Daniel P. Kohen

The Use of Relaxation-mental Imagery (self-hypnosis) in the Management of 505 Pediatric Behavioral Encounters

This report assessed outcomes of hypnotherapeutic interventions for 505 children and adolescents seen by four pediatricians over a period of one year and followed from four months to two years. Presenting problems included enuresis, acute pain, chronic pain, asthma, habit disorders, obesity, encopresis, and anxiety. Using strict criteria for determination of problem resolution (e.g., all beds dry) and recognizing that some conditions were intrinsically chronic, the authors found that 51% of these children and adolescents achieved complete resolution of the presenting problem; an additional 32% achieved significant improvement, 9% showed initial or some improvement; and 7% demonstrated no apparent change or improvement. Children as young as three years of age effectively applied self-hypnosis techniques. In general, facility in self-hypnosis increased with age. There was an inverse correlation (p < 0.001) between clinical success and number of visits, suggesting that prediction of responsivity is possible after four visits or less.

Comparison of nebulized terbutaline and subcutaneous epinephrine in the treatment of acute asthma

Nineteen children who presented for treatment of acute asthma symptoms were studied. They were randomized to receive either subcutaneous epinephrine 0.01 mg/kg (0.3 mg maximum) or nebulized terbutaline 1 mg in 2 mL normal saline. The drugs were administered using the double-blind method. Each patient received either subcutaneous epinephrine with concurrent nebulized normal saline or nebulized terbutaline with a concurrent subcutaneous injection of normal saline. Depending on the patients clinical status, up to three doses of the same drug and placebo were administered. Pulmonary functions (FEV1, FVC, FEF25-75), heart rate, respiratory rate, and pulmonary index were obtained before treatment, at 20 minutes, and at one hour after the final treatment. Except for the baseline respiratory rate, the mean number of treatments, pulmonary index, heart rate, and respiratory rate (at 20 minutes and one hour) were not statistically different. Pulmonary functions were not significantly different at any time. The one-hour post-treatment pulmonary functions (percentage of predicted normal) for terbutaline and epinephrine were FEV1, 49.2 +/- 18.4% and 49.4 +/- 16.9%; FVC, 72.7 +/- 23.4% and 62.7 +/- 21.6%; and FEF25-75, 31.8 +/- 18.6% and 39.0 +/- 12.2%, respectively. The data presented support our hypothesis that terbutaline by nebulization is at least as effective as epinephrine in the management of children with similar degrees of pulmonary obstruction.

Applications of relaxation/mental imagery (self-hypnosis) in pediatric emergencies

Abstract Problems for which children come to Emergency Rooms are anxiety-producing for children and parents, whether or not these problems are perceived as “true” emergencies by health care professionals. Fear and pain are important factors in the response to such situations. Self-hypnosis (relaxation/mental imagery) is a useful adjunct for rapid reduction of anxiety and discomfort in pediatric emergency situations; it can serve to diminish fear, improve self-control, and alter the perception of discomfort. Hypnosis can also enhance development of a sense of mastery in the injured or ill child. 6 case examples are described which illustrate the variety of specific clinical applications and hypno-therapeutic approaches.

Wart Regression in Children: Comparison of Relaxation-Imagery to Topical Treatment and Equal Time Interventions

Abstract Relaxation mental imagery (RMI), standard topical treatment (TopTx), and equal time-control interventions were compared on measures of wart regression in sixty one, 6–12-year-old children. Subjects chose one common (“index”) wart and attended 4 visits over 8 weeks. At each visit, total and “index” extremity wart number were counted and a photo was taken of the “index wart” for later measurement. On average, total wart number decreased by 10% and “index wart” area decreased by 20% with no significant group differences during the first eight weeks. Phone follow was conducted 6 to 18 months from study entry. At phone follow up, there was a trend for more RMI and TopTx subjects to report complete wart resolution (p = 0.07) with a majority of RMI children reporting use of RMI or no specific treatment pursuit. We conclude there was no significant short-term benefit for RMI in this randomized controlled trial of wart regression in children. However, longer term benefits for RMI and TopTx groups are sugg...

Hypnotherapeutic management of pediatric and adolescent trichotillomania.

Trichotillomania in children is regularly described as analogous to a habit disorder. As such, it is thought at times to be benign in a manner analogous to habits such as thumb sucking and nail biting. It is also considered by some to be an obsessive-compulsive disorder, to be more recalcitrant to intervention, and to be more socially disabling than simple habits, particularly when persistence and intensity eventuate in obvious alopecia. This report presents five cases of trichotillomania in which self-monitoring, dissociative hypnotic techniques, and self-hypnosis (relaxation/mental imagery) practice were used in teaching children successful management of this vexing problem. Specific emphasis is placed on the nature and importance of modifying the described techniques for the personal and specific developmental needs of individual patients.

Depression in children and youth: Applications of hypnosis to help young people help themselves

We may not be able to make you love reading, but hypnosis and treating depression applications in clinical practice will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.

Long-Term Follow-Up of Self-Hypnosis Training for Recurrent Headaches: What the Children Say

Abstract The author sent surveys to 178 consecutive youths previously referred for hypnosis for headaches. The survey sought current status of headaches: treatment, application of self-hypnosis, headache intensity, frequency, duration after self-hypnosis, generalization of self-hypnosis to other problems, and attitudes regarding self-hypnosis and life stresses. Of 134 delivered surveys, 52 were returned complete. Years after treatment, 85% (44/52) reported continued relief with self-hypnosis, 44% (23/52) reported decreased headache frequency, 31% (16/52) noted decreased severity, and 56% (29/52) reported that self-hypnosis reduced headache intensity. Many (26/52) emphasized the value of self-hypnosis to life stresses. In children and adolescents, self-hypnosis is associated with significant improvement of headaches and with an enduring positive effect for many years following training. Results suggest common and spontaneous generalizability of self-hypnosis by young people to modulation of other problems in their lives.

Clinical Hypnosis with Children and Adolescents—What? Why? How?: Origins, Applications, and Efficacy

This review article addresses the process, intention, and therapeutic value of clinical hypnosis with children and adolescents. A brief historical perspective is followed by a digest of the published laboratory and clinical research that has accelerated substantially over the past two decades. This review lends appropriate credence to the benefits and integration to clinical practice of this powerful tool for teaching young people self-regulation skills. The breadth of application is described, and several clinical vignettes are provided as examples of what is possible. In addition to the provision of the most relevant citations in the pediatric, psychological, and neuroscience literature, this synopsis concludes with information regarding availability of skill development training in pediatric clinical hypnosis.

A Spiral Curriuculm for Hypnosis Training

Abstract Although hypnosis has been used for centuries, there are few reports of systematic, professional training. The most thorough codification of instructional content is the Standards of Training in Clinical Hypnosis (SOTCH) (Elkins & Hammond, 1994), endorsed by The American Society of Clinical Hypnosis (ASCH), and The Society of Clinical and Experimental Hypnosis (SCEH) for annual workshops. This curriculum is organized around two assumptions: training is presented to adult professionals who know their own objectives; and each participant has a favorite learning style that should be accommodated. The workshop follows the content and time recommendations of the SOTCH. Some content is scheduled with spaced opportunity for practice. Concepts are organized in a spiral pattern, then presented and reviewed several times, each time in more detail, and in ways that accommodate different learning styles.

Chronic Daily Headache: Helping Adolescents Help Themselves With Self-Hypnosis

Although the evidence is clear that hypnosis has been an effective treatment for recurrent headaches in children, review of the literature revealed no previous reports of hypnosis for youth with the condition of chronic daily headache. Two adolescents with continuing chronic daily headaches were taught self-hypnosis through careful attention to individual strengths and finding the hypnotic elements within the clinical encounters. Self-reports of intensity, frequency, and duration of headaches described substantial benefit from learning and practicing self-hypnosis after little to no benefit from pharmacologic and other nonpharmacologic therapies. These results and analogous success with several other adolescents with chronic daily headache support the further use of self-hypnosis training for this condition. As a self-regulation technique that is quickly and easily learned by most young people, self-hypnosis training holds considerable promise for effectively treating and perhaps preventing chronic daily headaches in children and adolescents.