Self-Hypnosis, Homework, and Generalization of Gains
Teaching self-hypnosis
Self-hypnosis is the mechanism that carries gains out of the office. Teach a short, portable routine: a physical anchor (slow breathing, hand placement), a brief induction the patient can do alone, one or two personalized suggestions, and a clear exit. Provide a written or recorded script and have the patient practice in session while you observe, correcting technique before they practice alone. Shorter and repeatable beats elaborate and rarely used.
Homework and generalization
Assign specific, small, scheduled practice rather than "practice when you can." Pair self-hypnosis with behavioral goals (using the cue before a stressor, during a pain flare, at bedtime) and with a simple log of frequency, context, and effect. Plan for transfer: rehearse in varied settings, vary imagery, and build in relapse-prevention language so a lapse is framed as information rather than failure. Review homework explicitly at the next session.
Traps
Questions imply that home practice is optional or that in-session success generalizes automatically - it does not. Another trap is prescribing long daily practice that patients abandon. Watch for answers that omit review of homework or that treat a single lapse as treatment failure.
Rule of thumb
If the patient cannot describe their self-hypnosis routine in three sentences, it is too complicated to use under stress.
Worked example
A patient with panic wants help between sessions. Plan: teach a 60-second breathing anchor with one coping phrase, rehearse it in session, assign twice-daily practice plus use at early warning signs, and review the log next visit.