How it differs from CBT
COMPARING APPROACHES
If you’ve studied CBT, work in psychology, or already practise hypnotherapy, you’re likely asking how Hypno-CBT® compares.
At a glance
Hypno-CBT® combines CBT, hypnosis and mindfulness into a single integrated approach, rather than treating them as separate techniques used alongside one another.
CBT
+ Hypnosis
+ Mindfulness
= One integrated approach
It builds on the same evidence-based foundations as CBT, integrating structured hypnotic techniques that help people mentally rehearse new ways of thinking, feeling and responding. The aim is not just to help clients understand change intellectually, but to give them a practical method for embedding it in everyday life.
It’s also worth clearing up a common misconception: Hypno-CBT® is not hypnosis in the popular sense, but focused attention, expectation and imagination within an evidence-based psychological framework.
The same foundations as CBT
Hypno-CBT® starts from exactly the same understanding of psychological problems as CBT.
Whether someone is struggling with anxiety, depression, stress or a phobia, the focus is on the thoughts, emotions and behaviours that are maintaining the problem in the present; not on uncovering hidden causes from the distant past.
Like CBT, treatment involves helping clients learn practical skills such as recognising unhelpful thinking patterns, reducing avoidance, approaching feared situations gradually and developing more balanced ways of responding.
The difference is that Hypno-CBT® integrates hypnosis throughout this process rather than treating it as something separate.
Modern clinicians generally view hypnosis not as a complete therapy in its own right, but as a way of strengthening established psychological treatments. Hypno-CBT® builds on this idea by weaving hypnosis into CBT from beginning to end.
What does hypnosis add?
The key addition is mental rehearsal.
CBT helps people understand new ways of thinking and behaving. Hypno-CBT® goes one step further by helping clients vividly rehearse those new responses through focused imagination.
Rather than simply discussing how to stay calm in a difficult situation, for example, clients repeatedly imagine themselves responding calmly, confidently and successfully. This gives both mind and body an opportunity to practise the new response before encountering it in everyday life.
This integration extends throughout therapy.
In CBT, people learn to notice negative automatic thoughts – the habitual thoughts that seem to pop into the mind on their own. Hypno-CBT® builds on this by helping people step back from those thoughts, before using focused imagination and self-hypnosis to practise more helpful ways of thinking and responding.
Mindfulness also plays an important role by helping clients observe thoughts without automatically believing or reacting to them.
Does it work better than CBT alone?
CBT is one of the most extensively researched psychological therapies available, so demonstrating an improvement over CBT represents a high standard.
A growing body of research suggests that integrating hypnosis with CBT can improve outcomes for many clients.
What does the research show?
70%
The average client in CBT + hypnosis improved more than at least 70% of those in CBT alone (Kirsch et al.)
controlled studies reviewed in the Ramondo et al. (2021) meta-analysis
participants pooled in the Ramondo et al. study
72%
of participants showed better outcomes at follow-up with CBT + hypnosis
Kirsch et al. (1995)
Analysed controlled studies involving 577 participants comparing CBT alone with CBT combined with hypnosis. The average client receiving CBT combined with hypnosis showed greater improvement than at least 70% of those receiving CBT alone.
Ramondo et al. (2021)
Revisited this question with a substantially larger and more rigorous analysis, reviewing 48 controlled studies involving 1,928 participants. They found that the average client receiving CBT plus hypnosis was better off than 66% of those receiving CBT alone immediately after treatment, rising to 72% at follow-up. Both studies found the effect statistically significant and in the same direction.
Alladin & Alibhai (2007)
Studied a related model (combining CBT with a dissociation-based approach to hypnosis) for depression, finding greater reductions in depression, anxiety and hopelessness than CBT alone, maintained at six and twelve months.
Taken together, the evidence suggests that hypnosis is most effective when used to enhance an already well-established psychological therapy, not as an alternative to it.
How hypnosis enhances CBT
Research points to several ways in which hypnosis can enhance cognitive and behavioural interventions, including:
- increasing positive expectations about treatment, which are themselves an important part of psychological change;
- promoting deep relaxation, making new responses easier to learn and practise;
- enhancing mental imagery, allowing clients to rehearse new patterns of behaviour more vividly;
- teaching self-hypnosis, improving confidence, self-regulation and independence between sessions;
- deepening the therapeutic relationship between practitioner and client.
These processes are not alternatives to CBT, they help strengthen the cognitive and behavioural techniques already being used. Their combined effect is thought to contribute to the improved outcomes seen in research comparing CBT integrated with hypnosis against CBT alone – the same principle Hypno-CBT® is built on.
What does a session involve?
Although hypnosis is integrated throughout therapy, sessions remain recognisably cognitive behavioural in style.
Every practitioner works slightly differently, but a typical Hypno-CBT® session might include:
- developing a shared understanding of the problem with the client, using a CBT formulation;
- teaching practical cognitive and behavioural strategies;
- guiding relaxation and attention-control skills;
- supporting clients in gradually facing feared situations where appropriate;
- using guided imagery and self-hypnosis to help clients rehearse new ways of thinking, feeling and responding until they become familiar responses.
What Hypno-CBT® is not
Hypno-CBT® deliberately avoids ideas that are common in popular culture but are not part of modern evidence-based practice.
It does not involve:
- being “put into a trance”;
- uncovering repressed memories;
- searching for hidden unconscious causes;
- regression therapy to relive childhood experiences;
- vague claims about “reprogramming the unconscious mind.”
Instead, it focuses on helping people develop practical skills that they can continue using long after therapy has ended.
In summary
Hypno-CBT® is not an alternative to CBT – it is CBT, enhanced through the structured integration of hypnosis and mindfulness. By combining evidence-based cognitive and behavioural techniques with focused mental rehearsal, it is designed to help new ways of thinking and responding become practised, familiar and easier to apply in everyday life.
Explore further
For the full evidence base behind these findings, see The science. If you’re a therapist interested in training in Hypno-CBT®, see The Hypno-CBT® Diploma.
Deep dive
The science
The full evidence base behind Hypno-CBT®.
Training
The Hypno-CBT® Diploma
How to train as a Hypno-CBT® practitioner.
References
- Alladin, A., & Alibhai, A. (2007). Cognitive hypnotherapy for depression: An empirical investigation. International Journal of Clinical and Experimental Hypnosis, 55(2), 147–166.
- Kirsch, I., Montgomery, G., & Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioural psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214–220.
- Ramondo, N., Gignac, G. E., Pestell, C. F., & Byrne, S. M. (2021). Clinical hypnosis as an adjunct to cognitive behavioural therapy: An updated meta-analysis. International Journal of Clinical and Experimental Hypnosis, 69(2), 169–202.