Michael Yapko (1989, 1992, 1994) is the most prolific current therapist to enthusiastically embrace the application of hypnotic techniques to the management of depression. Unfortunately, it is necessary to agree with recent reviewers of his work (Stanley, 1994; Council, 1993) that what is undoubtedly a 'flexible and creative approach to patient management' (Stanley, 1994) is accompanied by a relative disregard for empirical data. Others have levelled this criticism at the Ericksonian/ brief therapy literature in general (Bloom, 1991). The criticism of a general lack of attention to theory, research and to standardize assessment, however, can validly be directed towards the body of published material in the area of hypnosis as a whole, which remains dominated by descriptive case material.
To make any useful statement about the value of hypnosis in the management of depression, it is necessary to look more broadly at the wider research on depression and consider the ways in which hypnotic techniques may augment clinical approaches to the management of depression. The National Institute of Mental Health Treatment of Depression Collaborative Research Programme (TDCRP: Elkin, Parloff, Hadley & Autry, 1985) with its analysis and follow-up of 250 unipolar depressed outpatients at three different sites, randomly assigned to one of four treatment conditions (cognitive-behaviour therapy, imipramine plus clinical management, interpersonal psychotherapy and a pill-placebo control), contributes significantly to the current body of knowledge. The findings of this research and the ongoing debate (see, for example, Jacobson & Hollon, 1996) raise numerous significant issues for the area. As Shea, Elkin, Imber et al. (1992) point out, none of the treatments perform well in their capacity to promote lasting recovery. Major depression remains a challenge for all treatment approaches, including pharma-cotherapy. Jacobson & Hollon (1996) also raise the important issue of therapeutic allegiance in this context, suggesting that therapists who have a commitment to a specific treatment modality are likely to more effectively implement that treatment and less effectively implement others. Such considerations represent both a challenge and a potential source of increased power.
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