ART vs hypnotherapy: is ART a form of hypnosis?

No, Accelerated Resolution Therapy (ART) is not a form of hypnosis. The published ART protocol contains no hypnotic induction or trance. You are awake and alert throughout: following the therapist’s hand with your eyes, noticing and reporting body sensations, and rating your own distress. When it comes to replacing distressing images, you choose the new scene yourself. You remember the session, and you still remember what happened to you.

The confusion is understandable. ART works with mental imagery, and its developer lists guided imagery among the approaches it draws on. Words like “replacing images” can sound like suggestion. The rest of this page sets out where the two really differ and where they overlap.

What hypnosis and hypnotherapy are

The American Psychological Association’s hypnosis division (Division 30) defines hypnosis as “a state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion.” Hypnotherapy is “the use of hypnosis in the treatment of a medical or psychological disorder or concern.” The VA describes it as deliberately entering a trance, or focused-attention, state and then using that state to encourage healing.

Hypnotherapy has no single developer and no standard protocol for PTSD. Methods vary widely from one practitioner to another, including how much, if at all, the trauma itself is revisited.

What ART involves

ART was developed in 2008 by Laney Rosenzweig, LMFT, as an adaptation of EMDR. The published protocol runs in a set order: you rate your distress, bring the scene to mind briefly while following sets of about 40 side-to-side eye movements, use further sets to settle the physical sensations, and then replace the distressing images with a scene of your choosing through Voluntary Image Replacement. Finally you check how the memory feels now.

The therapist guides the process and may suggest creative ways to approach the replacement, but the new scene is your material. The researchers who describe the protocol note that knowledge of the original scene remains in memory. What changes is the distress and the images, not the facts. See will I forget what happened?

Side by side

The evidence, plainly

Both sit in the same place in the 2023 VA/DoD PTSD guideline: insufficient evidence to recommend for or against. Neither is a first-line treatment, and neither has the research base of CPT, prolonged exposure or EMDR.

Hypnotherapy. The VA/DoD guideline states that “No evidence was identified evaluating … hypnosis and self-hypnosis … for the treatment of PTSD” within its review. The ISTSS guidelines list hypnotherapy as having insufficient evidence to recommend. A 2016 meta-analysis (Rotaru and Rusu) found that of 47 articles on hypnosis for PTSD, only 6 were experiments testing whether it works; it reported a large average effect, but it pooled a small, varied set of studies using a fixed-effects model, which limits how much weight the result can bear. Hypnosis does appear in one sleep position paper: the American Academy of Sleep Medicine lists it among treatments that “may be used” for nightmare disorder.

ART. ART has two randomized trials with published results, both small and both involving researchers connected to ART: one in 57 service members and veterans against a non-therapy control, one in 54 bereaved caregivers against a wait-list. The VA/DoD guideline’s reason for its rating is that “No RCTs of ART included the critical outcome of clinician-rated PTSD.” A 2024 systematic review concluded ART “shows some promise” but “more high-quality studies are needed.” More detail is in the ART studies.

No study has compared ART with hypnotherapy.

Common worries about ART

• “Will I lose control?” No. You are awake, talking and following instructions throughout, and you can stop at any point.
• “Will someone plant memories or ideas?” The replacement images are ones you choose. ART doesn’t aim to change what you know happened, and the protocol assumes you still know it afterward.
• “Will I remember the session?” Yes. There is no trance to come out of.
• “Does it matter if I can’t be hypnotized?” No. ART doesn’t use hypnosis, so how you respond to it isn’t relevant.

ART can still bring up strong feelings and physical sensations, and trials reported occasional temporary low mood, poorer sleep or more nightmares afterward. Screening first matters; see who ART is not for.

Further comparisons

ART vs EMDR explains the therapy ART grew out of, and the full comparison table puts eight approaches side by side. If you would like to talk about whether ART suits you, you can get started here.