Science or Magic? Patient attitudes to hypnotherapy as a treatment for refractory Irritable Bowel Syndrome (IBS)

Problem

IBS is a common condition which has a high cost to GPs in both time and money. Hypnotherapy is a recommended treatment for refractory IBS within National Institute of Health and Care Excellence (NICE) guidelines since 2008 and studies suggest that 70+% of GPs are in favour of hypnotherapy for IBS. However, hypnotherapy for IBS does not appear to be popular with patients. In one study it was 7th least popular of 9 treatments and in another study 22% of IBS sufferers failed to take up a hypnotherapy referral. This lack of enthusiasm may be the product of media imagery of coercive power and bizarre effects. However, this contrasts with existing research which suggests the public as a whole are positive towards hypnotherapy. Only one qualitative study of IBS sufferers’ attitudes to hypnotherapy currently exists, which hints that sufferers may consider psychological approaches inappropriate for IBS. However, much more qualitative research is required to identify factors limiting IBS patients’ engagement with hypnotherapy services.

Approach

One to one, face to face, semi structured interviews with a convenience sample of IBS sufferers recruited from Internet support groups and via West Midlands large employers such as universities, financial services providers and manufacturers. These will be Adults (18≤) who self-identify as having IBS for which they have continued to experience symptoms for 12 months or more following pharmacological treatment. Recorded and transcribed data will be coded onto NVivo and analysed using the framework method to highlight freely emerging themes as well as those arising from the topic guide. In addition, the data will be further analysed using Weber’s concept of the gap between two forms of power: 1. Charisma - The undefinable or even magical qualities of a healer, in which the power lays within the healer. 2. Bureaucracy – Power derived from scientific knowledge and rigorous validated study, the centre of the power lays within the collective knowledge. This will allow the exploration of media influence on patients’ views and to ascertain where on the Charisma-Bureaucratic axis IBS sufferers perceive hypnotherapeutic treatment.

Findings

Three types of themes will be presented; those directly explored in the topic guide; additional freely emerging themes; those relating to charisma and bureaucracy. Their interaction, influence on patients and apparent barriers to uptake of hypnotherapeutic treatment will be discussed.

Consequences

Despite being recommended by NICE for refractory IBS and endorsed by GPs, hypnotherapy appears to have low uptake by patients. This qualitative study will provide an insight into refractory IBS patients’ views which can inform GPs when suggesting this treatment and help develop material for patient education.