Katherine Scheffrahn’s research while affiliated with Baylor University and other places

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Publications (5)


Hypnosis Apps: A Systematic Review
  • Literature Review
  • Full-text available

December 2024

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44 Reads

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2 Citations

Katherine Scheffrahn

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Morgan Snyder

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Gary R Elkins

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.

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Heart Rate Variability, Hypnosis, and Psychotherapy

Applied Psychophysiology and Biofeedback

Victor Julian Padilla

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Katherine Scheffrahn

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Vanessa Muñiz

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[...]

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Gary Elkins

Hypnotherapy is increasingly recognized as an effective treatment option for a wide range of psychological conditions and the psychological elements of physiologic health concerns. Despite its growing use, the mechanisms underlying hypnotherapy's therapeutic benefits remain unknown. Heart rate variability (HRV), a non-invasive biomarker of autonomic nervous system (ANS) activity and other processes relevant to the psychophysiological stress response, has been used to study the physiological effects of hypnosis. HRV is associated with adaptability to stress and overall mental and physical health. We review how HRV changes during hypnosis treatment and propose mechanisms by which hypnotherapy influences the stress response and psychological flexibility and improves wellbeing. Additionally, we highlight the use of HRV biofeedback as an adjunct to hypnotherapy and psychotherapy and illustrate its potential to enhance therapeutic outcomes. To showcase practical applications, we present a case study of hypnotherapy’s impact on HRV in the treatment of hot flashes in post-menopausal women. We conclude by calling for further empirical research, particularly randomized controlled trials, to solidify the integration of HRV metrics in hypnotherapy practice. Understanding the interaction between hypnotherapy and HRV will support more targeted and effective interventions, benefiting both clinicians and patients.


User Outcomes for an App-Delivered Hypnosis Intervention for Menopausal Hot Flashes: Retrospective Analysis (Preprint)

July 2024

BACKGROUND Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy. The Evia app delivers audio-recorded hypnotherapy and has the potential to help individuals experiencing hot flashes. OBJECTIVE This study aims to determine user outcomes in hot flash frequency and severity for users of the Evia app. METHODS This study is a retrospective analysis of a dataset of Evia app users. Participants were divided into 2 groups for analysis. The first group reported daytime hot flashes and night sweats, while the second group was asked to report only daytime hot flashes. The participants in the first group (daytime hot flashes and night sweats) were 139 women with ≥3 daily hot flashes who downloaded the Evia app between November 6, 2021, and June 9, 2022, with a baseline mean of 8.330 (SD 3.977) daily hot flashes. The participants in the second group (daytime hot flashes) were 271 women with ≥3 daily hot flashes who downloaded the Evia app between June 10, 2022, and February 5, 2024, with a baseline mean of 6.040 (SD 3.282) daily hot flashes. The Evia program included a 5-week program for all participants with daily tasks such as educational readings, hypnotic inductions, and daily hot-flash tracking. The app uses audio-recorded hypnosis and mental imagery for coolness, such as imagery for a cool breeze, snow, or calmness. RESULTS A clinically significant reduction, defined as a 50% reduction, in daily hot flashes was experienced by 76.3% (106/139) of the women with hot flashes and night sweats and 56.8% (154/271) of the women with daily hot flashes from baseline to their last logged Evia app survey. On average, the women with hot flashes and night sweats experienced a reduction of 61.4% (SD 33.185%) in their hot flashes experienced at day and night while using the Evia app, and the women with daily hot flashes experienced a reduction of 45.2% (SD 42.567%) in their daytime hot flashes. In both groups, there was a large, statistically significant difference in the average number of daily hot flashes from baseline to end point (women with hot flashes and night sweats: Cohen d =1.28; t 138=15.055; P <.001; women with daily hot flashes: Cohen d =0.82; t 270=13.555; P <.001). CONCLUSIONS Hypnotherapy is an efficacious intervention for hot flashes, with the potential to improve women’s lives by reducing hot flashes without hormonal or pharmacological intervention. This study takes the first step in evaluating the efficacy of an app-delivered hypnosis intervention for menopausal hot flashes, demonstrating the Evia app provides a promising app delivery of hypnotherapy with potential to increase accessibility to hypnotherapy.


User Outcomes for an App-Delivered Hypnosis Intervention for Menopausal Hot Flashes: A Retrospective Analysis (Preprint)

July 2024

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1 Read

JMIR Formative Research

Background Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy. The Evia app delivers audio-recorded hypnotherapy and has the potential to help individuals experiencing hot flashes. Objective This study aims to determine user outcomes in hot flash frequency and severity for users of the Evia app. Methods This study is a retrospective analysis of a dataset of Evia app users. Participants were divided into 2 groups for analysis. The first group reported daytime hot flashes and night sweats, while the second group was asked to report only daytime hot flashes. The participants in the first group (daytime hot flashes and night sweats) were 139 women with ≥3 daily hot flashes who downloaded the Evia app between November 6, 2021, and June 9, 2022, with a baseline mean of 8.330 (SD 3.977) daily hot flashes. The participants in the second group (daytime hot flashes) were 271 women with ≥3 daily hot flashes who downloaded the Evia app between June 10, 2022, and February 5, 2024, with a baseline mean of 6.040 (SD 3.282) daily hot flashes. The Evia program included a 5-week program for all participants with daily tasks such as educational readings, hypnotic inductions, and daily hot-flash tracking. The app uses audio-recorded hypnosis and mental imagery for coolness, such as imagery for a cool breeze, snow, or calmness. Results A clinically significant reduction, defined as a 50% reduction, in daily hot flashes was experienced by 76.3% (106/139) of the women with hot flashes and night sweats and 56.8% (154/271) of the women with daily hot flashes from baseline to their last logged Evia app survey. On average, the women with hot flashes and night sweats experienced a reduction of 61.4% (SD 33.185%) in their hot flashes experienced at day and night while using the Evia app, and the women with daily hot flashes experienced a reduction of 45.2% (SD 42.567%) in their daytime hot flashes. In both groups, there was a large, statistically significant difference in the average number of daily hot flashes from baseline to end point (women with hot flashes and night sweats: Cohen d=1.28; t138=15.055; P<.001; women with daily hot flashes: Cohen d=0.82; t270=13.555; P<.001). Conclusions Hypnotherapy is an efficacious intervention for hot flashes, with the potential to improve women’s lives by reducing hot flashes without hormonal or pharmacological intervention. This study takes the first step in evaluating the efficacy of an app-delivered hypnosis intervention for menopausal hot flashes, demonstrating the Evia app provides a promising app delivery of hypnotherapy with potential to increase accessibility to hypnotherapy.


Frequencies of demographic/clinical characteristics for users in total sample.
Mean and standard deviation of preprogram symptom severity scores for users in total sample.
Mean and standard deviation of new, total, and cumulative total sessions completed for paid users.
Chi-square test of independence of Nerva app program persistence across user/clinical characteristics for paid users.
Independent samples t-tests of preprogram symptom severity scores and Nerva app program persistence for paid users.

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Nerva, a mobile application of gut-directed hypnotherapy for irritable bowel syndrome: User characteristics, patterns of use, and predictors of persistence

June 2024

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98 Reads

Background Hypnotic intervention for irritable bowel syndrome (IBS), or gut-directed hypnotherapy (GDH), is an effective treatment for improving IBS symptoms with minimal burden and risk in delivery to patients. The Nerva app, developed by Mindset Health, shows promise for dissemination and implementation of evidence-based GDH intervention for IBS. Objectives This study aimed to describe the demographic and clinical characteristics of Nerva app users, examine usage patterns, and explore potential factors associated with Nerva app usage. Methods A retrospective analysis of data was conducted of 14,898 individuals who downloaded and used the Nerva app between January 2022 and September 2022. Descriptive statistics and Chi-square tests of independence were calculated to examine demographic/clinical characteristics, usage patterns, and their associations to program persistence. Simple linear regression models were used for correlations of GI symptoms severity scores to user persistence. Results Users predominantly identified as female (77.2%; n = 11,503) and had a mean age of 38.59 years old (SD = 13.38). Thirty-one percent of users persisted with the program, and a small statistically significant association was found between Nerva app program persistence and age, χ² (6, N = 6745) = 164.82, p < 0.001, V = .16. Conclusions The present study found promising adherence rates for the Nerva app program within the first six weeks of use. Statistics in prevalence estimates of IBS agree with previous literature and significant associations were found between user/clinical characteristics and Nerva app program persistence.