Hypnosis Using Cognitive Rehabilitation Versus Mindfulness Suggestions on Working Memory and Therapeutic Alliance in Patients in Alcohol Treatment

Excessive alcohol use can impair working memory, potentially hindering treatment outcomes. Suggestion-Based Cognitive Rehabilitation (SBCR), a hypnotic technique of potential benefit for restoring working memory in brain injury patients, may hold promise for alcohol use disorder (AUD). This randomized controlled trial compared SBCR-hypnosis to mindfulness-based hypnosis among individuals in AUD treatment. Forty-one participants who were at an inpatient facility were randomized to four weekly sessions of either intervention. Pre- and post-intervention assessments included working memory, well-being, alexithymia, abstinence confidence, and therapeutic alliance. Three-month follow-ups assessed relapse, abstinence confidence, and mental health. Analyses included repeated measures ANOVA, recurrent event regression, and structural equation modeling informed by factor analysis. No significant between-group differences emerged. However, both groups showed improved well-being. Exploratory analysis identified a latent therapeutic improvement factor influenced by trait absorption. Structural equation modeling revealed that SBCR-hypnosis predicted greater therapeutic alliance improvement, which further predicted reduced relapse, enhanced abstinence confidence, and improved mental health. Although SBCR-hypnosis was not superior on clinical AUD outcomes, it may uniquely enhance therapeutic alliance, a potential mechanism worth exploring in future studies.