Does online hypnotherapy work? Running sessions over Zoom

Yes, hypnotherapy can work over Zoom, but the evidence is still small. Studies of hypnotherapy delivered over Skype and Zoom report symptom improvement and high client satisfaction, and one pilot found results similar to in-person treatment from earlier trials. There are no large randomized trials comparing video with in-person sessions, so treat online work as promising and plan the setup and safety steps more carefully than you would in your office.

What does the evidence say about hypnotherapy over video?

Most of what we know comes from three kinds of study: a service evaluation, a pilot randomized trial and an open pilot. None of them is the large controlled comparison we would want.

IBS over Skype during COVID. The Manchester gut-directed hypnotherapy team moved patients with refractory IBS to Skype during the pandemic. After 12 remote sessions, 52 patients filled in a feedback form. 58% reported at least a 30% improvement in global IBS symptoms, and 46% reported at least a 30% reduction in pain. 90% would recommend remote sessions to others, and 52% said they would have chosen remote over face to face even without the pandemic. Still, 39% felt they would have benefited more face to face.¹ There was no control group, so this tells you clients accept it and many improve, not that video works as well as the office.

Crohn’s disease, virtual sessions. An Australian pilot randomized 37 adults with Crohn’s disease to a 7-week course of virtual gut-directed hypnotherapy plus usual care, or usual care alone. 88% of the hypnotherapy group completed every session and 73% were extremely satisfied, even though 60% had technical problems.² The trial was built to test feasibility, not effect size.

Chronic pain over Zoom. A University of Washington pilot gave 23 people with spinal cord injury pain four weekly sessions of hypnotic cognitive therapy over Zoom. Average pain fell by 1.28 points on a 0-10 scale at 4 weeks and 1.50 points at 12 weeks. The results were not significantly different from historical controls who had been treated in person.³ Historical controls are a weak comparison, and the authors call for a randomized trial.

What this means for your practice:

• Clients can go into hypnosis and benefit over video, and most find the technology easy.
• Expect technical trouble. In the Crohn’s pilot it hit most participants and they stayed anyway.
• Some clients still prefer the room. Offer a choice where you can.
• Don’t tell clients online is “just as effective.” Say it is a common way to work, small studies are encouraging, and you will both watch how it goes.

How should a client set up for an online session?

Send this checklist with the booking confirmation, and go through it again in the first five minutes of session one. A client who sorts it out in advance saves you ten minutes of “can you hear me?”

The client setup checklist

• A chair, not a bed. A supportive chair with head support, or a sofa sitting up. Lying in bed makes sleep more likely than trance, and you lose sight of their face.
• Camera at face height, showing head and shoulders. Ideally the upper body too, so you can see breathing and hands.
• Headphones. Wired or Bluetooth both work. Your voice stays close and clear, and household noise stays out of your microphone.
• Laptop or tablet on a stable surface, plugged in. Not a phone held in the hand.
• Phone on do not disturb. Computer notifications off too.
• A closed door and a quiet half hour. Ask them to tell anyone at home not to come in.
• A glass of water and a blanket within reach. Some people get cold in trance.
• Not driving, not at work, not in a parked car. Agree that if they join from anywhere unsuitable, you will talk but not do hypnosis.
• Their location and a phone number. Confirm at the start of each session where they are physically, and the number you can call if video fails.

Should someone else be nearby?

For most adult clients, no one needs to be in the room, and some will not talk freely if anyone is. Ask the question in your intake form instead of setting a blanket rule. Consider asking that another adult be home, or reachable, when:

• the client has a history of seizures, fainting or panic attacks,
• you are working with grief, trauma memories or strong emotion,
• the client is a minor (a parent or guardian should be at home and reachable, and you need their consent),
• the client lives alone and has told you about low mood.

For an intake question set that covers this, see what to ask on a hypnotherapy intake form.

What is the safety plan if the connection drops?

Agree the plan before the first induction, while the client is fully alert. Say it in plain words, and put the same lines in your consent or welcome email.

“If the call drops while you’re relaxed, you’ll simply drift back to normal awareness in your own time. If you don’t hear my voice for a minute or two, open your eyes, take a deep breath, stretch, and stay where you are. I’ll call you back on video, and if that doesn’t work within five minutes, I’ll phone you on [number].”

On your side:

1. Keep the client’s phone number open on screen during every session.
2. If video freezes but audio continues, keep talking and start a slow, gentle count back up to full awareness.
3. If you lose both, wait 30 seconds for a reconnect, then rejoin the meeting, then phone.
4. When you reconnect, do not drop straight back into the suggestion work. Check how they are, reorient them, and decide together whether to re-induce or end for the day.
5. Write a short note of what happened.

Some practitioners also build a short self-alerting suggestion into the induction, along the lines of: “If for any reason my voice stops, you’ll find yourself coming back gently and comfortably, fully alert, feeling well.” It costs ten seconds and gives the client a clear instruction for the moment the screen goes quiet.

How do you handle an abreaction over video?

An abreaction is a strong emotional release in trance: crying, shaking, panic, or reliving something painful. In the office you can move closer, hand over tissues, and read the whole body. On video you have a face, a voice and whatever the camera shows.

Before session one:

• Screen at intake. Ask about trauma history, panic, dissociation, current mental health treatment and medication. If a client is in crisis or has a history you are not trained for, refer them on. Hypnotherapists in most US states are not licensed health providers, so stay within what you are trained and allowed to do.
• Agree a stop signal. For example, raising one hand, or saying “stop.”
• Agree a grounding routine you both know. Feet on the floor, five things they can see, the name of the room they are in.

During the session:

1. Keep your voice slow and steady. Speak more, not less: on video, silence can feel like abandonment.
2. Use their name, and remind them where they are and that they are safe in their own room.
3. Bring them up gently with a count, and open their eyes.
4. Use the grounding routine with eyes open.
5. Do not end the call until they are fully oriented. Ask a simple orientation question, such as what they will do after the call.
6. If they are not settling, or say anything suggesting they are at risk of harming themselves, keep them on the call and help them reach help: 988 (the Suicide & Crisis Lifeline, by call or text) or 911 for an emergency. This is why you confirm their location at the start.

Should you record online sessions?

Zoom makes recording one click away, which makes it easy to do without thinking. Decide on purpose.

• Get written consent first, for the specific purpose (supervision, the client’s own listening, your notes). Some states require consent from everyone in a conversation. California, for example, makes it an offense to record a confidential communication without the consent of all parties.⁴
• Prefer a purpose-made recording over a recording of the live call. A clean audio recording made for the client to listen to at home is usually more useful than an hour of Zoom video. See recording hypnosis sessions for clients.
• Store recordings like notes. Know where Zoom saves them (your computer or Zoom’s cloud), who can open them, and when you delete them.
• Tell clients not to record you without asking, and agree whether they may record the session themselves.

If HIPAA is part of your thinking, read HIPAA for hypnotherapists first. Whether it applies depends on how your practice bills, not on the video platform.

Can you see clients in other states?

Video makes it easy to take a client in another time zone. It does not make the other state’s rules go away. Rules for hypnotherapists vary widely across the US. Many states have no specific hypnotherapy law. Others regulate it. Washington, for example, defines a hypnotherapist as a person registered under its counselor law, and its Department of Health issues a hypnotherapist registration.⁵⁶

Before you take a client in another state:

• Check that state’s rules for hypnotherapists and for unlicensed counseling, not just your own state’s.
• Check what you can call yourself there and what claims you can make.
• Ask your liability insurer whether out-of-state clients are covered.
• Keep the client’s state on file, and confirm it at intake. People move.

This is not legal advice. Rules change, and the state board or a lawyer in the client’s state is the right place to confirm.

How do you handle time zones?

Time zones cause more missed online sessions than technology does. A few habits prevent most of them:

• Always state the time with the zone: “Tuesday, 2:00 PM Eastern.”
• Let clients book in their own zone, and show yours too.
• Send a reminder with the meeting link shortly before the session.
• Watch the daylight saving changes in March and November, and Arizona, which does not change.

In Hypnocube, the booking page shows times in the client’s own time zone, and every client email states the session time in that zone. A 1-hour reminder with the meeting link goes out before online sessions by default. For more on reminders, see how to reduce no-shows.

How does Hypnocube handle online sessions?

Hypnocube has its own video, so there’s no Zoom account to connect. Each online session gets a private room, and the join link goes into the client’s confirmation and reminders. The client joins in their browser with no app or account, from 15 minutes before the start. Nothing is recorded, and the room shows the client by first name only. If you prefer Zoom, you can save your own meeting link and Hypnocube uses it instead. The details are in Online sessions with Hypnocube video.

A short run sheet for every online session

1. Two minutes early: open the meeting and have the client’s phone number on screen.
2. Admit the client from the waiting room.
3. Confirm where they are, that they are alone or who is nearby, phone on do not disturb, headphones in.
4. Check sound and picture: can you see their face and shoulders?
5. Remind them of the drop plan and the stop signal.
6. Do the work.
7. Bring them fully back and check orientation before you end.
8. Write your notes, including any technical problems.

Footnotes

1. Noble H, Hasan SS, Simpson V, Whorwell PJ, Vasant DH — Patient satisfaction after remotely delivered gut-directed hypnotherapy for irritable bowel syndrome during the COVID-19 era: implications for future practice. BMJ Open Gastroenterology, 2022;9(1):e001039. PubMed ↩

2. Lores T, Evans S, Chur-Hansen A, et al. — Virtual adjunctive gut-directed hypnotherapy for people with Crohn’s disease: a randomized controlled pilot and feasibility trial. Complementary Therapies in Clinical Practice, 2023;53:101791. PubMed ↩

3. Bombardier CH, Chan JF, Stensland E, Barber J, Jensen MP — The efficacy, safety, and satisfaction of telehealth-delivered hypnotic cognitive therapy for chronic pain in spinal cord injury: a pilot study with historical controls. Journal of Spinal Cord Medicine, 2025;48(6):1112-1123. PubMed ↩

4. California Penal Code section 632, Eavesdropping on or recording confidential communications. california.public.law ↩

5. Washington State Legislature — RCW 18.19.020, Definitions. app.leg.wa.gov ↩

6. Washington State Department of Health — Hypnotherapist. doh.wa.gov ↩