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Hypnosis Apps: A Systematic Review

Taylor & Francis
International Journal of Clinical & Experimental Hypnosis
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Abstract

For over a decade, the growing use of smartphone apps provided a way to make hypnotherapy more widely accessible. However, available apps vary widely in the quality of hypnosis provided to users. This study systematically reviewed apps delivering some form of hypnotherapy intervention and summarized their characteristics. Using hypnosis-related search terms, a list of apps was generated, yielding 679 unique hypnosis apps across both Android and iOS stores, and 168 apps met inclusion criteria for this review. The most common app targets were sleep (k = 94, 56.0%), relaxation/meditation (k = 92, 54.8%), and stress (k = 62, 36.9%). Only 34 (20.2%) of the apps indicated that the developer or person providing hypnosis was trained in hypnosis. Thirteen (7.7%) apps included some claim of evidence-based treatment. Only four apps reported inclusion in a clinical efficacy trial. Relationships between key app characteristics were explored using chi-square analysis. Though hypnotherapy apps have much potential in health care, apps based upon evidence-based protocols and empirical research are limited at this time.
Hypnosis Apps: A Systematic Review
Katherine Scherahn, Cameron T. Alldredge, Morgan Snyder, and Gary R. Elkins
Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
ABSTRACT
For over a decade, the growing use of smartphone apps provided a way to
make hypnotherapy more widely accessible. However, available apps vary
widely in the quality of hypnosis provided to users. This study system-
atically reviewed apps delivering some form of hypnotherapy intervention
and summarized their characteristics. Using hypnosis-related search
terms, a list of apps was generated, yielding 679 unique hypnosis apps
across both Android and iOS stores, and 168 apps met inclusion criteria for
this review. The most common app targets were sleep (k = 94, 56.0%),
relaxation/meditation (k = 92, 54.8%), and stress (k = 62, 36.9%). Only 34
(20.2%) of the apps indicated that the developer or person providing
hypnosis was trained in hypnosis. Thirteen (7.7%) apps included some
claim of evidence-based treatment. Only four apps reported inclusion in
a clinical ecacy trial. Relationships between key app characteristics were
explored using chi-square analysis. Though hypnotherapy apps have
much potential in health care, apps based upon evidence-based protocols
and empirical research are limited at this time.
ARTICLE HISTORY
Received 29 May 2024
Revised 29 August 2024
Accepted 3 September 2024
KEYWORDS
Hypnosis; mobile health;
smartphone apps; systematic
review
Introduction
The recent rise of mobile health (mHealth) smartphone apps provides the field of hypnosis
with a unique opportunity to deliver hypnotherapy via a smartphone app. Current barriers
to hypnotherapy access could potentially be addressed through smartphone app delivery,
including financial concerns, lack of geographic proximity to hypnotherapy providers,
debilitating chronic symptoms, or the time commitment needed for appointments
(Hasan & Vasant, 2023; Hussain, 2021). Additionally, for conditions where individuals
already might be inclined to turn to mHealth apps, hypnotherapy has been shown to be
beneficial, such as sleep (Elkins et al., 2021; Wofford et al., 2023), pain (Wallen et al., 2021),
food cravings (Delestre et al., 2022), anxiety (Roberts et al., 2021), smoking cessation (Batra
et al., 2024), stress (Olendzki et al., 2020), and hot flashes in menopausal women and breast
cancer survivors (Sliwinski & Elkins, 2017). Despite these advantages to smartphone
delivered hypnotherapy, the current hypnosis app landscape contains a wide variety of
quality and characteristics of the apps, creating the need for evaluation and review.
In 2013, Sucala and colleagues conducted a systematic review of smartphone apps
delivering hypnosis (Sucala et al., 2013). However, in the decade since this review was
published, smartphone technology and the mHealth industry have changed significantly. In
2013, 51% of Americans owned a smartphone, whereas in 2023 that number almost
doubled, with 97% of people owning a smartphone (Kunst, 2024; Pew Research Center,
CONTACT Gary R. Elkins gary_elkins@baylor.edu Department of Psychology and Neuroscience, Baylor University,
801 Washington Ave., 2nd Floor, Waco, TX 76701.
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS
https://doi.org/10.1080/00207144.2024.2434085
© 2024 International Journal of Clinical and Experimental Hypnosis
2024). Additionally, the 2013 review only included apps from the Apple’s iOS App Store,
which was the primary smartphone app store at the time; today, apps are provided through
both the Apple App Store and the Google Play Store.
In recent years, the mHealth industry has expanded dramatically, making this era of
mHealth app development crucial. Though mHealth apps were prevalent prior to the
COVID-19 pandemic, during the pandemic the field expanded, as governments and the
healthcare industry turned to mHealth as an invaluable resource during the era of
lockdowns and telehealth (El-Sherif & Abouzid, 2022). The global healthcare mobile
application market size leapt from 17.92 billion in 2019 (right before the pandemic) to
32.42 billion in 2023 (Grandview Research, n.d.a, n.d.b). The fact that the market share
remained high a few years after the pandemic began demonstrates the staying power of
the mHealth app industry. In fact, the industry is estimated to have a compound annual
growth rate of 40.2% through 2030 (Fortune Business Insights, 2023). To give an idea of
the number of mHealth apps available, at the end of 2022, there were 41,517 mHealth
apps available in the Apple App Store, and 54,546 apps were available in the Google Play
store (Ceci, 2023a, 2023b). North America dominated the mHealth global market with
a share of 30.48% (Fortune Business Insights, 2023). Looking to the future, it is likely
that the importance and implementation of mHealth apps will only grow, with future
possibilities of an increase in integration of mHealth into mainstream healthcare
(Rowland et al., 2020). As mHealth apps are further explored, benefits such as facilitated
communication with healthcare professionals, greater access to specific healthcare inter-
ventions, cost-effective treatment delivery, and greater ability for individuals to manage
their own health may be observed (Rowland et al., 2020). It is crucial for the hypnosis
field to take advantage of this moment of digital development by exploring how
hypnosis delivery through smartphone apps can be beneficial to the general public.
The mHealth app industry provides a developing opportunity for implementing hyp-
notherapy with a broad population of smartphone app users. There is some research
suggesting that user adherence is low in smartphone delivered hypnosis interventions
(Hasan et al., 2023). However, in addition to helping overcome accessibility barriers,
mHealth apps may be able to strategically increase individuals’ adherence to an intervention
by using behavioral strategies such as reminder alerts on their phone and practice logs
(Perski et al., 2017). Due to the ability of app developers to also receive information and
feedback from users, there is also a great potential for personalizing and adapting inter-
ventions in real-time to improve their users’ health outcomes (Grundy, 2022).
Despite the many benefits of mHealth hypnosis apps, there is also potential for misuse,
misinformation, or poorly delivered interventions. This is partly due to the lack of oversight
and regulation for mHealth apps; mHealth apps are delivered directly to the consumer, and
Google and Apple, as the hosts of the apps, are the default regulators through their app
review process prior to allowing app publication (Apple, 2024; Google, 2024). However,
these precursory reviews are not aimed at evaluating the effectiveness of mHealth apps, and
therefore do little to limit the claims made by mHealth app publishers. Though the
regulatory oversight differs by country, given the challenges of limiting apps across inter-
national boundaries, most mHealth oversight has attempted to be somewhat cohesive with
the FDA (Grundy, 2022; IMDRF, 2013). In 2019, and again in 2022, the FDA determined
that only apps qualifying as “medical devices” are subject to FDA regulation, which is
defined as apps designed to treat, diagnose, cure, mitigate, or prevent disease (FDA, 2022).
2K. SCHEFFRAHN ET AL.
Though this seems to be a broad definition that would include hypnosis apps, in practice,
the FDA regulates apps that collect medical information or monitor physiological measures
of a user and apps which, if malfunctioning, could cause harm to users (FDA, 2022). As is
true for most mHealth apps, these criteria do not include hypnosis apps. The resulting lack
of oversight for hypnosis apps contributes to the variability present in the market, with apps
differing vastly in their quality and qualifications for providing hypnosis.
With the increased use of mHealth, it is important to evaluate the present landscape of
hypnotherapy apps available. The field of hypnotherapy can benefit from the burgeoning
mHealth industry, but it is crucial to understand more about the offering of hypnosis
smartphone delivery. The aim of the present review is to provide a necessary update to the
2013 systematic review and to provide an understanding of the current field of available
hypnotherapy smartphone apps. Based on the public facing information about the apps,
including the app description and app store information, this review aims to summarize
characteristics of currently available hypnosis apps, compare trends over time, examine app
quality standards, and discuss potential improvements to this mHealth sector.
Method
This review is an expansion upon and an update to the Sucala et al. (2013)
systematic review of hypnosis apps. A comprehensive list of hypnosis apps was
generated from the Apple App Store and the Google Play Store using the following
search terms in separate searches: “hypnosis,” “hypnotherapy,” “hypnotic,” and
“hypnotize.” These search terms are identical to the ones used in the 2013 review.
The search for apps was performed December 7, 2022, through December 12, 2022.
Duplicates were removed, and the title and description of each app were reviewed by
independent raters to determine whether the app met the inclusion criteria. Any
disagreements on the inclusion/exclusion of an app were resolved through a meeting
of the research staff. The criteria for inclusion in this review were as follows: 1) The
app description mentioned the use of hypnosis, hypnotherapy, or the user being
hypnotized; 2) the hypnosis was advertised to target a symptom/problem/quality of
life and was not solely for entertainment; 3) the app description was available in
English; and 4) hypnosis had a written or verbal component (rather than just images
or sounds).
After an initial screening, data extraction of the apps was conducted by independent
raters. The raters completed a standardized data extraction form for each app. Data
extraction from the app descriptions and the app stores was completed by April 9, 2023.
The data extracted included targeted outcome, price, consumer rating out of five stars,
number of reviews, mode of hypnosis delivery, customization options, hypnosis provider
training, disclaimers, and presence of scientific and/or theoretical basis. These data were
extracted from the app description and app store statistics only as the scope of this review
did not include downloading and using the apps. We chose to only extract data from the
app store and app description because those contain the information that the general public
would access when deciding upon an app. Also, this review only reports on the information
presented in the app description or app store and did not verify any claims made in the
descriptions. For evaluating apps claiming to be evidence-based, if an app claimed there was
clinical research performed including the app, we sought out whether there was existing
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 3
research on the app; however, searching for potential clinical research for each app included
in the review regardless of the app description was outside the scope of this review. These
data were synthesized and evaluated for the review. Statistical analysis included descriptive
statistics and chi-square tests for independence with an alpha level of .05 (α = .05) which
were used to assess the presence of relationships between variables.
Results
The initial search on the Google Play Store and the Apple App Store yielded 1,408 apps.
There were 729 duplicates removed. The remaining 679 were screened, leaving a final 168
apps included in the review by meeting the inclusion criteria (Figure 1).
App Outcome Targets
The hypnosis apps included in this review had a variety of intended goals to help users
(Table 1). The most frequently stated app goals were sleep (56.0%, k = 94), relaxation/
meditation (54.8%, k = 92), and stress (36.9%, k = 62). Additionally, the majority of the apps
(80%, k = 134) included had multiple hypnosis goals instead of focusing on a single inter-
vention goal (20%, k = 34). See Table 1 for further information on the stated app targets.
Apps identified through database
searching
(n = 1,408)
Duplicate records removed
(n = 729)
Apps screened
(n = 679)
Apps assessed for eligibility
(n = 679)
Excluded:
Not hypnosis (n = 110)
Not hypnotherapy focused (n = 74)
No treatment target (n = 6)
Insufficient description (n = 6)
Not in English (n = 8)
No longer found (n = 58)
Apps included in the review
(n = 168)
Identification
Screening
Included
Figure 1. PRISMA for Systematic Review
4K. SCHEFFRAHN ET AL.
App Pricing
There was a great deal of variety in price and pricing structure between the apps. The
majority (70%, k = 117) of the apps were free to download but had “In-App Purchases,”
which is typically indicative of a required subscription plan. Because subscription prices
were not usually disclosed in app store descriptions, additional data were not available.
Other apps were free to download and use (17%, k = 29), and some apps had a fixed price
(13%, k = 22).
The fixed prices ranged from $0.99 to $10.99, and the average price was $5.51. The most
common price for a fixed-price app was $4.99 (k = 7). Of the fixed-price apps, 40.9% (k = 9)
cost between $0.99 and $3.99; 40.9% (k = 9) cost between $4.00 and $7.99; 18.2% (k = 4) cost
between $8.00 and $10.99.
App Consumer Ratings
The majority (71.4%, k = 120) of the apps had received at least one consumer rating on their
respective app listing. On both the Apple App Store and the Google Play Store, app ratings
are given as stars (1–5) in increments of 1, with higher star ratings reflecting greater user
satisfaction. The overall star rating of an app is the average of all the consumer ratings. Of
the 120 apps, 1.7% (k = 2) received an average rating of between 1 and 2 stars, 6.7% (k = 8)
received an average rating of between 2 and 3 stars, 14.2% (k = 17) received an average
rating of between 3 and 4 stars, 71.7% (k = 86) received an average rating of between 4 and 5
Table 1. App Targets.
Target Indicated Number of Apps Percent of Apps (%)
Sleep 94 56.0
Relaxation/meditation 92 54.8
Stress 62 36.9
Confidence/self-esteem 54 32.1
Anxiety 53 31.5
Weight loss 41 24.4
Nonspecific self-development 39 23.2
Smoking cessation 37 22.0
Fear/phobia 30 17.9
Emotional 29 17.3
Relationships 28 16.7
Motivation 28 16.7
Habit 27 16.1
Success 27 16.1
Focus 25 14.9
Addiction 24 14.3
Sport/physical 23 13.7
Pain 21 12.5
Wealth/money 17 10.1
Lucid dreaming 15 8.9
Law of attraction 13 7.7
Sexual 10 6.0
Depression 9 5.4
Birth 7 4.2
IBS 4 2.4
Tinnitus 3 1.8
Hot flashes 3 1.8
Other 17 10.1
As many apps had multiple listed targets, the percentages add up to over 100%.
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 5
stars, and 5.8% (k = 7) received an average rating of 5 stars. It is important to note that all
the apps receiving 5 stars had under 30 reviews.
The number of reviews ranged from 0 to 31,312. Of the apps that had been rated, the
average number of reviews given was 962. At the time of the data extraction, the most
reviewed apps were Mesmerize (4.8 stars with 31,312 reviews), Slumber (4.7 stars 15,900
reviews), Relax & Sleep Well Hypnosis (4.7 stars 12,700 reviews), Law of Attraction Space
(4.4 stars, 8,830 reviews), and Nerva: IBS & Gut Hypnotherapy (4.6 stars, 5,400 reviews).
Modes of Delivery
Among included apps, 129 apps (76.8%) described the mode of hypnosis delivery. Of those
reporting the mode of delivery, audio alone was the most common (k = 106, 82.2%),
followed by audio combined with visual elements (k = 24, 18.6%). Forty-six (27.4%) of all
the apps offered users the ability to customize the hypnosis experience. The customizations
offered were choosing between a “wake” or a “sleep” end to a hypnosis session (k = 24),
choice of background sound (i.e. nature sounds or music; k = 20), choosing the session
length (k = 14), being able to change volume for different components separately (i.e.
adjusting the suggestion audio and the background sound audio separately; k = 14), looping
the background sounds (k = 14), looping the entire session (k = 10), and creating a playlist of
sounds or sessions (k = 12).
Other less frequent customization options included customizing sessions (k = 8), choos-
ing the visual (i.e. background animations during a session; k = 6), including “optional
hypnosis instructions” (k = 4), being able to choose a female or male voice (k = 2), choosing
playback speed (k = 2), and allowing users to record or input their own audio to be a part of
their session (k = 1).
Hypnosis Training and Qualications
A minority (k = 34, 20.2%) of the apps claimed in the descriptions that the person providing
the hypnosis had been certified or trained in hypnosis. Sixteen (9.5%) apps indicated the
developer or person delivering the hypnosis had a professional title, such as doctor (k = 6),
PhD (k = 5), therapist (k = 5), or other healthcare-related professional titles (k = 1). Four
(2.4%) of the apps gave an unspecific claim regarding experts of some kind being involved
in the development of the apps. Eleven (8.2%) apps included a claim of how long the
involved hypnotist had worked full time in hypnosis, with the described experience ranging
from 15 to 25 years. As the hypnotist qualifications were varied in description, evaluating
these training experiences was beyond the scope of this review.
Disclaimer Inclusion
A minority (26.2%, k = 44) of apps included a disclaimer of some kind. Of these apps,
27 (61.4%) indicated that users should not use the app or should consult a doctor before
using if they experience certain conditions; 23 (52.3%) indicated that the app’s services do
not replace medical advice or medical treatment; 17 (38.6%) warned against driving or
operating heavy machinery while using; 12 (27.3%) gave a disclaimer that the results are not
6K. SCHEFFRAHN ET AL.
proven; 4 (9.1%) indicated that results will vary; and 2 (4.5%) gave a disclaimer that
hypnosis is not a “magical solution.” Apps could include multiple types of disclaimers.
Of the apps indicating that users should not use the app or should consult a doctor before
using if experiencing certain conditions, of the conditions listed in the disclaimer, epilepsy
was mentioned the most (k = 22, 81.5%), followed by mood disorders (including depression,
panic, and anxiety disorders; k = 15, 55.6%), heart conditions (k = 14, 51.9%), being under
the influence of drugs or alcohol (k = 2, 7.4%), paranoia (k = 2, 7.4%), schizophrenia (k = 2,
7.4%), psychosis disorder (k = 2, 7.4%), and “other nervous, psychiatric, or neurological
condition” (k = 13, 48.1%). Breastfeeding/pregnancy, history of strokes, and suicidal or
violent ideation were each mentioned once (3.7%). Three of these apps (11.1%) indicated
that users should consult a doctor before using if they were undergoing any kind of medical
or psychological treatment or consultation.
Proposed Science or Theory
A minority (41.1%, k = 69) of the apps discussed some scientific theory or explanation for
hypnosis’ benefits (Table 2). Of these apps, 35 (50.7%) mentioned the “subconscious” or
“unconscious” mind; 31 (44.9%) mentioned hypnotic suggestions; 21 (30.4%) referenced
“relaxation” techniques; 14 (20.3%) mentioned “brainwaves” or “brainwave frequency;”
10 (14.5%) mentioned “subliminal” signals, messaging, or suggestions; 6 (8.7%) mentioned
neurolinguistic programming; 5 (7.2%) mentioned visualization; 5 (7.2%) mentioned
focused attention. Other scientific theories or explanations included mentions of “trance”
(k = 4, 5.8%), “altered state of consciousness” (k = 2, 2.9%), “electrical impulses” (k = 2,
2.9%), “psychic activity” (k = 2, 2.9%), and “neurowave stimulation” (k = 2, 2.9%).
Additionally, 14 (8.3%) of all the apps made some claim of their app being evidence-
based. Of these apps, 5 described how hypnosis in general has been found to provide
benefits, by describing various medical associations and institutes that have recommended
hypnotherapy, such as the American Medical Association, the American Psychological
Association, the National Institutes of Health, the Menopause Society, and the Royal
Australian and New Zealand College of Obstetricians and Gynecologists; of these apps, 4
provided only this description as proof of the scientific nature of their app’s intervention.
One app claimed its hypnosis was developed using “clinically validated principles” and
provided a link to their website to see more specific information on the scientific basis. Two
Table 2. Described Science and Theory Behind Apps.
Description Number of Apps Percent of Apps Discussing Scientific Theory
Subconscious or unconscious mind 35 50.7%
Suggestions 31 44.9%
Relaxation techniques 21 30.4%
Brainwaves or brainwave frequency 14 20.3%
Subliminal (signals, messaging, or suggestions) 10 14.5%
Neurolinguistic programming 6 8.7%
Visualization 5 7.2%
Focused attention 5 7.2%
Trance 4 4.8%
Altered state of consciousness 2 2.9%
Electrical impulses 2 2.9%
Psychic activity 2 2.9%
Neurowave stimulation 2 2.9%
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 7
apps cited a specific study for the use of hypnosis with a specific target, one utilizing
hypnosis with IBS and the other with smoking cessation. Five apps made a claim of
scientific proof without offering any reference of evidence for that claim, with three apps
stating it was “scientifically proven,” one app claiming it was “based on clinical experience
and research in the field,” and one app claimed its intervention was “verified by sleep
experiments” but offering no further details.
Only two (1.2%) of the apps reported the app itself being tested in a clinical efficacy trial
within the app store description. These two apps were the Evia app, for menopausal hot
flashes, and iEgo Hypnosis Meditation Sleep, which claimed a clinical trial found
a reduction in procrastination with use of the app. However, two additional apps included
in the review were brought to the reviewers’ attention as having been tested in clinical
efficacy trials: the Finito app for smoking cessation and the Nerva app for irritable bowel
syndrome (IBS).
Relationships Between App Characteristics
By exploring the relationships between app characteristics, several associations were indi-
cated. Chi-square tests were utilized to indicate whether variable frequencies were related.
There was a significant relationship present between descriptions of hypnosis training and
certification with the inclusion of disclaimers χ
2
(1,168) = 4.952, p = .026 and inclusion of
a scientific explanation of hypnosis χ
2
(1,168) = 7.542, p = .006, meaning that apps involving
someone self-reporting hypnosis training were more likely to include disclaimers and
a scientific explanation for hypnosis. There was also a significant relationship between the
description of professional training (e.g., “doctor” and “PhD”) and the inclusion of dis-
claimers, so that apps that included a self-report of some kind of professional training were
more likely to include a disclaimer, χ
2
(1,168) = 6.658, p = .010. The ability to customize the
hypnosis experience on an app was significantly associated with a description of hypnosis
training χ
2
(1,168) = 25.345, p < .001. However, customization was not significantly asso-
ciated with the description of a professional title.
Other relationships were significant but with questionable validity because more than
20% of their expected count was less than five. For example, the mention of professional
hypnosis experience and the inclusion of a disclaimer χ
2
(1,168) = 4.177, p = .041, indicat-
ing that apps with a claim of extensive hypnosis experience were more likely to include
a disclaimer. Another example is the inclusion of a claim hypnosis would definitely
provide benefit to the user were more likely to also claim that the app was evidence-
based, χ
2
(1,168) = 22.780, p < .001.
Discussion
Due to an increasing presence of mobile health (mHealth) apps among the general public,
this systematic review sought to reevaluate the landscape of hypnosis-specific smartphone
apps initially provided over a decade ago by Sucala and colleagues (Sucala et al., 2013). We
believe that app-delivered hypnosis is an important way to increase positive awareness of
and access to clinical hypnosis. Hypnosis delivered via smartphone app can help users
overcome accessibility barriers and access hypnosis intervention; however, there is still
much unknown about the most effective methods to deliver hypnosis through app, and
8K. SCHEFFRAHN ET AL.
there is little research on the currently available hypnosis apps. The current review provides
information to clinicians and researchers alike to highlight helpful resources for patients
and gaps in the literature for future studies.
Both the Apple App Store and the Google Play Store were searched for smartphone apps
that delivered hypnosis for an intended outcome. The search yielded 679 unique apps which
eventually led to the final inclusion of 168 apps. Data was extracted from the app listing and
its associated description. Variables of interest included targeted outcomes, price, consumer
rating, and information regarding hypnosis provider training, disclaimers, and the presence
of a scientific or theoretical basis.
The majority of the apps (80%) indicated multiple goals for hypnosis, with a minority of
the apps (20%) focusing on just one hypnosis goal. App developers creating hypnosis apps
may tend to incorporate multiple treatment targets into the app design due to a drive to
attract as many users as possible. This study did not examine whether within the apps there
were separate and specific hypnosis sessions individually targeting each of the stated app
goals, as doing so was outside the scope of this review. App developers should consider
whether a hypnosis app focusing on multiple targets might take away from the app’s ability to
best provide an effective hypnosis intervention for users, with the alternative being focusing
on one goal and ensuring that the hypnosis provided adequately addresses that singular goal.
The most frequently appearing app goals included sleep (56%), relaxation/meditation
(54.8%), and stress (36.9%). Sucala et al. (2013) found that the top hypnosis app goals at that
time were weight loss (22.6%), increasing self-esteem/confidence (20.4%), and relaxation/
stress reduction (19.9%). In comparing the current results with the 2013 review, it is
interesting to note that weight loss and increasing self-esteem no longer are the topmost
prevalent goals, but relaxation and stress reduction are still among the most prevalent.
In the Sucala et al. (2013) review, the authors gave a recommendation that “future
hypnosis apps be based on empirical evidence, indicating that hypnosis is effective for the
proposed goal, which has been published in a peer-reviewed journal” (Sucala et al., 2013,
p. 4). The authors of this present review reiterate this recommendation as, 10 years later,
there is no indication that the hypnosis app market has moved toward that goal. Only two
apps reported being based upon empirical clinical research, reporting being included in
a clinical trial seeking empirical evidence for the app’s effectiveness. Only two other apps
cited specific studies for the use of hypnosis for the stated treatment goal. However, when
examining the list of indicated app targets, many show promise based on the current state of
hypnosis research, despite the app descriptions themselves not indicating this. For example,
hypnosis has been found to be beneficial for issues like sleep (Elkins et al., 2021; Grégoire
et al., 2022), smoking cessation (Batra et al., 2024; Carmody et al., 2008), and pain (Eaton
et al., 2023; Williams et al., 2022), so the apps addressing those goals could structure their
treatment based on this previously conducted research. However, as also noted in the 2013
review, many apps state certain treatment goals that are not supported by research, such as
gaining wealth or attracting a romantic partner. The authors of this review recommend that
all hypnosis apps should include in their app description an indication of which treatment
targets have been supported by hypnosis research; since the general public are unaware of
the current state of hypnosis research, this information being included in the description is
necessary. Additionally, any clinicians working with patients who may be seeking digitally
delivered hypnosis can also provide information on what goals might be benefitted through
the use of hypnosis apps.
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 9
Compared to the 2013 review, this review found a higher percentage of the apps had been
rated on their respective app stores (35.38% compared to 71.4%). This may be due to either
increased usage of hypnosis-focused apps, a greater focus from companies on eliciting
reviews from consumers, or the increase in the practice of gaining factitious reviews for
apps (Martens & Maalej, 2019; Rathore et al., 2021). This review found that the greatest
number of apps (71.7% of rated apps) had an average rating between 4 and 5 stars;
comparatively, Sucala et al. found that the greatest number of apps (52.1%) had an average
rating between 3 and 4 stars. This increase in average ratings may show a higher quality of
the available hypnosis apps (from a user’s perspective), though this should be interpreted
cautiously, as the 2013 review included a larger sample of apps.
This review found that the majority of the apps (70%) were priced using a subscription
plan, meaning the app was free to download but required in-app purchases of a subscription
plan to use all features. This may be due to the prevalence of subscription plans in the app
economy, but within the overall mHealth market, only 8% of apps are subscription-based
(Ceci, 2024); therefore, the hypnosis sector of the mHealth industry is far more subscription
motivated than the overall industry numbers. This may be a positive factor, however, as app
developers may be more engaged in keeping their app up to date to maintain their
subscription base. The fixed-price range for apps ($0.99–$10.99) is lower than found in
the Sucala et al. review ($0.99–$19.99). A higher percentage of apps were free to download
(17%) than in the 2013 review (13%). The changes seen in the pricing structure are likely
due to the changed digital landscape in the decade since the previous review; as the
smartphone became more prolific, the industry surrounding apps developed as well, thus
changing the standards of pricing. Inflation in the United States changed from 1.5% in 2013
to 4.1% in 2023, which is when the data were extracted (World Bank Group, 2024). Though
Sucula et al. did not report an average fixed price, the most frequent range of app pricing
was from 1.99 to 6.99, the average of which is $4.49. Once adjusted for inflation, this would
be $5.87. When compared to the average of this present review of $5.51, hypnosis apps on
average have decreased in price for a fixed price model. However, this may be due to the
increase in subscription model pricing, which over time will be more expensive for con-
sumers than the one-time payment.
With a majority (76.8%) of the apps indicating the mode of delivery in the app store
description, this review found audio alone to be the most commonly utilized delivery
method (63%). In comparison, the 2013 review found that 83% of all the apps used audio
alone as a mode of delivery; thus, this review found a higher proportion of apps combined
visual and audio methods (14%) compared to the 2013 review (4%).
The proportion of apps that allowed some form of customization differed between the
two reviews, with the present review finding 27% including customization options in the
description, while Sucala and colleagues found 37%. Allowing customization such as
being able to alter the session length, ending, speed, background noises, accompanying
visuals, voice performing the induction, and more – allows for a greater range of preferences
than might be possible even with an in-person hypnotherapist; these customization options
may cause users to feel as comfortable as possible in their hypnosis experience, thus
encouraging adherence to the mobile delivery of the intervention. Sucala et al. (2013)
recommends that “tailoring options should be based on empirical support for their efficacy
and should be guided by a combination of patient preferences and evidence” (Sucala et al.,
2013, p. 5). There are no significant studies that indicate what types of customization or
10 K. SCHEFFRAHN ET AL.
induction delivery options might be more effective. While customization options may
attract and retain more app users, it is crucial to ensure that the possible customizations
do not detract from the hypnotherapy.
Only a minority of the apps (20.2%) claimed that the developer or person providing the
hypnosis had received formal training or certification in hypnosis. This proportion is less
than Sucala et al. (2013) found to report hypnosis training or certification (34.6%). This
decrease in the proportion of apps claiming hypnosis training is concerning, given that
hypnotherapy is viewed as a psychological intervention that should only be provided by an
adequately trained individual, meaning someone who has received formal clinical hypnosis
training.
The 2013 review provided a recommendation that “hypnosis app developers should be
able to prove adequate training in hypnosis under supervision, and this training should be
verifiable by consumers” (Sucala et al., 2013, p. 5). This recommendation is still true today
and is evermore necessary, given the current state of hypnosis apps. We recommend that
adequate training be defined as someone who has been certified in clinical hypnosis through
a training program. Apps developed in the future should include information in the
description regarding hypnosis training and certification, with details regarding where the
training was received. We acknowledge it is possible that the apps provided additional
information regarding certification or qualifications within the app; however, requiring
users to download, or in some cases even purchase, an app before learning about the
qualifications of the hypnotherapist limits accessibility to effective hypnotherapy delivered
via the app.
Hypnosis apps should include disclaimers in their app descriptions, as well as within
their app. It is crucial to educate users, who may have never experienced hypnotherapy
previously, on how to best utilize hypnotherapy. Providing users with accurate and
straightforward disclaimers will allow the hypnotherapy experience to be safe for users.
Giving disclaimers regarding safety while driving/operating machinery and advising to
consult medical professionals should be considered as necessary for developing
a beneficial hypnotherapy app. As Sucala et al. stated, “Hypnosis apps should be accom-
panied by at minimum a disclaimer, and preferably by an implied consent document”
(Sucala et al., 2013, p. 5). Including disclaimers, as well as implied consent, serves to protect
consumers’ safety and their expectations and also protects the app developers from legal
issues that may arise without the presence of disclaimers. We strongly urge all future app
developers or clinicians involved in hypnosis app development to include disclaimers
regarding the proper use of hypnosis.
This review found 26.2% of the apps included a disclaimer of some kind. When
compared to the 14% of apps including disclaimers in 2013, there is a higher percentage
of hypnosis apps that include a disclaimer available in 2023 than in 2013. Both reviews
found similar types of disclaimers were included in the app descriptions. In the present
review, the most frequently included disclaimer was “users should not use the app or should
consult a doctor before using if they experience certain conditions;” Sucala et al. (2013)
found that the most frequently included disclaimer was that “the app is not meant to
substitute for a licensed professional and advised consulting a medical professional.”
Therefore, both in 2013 and in 2023, apps were most likely to advise users to consult
a medical professional. Interestingly, the inclusion of disclaimers in the description was
related to both the hypnosis provider having hypnosis training and self-identifying as
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 11
a professional in a certain discipline (e.g., psychologist). This is a reasonable result, given
that those with more experience and training with hypnosis would be aware of the need to
include certain disclaimers in a product being marketed to the general public. As disclai-
mers provide a necessary form of education to the general public, app descriptions should at
minimum include the disclaimers that 1) users should not use the app while driving or
operating heavy machinery and 2) the app does not replace medical advice or treatment.
This review found a smaller percentage of apps (41%) included some scientific theory or
explanation of hypnosis compared to the 2013 review (48%). Both reviews found the most
commonly included explanation was mentioning the “subconscious/unconscious mind.”
“Relaxation” and “suggestion” were also prominent in both reviews. However, “neurolin-
guistic programming” was not as prominent in the present review (8.7%) as in the 2013
review (30.9%). The shifts in the presence of specific explanations for hypnosis’ benefits
may be due to changing perspectives on hypnosis and hypnotherapy among the general
public.
There was a slight, but encouraging, increase in the number of apps tested for efficacy.
Sucala and colleagues found that none of the apps had been tested for efficacy, and no apps
reported being evidence-based. The present review found that 14 (8.3%) of the apps made
some claim of being evidence-based. However, the content of these claims differed; only two
apps cited a specific study that used hypnosis for the specific treatment goal the app
addressed, and five apps made a claim of evidence-based hypnosis without providing any
further information. Four apps (two included in the descriptions at the time of data
extraction, two brought to the reviewers’ attention directly after) did report the app itself
being based upon clinical efficacy trials: the Evia app for hot flashes and sleep in menopausal
women and breast cancer survivors, the Finito app for smoking cessation, the Nerva app for
irritable bowel syndrome (IBS), and the iEgo Hypnosis Meditation app for a wide range of
concerns (“focus, sleep, anxiety, confidence, and more”). However, we were not able to find
the claimed randomized clinical trial of the iEgo Hypnosis Meditation app. There is
a pressing need for hypnotherapy delivery apps to be tested via a clinical efficacy trial;
such trials allow physicians to recommend an app with confidence to patients seeking an
accessible hypnosis intervention.
There are potential risks in the current state of hypnosis apps available. The apparent lack
of clinically influenced hypnotherapy apps likely results in users who are seeking beneficial
hypnosis to utilize apps that may not be as effective, may not have any hypnosis-trained
professional involvement, and might not have adequate public safety communication with
users. These aspects not only result in users being unable to benefit from hypnosis but also
such a state of affairs can lead to a lessened sense of the legitimacy of clinical hypnosis and
lessened trust by patients in clinical hypnosis. Ultimately, individuals are attempting to seek
out beneficial treatment through app-delivered hypnosis but in many cases are paying for
a service that may have no scientific backing whatsoever and is just an approximation of
clinical hypnosis. One solution to resolve this would be increased standards placed upon
apps before they are made available on app stores, requiring a minimum standard to be met.
Another alternative would be if the United States Centers for Medicare and Medicaid
Services (CMS), which runs the Medicare program, revised rules for reimbursement that
include a plan to start paying for software-based psychological interventions such as
hypnotherapy apps for specific medical and psychological conditions. This could pave the
way for hypnotherapy apps that are evidence-based and with sufficient clinical trial research
12 K. SCHEFFRAHN ET AL.
to be identified and recommended. Such a CMS rule change could also make effective
hypnotherapy apps more accessible and reduce health disparities.
It should be noted that the Food and Drug Administration (FDA) provides some limited
regulation over certain medical apps, but the definition of what qualifies as a medical app is
very limited; a guidance document released by the FDA on the regulation of medical apps
indicates that oversight would only apply to apps, which would have a potential high risk for
patients if the app malfunctioned or apps that operate as medical devices that would collect
physiological data (FDA, 2022; Larson, 2018). Thus, hypnosis apps, despite providing
a medical benefit, do not fall under such regulations. Google and Apple, as the app hosts,
provide some oversight when apps are first published. Prior to being published by the app
stores, new apps typically undergo a review process. Google, though limiting apps that may
have harmful or offensive content, does not have any specific requirements for medical apps
(Google Play Store, 2024). Apple indicates that a medical app could be rejected if it behaves
in a way that risks physical harm but focuses mostly on apps that are used for diagnosing or
treating patients (Apple Inc, 2024). As a result of this state of the app industry, the focus
must be on researchers, who can provide more information on which apps are evidence-
based, and clinicians, who can provide advice and recommendations to patients seeking
hypnotherapy apps.
An additional matter of import when dealing with smartphone apps is that of data
privacy. In recent years, there has been increased focus on the ethics of companies collect-
ing, storing, and using data gathered from smartphone app users. Though this topic is one
that is far larger than the scope of this review, we wish to note that going forward, all
hypnosis app developers should include clear, concise, and transparent information regard-
ing what data they are collecting from the user, and how they are using and storing the data.
Limitations
This systematic review was limited by the inclusion of only English-language apps; a future
systematic review may be warranted to examine smartphone apps for hypnosis available in
other languages to gain a better understanding of the current state of hypnosis apps
available internationally. As is inherent in the rapidly changing nature of smartphone
apps, it is also likely that information available in app descriptions and the presence of
certain apps will be different at the time this article is published. Additionally, this review
did not examine the actual content of the apps included, nor did this review perform
verification of the claims made in the descriptions, such as the hypnosis training.
Future Directions
App-delivered hypnotherapy improves accessibility to treatment, yet there is a lack of
quality assurance and research that would assure users of receiving beneficial treatment.
As mHealth and hypnosis app usage continues to increase, app developers should consider
taking steps to produce a quality app to deliver hypnotherapy. Sucala et al. (2013) included
a checklist for hypnosis app quality in their review, which we believe is still relevant today.
This checklist requires that 1) the hypnosis app is based on empirical evidence that hypnosis
is effective/efficacious for the goal that the app was developed for, 2) the hypnosis app
efficacy is supported by at least one randomized controlled trial, 3) the hypnosis app is
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 13
developed by, or in collaboration with, a licensed health-care professional, with adequate
hypnosis training and experience, and 4) the hypnosis app has adequate disclaimers (Sucala
et al., 2013). All of these items are still necessary for assurance that an app is delivering
quality hypnotherapy. However, since 2013 there has been limited progress in this regard.
There is still a need for future studies evaluating the current state of hypnotherapy
smartphone apps. Evaluating the content or usage of hypnosis apps was outside the scope of
this review, however, we recommend future research be conducted on the content of
hypnosis apps, evaluating whether the apps are designed to deliver effective hypnosis.
Future studies examining the clinical efficacy of certain apps will be necessary to provide
both clinicians and future users with greater confidence in using an app-delivered hyp-
notherapy intervention. We also recommend randomized controlled trials be performed to
compare the effectiveness of specific hypnotherapy apps compared to a control group, as
there is a significant lack of RCTs available on this topic. Future studies should also evaluate
user adherence to the hypnosis apps as well as strategies to increase app adherence, such as
phone notifications.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Data Availability Statement
Data tables of the included apps are available upon request.
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Hypnose-Apps: Eine systematische Überprüfung
KATHERINE SCHEFFRAHN, CAMERON T. ALLDREDGE, MORGAN SNYDER, UND GARY R. ELKINS
Zusammenfassung: Seit über einem Jahrzehnt bietet die zunehmende Nutzung von Smartphone-
Apps eine Möglichkeit, Hypnotherapie einem breiteren Publikum zugänglich zu machen. Die
Qualität der Hypnose, die den Nutzern angeboten wird, ist bei den verfügbaren Apps jedoch sehr
unterschiedlich. In dieser Studie wurden Apps, die eine Form von Hypnotherapie anbieten, system-
atisch untersucht und ihre Merkmale zusammengefasst. Unter Verwendung von Suchbegriffen, die
sich auf Hypnose beziehen, wurde eine Liste von Apps erstellt, die 708 einzigartige Hypnose-Apps in
Android- und iOS-Stores enthielt. 168 Apps erfüllten die Einschlusskriterien für diese Untersuchung.
Die häufigsten App-Ziele waren Schlaf (k = 94, 56,0%), Entspannung/Meditation (k = 92, 54,8%) und
Stress (k = 62, 36,9%). Nur 34 (20,2%) der Apps gaben an, dass der Entwickler oder die Person, die
Hypnose anbietet, in Hypnose ausgebildet ist. Dreizehn (7,7%) Apps gaben an, dass es sich um eine
evidenzbasierte Behandlung handelt. Nur vier Apps berichteten über die Teilnahme an einer kli-
nischen Wirksamkeitsstudie. Die Beziehungen zwischen den wichtigsten App-Merkmalen wurden
mittels Chi-Quadrat-Analyse untersucht. Obwohl Hypnotherapie-Apps ein großes Potenzial für die
Gesundheitsversorgung haben, gibt es derzeit nur wenige Apps, die auf evidenzbasierten Protokollen
und empirischer Forschung basieren.
16 K. SCHEFFRAHN ET AL.
Applications d’hypnose : Une revue systématique
KATHERINE SCHEFFRAHN, CAMERON T. ALLDREDGE, MORGAN SNYDER ET GARY R. ELKINS
Résumé: Depuis plus d’une décennie, l’utilization croissante d’applications pour smartphones
a permis de rendre l’hypnothérapie plus largement accessible. Cependant, les applications disponibles
varient considérablement dans la qualité de l’hypnose fournie aux utilisateurs. Cette étude passe
systématiquement en revue les applications proposant une forme d’intervention hypnothérapeutique
et résume leurs caractéristiques. En utilisant des termes de recherche liés à l’hypnose, une liste
d’applications a été générée, donnant 708 applications d’hypnose uniques à travers les magasins
Android et iOS, et 168 applications répondaient aux critères d’inclusion pour cette étude. Les
applications les plus corantos ciblaient le sommeil (k = 94, 56,0%), la relaxation/méditation (k = 92,
54,8%) et le stress (k = 62, 36,9%). Seules 34 (20,2%) des applications indiquaient que le développeur
ou la personne fournissant l’hypnose était formé à l’hypnose. Treize (7,7%) applications ont fait état
d’un traitement fondé sur des données probantes. Seules quatre applications ont fait état d’une
inclusion dans un essai clinique d’efficacité. Les relations entre les principales caractéristiques des
applications ont été explorées à l’aide d’une analyze du chi carré. Bien que les applications
d’hypnothérapie aient un grand potentiel dans le domaine des soins de santé, les applications
basées sur des protocoles fondés sur des preuves et des recherches empiriques sont limitées à l’heure
actuelle.
Aplicaciones de hipnosis: Una revisión sistemática
KATHERINE SCHEFFRAHN, CAMERON T. ALLDREDGE, MORGAN SNYDER Y GARY R. ELKINS
Resumen: Durante más de una década, el creciente uso de aplicaciones para teléfonos inteligentes ha
proporcionado una manera de hacer la hipnoterapia más accesible. Sin embargo, las aplicaciones
disponibles varían ampliamente en la calidad de la hipnosis proporcionada a los usuarios. Este
estudio revisa sistemáticamente las aplicaciones que ofrecen algún tipo de intervención
hipnoterapéutica y resume sus características. Utilizando términos de búsqueda relacionados con la
hipnosis, se generó una lista de aplicaciones, con 708 aplicaciones de hipnosis únicas en las tiendas de
Android e iOS, y 168 aplicaciones cumplieron los criterios de inclusión para esta revisión. Los
objetivos más comunes fueron sueño (k = 94, 56.0%), relajación/meditación (k = 92, 54.8%),
y estrés (k = 62, 36.9%). Sólo 34 (20,2%) de las aplicaciones indicaban que el desarrollador o la
persona que proporcionaba la hipnosis tenía formación en hipnosis. Trece (7,7%) aplicaciones
incluían alguna afirmación de tratamiento basado en la evidencia. Sólo cuatro aplicaciones infor-
maron de su inclusión en un ensayo clínico de eficacia. Las relaciones entre las características clave de
las aplicaciones se exploraron mediante análisis de ji cuadrado. Aunque las aplicaciones de hipnoter-
apia tienen mucho potencial en la atención sanitaria, las aplicaciones basadas en protocolos basados
en la evidencia y la investigación empírica son limitadas en este momento.
Translation acknowledgments: The Spanish, French, and German translations were conducted using
DeepL Translator (www.deepl.com/translator).
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL HYPNOSIS 17
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Clinical hypnosis has applications in a wide range of psychological and health related problems. Research into clinical hypnosis has seen an improvement in scientific rigor and, in the past two decades, new research has expanded to include both randomized control trials and meta-analyses. However, the use of hypnosis in psychology, medicine, and psychotherapy lags behind its empirical support. As illustrated in the cases of Darlene (breast cancer survivor with hot flashes), Paul (smoking cessation), and Linda (irritable bowel syndrome) evidence supports clinical hypnosis for anxiety/stress, menopausal hot flashes, smoking cessation, and irritable bowel syndrome. Increasingly, hypnotherapy apps are integrated into care to provide low-cost access to self-hypnosis sessions. Clinical psychologists can expand their practice and competency with training in clinical hypnosis.
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Worldwide, more than eight million people die each year as a result of tobacco use. A large proportion of smokers who want to quit are interested in alternative smoking cessation methods, of which hypnotherapy is the most popular. However, the efficacy of hypnotherapy as a tobacco cessation intervention cannot be considered sufficiently proven due to significant methodological limitations in the studies available to date. The aim of the present study was to compare the efficacy of a hypnotherapeutic group program for smoking cessation with that of an established cognitive-behavioral group program in a randomized controlled trial. A total of 360 smokers who were willing to quit were randomly assigned to either hypnotherapy (HT) or cognitive-behavioral therapy (CBT) at two study sites, without regard to treatment preference. They each underwent a 6 weeks smoking cessation course (one 90 min group session per week) and were followed up at regular intervals over a 12 months period. The primary outcome variable was defined as continuous abstinence from smoking according to the Russell standard, verified by a carbon monoxide measurement at three measurement time points. Secondary outcome variables were 7 days point prevalence abstinence during the 12 months follow up and the number of cigarettes the non-quitters smoked per smoking day (smoking intensity). Generalized estimating equations were used to test treatment condition, hypnotic suggestibility, and treatment expectancy as predictors of abstinence. The two interventions did not differ significantly in the proportion of participants who remained continuously abstinent throughout the follow-up period (CBT: 15.6%, HT: 15.0%) and also regarding the 7 days abstinence rates during the 12 months follow-up (CBT: 21.2%, HT: 16.7%). However, when controlling for hypnotic suggestibility, CBT showed significantly higher 7 days abstinence rates. In terms of the continuous abstinence rates, it can be concluded that the efficacy of hypnotherapeutic methods for smoking cessation seem to be comparable to established programs such as CBT. Clinical trial registration ClinicalTrials.gov, identifier NCT01129999.
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Gut‐directed hypnotherapy (GDH) is a highly effective brain‐gut behavioral therapy which is recommended in international guidelines for the treatment of irritable bowel syndrome (IBS). There is increasing recognition of the value of GDH as part of integrated care alongside medical and dietary approaches. This has led to recent innovations to widen access to GDH to meet the increasing demand. Recent advances include streamlined courses of individualized GDH, group therapy, and remote delivery. In this issue of Neurogastroenterology and Motility, Peters et al. retrospectively report outcomes of smartphone app‐delivered GDH in a population with self‐reported IBS. While adherence was low, those that completed smart phone‐delivered GDH‐achieved symptom benefit. This mini‐review summarizes the current evidence‐base for available modalities of GDH and discusses the current and future utility and development of mobile health applications in the digital therapeutics' era.
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Purpose Nonpharmacological interventions such as hypnosis show promising evidence for the self-management of pain and pain-related sequelae among cancer survivors. The purpose of this study was to evaluate the efficacy of a 4-week recorded hypnosis intervention in reducing pain intensity compared to a recorded relaxation intervention in cancer survivors with chronic pain. Methods Adult cancer survivors were randomly assigned to listen to hypnosis (n = 55) or relaxation recordings (n = 54) daily for 28 days. Primary (pain intensity) and secondary outcomes (pain interference, anxiety, depression, fatigue, sleep disturbance) measures were completed pre- and post-treatment. Treatment effects were evaluated using a series of analyses of covariance. Results Both hypnosis and relaxation provided significant and moderate to large improvements in the primary outcome and the secondary outcomes of pain interference and anxiety (ds = 0.44–0.88). The hypnosis group also experienced a moderate improvement in fatigue (d = 0.47) and sleep disturbance (d = 0.54). The effect size for pain reduction from pre- to post-treatment for the hypnosis group was d = 0.86 and for the relaxation group, d = 0.88. There were no significant between-group differences in primary and secondary outcomes from pre- to post-treatment. Conclusions The results support that recorded hypnosis and relaxation interventions are similarly effective in reducing pain and the pain-related sequelae of pain interference and anxiety among cancer survivors with chronic pain. The hypnosis intervention also reduced fatigue and sleep disturbance. Audio recordings can provide a convenient delivery method of nonpharmacological interventions to self-manage chronic pain. Trial registration ClinicalTrials.gov Identifier: NCT03867760, registered March 8, 2019.
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Background Mobile health applications (mHealth apps) offer enormous promise for illness monitoring and treatment to improve the provided medical care and promote health and wellbeing. Objective We applied bibliometric quantitative analysis and network visualization to highlight research trends and areas of particular interest. We expect by summarizing the trends in mHealth app research, our work will serve as a roadmap for future investigations. Methods Relevant English publications were extracted from the Scopus database. VOSviewer (version 1.6.17) was used to build coauthorship networks of authors, countries, and the co-occurrence networks of author keywords. Results We analyzed 550 published articles on mHealth apps from 2020 to February 1, 2021. The yearly publications increased from 130 to 390 in 2021. JMIR mHealth and uHealth (33/550, 6.0%), J. Med. Internet Res. (27/550, 4.9%), JMIR Res. Protoc. (22/550, 4.0%) were the widest journals for these publications. The United States has the largest number of publications (143/550, 26.0%), and England ranks second (96/550, 17.5%). The top three productive authors were: Giansanti D., Samuel G., Lucivero F., and Zhang L. Frequent authors’ keywords have formed major 4 clusters representing the hot topics in the field: (1) artificial intelligence and telehealthcare; (2) digital contact tracing apps, privacy and security concerns; (3) mHealth apps and mental health; (4) mHealth apps in public health and health promotion. Conclusions mHealth apps undergo current developments, and they remain hot topics in COVID-19. These findings might be useful in determining future perspectives to improve infectious disease control and present innovative solutions for healthcare.
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Cancer can provoke fatigue, sleep disturbances, and emotional distress. Hypnosis interventions have shown positive short-term effects on these symptoms. However, less is known about their long-term effects. This study assessed the short- and long-term effects of a group intervention combining self-care and self-hypnosis on these symptoms in posttreatment cancer patients. Ninety-five female cancer survivors were randomized to either a hypnosis group intervention or wait-list control. Results showed significant decreases in fatigue, sleep difficulties and emotional distress after intervention for the hypnosis group intervention in comparison to the wait-list control. Most of these positive effects were maintained at 1-year follow-up. Most participants received the hypnosis group intervention approximately 10.65 months after diagnosis, and it is possible that delivering the intervention earlier after diagnosis could have achieved a more robust impact. Further studies are needed to replicate these results in comparison to an active control condition and investigate the best time postdiagnosis for initiating the intervention.
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Sleep disturbance can negatively affect physical and psychological health. Hypnotherapy may be effective for improving sleep with fewer side effects than other treatments. The purpose of this systematic review is to comprehensively identify studies and evidence regarding hypnotherapy for sleep disturbances. Four databases were searched to identify studies examining the use of hypnotherapy for sleep in adult populations. The search yielded 416 articles, of which 44 were included. Qualitative data analysis revealed that 47.7% of the studies showed positive results regarding the impact of hypnotherapy for sleep, 22.7% showed mixed results, and 29.5% showed no impact. A subset of 11 studies that set sleep disturbance as an inclusion criterion and included suggestions for sleep were examined separately and had more favorable results, such that 54.5% showed positive results, 36.4% showed mixed results, and 9.1% showed no impact results. Hypnotherapy appears to be a promising treatment for sleep disturbance. Future studies should report effect sizes, adverse events, and hypnotizability and include sleep-specific suggestions, standardized measures, and descriptions of hypnotherapy intervention procedures.
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Remote hypnotherapy is a treatment that is increasingly being utilized internationally. Its adoption has been accelerated following the COVID-19 pandemic when infection control measures mandated its implementation. Remote hypnotherapy via video, rather than telephone therapy, appears to be more popular and effective, which appears to be acceptable to patients and - compared to face-to-face therapy - has the potential to improve access. In this state-of-the-art article, the authors therefore review the latest literature in this exciting field of remote teletherapy, discussing adoption of video hypnotherapy; its evidence, including efficacy compared to face-to-face therapy; patient satisfaction; advantages and disadvantages of teletherapy; as well as practical considerations and factors that should be considered when deciding on the mode of delivery. They also discuss training implications of the recent developments. Finally, they highlight areas for future research and development. Overall, it is likely that remote hypnotherapy via video platforms is here to stay long term and has potential to become the standard form of therapy worldwide. However, recent data suggest that there may still be a need for face-to-face therapy with patient choice being an important factor.
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Effective, rigorously evaluated nonpharmacological treatments for chronic pain are needed. This study compared the effectiveness of training in hypnosis (HYP) and mindfulness meditation (MM) to an active education control (ED). Veterans (N=328) were randomly assigned to 8 manualized, group-based, in-person sessions of HYP (n = 110), MM (n = 108), or ED (n = 110). Primary (average pain intensity; API) and secondary outcomes were assessed at pretreatment, posttreatment, and 3- and 6-months posttreatment. Treatment effects were evaluated using linear regression, a generalized estimating equation approach, or a Fisher exact test, depending on the variable. There were no significant omnibus between-group differences in pre- to posttreatment change in API, however pre- to posttreatment improvements in API and several secondary variables were seen for participants in all three conditions. Participation in MM resulted in greater decreases in API and pain interference at 6-months posttreatment relative to ED. Participation in HYP resulted in greater decreases in API, pain interference, and depressive symptoms at 3- and 6-months posttreatment compared to ED. No significant differences on outcomes between HYP and MM were detected at any time point. This study suggests that all three interventions provide posttreatment benefits on a range of outcomes, but the benefits of HYP and MM continue beyond the end of treatment, while the improvements associated with ED dissipate over time. Future research is needed to determine whether the between-group differences that emerged posttreatment are reliable, whether there are benefits of combining treatments, and to explore moderating and mediating factors.
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Mobile health applications (apps) have transformed the possibilities for health promotion and disease self-management; however, their promise is not fully realized owing to their reliance on commercial ecosystems for development and distribution. This review provides an overview of the types of mobile health apps and describes key stakeholders in terms of how apps are used, developed, and regulated. I outline key challenges facing consumers, public health professionals, and policy makers in evaluating the quality of health apps and summarize what is known about the impact of apps on health outcomes and health equity. I suggest that factors within the wider mobile ecosystem largely define the impact of health apps and, most notably, practices around the collection and commercialization of user data. Finally, I suggest that upstream public health strategies, grounded in an understanding of corporate influences on health, are necessary to promote healthy digital environments in which mobile health app innovation can flourish. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.