Whereas the older "depth scales" tried to infer the level of "hypnotic trance" from supposed observable signs such as spontaneous amnesia, most subsequent scales have measured the degree of observed or self-evaluated responsiveness to specific suggestion tests such as direct suggestions of arm rigidity (catalepsy). The Stanford, Harvard, HIP, and most other susceptibility scales convert numbers into an assessment of a person's susceptibility as "high", "medium", or "low". Approximately 80% of the population are medium, 10% are high, and 10% are low. There is some controversy as to whether this is distributed on a "normal" bell-shaped curve or whether it is bi-modal with a small "blip" of people at the high end. Hypnotizability Scores are highly stable over a person's lifetime. Research by Deirdre Barrett has found that there are two distinct types of highly susceptible subjects, which she terms fantasizers and dissociaters. Fantasizers score high on absorption scales, find it easy to block out real-world stimuli without hypnosis, spend much time daydreaming, report imaginary companions as a child, and grew up with parents who encouraged imaginary play. Dissociaters often have a history of childhood abuse or other trauma, learned to escape into numbness, and to forget unpleasant events. Their association to "daydreaming" was often going blank rather than creating vividly recalled fantasies. Both score equally high on formal scales of hypnotic susceptibility.
Barber, Spanos, and Chaves (1974) proposed a nonstate "cognitive-behavioural" theory of hypnosis, similar in some respects to Sarbin's social role-taking theory and building upon the earlier research of Barber. On this model, hypnosis is explained as an extension of ordinary psychological processes like imagination, relaxation, expectation, social compliance, etc. In particular, Barber argued that responses to hypnotic suggestions were mediated by a "positive cognitive set" consisting of positive expectations, attitudes, and motivation. Daniel Araoz subsequently coined the acronym "TEAM" to symbolise the subject's orientation to hypnosis in terms of "trust", "expectation", "attitude", and "motivation".
This popular representation bears little resemblance to actual hypnotism, of course. In fact, modern understanding of hypnosis contradicts this conception on several key points. Subjects in a hypnotic trance are not slaves to their "masters" -- they have absolute free will. And they're not really in a semi-sleep state -- they're actually hyperattentive.
In the 2000s, hypnotherapists began to combine aspects of solution-focused brief therapy (SFBT) with Ericksonian hypnotherapy to produce therapy that was goal focused (what the client wanted to achieve) rather than the more traditional problem focused approach (spending time discussing the issues that brought the client to seek help). A solution-focused hypnotherapy session may include techniques from NLP.
He also believed that hypnosis was a "partial sleep", meaning that a generalised inhibition of cortical functioning could be encouraged to spread throughout regions of the brain. He observed that the various degrees of hypnosis did not significantly differ physiologically from the waking state and hypnosis depended on insignificant changes of environmental stimuli. Pavlov also suggested that lower-brain-stem mechanisms were involved in hypnotic conditioning.
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At the outset of cognitive behavioural therapy during the 1950s, hypnosis was used by early behaviour therapists such as Joseph Wolpe and also by early cognitive therapists such as Albert Ellis. Barber, Spanos, and Chaves introduced the term "cognitive-behavioural" to describe their "nonstate" theory of hypnosis in Hypnosis, imagination, and human potentialities. However, Clark L. Hull had introduced a behavioural psychology as far back as 1933, which in turn was preceded by Ivan Pavlov. Indeed, the earliest theories and practices of hypnotism, even those of Braid, resemble the cognitive-behavioural orientation in some respects.
It is used for a wide variety of applications, and studies into its efficacy are often of poor quality which makes it difficult to determine efficacy. Several recent meta-analyses and systematic reviews of the literature on various conditions have concluded that the efficacy of hypnotherapy is "not verified", that there is no evidence or insufficient evidence for efficacy.