Cognitive-Behavioural Therapy plus Hypnosis as an evidence-based intervention to reduce emotional distress in women with breast cancer

Radiotherapy is a common and effective treatment for women with breast cancer. However, radiotherapy has also been shown to adversely affect patients’ emotional well-being. One intervention which has demonstrated clinical efficacy in the breast cancer radiotherapy setting is Cognitive-Behavioural Therapy plus Hypnosis. According to a study published in 2014, breast cancer patients receiving radiotherapy showed decreased fatigue as a result of cognitive behavioural therapy plus hypnosis. A randomized controlled trial of 100 patients showed that the treatment group displayed significantly less fatigue than a control group during the treatment and for up to 6 months post treatment.
The study, published in the Journal of Clinical Oncology (2014; doi:10.1200/JCO.2013.49.3437), was led by Guy Montgomery, PhD, associate professor and director of the Integrative Behavioural Medicine Program in the Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai in New York, New York.
The aim of the study was to investigate the impact of Cognitive-Behavioural Therapy plus Hypnosis on emotional distress in women with breast cancer undergoing radiotherapy. One hundred patients were randomly assigned to either the Cognitive-Behavioural Therapy plus Hypnosis (n = 50) or Attention Control (n = 50) group. Patients were taught the ABC model of cognitive-behavioural therapy: A, activating events; B, beliefs; and C, consequences. They were taught to identify beliefs that were negative and unhelpful and their consequences. They completed a thought worksheet based on the ABC model, and they were taught behavioural strategies such as activity scheduling and distraction to help them manage fatigue.
Results revealed significant benefits of Cognitive-Behavioural Therapy plus Hypnosis on emotional distress at the mid-point (d = 0.54), the conclusion (d = 0.64), and 4 weeks following the conclusion (d = 0.65) of radiotherapy (all ps < 0.05).
In summary, the results support further study of Cognitive-Behavioural Therapy plus Hypnosis has the benefits of being brief, non-invasive, lacking side-effects, and producing beneficial effects which last beyond the conclusion of radiotherapy. Given these strengths, the researchers propose that Cognitive-Behavioural Therapy plus Hypnosis is a strong candidate for greater dissemination and implementation in cancer populations.