What Is Cognitive Behavioural Hypnotherapy?

If you've done any research into therapy, you've probably come across CBT — cognitive behavioural therapy. It's one of the most widely researched and recommended forms of psychological treatment, offered routinely by the NHS. You've probably also encountered hypnotherapy, which has its own growing evidence base. But what happens when you combine them?

Cognitive behavioural hypnotherapy (CBH) is exactly that combination, and it forms the core of my practice at Hypnotherapy Choice. It's not a gimmick or a marketing exercise. There are solid theoretical and practical reasons why these two approaches complement each other so well.

The Logic Behind the Combination

CBT works primarily at the conscious level. It helps you identify unhelpful thought patterns (cognitive distortions), challenge them rationally, and develop healthier alternatives. It's effective, practical and well-evidenced. But it has a limitation: it relies on conscious, deliberate effort to change patterns that often operate automatically and subconsciously.

Hypnosis, on the other hand, communicates directly with the subconscious mind. It's excellent at changing automatic responses, deeply held beliefs and habitual behaviours. But traditional hypnotherapy sometimes lacked the structured, evidence-based framework that CBT provides.

CBH brings both together. You get the structured, evidence-based cognitive work of CBT reinforced by the subconscious change potential of hypnosis. The result is a therapy that works at both levels simultaneously.

What CBH Looks Like in Practice

A typical CBH session has a clear structure:

Phase 1: Cognitive Work (Conscious Level)

We discuss your experiences since the last session. What went well? What was challenging? We identify specific thought patterns or situations to work on and develop cognitive strategies for addressing them. This might involve examining evidence for and against a particular belief, developing more balanced perspectives, or planning behavioural experiments.

Phase 2: Hypnosis (Subconscious Level)

The insights and strategies developed during the cognitive phase are then reinforced under hypnosis. While you're in a deeply relaxed, focused state, I use suggestions and imagery to embed the new thought patterns at a subconscious level. We might rehearse confident responses to previously anxiety-provoking situations, strengthen new beliefs about yourself, or desensitise you to specific triggers.

Phase 3: Integration

After the hypnosis, we briefly debrief. I'll often give you self-hypnosis exercises that mirror the session's therapeutic focus, giving you a tool to continue the work between appointments.

The Evidence

A landmark meta-analysis by Kirsch, Montgomery and Sapirstein, published in the Journal of Consulting and Clinical Psychology, examined 18 studies comparing CBT alone with CBT combined with hypnosis. The findings were striking: adding hypnosis to CBT substantially enhanced treatment outcomes. The average client receiving CBH showed greater improvement than approximately 70% of clients receiving CBT alone.

This isn't a niche finding. It's been replicated across multiple conditions including anxiety, obesity, insomnia and chronic pain.

Who Developed CBH?

The formal integration of CBT and hypnotherapy has been developed by several practitioners and researchers, notably Donald Robertson, whose book The Practice of Cognitive Behavioural Hypnotherapy provides a comprehensive framework. The approach also draws on earlier work by Albert Ellis (founder of REBT) and Aaron Beck (founder of CBT), both of whom acknowledged the potential of hypnosis within cognitive therapeutic frameworks.

What Conditions Does CBH Treat?

CBH is effective for essentially the same conditions as both CBT and hypnotherapy, often with better outcomes than either alone:

• Generalised anxiety and social anxiety
• Specific phobias
• Low self-esteem and negative self-image
• Insomnia and sleep difficulties
• Chronic pain
• Weight management
• Performance anxiety
• Stress management

How CBH Differs from Traditional Hypnotherapy

Traditional hypnotherapy tends to rely heavily on direct suggestion — essentially telling the subconscious what to think and feel. CBH adds a cognitive dimension: before we make suggestions, we've thoroughly analysed the thought patterns that maintain the problem. The suggestions are then precisely targeted and integrated with conscious strategies.

This means the work you do in CBH sessions isn't just received passively. You understand why you think and feel the way you do, you've developed conscious strategies for change, and those strategies are then reinforced at a deeper level through hypnosis. It's a belt-and-braces approach.

Is CBH Right for You?

CBH suits people who appreciate an evidence-based, structured approach and want to understand the "why" behind their problems as well as receiving treatment. If you prefer to understand the mechanism of your therapy rather than simply trusting the process, CBH is likely a good fit.

It also suits people who have tried CBT and found it helpful but incomplete — who recognise the truth in the cognitive insights but struggle to make them stick at an emotional or behavioural level. Hypnosis provides the missing piece.

To discuss whether CBH might help with your specific issue, book a free telephone consultation. You can also read more about how hypnosis works or how it compares to other therapies.