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Examining Hypnosis Legislation: ASurvey of the Practice in IsraelAlex Aviv a , Gilboa Dalia b , Golan Gaby c & Peleg Kobi da Abarbanel Mental Health Center and Sackler School ofMedicine , Tel-Aviv University , Tel-Aviv, Israelb Ministry of Health , Jerusalem, Israelc Sackler School of Medicine , Tel-Aviv University , Tel-Aviv, Israeld The Gertner Institute for Epidemiology and HealthPolicy Research , Tel-Hashomer, IsraelPublished online: 27 Oct 2010.
To cite this article: Alex Aviv , Gilboa Dalia , Golan Gaby & Peleg Kobi (2007) ExaminingHypnosis Legislation: A Survey of the Practice in Israel , International Journal of Clinicaland Experimental Hypnosis, 56:1, 47-62, DOI: 10.1080/00207140701673001
To link to this article: http://dx.doi.org/10.1080/00207140701673001
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Intl. Journal of Clinical and Experimental Hypnosis, 56(1): 47–62, 2008Copyright © International Journal of Clinical and Experimental HypnosisISSN: 0020-7144 print / 1744-5183 onlineDOI: 10.1080/00207140701673001
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NHYP0020-71441744-5183Intl. Journal of Clinical and Experimental Hypnosis, Vol. 56, No. 1, Oct 2007: pp. 0–0Intl. Journal of Clinical and Experimental HypnosisEXAMINING HYPNOSIS LEGISLATION: A Survey of the Practice in Israel
Hypnosis in IsraelAlex Aviv et al. ALEX AVIV1,2
Abarbanel Mental Health Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
GILBOA DALIA
Ministry of Health, Jerusalem, Israel
GOLAN GABY
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
PELEG KOBI
The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel
Abstract: Hypnosis as a therapeutic technique bears potential riskswhen carried out inexpertly. Because of this, Israel was the first to leg-islate hypnosis. This study examines the current state of clinical hyp-nosis practice in Israel. A questionnaire was sent to 470 licensedhypnotists and 1250 unlicensed professionals; 478 (25.7%) of the 1720potential respondents returned the questionnaires. Of these, 249(51.8%) were licensed hypnotists, and 232 (48.2%) were unlicensed.Of the unlicensed professionals, 45% reported practicing hypnosis;50% of them practice hypnosis with adolescents and 41.2% with chil-dren. Many of them practice hypnosis in public clinics (71.6%). Of thelicensed professionals, 94.4% reported practicing hypnosis in thecourse of their clinical work. The authors conclude that great numberof unlicensed hypnotists carry on clinical practice of hypnosis andsuggest steps to increase the efficiency of the law as part of a regula-tory system.
Hypnosis is a therapeutic technique, which can be defined in morethan one way. The Israeli Uses of Hypnosis Law defines it as “any act orprocess intended or likely to cause, by means of suggestion, changes inthe state of consciousness or degree of awareness, or in the body
Manuscript submitted December 5, 2001; final revision accepted August 16, 2006.1We would like to thank Avia Munchik, Alon Yaffe, and Ester Hadar for their
research and editorial assistance.2Address correspondence to Dr. Alex Aviv, M.D., Abarbanel Mental Health Center,
15 Keren Kayemet St., Bat Yam 59100, Israel. E-mail: [email protected]
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sensations, feelings, thinking, memory or behavior of other person”(The Israeli Society of Hypnosis, n.d.).
There is widespread agreement among professionals and research-ers that hypnosis, just as any other therapeutic intervention, bearspotential risks when carried out inexpertly (Barber, 1998; Coe & Ryken,1979; Frauman, Lynn, & Brentar, 1993; Lynn, Martin, & Frauman, 1996;MacHovec, 1986). Cases in which harmful consequences followed themisuse of hypnosis (e.g., Kleinhauz & Beran, 1981; Kleinhauz,Dreyfuss, Beran, Goldberg, & Azikri, 1979) and others in which com-plications and negative effects occurred during and after hypnosis(e.g., Coe & Ryken; Lynn et al.) are well documented in the literature.Therefore, professional standards dictate that any hypnosis treatmentmust be grounded in a knowledge based on past experience andpractice with solid roots in scientific knowledge (Thomson, 2003). Still,many therapists endorse popular yet mistaken beliefs about hypnosis(Channon, 1984; Yapko, 1994), and it seems that many others treatpatients with hypnosis on the mere basis of their personal beliefs andphilosophy and without a thorough understanding and knowledge ofthe facts now sufficiently established in this field (Kai-ching Yu, 2004;Yapko).
Acknowledging the potential harm that might be caused to patientsby the misuse of hypnotic interventions, the Israeli legislature resolvedto take the necessary steps that would promote the safety of thepatients. To meet this end, the Israeli Ministry of Health gathered agroup of experts in the field of hypnosis to formulate the principlesupon which a hypnosis law could be based. The Israeli legislativeauthority (the Knesset) finally approved the Uses of Hypnosis Law in1984. As a result, Israel became the first country to legislate hypnosis.It should be noted here that numerous countries, such as Norway,Sweden, Austria, and Australia, have similar regulations, which limitthe practice of hypnosis to physicians, psychologists, and dentists.However, the training required in hypnosis and the licensing processhas not been legislated and thus is not monitored or standardized bytheir governments. The main purpose of the legislation in Israel was todefine clear boundaries and limitations that would best ensure thatonly skilled and qualified professionals practice hypnosis. In line withthis, the law determines that only certified physicians, psychologists,and dentists are allowed to practice hypnosis, following an adequateeducation and formal certification.
These limitations were based on the published literature thatstresses the importance of medical or psychological training thatenables a better understanding of hypnotic processes (e.g., Fraumanet al., 1993). It has been argued that hypnotists who lack professionalpsychiatric, medical, psychological, or dental training will most likelybe unable to recognize or to perceive messages of distress or emotional
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signs from the patient (Kleinhauz & Beran, 1981). Moreover, lacking anunderstanding of the processes involved, the practitioner cannot inter-vene to redirect these messages or to utilize them in a constructivemanner (Kleinhauz & Beran). Bloom (1993) emphasizes this point bystressing that no one should treat patients with hypnosis for any condi-tion for which he or she would not treat them without it.
The law also determines that a person will be authorized to practicehypnosis only if he or she has completed recognized studies in hypnosisand passed the official examinations (Israeli Society of Hypnosis, n.d.).Any practice of hypnosis without training and license is therefore anillegal act in Israel. It was the legislators’ belief, in congruence withresearchers in this field, that a professional who is trained and licensed asa hypnotist is more likely to be able to identify and to intervene appropri-ately in the case of an incipient negative reaction, thereby mitigating itssignificance and potential harm to the patient (Frauman et al., 1993).
Stipulating the practice of hypnosis in a law was also meant toimprove this clinical practice’s status and reputation. Johnson andHauck (1999), reviewing the literature, conclude that there is wide-spread misunderstanding regarding hypnosis in the general public,which is based on myth and misconception. There is evidence thatpatients whose main source of information about hypnosis is eithertelevision or stage acts hold unfavorable views about hypnosis. Thesepeople tend to believe that hypnosis is not clinically useful and toadmit that they would not easily consent to hypnosis-based treatment(McIntosh & Hawney, 1983). Nevertheless, both McConkey (1986) andGreen (2003) showed that such opinions and other misconceptionsabout hypnosis might change substantially following the experience ofbeing hypnotized in a standardized procedure. Acknowledging thathypnosis often suffers from an unjustified bad reputation because ofthe harmful misuse of it by charlatans or the entertainment industry,the Israeli Law of Hypnosis prohibits stage hypnosis and any other useof hypnosis for purposes of entertainment. It was hoped that this pro-hibition would help hypnosis gain the credibility it deserves in theeyes of the public and the professional community.
Another purpose of the law, other than its aim of controlling the prac-tice of hypnosis, was also the formation and defining of a structured andreliable route for training and certification in hypnosis. In order toachieve that, the law authorized the Minister of Health to establish theAdvising Committee for Hypnosis (ACfH). This committee functions asa controlling body that determines which are the institutions that areentitled to provide training in hypnosis, the nature and extent of thetraining programs, and the required examinations. In addition, the com-mittee is responsible for the training and the authorization of the guidesthat teach in each of the recognized institutions and for the monitoringand quality assurance of these training programs.
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In spite of the legislation of hypnosis in Israel, the ACfH estimates thata considerable number of physicians, dentists, and psychologists todaystill practice hypnosis as a clinical intervention while lacking an adequatetraining and/or licensing and are consequently breaking the law. Thus, itseems that while the law surely fulfilled some of its objectives, muchwork is still needed before it accomplishes its ultimate purpose.
Another issue that deserves attention is whether or not and theextent to which professionals who are trained and authorized in hyp-nosis actually integrate hypnosis into their practice. The possibilitythat some of them refrain from the clinical practice of hypnosis mightbe an indication that hypnosis training needs to be improved, modi-fied, or otherwise adjusted to meet the needs of these professionals.
These concerns encouraged the ACfH in 2003 to initiate the currentstudy, which the Gertner Institute for Epidemiology and Health Policyconducted on behalf of the committee.
The broad purpose of the study was to examine the implementationof the Uses of Hypnosis Law in Israel and to outline the dimensions ofclinical hypnosis practice. More specifically, one major question was theextent of the illegal clinical practice of hypnosis in Israel by profession-als who were trained in hypnosis yet not certified. In relation to thisquestion, the study was also aimed at shedding light on the reasons thatdeter many professionals from taking the necessary steps for acquiringa license to practice hypnosis. Another question asked the extent of theactual practice of hypnosis by authorized professionals. In addition, thestudy wished to demographically characterize licensed hypnotists com-pared with their colleagues who were trained yet not certified.
It is important to note that there is another group of professionals,from health-related disciplines, that have not acquired any sort of formaleducation in hypnosis but practice hypnosis in their daily clinical set-tings. Several of these professionals do this in an overt manner, but themajority practice hypnosis through the use of various therapeutictechniques, such as healing, guided-imagination, and Eye MovementDesensitization and Reprocessing (EMDR), as well as alternative medi-cine. It was impossible to estimate their number or to track them downfor the purpose of this study. However, the study did try to examine theextent to which trained hypnotists, licensed or unlicensed, actually prac-tice hypnosis through other therapeutic techniques and whether theyuse methods of alternative medicine as part of their clinical practice.
METHOD
Sample SelectionAll 1720 professionals who had attended authorized training
courses were contacted, 470 (27.3%) of whom were legally certified and1250 (72%) of whom had failed to qualify. All licensed professionals
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(physicians, psychologists, and dentists) were registered in the Minis-try of Health in 2003. Those who were trained but not certified wereprofessionals who had, in the course of the years, participated in ahypnosis course in one of the accredited institutions in Israel but werenot licensed because they either didn’t take the test or had failed topass it.
InstrumentsA 25-item questionnaire was constructed, comprising of 3 items
on the demographic characteristics of the recipient (gender, age, res-idency) and of 22 multiple answer items, as well as questions thatrequested the recipient to state a number. The questionnaire was for-mulated so to give an overview of the hypnosis practice in Israel andthe participants’ opinions regarding the license-obtaining process inIsrael. Most of the items were on a Likert scale, which requiredselecting one answer out of four to seven possibilities. The anonym-ity and confidentiality of the questionnaire were emphasized(Appendix A).
ProcedureThe two-page questionnaire, a cover letter from the advising com-
mittee, and a stamped, addressed return envelope were mailed out tothe 1720 professionals. The cover letter explained the purpose of thestudy, and participants were asked to mail or to fax the questionnaireback. The survey was conducted between November 2003 and June2004.
The questionnaires that were returned due to incorrect addresswere remailed after locating an updated address. Sixty-four (3.72%)questionnaires were not remailed, because the correct addresses werenot obtained.
RESULTS
Characteristics of the RespondentsThe questionnaires were returned by 478 (25.7%) of the 1720 poten-
tial respondents. Of the total number of respondents, 249 (51.8%) werelicensed hypnotists, showing a response rate of 44.7%; 232 (48.2%)were unlicensed professionals, with a somewhat smaller response rateof 18.4%; 46.3% of the respondents were psychologists, 30.6% werephysicians, and 23% dentists. A Chi-square analysis did not yield anysignificant difference in the prevalence of the three professions withinthe two groups (licensed/unlicensed). Of the total respondents, 55.1%were male, 44.9% were female, and the mean age was 48.7, with a stan-dard deviation of 9.99. The minimum age was 27 and maximum agewas 85.
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Regarding training, 51.1% of the respondents acquired their hypno-sis education in a university, 36.4% studied in one of the recognizedhypnosis training institutions, 11% studied in other institutions, and1.5% did not mark any of the options to this question. Of the total num-ber of respondents, 4% underwent their hypnosis training before 1980,14% studied during the 1980s, 58% during the 1990s, and 24% acquiredtheir training between 2000 and 2003. Seventy-one percent of therespondents were residents of central Israel, 21% reside in north Israel,and the remaining 8% in south Israel.
Dimensions and Characteristics of the Unauthorized PractitionersOf the unlicensed professionals, 45% (103 people) reported that they
use hypnosis in the course of their clinical work. Of all unlicensed pro-fessionals, only 3% (7 people) took the test and failed it; the remaindernever even attempted the test. The most common reason for avoidingthe governmental qualifying exam is a feeling of not having enoughpractical experience in the field of hypnosis prior to the exam. Of theunlicensed professionals, 35.4% marked this option as their reason forfailing to take the test; 29.7% did not take the test because they do notpractice hypnosis; 18.8% stated that the license is meaningless to them;and 7.4% cited fear of failure as their main reason for avoiding the test.Nevertheless, 30% of the unlicensed professionals indicated that theywere planning to take the test in the following year.
Of the unlicensed professionals, 34.1% indicated also that a shortcourse to refresh the hypnosis course material would encourage manyto take the governmental qualifying exam; 32.8% thought that seniorprofessionals should be exempt from taking the exam. In response tothe question of what would encourage people to sit for the licensingexam, 8.7% responded that an easier exam would, 7.4% said a writtenexam, 11.4% marked other as their answer, and 22.7% did not answerthat question altogether.
As shown by the data, unlicensed hypnosis is being practiced withadults (80%), adolescents (50%), and children (41.2%). It is beingpracticed not only in private clinics (30.4%) but also in a large number ofpublic clinics (71.6%) and to some extent also in hospitals (15.7%). Ahigher percentage of the unlicensed professionals live in the central areasof Israel (68.1%), compared to those residing in peripheral areas (31.9%).
As for the use of other therapeutic methods by practitioners who donot possess a license for hypnosis, 85.4% (194 people) of them usemethods such as healing, guided imagination, relaxation, and EMDR,and 10.8% (25 people) use alternative medicine methods.
Dimensions and Characteristics of the Authorized PractitionersOf the licensed professionals, 94.4% (235 people) reported that they
use hypnosis during the course of their clinical work. However, only
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7.2% (18 people) of the total licensed professionals reported using hyp-nosis as the main part of their work, and 51% (120 people) of thelicensed professionals that reported using hypnosis indicated that theiruse of hypnosis encompasses only a small portion of their clinicalwork.
Of the licensed professionals, 97.1% (238 people) reported usingtechniques of healing, guided imagination, EMDR, or relaxation, and66.1% indicated that they use these techniques frequently. Only 14.2%(35 people) reported the use of alternative medicine methods.
The licensed professionals practice hypnosis mainly in private clin-ics as indicated by 66.6% (187 people). Only 31% (89 people) reportedpracticing hypnosis in hospitals or public clinics. Most of the profes-sionals (91.1%) treat adults with hypnosis, 63% reported treatingadolescents, and 43.8% reported treating children.
The study shows that 60.6% of the licensed professionals acquiredtheir training in hypnosis at university, compared with 48% whostudied in recognized hypnosis training institutions, and 24.5% whostudied in other institutions. As in the case of the unlicensed hypno-tists, a higher percentage of the licensed professionals live in thecentral areas of Israel (73.9%) than in peripheral areas (26.1%).
Comparisons Between the Two PopulationsA 2 × 4 chi-square analysis comparing the reasons that licensed and
unlicensed professionals studied hypnosis (for work/professional need,personal needs, intellectual interest only, or for self-enrichment) revealed asignificant difference in the prevalence of reasons reported by thesetwo groups, χ2(3, N = 595) = 24.45, p < .0001. Of the licensed hypno-tists, 79.1% reported studying hypnosis because of a professional need,compared to 60.9% of the unlicensed professionals. Further, a 2 × 4chi-square analysis comparing the two groups in their reportedimpression of the course (excellent, good, mediocre, or bad) also revealeda significant difference, χ2(3, N = 473) = 12.48, p < .01. Of the licensedhypnotists, 54.7% graded their hypnosis course as excellent comparedto only 41.7% of the unlicensed professionals. As for their opinionsabout the curriculum of the course (satisfactory, needs more practicaltraining, or other), a 2 × 3 chi-square analysis showed a significant dif-ference between the groups, χ2(2, N = 458) = 24.35, p < .0001. Of thelicensed hypnotists, 61.9% thought that the curriculum of the coursewas satisfactory, and 39.2% of the unlicensed professionals thought thesame. Of the unlicensed professionals, 59.9% felt that the trainingdidn’t provide enough practical experience, whereas 36.9% of the licensedhypnotists felt the same.
In addition, the chi-square analysis of the responses to the item per-taining to receiving any guidance/supervision in hypnosis-basedtreatments in the past or at the moment (after completing the hypnosis
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training, undergoing training at the moment, planning to undergo trainingin the near future, did not undergo training and am not planning to)revealed another significant difference between the groups, χ2(3, N =467) = 122.63, p < .0001. While 74% of the licensed hypnotists reportedhaving received some guidance on practicing hypnosis following theirhypnosis training, only 26.2% of the unlicensed professionals receivedsimilar guidance.
Of the licensed hypnotists, 51.7% participated in an advancedcourse in hypnosis compared to 26.8% of the unlicensed professionals.This proved to be a significant difference in a 2 × 2 chi-square analysis,χ2(1, N = 464) = 30.20, p < .0001). Of the licensed hypnotists, 79.6%claimed that they participate in seminars or conferences on hypnosis,whereas 48.9% of the unlicensed professionals claimed to do the same.Again, this difference reached a significant level in a 2 × 4 chi-squareanalysis comparing the participation in seminars or conferences (par-ticipate in all seminars/conferences, participate in some seminars/conferences,participate very little in seminars/conferences, and do not participate at all)of the two groups, χ2(3, N = 478) = 79.22, p < .0001.
DISCUSSION
Hypnosis as a therapeutic tool in different practices is a growingfield. As indicated in the present study, the popularity of this field isgrowing as evidenced by a greater interest in participating in hypnosiscourses in the last few years. The development of the field of hypnosisserves to emphasize the need for a regulatory system; as the fieldgrows and the uses of hypnosis expand, it is increasingly important toensure that clear boundaries are set for this practice. As the possibilityincreases that a patient seeking health care will encounter a profes-sional who uses hypnosis, it is the health authorities’ duty to monitorthese caretakers so that the patient is provided with professionaltreatment.
That said, the claim made in this paper—that governmental inter-vention in the form of legislation is required to regulate hypnosis—isnot a trivial one. Is this indeed the body that is most appropriate tointervene in clinical treatment? Is not a professional body, such as themedical or psychological association, better suited for this importantfunction? Moreover, it is possible that professionals may feel deterredby an intrusion from “without” and may be more comfortable, andtherefore more accommodating, with a body with which they identify.These aspects should be given careful consideration, as the issue ismore complex than it may seem and may have implications that needto be taken into account.
The Israeli hypnosis law was legislated 20 years ago. Yet, as this studyreveals, the practice of hypnosis in Israel by unlicensed practitioners is
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still widespread today—45% of the unlicensed practitioners reportedusing hypnosis during the course of their clinical work. Furthermore,50% of the practitioners reported treating adolescents with hypnosis,and 41.2% treat children.
Surprisingly, this illegal practice is being carried on not only inprivate clinics but in large part also in public clinics, as 71.6% of theunlicensed hypnotists indicated. In addition, it can be argued that thisestimation of the unauthorized use of hypnosis is an underestimation.We base this claim mainly on the high rate (85.4%) of unlicensed prac-titioners that reported using other kinds of therapeutic techniques(healing, guided imagination, EMDR, and relaxation), which involvehypnosis to a certain extent. Also, because the sample surveyed in thisstudy only included practitioners who utilized hypnosis after they hadattended the required training programs, it is difficult to evaluate howmany practitioners are illegally using hypnosis without ever partici-pating in training courses.
This is the place to note a limitation of this study: the relativelysmall number of responses received from the unlicensed practitioners.Therefore, we must be somewhat cautious with our conclusions refer-ring to how widespread the phenomenon of illegally practicing hypno-sis in Israel is. That said, the findings of the study suggest this issuewarrants further investigation.
Another question that should be asked is why so many health careprofessionals do not follow the requirement stipulated by the law. Itseems reasonable to assume that they are either not aware of the law orchoose to disregard it, possibly because it is not adequately enforced.The authors recommend that steps be taken to facilitate the enforce-ment of the law so that it is more effective in achieving its aims. Also, itis important to raise awareness of the law, both of the professionalcommunity and the public.
These enforcement measures might influence the unlicensed hypno-tists who did not even attend hypnosis training and were not part ofthe present study. Surely, it will also encourage some unauthorizedbut trained hypnotists to take the qualifying exam, for, as mentionedbefore, only 3% of them ever attempted the test, and 18.8% evenclaimed that they did not take it because the license is “meaningless”to them.
Another important aspect of the law passed in Israel is that it stipu-lates that the training programs be monitored so that they all maintainhigh standards. Having experienced and skilled professionals teachingin these programs ensures that the new hypnotists acquire extensiveknowledge and understanding of the potential benefits and risks ofusing hypnosis in their practice. It is still unclear why, of those hypno-tists who are trained and licensed to practice hypnosis, the extent ofthe actual use of hypnosis is so relatively small. As this study shows,
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although many of them use hypnosis as part of their clinical work,only a small number (7.2%) use hypnosis as the main part of theirwork, and about half (51%) indicated that their use of hypnosis encom-passes only a small portion of their clinical work.
If it is decided that changes in the training programs be made, a fewthings need to be taken into consideration; the number of unlicensedpractitioners that thought the curriculum of the course was satisfactorywas significantly lower than the number of licensed practitioners thatthought the same. In addition, 35.4% of the unlicensed respondentsclaim to not have taken the test since they did not have enough practi-cal experience in the field of hypnosis. Thus, we suggest that a reexam-ination of the curriculum should be performed and that the practicalexperience part of the course receive a greater emphasis during thetraining. Furthermore, as 34.1% of the unlicensed practitioners alsoindicated that a short course to refresh the materials of the hypnosistraining would encourage them to take the governmental qualifyingexam and only 26.2% of the unlicensed professionals received someguidance and supervision on practicing hypnosis following their hyp-nosis training (compared with 74% of the licensed hypnotists), webelieve that the system of posttraining courses, guidance, and supervi-sion should be reconsidered and possibly restructured. At themoment, posttraining guidance is not mandatory and is mostly self-financed. The authors believe that it should be an integral part of thetraining process and should be encouraged by government subsidy. Ashort course to refresh the materials learned should also be availablefor those who for some reason do not take the test immediately afterthe training.
Furthermore, while the finding that the majority of licensed andunlicensed practitioners work in the central area of Israel is consistentwith the general distribution of employed professionals in Israel (i.e.,the majority of academic professionals work in central Israel; CentralBureau of Statistics, 2004), we suggest that the courses be available indifferent areas of the country and not only in the center so that theywould be more accessible nationwide.
We believe that taking the above-suggested steps would remark-ably change the face of this field in Israel. As was already mentioned,30% of the unlicensed professionals indicated that they were planningto take the test in the year to come. It is a task of great importance aswell as our responsibility to prompt these unlicensed professionalsand others to take the qualifying exam.
As Israel was the first state to pass such legislation about 20 yearsago, it would be interesting to compare the current state of affairs withother countries. Specifically, the fact that the training programs aremonitored in Israel increases the likelihood of a different standard ofeducation for the licensed hypnotists (although this assertion is by no
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means irrefutable and should be empirically investigated). Lack ofmonitoring of the training programs in other countries might result inpractitioners who are not adequately trained to treat with hypnosis, tothe detriment of their patients. Thus, the findings of this study in Israelmight be relevant for other countries that are currently consideringpassing a similar law or regulation.
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Frauman, D., Lynn, S., & Brentar, J. (1993). Prevention and therapeutic management of“negative effects” in hypnotherapy. In J. Rhue, S. Lynn, & I. Kirsch (Eds.), Handbook ofclinical hypnosis (pp. 95–120). Washington, DC: American Psychological Association.
Green, J. P. (2003). Beliefs about hypnosis: Popular beliefs, misconceptions, and the impor-tance of experience. International Journal of Clinical and Experimental Hypnosis, 51, 369–381.
Israeli Society of Hypnosis (IsSH). (n.d.). The Israeli Uses of Hypnosis Law. Retrieved Octo-ber 20, 2005, from http://www.hypno.org.il/law_eng.asp
Johnson, M. E., & Hauck, C. (1999). Beliefs and opinions about hypnosis held by the gen-eral public: A systematic evaluation. American Journal of Clinical Hypnosis, 42, 10–22.
Kai-Ching Yu, C. (2004). Beliefs and opinions regarding hypnosis and its applicationsamong Chinese professionals in medical settings. Contemporary Hypnosis, 21, 177–186.
Kleinhauz, M., & Beran, B. (1981). Misuses of hypnosis: A medical emergency and itstreatment. International Journal of Clinical and Experimental Hypnosis, 2, 148–161.
Kleinhauz, M., Dreyfuss, D. A., Beran, B., Goldberg, T., & Azikri, D. (1979). Some after-effects of stage hypnosis: A case study of psychopathological manifestations.International Journal of Clinical and Experimental Hypnosis, 3, 219–226.
Lynn, S. J., Martin, D. J., & Frauman, D. C. (1996). Does hypnosis pose special risks fornegative effects? A master class commentary. International Journal of Clinical andExperimental Hypnosis, 44, 7–19.
MacHovec, F. J. (1986). Public hypnosis and the public conscience. Psychotherapy in Pri-vate Practice, 4, 51–56.
McConkey, K. M. (1986). Opinions about hypnosis and self-hypnosis before and after hyp-notic testing. International Journal of Clinical and Experimental Hypnosis, 34, 311–319.
McIntosh, I. B., & Hawney, M. (1983). Patient attitudes to hypnotherapy in a generalmedical practice: A brief communication. International Journal of Clinical and Experi-mental Hypnosis, 31, 219–223.
Thomson, L. (2003). A project to change the attitudes, beliefs, and practices of health pro-fessionals concerning hypnosis. American Journal of Clinical Hypnosis, 46, 31–45.
Yapko, M. D. (1994). Suggestibility and repressed memories of abuse: A survey of psy-chotherapists’ beliefs. American Journal of Clinical Hypnosis, 36, 163–171.
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APPENDIX A
Dear colleague:The advising committee to the Minister of Health on the matters of
hypnosis is interested in investigating the extent of use of hypnosisamong professionals in Israel. The assessment is carried out by theGertner Research Institute of Epidemiology and Health policy.
We ask you to complete the following questionnaire and to return itin the attached envelope—no stamp is required—or to fax it to the fol-lowing number 03–5353393.
The following questionnaire is anonymous and is used forstatistical purposes only.
1. Indicate your profession:
1. Physician2. Dentist3. Psychologist
2. How many years have you been practicing your profession (as a physi-cian/dentist/psychologist)? ____ years
3. What is your area of specialization? ______4. When did you participate in a basic hypnosis course? _____5. Did you complete the entire course of study in the basic hypnosis
course?
1. Yes in what year? ____2. No
6. In which framework did you take the basic hypnosis course? (Specify thename of the university/institution.)
1. University _____2. Recognized institution _______3. Other. Detail: _______
7. Indicate the name of the main lecturer/s who taught you in the hypnosiscourse. ______
8. What was your impression of the hypnosis course? Was the course:
1. Excellent2. Good3. Mediocre4. Bad
9. Was the curriculum of the hypnosis course?
1. Satisfactory
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2. Needs more practical training3. Other. Detail: _____
10. For what purpose did you study hypnosis?
1. For work/professional needs2. Personal needs3. Intellectual interest only4. For self-enrichment5. Other. Detail: _______
11. Did you receive in the past or are receiving at the moment any guid-ance/supervision regarding hypnosis-based treatments?
1. I received training after completing the hypnosis training.2. Undergoing training at the moment.3. Planning to undergo training in the near future.4. Did not undergo training and am not planning to.
12. Did you ever take the government hypnosis exam?
1. I was examined, and passed it. When? ____2. Have not attempted the exam yet.3. I attempted the exam but did not pass it.4. Other: ______
13. (If you did not attempt the hypnosis exam) what is the reason for notattempting the exam?
1. Fear of failure.2. Have not gained enough experience in the field.3. The license has no meaning for me.4. Do not practice hypnosis.5. The field does not interest me.6. I did not plan to practice hypnosis in advance.7. Other. Detail: ________
14. Do you plan to attempt the government’s exam in hypnosis in the nearfuture (within a year)?
1. Yes2. No
15. In your opinion, what would cause people who studied hypnosis anddid not attempt the exam to take the exam in order to obtain the license?
1. Easier exam2. A refresher course to invigorate the material3. A written exam
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60 ALEX AVIV ET AL.
4. Exemption from the exam for senior physicians/psychologists5. Other. Detail: __________
16. Did you participate in an advance course in hypnosis?
1. Yes2. No
17. Do you participate in seminars/conferences on the subject ofhypnosis?
1. Participate in all seminars/conferences2. Participate in some seminars/conferences3. Participate very little in seminars/conferences4. Do not participate at all
18. To what extent do you use hypnosis in your work?
1. My main work treatment is based on hypnosis.2. Part of my work treatment is based on hypnosis.3. Very little of my work treatment is based on hypnosis.4. I do not use hypnosis in my work treatment at all (skip to
question 21).
19. Which populations do you usually treat using hypnosis?
Children Yes NoAdolescents Yes NoAdults Yes No
20. Under which framework do you mainly practice hypnosis?
1. Hospital2. Public clinic3. Private clinic4. Other. Detail: _______
21. Do you use in your work therapeutic techniques such as: relaxation,healing, guided imagination, EMDR?
1. Often2. Rarely3. Never
22. Do you use in your work treatment methods of alternative medicine?
1. Often2. Rarely3. Never
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HYPNOSIS IN ISRAEL 61
Finally, a number of demographic items, which are essential for sta-tistical purpose only:
23. Your age ____24. Gender
1. Male2. Female
25. Area of residency
1. North2. North Central3. Central4. South
Untersuchung zur Gesetzgebung im Bereich Hypnose: Eine Erhebung der gegenwärtigen Praxis in Israel
Alex Aviv, Gilboa Dalia, Golan Gaby und Peleg KobiZusammenfassung: Hypnose als therapeutisches Verfahren birgt potentielleRisiken wenn sie falsch eingesetzt wird. Aus diesem Grund hat Israel alserstes Land ein Gesetz für Hypnose erlassen. Diese Untersuchung gibt einenÜberblick über die gegenwärtige Situation der Praxis der klinischenHypnose in Israel. An 470 lizensierte Hypnosefachleute und 1250unlizensierte Personen wurde ein Fragebogen verschickt, 478 (25.7%) der1720 möglichen Teilnehmer sandten den Fragebogen zurück, darunter 249(51.8%) lizensierte Hypnosefachleuten und 232 (48.2%) Unlizensierte. 45%der unlizensierten Therapeuten gaben an, Hypnose einzusetzen, davon 50%mit Adoleszenten und 41.2% mit Kindern. Die Mehrzahl praktizierteHypnose dabei in öffentlichen Kliniken (71.6%). Auf Seite der lizensiertenFachleute gaben 94.4% an, Hypnose im Rahmen ihrer Tätigkeit einzusetzen.Die Autoren schlussfolgern dass eine große Zahl unlizensierterHypnotiseure Hypnose im Rahmen ihrer klinischen Arbeit praktizieren undschlagen Schritte vor, die die Effektivität von gesetzlichen Regelungenerhöhen könnten.
RALF SCHMAELZLE
University of Konstanz, Konstanz, Germany
Examen des lois régissant l’hypnose: Une revue de la pratique en Israël
Alex Aviv, Gilboa Dalia, Golan Gaby et Peleg KobiRésumé: En tant que technique thérapeutique, l’hypnose comporte desrisques potentiels lorsqu’elle est effectuée par des personnes qui ne sont pasconsidérées comme des experts en la matière. C’est pourquoi l’Israël a été lepremier pays à légiférer en matière d’hypnose. La présente étude examinel’état actuel de la pratique de l’hypnose clinique en Israël. Un questionnairea été envoyé à 470 hypnotiseurs agréés et à 1 250 hypnotiseurs non agréés;
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478 (25,7%) des 1 720 répondants potentiels ont rempli et retourné lequestionnaire. De ce nombre, 249 (51,8%) étaient des hypnotiseurs agréés et232 (48,2%) n’étaient pas agréés. Parmi les professionnels non agréés, 45%ont dit pratiquer l’hypnose; 50% d’entre eux pratiquaient l’hypnose auprèsd’adolescents et 41,2% auprès d’enfants. Bon nombre d’entre eux (71,6%)exercent leurs activités dans des cliniques publiques. Parmi lesprofessionnels agréés, 94,4% ont dit pratiquer l’hypnose dans le cadre deleur travail clinique. Les auteurs en ont conclu qu’un grand nombred’hypnotiseurs non agréés pratiquent l’hypnose clinique, et ont suggéré desmesures visant à augmenter l’efficacité des lois dans le cadre d’un systèmeréglementaire.
JOHANNE REYNAULT
C. Tr. (STIBC)
Un examen sobre la legislación de la hipnosis: Una encuesta sobre la práctica en Israel
Alex Aviv, Gilboa Dalia, Golan Gaby, y Peleg KobiResumen: La hipnosis como una técnica terapéutica tiene riesgos potencialescuando se realiza inadecuadamente. Por ello, Israel fue el primero en legislarla hipnosis. Este estudio examina el estado actual de la práctica clínica de lahipnosis en Israel. Enviamos un cuestionario a 470 hipnotistas licenciados y1250 profesionales no licenciados; 478 (25.7%) de los 1720 participantes enpotencia regresaron los cuestionarios. De éstos, 249 (51.8%) hipnotistaslicenciados, y 232 (48,2%) no licenciados. De los profesionales nolicenciados, 45% mencionaron practicar hipnosis; 50% de ellos practicanhipnosis con adolescentes y 41.2% con niños. La mayoría de ellos practicanla hipnosis en clínicas públicas (71.6%). De los profesionales licenciados,94.4% mencionaron usar la hipnosis en el curso de su trabajo clínico. Losautores concluyen que un gran número de hipnotistas no licenciadospractican hipnosis clínica y sugieren pasos para aumentar la eficiencia de laley como parte de un sistema regulador.
ETZEL CARDEÑA
Lund University, Lund, Sweden
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