Effect of hypnosis versus mindfulness on self-defined treatment goals and sleep following acquired brain injury: a randomized actively controlled trial

Introduction: Cognitive rehabilitation for brain injury using hypnosis has received little attention. Methods: Here, we report on self-defined treatment goals and sleep-related outcomes from a randomized actively controlled trial of 49 patients with chronic cognitive sequelae following acquired brain injury. Patients were randomized to two groups, who initially received hypnotic suggestions either from a classical hypnosis tradition (“targeted”) or from a mindfulness tradition (“non-targeted”). Patients set self-defined goals for their everyday lives. Results: After eight sessions, patients reported outcomes (PROs) indicated large improvements with “same” (13%), “better” (44%), “much better” (18%), or “not a problem anymore” (25%). The reported “not a problem anymore” was exclusively reported following hypnosis, not mindfulness. After a 7-week follow-up period both groups experienced a decrease in their need for sleep (~ 55 min/day). Exploratory factor analysis showed that only improvement on objective but not subjective measures (e.g. Working Memory Index, Trail Making Test, and the European Brain Injury Questionnaire scored by a relative) reflected a latent improvement factor. This indicates that subjective reports following hypnotic suggestions should be interpreted cautiously. Conclusion: Based on our findings and converging evidence, we conclude that hypnosis is a promising method in cognitive neurorehabilitation following acquired brain injury, although further high-quality randomized controlled trials are required.