172(3), 105-109.
Rauckhorst, L. (1997). Integration of complementary therapies in the nurse practitioner curriculum. Clinical Excellence for Nurse Practitioners, 1, 257-265.
Thomson, L. (2003). A project to change the attitudes, beliefs and practices of health professionals concerning hypnosis. American Journal of Clinical Hypnosis, 46(1), 31-44.
Walling, D. P., Baker, J. M., & Dott, S. G. (1998). Scope of hypnosis education in academia: results of a national survey. International journal of clinical and experimental hypnosis, 46(2), 150-156.
