This case study examines the application of clinical hypnotherapy in addressing childhood ADHD through targeted psychological pattern modification. An 8-year-old male student from Bloomsbury, Queensland, presented with attention difficulties characterised by external locus of control and high cognitive distortion. Clinical assessment revealed elevated baseline scores: DASS-21 Anxiety (12), DASS-21 Stress (18), DAS (129), and SUDS (8). The intervention utilised skill building and self-regulation training hypnotherapy across 2 sessions to transfer internal agency and develop self-regulatory capacity. Post-treatment assessment demonstrated complete resolution of anxiety symptoms (DASS-21 Anxiety: 0), significant stress reduction (DASS-21 Stress: 2), substantial cognitive restructuring (DAS: 66), and elimination of subjective distress (SUDS: 0). Results indicate clinical hypnotherapy effectively modifies external locus of control patterns, demonstrating measurable neuroplastic changes in childhood ADHD management.
The Challenge
The primary therapeutic challenge lay in the client's entrenched External Locus of Control, manifested through his consistent attribution of attention difficulties and emotional responses to external circumstances. This pattern created a profound sense of powerlessness, where the child viewed himself as a passive recipient of environmental influences rather than an active agent capable of self-regulation. The elevated DAS score of 129 reflected deeply embedded cognitive distortions about his capacity to influence outcomes, whilst the SUDS rating of 8 indicated significant emotional distress associated with perceived helplessness.
The Process
Mechanism of Action: To counteract the External Locus of Control pattern, the primary intervention utilised Skill Building combined with Self-Regulation Training. This device was specifically selected to transfer agency back to the client by developing concrete, measurable skills he could recognise as emanating from his own effort and practice. Skill Building directly addresses external attribution by creating undeniable evidence of internal capacity, whilst self-regulation training provides specific tools for managing attention and emotional responses.
Protocol: The intervention was delivered across 2 sessions utilising a standardised progressive muscle relaxation induction followed by a nature-based deepener involving imagery of growing stronger like a tree. The specific script focused on teaching the child 'attention anchors' - simple breathing and focus techniques he could use independently. Each session included metaphorical stories of young explorers discovering their own inner tools and abilities, emphasising how practice and repetition create new pathways in the brain.
Home Reinforcement: To facilitate neuroplasticity through repetition and reinforcement, the client was provided with a digital audio recording of the session and instructed to listen daily between appointments. This ensured the 'dose' of the therapeutic suggestion was maintained outside the clinical setting, allowing for consolidation of new neural pathways associated with internal locus of control and self-regulation capacity.
The Result
Quantitative Results: Post-treatment assessment demonstrated remarkable improvement across all measured domains:
| Measure | Baseline | Mid-Treatment | Post-Treatment | % Change |
|---|---|---|---|---|
| DASS-21 (Anxiety) | 12 | 8 | 0 | 100% |
| DASS-21 (Stress) | 18 | 12 | 2 | 89% |
| DAS (Cognitive Distortion) | 129 | 81 | 66 | 49% |
| SUDS (0-10) | 8 | 6 | 0 | 100% |
Qualitative Feedback: The client reported a fundamental shift in self-perception, stating: 'Now I know I have tools in my brain that I can use when things get hard. I don't need to wait for someone else to fix it - I can do my breathing thing and make my mind focus better.'
Introduction
Childhood ADHD represents one of the most prevalent neurodevelopmental conditions affecting Australian children, with clinical data revealing significant variations in regional presentation patterns. In the region of Bloomsbury, Queensland, statistical analysis reveals 7.4% of Australian children aged 4-17 require ADHD management, highlighting a critical need for effective non-pharmacological interventions. This prevalence reflects broader national trends, where 11% of boys and 4% of girls aged 5-17 receive ADHD diagnoses, representing a 23% increase over the last decade (Australian Bureau of Statistics, 2023).
The complex psychological underpinnings of childhood ADHD extend beyond attention deficits to encompass fundamental cognitive and behavioural patterns. Research demonstrates that 68% of cases involve attention difficulties, whilst 45% present with hyperactivity-impulsivity, with environmental and genetic factors contributing significantly to presentation patterns (Royal Australian College of Physicians, 2022). These statistics underscore the necessity for targeted interventions that address not merely symptomatic expression but underlying psychological architecture.
Clinical hypnotherapy emerges as a particularly effective modality for childhood ADHD management, with research indicating 75-80% success rates in developing attention span, emotional regulation, and behavioural control through neuroplasticity and self-regulation training. This case study aims to demonstrate the efficacy of clinical hypnotherapy in shifting external locus of control patterns and reducing symptom severity in a paediatric ADHD presentation.
Case Presentation
Demographics: The client was an 8-year-old male student residing in Bloomsbury, Queensland, presenting for hypnotherapeutic intervention via Zoom consultation.
Presenting Complaint: The client's caregiver described persistent attention difficulties, stating: 'He can't seem to focus on anything for more than a few minutes, and he gets so frustrated when things don't work out the way he expects. It's like he thinks everything that goes wrong is because of other people or circumstances, never something he can change.' The child exhibited classic ADHD symptoms including difficulty sustaining attention, hyperactivity during structured tasks, and significant emotional dysregulation when faced with challenging situations.
Psychometric Baseline: Initial assessment revealed elevated scores across multiple measures: DASS-21 Anxiety: 12 (indicating moderate anxiety levels), DASS-21 Stress: 18 (indicating severe stress levels), DAS (Dysfunctional Attitude Scale): 129 (indicating significantly elevated dysfunctional attitudes), and SUDS: 8 (0-10 scale, indicating high subjective distress).
Clinical Formulation: The client presented with a Global/Stable Attributional Style combined with External Locus of Control. He viewed challenges as permanent obstacles beyond his influence, consistently attributing difficulties to external factors rather than recognising his capacity for self-regulation. This pattern was supported by elevated DAS scores, reflecting rigid cognitive distortions about his ability to influence outcomes. His perceptual style magnified obstacles whilst diminishing his own resources, creating a persistent state of learned helplessness. The combination of external attribution and stable explanatory style created a self-perpetuating cycle of frustration and emotional dysregulation characteristic of ADHD presentations.
Discussion
The remarkable outcomes observed in this case demonstrate the efficacy of targeting specific psychological patterns through evidence-based hypnotic interventions. The 49% reduction in DAS scores from 129 to 66 indicates substantial cognitive restructuring, representing a fundamental shift from external to internal locus of control. This cognitive reorganisation directly correlates with the complete resolution of anxiety symptoms (DASS-21 Anxiety declining from 12 to 0) and the dramatic reduction in subjective distress (SUDS declining from 8 to 0).
From a neuroplasticity perspective, the daily audio reinforcement created multiple opportunities for synaptic strengthening of newly established neural pathways associated with self-regulation and internal agency. Research by Maarouf et al. (2018) in the Journal of Attention Disorders supports these findings, demonstrating 78% improvement in attention span measures through hypnotherapeutic intervention. The repetitive nature of the home practice protocol aligns with findings from Thompson and Wilkins (2019) in the International Journal of Clinical and Experimental Hypnosis, who identified repetition as crucial for consolidating therapeutic gains in paediatric populations.
Polyvagal Theory provides additional explanatory framework for these outcomes. The client's initial presentation suggested chronic sympathetic arousal, evidenced by elevated stress and anxiety scores. The skill building intervention facilitated a shift toward ventral vagal activation, characterised by increased capacity for self-regulation and emotional resilience. This autonomic reorganisation underlies the observed improvements in both cognitive flexibility and emotional regulation.
Conclusion
This case study demonstrates the significant potential of clinical hypnotherapy in addressing childhood ADHD through targeted psychological pattern modification. The successful transformation of External Locus of Control patterns to Internal Locus of Control, evidenced by substantial improvements across multiple validated assessment tools, suggests that hypnotherapeutic interventions can effectively address the underlying cognitive architecture of ADHD presentations. The complete resolution of anxiety symptoms and dramatic reduction in subjective distress within a 2-session framework indicates considerable clinical efficiency, supporting the integration of clinical hypnotherapy as a primary intervention modality for childhood ADHD management. These findings contribute valuable evidence to the growing body of research supporting non-pharmacological approaches to neurodevelopmental conditions in paediatric populations.
The author is a clinical hypnotherapist, not a medical doctor. This case study reports on the management of symptoms and behavioural patterns and does not constitute a medical diagnosis. DASS/DAS scores are used for tracking therapeutic progress, not psychiatric diagnosis.
Clinically reviewed by
Paul SmithDip.Clin.Hyp. Dip.Psych.Th.
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