In-person therapist-delivered hypnotherapy versus smartphone-based self-guided hypnotherapy in IBS: a multicentre three-armed randomised controlled trial
In brief
In-person therapist hypnotherapy yields 48% pain response; self-guided app 33%
In a 230-patient trial, 48% of those receiving therapist-delivered hypnotherapy met the FDA pain-response definition versus 33% with a smartphone self-guided program and 22% with psychoeducation. Non-inferiority of the app could not be proven, though both hypnotherapy approaches outperformed psychoeducation at six months, with no added psychological benefit.
- Journal
- Gut (Q1)
- Published
- 25 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Johanna T W Snijkers, Michelle H M A Bosman, Bjorn Winkens, Bertram J T Haarhuis, Ben J M Witteman, Nikolien Pijnenborg, et al.
- PMID
- 42502003
- DOI
- 10.1136/gutjnl-2026-338385
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 11 October 2026): In-person vs smartphone hypnotherapy for IBS
Abstract
BACKGROUND: Hypnotherapy is an evidence-based therapy recommended for IBS, but access to therapist-led hypnotherapy is limited by costs and availability. OBJECTIVE: We studied the effectiveness of smartphone-based self-guided hypnotherapy versus in-person therapist-delivered hypnotherapy. DESIGN: This multicentre, three-armed non-inferiority randomised controlled trial (RCT) included patients with IBS (Rome IV, 16-75 years). Patients were randomised to 12-week in-person therapist-delivered hypnotherapy, smartphone-based self-guided hypnotherapy or online self-guided psychoeducation. The primary endpoint was abdominal pain response per Food and Drug Administration (FDA) definition (≥30% reduction from baseline in weekly average of worst daily abdominal pain in at least 2 out of 4 weeks follow-up). The non-inferiority margin was 10%. Secondary endpoints included ≥50 points IBS-symptom severity scale reduction and changes in psychological symptoms. RESULTS: A total of 230 patients (mean±SD age 38.2±13.8 years, 70.4% female) were randomised. FDA abdominal pain response rates were 48% for in-person therapist-delivered hypnotherapy, 33% for smartphone-based self-guided hypnotherapy and 22% for psychoeducation. Non-inferiority of online to in-person hypnotherapy could not be shown (-14.7%, 95% CI -29.3% to 0.9%). In-person hypnotherapy was more effective than psychoeducation (OR 3.48, 95% CI 1.68 to 7.20, p<0.001) at week 16, both hypnotherapy groups were more effective at 6-month follow-up (OR 3.11, 95% CI 1.37 to 7.09, p=0.007 and OR 4.68, 95% CI 2.07 to 10.57, p<0.001). There were no significant treatment effects on psychological symptoms between groups. CONCLUSION: This multicentre RCT could not demonstrate non-inferiority of smartphone-based self-guided hypnotherapy compared with in-person therapist-delivered hypnotherapy in reducing abdominal pain. However, substantial response rates for smartphone-based self-guided hypnotherapy highlight its potential as a broadly applicable and cost-effective alternative. TRIAL REGISTRATION NUMBER: NCT03899779.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.