Clinical hypnosis in pediatric care: An adjunctive tool or therapeutic illusion

Table 4 Clinical applications of hypnosis in pediatric medicine with degree of recommendation

Medical domain	Specific applications & conditions	Degree of recommendation
Pain management	Acute procedural pain: Venipuncture, intravenous cannulation, lumbar puncture, bone marrow aspiration, burn dressing, dental procedures, post-operative pain, suturing, catheterization. Chronic/recurrent pain: Functional abdominal pain, migraines, tension headaches, fibromyalgia, sickle cell crises, juvenile arthritis, CRPS, neuropathic, and phantom pain	A
Anxiety & phobias	Procedural anxiety, preoperative fear, needle phobia (trypanophobia), dental phobia, “white coat” syndrome, generalized anxiety, separation anxiety, social and performance anxiety, panic attacks	A
Oncology	Pain from procedures and treatment, chemotherapy-induced nausea and vomiting (especially anticipatory), procedural anxiety, fatigue, emotional coping, and appetite improvement	A
Gastroenterology	IBS, functional abdominal pain, dyspepsia, cyclic vomiting syndrome, functional nausea, encopresis, constipation, rumination syndrome, IBD-related pain, and anxiety	B
Neurology/behavioral health	Tics, Tourette's, habit cough, PNES, FND, sleep disorders, nocturnal enuresis, anger and impulse control issues, and bruxism	B
Dermatology	Atopic dermatitis (itch-scratch cycle), warts, trichotillomania, excoriation disorder, psoriasis, and neurodermatitis	B
Pulmonology	Asthma-related anxiety, hyperventilation syndrome, procedural anxiety in cystic fibrosis, and treatment adherence (e.g., nebulizers/inhalers)	B
General health & wellness	Stress management, focus and concentration (non-ADHD specific), self-esteem, habit cessation (e.g., nail biting), body image, sleep hygiene, relaxation training, and reinforcement of a healthy lifestyle	B
Urology	Nocturnal enuresis, functional voiding disorders, urgency/frequency syndromes, and anxiety during urodynamic testing	B
Rehabilitation & physical therapy	Enhancing pain tolerance during therapy, improving motivation, managing movement fear, and recovering from injury	C
Endocrinology & metabolism	Support for insulin injections, blood glucose monitoring, and coping with chronic illness stress (e.g., diabetes)	C

The degree of recommendation reflects the strength of evidence and expert consensus supporting the clinical use of hypnosis for specific pediatric conditions. It is adapted from clinical guideline grading systems to reflect the pediatric hypnotherapy context: A (strong recommendation): Based on high-quality evidence from multiple randomized controlled trials (RCTs), systematic reviews, or meta-analyses. Indicates a high degree of confidence in the efficacy and safety of pediatric hypnosis for the specified condition. B (moderate recommendation): Supported by moderate-quality studies (e.g., cohort studies, case-control studies, or limited RCTs) and/or strong expert consensus. Indicates hypnosis is likely effective and appropriate for use, but may benefit from further research. C (emerging or limited evidence): Based on case series, case reports, or expert opinion without robust clinical trials. Hypnosis may be used as a complementary tool, with promising potential; however, more rigorous studies are needed to confirm its efficacy. ADHD: Attention-deficit/hyperactivity disorder; CRPS: Complex regional pain syndrome; FND: Functional neurological disorder; PNES: Psychogenic non-epileptic seizures; IBDs: Inflammatory bowel diseases; IBS: Irritable bowel syndrome.