Pedicatric Oncology & Hypnosis

Summary of Medical Literature — Hypnosis

A range of studies reporting on hypnosis in the pediatric oncology population have been conducted. Studies listed below are grouped by category: anticipatory nausea and vomiting, pain and anxiety, and case reports.

 

 

 

Anticipatory Nausea and Vomiting

Hawkins P, Liossi C, Ewart B, et al. Hypnotherapy for control of anticipatory nausea and vomiting in children with cancer: Preliminary findings. Psycho-Oncology. 1995; 4: 101-6.

Summary: Pediatric oncology patients often experience significant chemotherapy related nausea and vomiting (NV). A number of controlled studies have shown that a variety of behavioral interventions are effective in treating both anticipatory and postchemotherapy NV. The present randomised, controlled-design study aims to assess the possible therapeutic gains that may be derived from hypnosis while controlling for gains that may be derived from non-specific therapeutic factors. Thirty paediatric oncology patients (5-17 years of age), following baseline assessment, were randomly assigned to one of three groups--' treatment as usual' control group, therapist contact group, and a hypnosis training group-- during an identical chemotherapy pulse. Statistical analysis demonstrates the effectiveness of hypnosis for the reduction of anticipatory nausea and vomiting. Therapist contact alone was also found to be effective in reducing anticipatory nausea but it is suggested that this may be a statistical rather than a clinical effect. The results of the present study suggest that hypnosis is effective in the treatment of ANV in children.

 

Jacknow D, Tschann J, Link M, et al. Hypnosis in the prevention of chemotherapy-related nausea and vomiting in children: A prospective study. Journal of Developmental and Behavioral Pediatrics. 1994; 15: 258-64.

Abstract: To study the effectiveness of hypnosis for decreasing antiemetic medication usage and treatment of chemotherapy-related nausea and vomiting in children with cancer, we conducted a prospective, randomized, and controlled single-blind trial in 20 patients receiving chemotherapy for treatment of cancer. Patients were randomized to either hypnosis or standard treatment. The hypnosis group used hypnosis as primary treatment for nausea and vomiting, using antiemetic medication on a supplemental (p.r.n.) basis only, whereas the control group received a standardized antiemetic medication regimen. Nausea, vomiting, and p.r.n. antiemetic medication usage were measured during the first two courses of chemotherapy. Anticipatory nausea and vomiting were assessed at 1 to 2 and 4 to 6 months postdiagnosis. Patients in the hypnosis group used less p.r.n antiemetic medication than control subjects during both the first (p < .04) and second course of chemotherapy (p < .02). The two groups did not differ in severity of nausea and vomiting. The hypnosis group experienced less anticipatory nausea than the control group at 1 to 2 months postdiagnosis (p < .02). Results suggest self-hypnosis is effective for decreasing antiemetic medication usage and for reducing anticipatory nausea during chemotherapy.

 

Contanch P, Hockenberry M, Herman S. Self-hypnosis as antiemetic therapy in children receiving chemotherapy. Oncology Nursing Forum. 1985; 12:4; 41-6.

Abstract: The purpose of the study was to examine the efficacy of the behavioral intervention of relaxation/self hypnosis (IRtx) as antiemtic therapy in children receiving chemotherapy. Twenty children were identified by their attending oncologists as experiencing troublesome chemotherapy nausea and vomiting. The children were randomized into an experimental group (trained in IRtx) and a control group who received standard preparation (SP) and were then followed for four courses of chemotherapy (two baseline and two follow-up). Data were gathered on amount, frequency, intensity of vomiting; amount, duration, and intensity of nausea; oral intake; and type, amount and frequency of antiemetics administered for 24 hours following chemotherapy using both self report from the children and charting from the attending nurse. In the experimental group, there was significant reduction in nausea and vomiting both in intensity and severity, and a significant increase in oral intake post chemotherapy. There was no change in antiemetic administration between groups. This study suggests that chemotherapy related nausea and vomiting in children can be reduced and oral intake improved with the use of a behavioral intervention.

 

Zeltzer L, LeBaron S, Zeltzer PM. The effectiveness of behavioral intervention for reduction of nausea and vomiting in children and adolescents receiving chemotherapy. Journal of Clinical Oncology. 1984; 2(6): 683-90.

Abstract: Fifty-one children 6-17 years of age rated the severity of nausea, vomiting, and the extent to which chemotherapy bothered them during each course of chemotherapy. Sixteen patients had no symptoms and the doses administered to 16 others were not constant so that matched courses could not be assessed. After baseline measurement of two matched courses, the remaining 19 patients were randomized to receive hypnosis or supportive counseling during two more matched courses. An additional course with no intervention was assessed in half of the patients. No significant reduction of symptoms was demonstrated prior to intervention. However, intervention with both hypnosis and supportive counseling was associated with significant reductions in nausea, vomiting, and the extent to which these symptoms bothered patients (all p less than 0.001). Also, after termination of intervention, symptom ratings remained significantly lower than baseline. The data indicate that chemotherapy-related nausea and emesis in children can be reduced with behavioral intervention and that reductions are maintained after intervention has been discontinued. © 1984 by the American Society of Clinical Oncology

 

Zeltzer L, Kellerman J, Ellenberg L, Dash J. Adolescents with cancer. Hypnosis for reduction of vomiting associated with chemotherapy and disease in adolescents with cancer. Journal of Adolescent Health Care. 1983; 4(2): 77-84.

Abstract: Eighteen adolescents with cancer were trained in hypnosis to ameliorate the discomfort and anxiety associated with bone marrow aspirations, lumbar punctures, and chemotherapeutic injections. Two patients rejected hypnosis. The remaining 16 adolescents achieved significant reductions in multiple measures of distress after hypnosis training. Preintervention data showed no pattern of spontaneous remission or habituation, and, in fact, an increasing anticipatory anxiety was observed before hypnotic treatment. Group reductions in pain and anxiety were significant at levels ranging from p less than 0.02 to p less than 0.002 (two-tailed t-tests). Significant reductions were also found in Trait Anxiety. A non-significant trend toward greater self-esteem was present. The predicted changes in the Locus of Control and General Illness Impact were not found. Comparisons between hypnosis rejectors and successful users unusually showed higher levels of pretreatment anxiety in the former. The pragmatic nature of hypnosis as part of comprehensive medical care in oncology is noted. © 2008 Elsevier B.V.

Pain & Anxiety

Liossi C, White P, Hatira P. A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain pf paediatric patients. Pain. 2009; 142 (3): 255-263.

Venepuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anaesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venepuncture-induced pain and anxiety in 45 paediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents' anxiety levels during their child's procedure. Patients were randomized to one of three groups: local anaesthetic, local anaesthetic plus hypnosis, and local anaesthetic plus attention. Results confirmed that patients in the local anaesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioural distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anaesthetic plus hypnosis condition experienced less anxiety during their child's procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up. The present findings are particularly important in that this study was a randomized, controlled trial conducted in a naturalistic medical setting. In this context, convergence of subjective and objective outcomes was reached with large effect sizes that were consistently supportive of the beneficial effects of self-hypnosis, an intervention that can be easily taught to children, is noninvasive and poses minimal risk to young patients and their parents.

 

Liossi C, White P, Hatira P. Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain. Health Psychology. 2006; 25(3): 307-315.

Abstract: A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention. Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently. © 2006 APA.

 

Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology patients. International Journal of Clinical and Experimental Hypnosis. 2003; 51(1): 4-28.

Abstract: This prospective controlled trial investigated the efficacy of a manual-based clinical hypnosis intervention in alleviating pain in 80 pediatric cancer patients (6-16 years of age) undergoing regular lumbar punctures. Patients were randomly assigned to 1 of 4 groups: direct hypnosis with standard medical treatment, indirect hypnosis with standard medical treatment, attention control with standard medical treatment, and standard medical treatment alone. Patients in the hypnosis groups reported less pain and anxiety and were rated as demonstrating less behavioral distress than those in the control groups. Direct and indirect suggestions were equally effective, and the level of hypnotizability was significantly associated with treatment benefit in the hypnosis groups. Therapeutic benefit degraded when patients were switched to self-hypnosis. The study indicates that hypnosis is effective in preparing pediatric oncology patients for lumbar puncture, but the presence of the therapist may be critical.

 

Liossi C, Hatira P. Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations. The International Journal of Clinical and Experimental Hypnosis. 1999; 47(2): 104-116.

Abstract: A randomized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral (CB) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients (age 5 to 15 years) undergoing bone marrow aspirations. Patients were randomized to one of three groups: hypnosis, a package of CB coping skills, and no intervention. Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline. Hypnosis and CB were similarly effective in the relief of pain. Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group. It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration.

 

Harper G. A developmentally sensitive approach to clinical hypnosis for chronically and terminally ill adolescents. American Journal of Clinical Hypnosis. 1999; 42(1): 50-60.

Abstract (Case Series): Adolescents who suffer from terminal and/or chronic medical illnesses must face difficult developmental issues coupled with increased burdens of physical discomfort and uncertainty about survival. Clinical hypnosis is one technique that can be used to help these individuals gain a sense of comfort and control over their lives. I describe the use of a developmentally sensitive hypnotherapeutic intervention for chronically and terminally ill adolescents. I have used the technique for the reduction of various types of physical and psychological discomfort secondary to a range of medical problems such as cancer, end-stage renal disease, organ transplant, and HIV disease. The treatment focuses on the use of personalized procedures that attempt to increase perceptions of control through interactive formats. Movement through a personally intriguing journey is used as a metaphor for controlling and moving away from discomfort. I also present three case examples as well as general treatment recommendations for clinical use.

 

Hockenberry M. Relaxation techniques in children with cancer:  The nurse's role. Journal of Pediatric Oncology Nursing. 1998; 5: 1&2; 7-11.

Abstract (Case Series): Relaxation techniques used to decrease the deleterious side effects of cancer therapy are now accepted approaches at most institutions. Utilization of these methods by nurses can offer effective coping strategies for children with cancer. Those individuals most intimately involved in the care of the child can provide a trusting relationship that will facilitate more effective use of relaxation techniques. Involvement of parents with these methods can enhance the utilization of these techniques while increasing their involvement in the child's care.

 

Hawkins PJ, Liossi C, Ewart BW, Hatira P, Kosmidis VH. Hypnosis in the alleviation of procedure related pain and distress in paediatric oncology patients. Contemporary Hypnosis. 1998; 15(4): 199-207.

Abstract: The aims of this study were: (1) to evaluate two different therapeutic approaches, namely direct versus indirect suggestions, in reducing pain during lumbar punctures; and (2) to explore the relationship between hypnotizability and outcome. Thirty children with leukaemia and non-Hodgkin's lymphoma who were undergoing regular lumbar punctures were randomly allocated to two groups. In one group, children were hypnotized and given direct suggestions associated with pain relief whilst undergoing lumbar puncture. In the second group children were given indirect hypnotic suggestions associated with pain relief. After hypnotic intervention, there was a statistically significant reduction over baseline for pain and anxiety during lumbar punctures in both groups. Direct and indirect methods were found to be equally effective. The level of hypnotizability was significantly associated with the magnitude of treatment outcome.

 

Zeltzer LK, Dolgin MJ, LeBaron S, LeBaron C. A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. Pediatrics. 1991; 88(1): 34-42.

Abstract: Fifty-four pediatric cancer patients were studied to determine the relative efficacy of two forms of behavioral intervention for reducing chemotherapy-related distress. Following baseline assessment, subjects were randomly assigned to receive either hypnosis, non-hypnotic distraction/relaxation, or attention placebo (control) during the subsequent identical chemotherapy course. Observational and interview measures of anticipatory and postchemotherapy nausea, vomiting, distress, and functional disruption served as outcome data. Results indicated that treatment condition was the single best predictor of change from baseline to intervention, with children in the hypnosis group reporting the greatest reduction of both anticipatory and postchemotherapy symptoms. The cognitive distraction/relaxation intervention appeared to have a maintenance effect in which symptoms did not get much worse or much better, while children in the control group had symptoms that consistently became worse over time. Emetic potential of the chemotherapy and the prophylactic use of antiemetics each appeared to contribute to the overall severity of symptoms. While the efficacy of hypnosis in the management of chemotherapy distress is supported, the complexities of interacting biologic and psychologic factors are highlighted. © 1991 American Academy of Pediatrics

 

Hockenberry-Eaton M, Contach PH. Evaluation of a child's perceived self-competence during treatment for cancer. Journal of Pediatric Oncology Nursing. 1989; 6(3): 55-62.

Abstract: The purpose of this study was to evaluate the effect of self-hypnosis on the perceived self-competence of children undergoing treatment for cancer and to determine longitudinal differences in perception of self-competence over time. Twenty-two children were randomized into an experimental group (taught self-hypnosis) and a control group (given standard care). Data were collected using the Harter Perceived Self-Competence Profile (HPSCP) during four courses of chemotherapy. A decrease in mean scores for the control group was found compared with the hypnosis group, which showed an increase in mean scores in five of six domains. Both groups showed a statistically significant increase in the scholastic cognitive domain and social acceptance domain from the time of diagnosis compared with the second test period. Ten children had a visible physical disability. These children were found to have significant decreases in the domains of athletic competence, social acceptance, and global self-worth. Decreases remained significant throughout all test periods in the athletic competence domain for the children with a visible physical disability. This study is unique in that the researchers evaluated children's perception of self-competence over time. These findings support previous studies and identify the need for nurses to become actively involved in helping children develop effective coping skills during chemotherapy for cancer.

 

Wall V, Womack W. Hypnotic versus active cognitive strategies for alleviation of procedural distress in pediatric oncology patients. American Journal of Clinical Hypnosis. 1989; 31: 181-91.

Abstract: This study provided a differential comparison of the efficacy of standardized instruction in hypnosis or active cognitive strategy for provision of relief from procedurally induced pain and anxiety. Subjects were instructed to self-direct in the use of strategies during medical procedures. Twenty pediatric oncology patients participated in the study. They were not informed that hypnosis was one of the strategies. Subjects were screened for hypnotizability and randomly assigned to treatments. Demographic data were collected. Pre-strategy training observations were made during a Bone Marrow Aspiration or Lumbar Puncture (BMA/LP) using visual analog scales, the McGill Pain Questionnaire, State-Trait Anxiety Inventory, pulse and temperature readings, and interview. Following strategy training, data were collected during a second BMA/LP using the same measures as employed pre-intervention. Results indicated that both strategies were effective in providing pain reduction. Neither technique provided for anxiety reduction. Hypnotizability scale scores failed to correlate with degree of pain reduction.

 

Kuttner L, Bowman M, Teasdale M. Psychological treatment of distress, pain, and anxiety for young children with cancer. Journal of Developmental and Behavioral Pediatrics. 1988; 9: 374-82.

Abstract: The study compared the efficacy of hypnotic "imaginative involvement," behavioral distraction and standard medical practice for the reduction of pain, distress and anxiety in children with leukemia, during bone marrow aspirations. Two age groups of children, 3 to 6, and 7 to 10 years, were randomized to the three treatment groups. Two intervention sessions were given. At first intervention, observational ratings of distress indicated significant reductions for the younger group in the hypnotic treatment, whereas the older group achieved significant reductions in both treatment conditions for observer-rated pain and anxiety. At second intervention, all groups showed reductions and the control group appeared to be contaminated. The hypnotic method with its internal focus had an all-or-none effect, whereas distraction appeared to require that coping skills be learned over one session or more. © 2000-2007 Ovid Technologies, Inc.

 

Katz E, Kellerman J, Ellenberg L. Hypnosis in the reduction of acute pain and distress in children with cancer. Journal of Pediatric Psychology. 1987; 12: 379-94.

Abstract: Hypnosis has been used as a behavioral approach to help children tolerate aversive medical procedures more effectively, but empirical longitudinal research evaluating the outcome of such interventions has been limited. In the present study, 36 children with acute lymphoblastic leukemia between the ages of 6 and 12 years of age undergoing repeated bone marrow aspirations (BMAs) were randomized to hypnosis or play comparison groups. Subjects were selected on their behavioral performance on baseline procedures and received interventions prior to their next three BMA procedures. Major results indicated an improvement in self-reported distress over baseline with both interventions, with no differences between them. Girls exhibited more distress behavior than boys on three of four dependent measures used. Suggestions of an interaction effect between sex and treatment group were noted. The role of rapport between patient and therapist in therapeutic outcome was also evaluated. Results are discussed in terms of potential individual differences in responding to stress and intervention that warrant further research. © 2008 Society of Pediatric Psychology.

 

Zeltzer L, LeBaron S. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. The Journal of Pediatrics. 1982; 101: 1032-1035.

Abstract: Hypnosis was compared with nonhypnotic behavioral techniques for efficacy in reducing pain and anxiety in 27 children and adolescents during bone marrow aspiration and in 22 children and adolescents during lumbar puncture. The patients and independent observers each rated (scale of 1 to 5) pain and anxiety during one to three procedures prior to intervention and one to three procedures with intervention. Prior to intervention for both groups, pain during bone marrow aspiration was rated as more severe (p<0.01) than pain during lumbar puncture. During bone marrow aspiration pain was reduced to a large extent by hypnosis (p<0.001) and to a smaller but significant extent by nonhypnotic techniques (p<0.01), and anxiety was significantly reduced by hypnosis alone (p<0.001). During lumbar puncture only hypnosis significantly reduced pain (p<0.001); anxiety was reduced to a large degree by hypnosis (p<0.001) and to a smaller degree by nonhypnotic techniques (p<0.05). Thus hypnosis was shown to be more effective than nonhypnotic techniques for reducing procedural distress in children and adolescents with cancer.© 2008 Elsevier B.V.

 

Hilgard J, LeBaron S. Relief of anxiety and pain in children and adolescents with cancer: Quantitative measures and clinical observations. International Journal of Clinical and Experimental Hypnosis. 1982; 30: 417-22.

Abstract: Children and adolescents with cancer, chiefly forms of leukemia, aged 6 to 19 years, underwent medical treatments which required repeated bone marrow aspirations, normally a painful and anxiety-provoking experience. Data were obtained in baseline bone marrow observations on 63 patients, who were then offered the opportunity to volunteer for hypnotic help in pain control. Of the 24 patients who accepted hypnosis, 19 were highly hypnotizable. 10 of the 19 reduced self-reported pain substantially by the first hypnotic treatment (the prompt pain reducers) and 5 more reduced self-reported pain by the second treatment (the delayed pain reducers) while none of the 5 less hypnotizable patients accomplished this. The latter benefited by reducing anxiety. Short case reports illustrate the variety of experiences. Analysis of baseline observations before any therapeutic intervention revealed age and sex differences. The difference between self-reported and observed pain was not statistically significant for patients under age 10 but was significant for the patients age 10 and older (p < .001). There were minor but significant sex differences both in observed pain (p < .01) and in self-reported pain (p < .05), with the females reporting more pain.

Case Reports

Silva M. 'May the force be with you' hypnotherapy with a leukemic child. Psychotherapy Private Practice. 1990; 8: 49-54.

Abstract (Case Report): Hypnotic intervention with a four year old male child suffering from leukemia is discussed. The process involved three one hour sessions in the therapist's office and two sessions at the hospital. Successful results were achieved in reducing the child's fear of the surgical procedure and related pain.

 

Kaufman K, Tarnowski K, Olson R. Self-regulation treatment to reduce the aversiveness of cancer chemotherapy. Journal of Adolescent Health Care. 1989; 10: 323-7.

Summary: In an A-B design, the effectiveness of a multicomponent intervention for reducing chemotherapy-associated nausea and emesis in an 11-year-old cancer patient was evaluated. A highly structured, time-limited, self-regulation treatment was implemented that consisted of patient and parent instruction in self-hypnotic methods, cue-controlled relaxation, and guided imagery. Practice of the self-regulation methods at home and in vivo (clinic setting) in the absence of chemotherapy infusion were emphasized to promote skill acquisition and cross-setting generalization. Dependent variables included self-reported nausea intensity and parental report of duration of the patient's sleep and vomiting frequency. Data were obtained before, during, and following chemotherapy for baseline and self-regulation treatment phases across five cycles of chemotherapy that occurred over a 5-month period. During the intervention phase, a marked and clinically significant reduction in self-reported nausea and parent-observed vomiting were noted as well as a concurrent increase in sleep duration. The integrity of patient self-report and parental observations were supported by clinic staff anecdotal data. Treatment limitations and cost-effectiveness are discussed as well as the use of this intervention with adolescent patients.

 

LaClave L, Blix S. Hypnosis in the management of symptoms in a young girl with malignant astrocytoma: A challenge to the therapist. International Journal of Clinical and Experimental Hypnosis. 1989; 37:6-14.

Abstract (Case Report): This paper presents the case of a 6.5-year-old girl with malignant astrocytoma of the left brain hemisphere. During the course of her chemotherapy treatment, severe vomiting developed to the degree that on several occasions she became dehydrated. Discontinuation of chemotherapy was being considered when she was referred for hypnotherapy. Despite severe neurological impairments which excluded many traditional techniques, hypnosis was successful in eliminating emesis. Hypnosis was also utilized to decrease pain and to improve sleep patterns. Drawings are presented to help show how this child resolved anxiety associated with treatment and fears surrounding the knowledge of her impending death.

 

Ellenberg L, Kellerman J, Dash J. Use of hypnosis for multiple symptoms in an adolescent girl with leukemia. Journal of Adolescent Health Care. 1980; 1:132-6.

Abstract (Case Report): An adolescent girl with chronic myelogenous leukemia was treated with hypnosis for several disease- and treatment-related problems during the last 4 months of her life. Data were collected before and after hypnosis on the nature and intensity of the patient's acute pain and anxiety during bone marrow aspirations, chronic headache and backache, nausea and vomiting during chemotherapy, anorexia, and the discomfort associated with spiking temperatures. Comparisons of baseline and posthypnosis reports suggest that hypnosis was successfully used for acute and chronic pain, anxiety, unpleasant body sensations and, possibly, nausea and vomiting. The hypnotic techniques used, the limitations of hypnosis and clinical issues in this case are presented and discussed.

 

Mille JA. Hypnosis in a boy with leukemia. The American Journal of Clinical Hypnosis. 1980; 22: 231-235.

Case Report : A case history of a 9-year old boy with ALL who had tremendous anxiety over his illness. His anxiety interfered with treatment and his social interactions during treatment and upon entering remission. The hypnosis was successful in helping the 9-year old boy cope with his anxiety.

 

Gardner G. Childhood, death, and human dignity: Hypnotherapy for David. The International Journal of Clinical and Experimental Hypnosis. 1976; 23(2): 122-39.

Abstract (Case Report): Hypnotherapy can be a significant part of the treatment of a dying child. A detailed clinical report illustrates how hypnotherapy was integrated with other treatment modalities to help a terminally ill child and his family cope effectively with problems and enhance their ability to use their own resources for personal growth and mastery throughout the dying process.

Copyright (c) 2007 Seth-Deborah Roth
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