International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOSIS AND DEPRESSION 137
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
signi®cantly to the current body of knowledge. The ®ndings of this research and
the ongoing debate see, for example, Jacobson & Hollon, 1996) raise numerous
signi®cant 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 pharmacotherapy.
Jacobson & Hollon 1996) also raise the important issue of therapeutic
allegiance in this context, suggesting that therapists who have a commitment to a
speci®c 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.
COMBINING HYPNOSIS WITH CURRENT THERAPEUTIC
APPROACHES TO DEPRESSION
As summarized earlier, numerous case studies have suggested ways in which
hypnotic methods can be utilized in psychodynamic therapy. Yapko 1989, 1992,
1994) has described a variety of indirect and metaphoric techniques in a cognitivebehavioural
framework. However, as Stanley 1994) has commented, he has made
little use of the wide variety of well-documented, more directive cognitivebehavioural
techniques. The Cognitive Dissociative Model of nonendogenous
unipolar depression Alladin, 1994) attempts to utilize hypnosis and cognitivebehavioural
techniques in a multifactorial treatment approach. The way in which
hypnotic techniques may augment a cognitive-behavioural management programme
for depression represents a challenge for future research.
UTILIZING HYPNOTIC TECHNIQUES IN A COGNITIVE-
BEHAVIOURAL MANAGEMENT PROGRAMME FOR
DEPRESSION
A range of possibilities exists for the integration of hypnosis with cognitivebehavioural
techniques. These include
1 A thorough assessment of depression, including records of activities, cognitions