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Complimentary and Alternative Therapy

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Samantha Marois

on 26 March 2014

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Transcript of Complimentary and Alternative Therapy

Complimentary and Alternative Therapy
What is CAM?
“CAM is a broad domain of healing health resources that encompasses all health systems, modalities, and practices, and their accompanying theories & beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period" (Cimino & Mamtami, 2002)
Major Domains of CAM
Alternative Medical systems

What's the Difference?
History of CAM
used together with conventional therapies
used in place of conventional medicine
Issues & Concerns
CAM Guidelines
relationship between patient and practitioner
recap- how to apply
“Alternative medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States.”

Homeopathy, Naturopathy, Ayurveda, etc.
As determined by the NCCAM
Mind-Body Interventions
“Mind-body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms.”

Yoga, meditation, biofeedback, hypnosis, etc.
Biologically-based therapies
“Mind-body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms.”
Herbs, supplements, special diets, aromatherapy
Manipulative & Body-based therapies
“Mind-body medicine uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms.”
massage therapy, Chiropractic care, acupuncture?, etc.
Energy Therapies
Energy therapies involve the use of energy fields. There are two types:
* Biofield Therapies
are intended to affect energy fields that purportedly surround and penetrate the human body
* Bioelectromagnetic-based Therapies
involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or altering-current or direct-current fields
: Qigong, Reiki, etc.
CAM usage by age (NIH NCCAM Study 2007)
Most common CAM therapies in Adults (2005)
Health care/CAM expenses
"Mood disorders are among the most prevalent mental health issues today and there are many approaches towards their management. While many different types of medication are available, more and more people turn to CAM interventions to help manage their mood disorders. CAM interventions can include herbal remedies, acupuncture and meditation. There is an increasing number of research studies on CAM intervention in mood disorders."

(Complementary and Alternative Medicine Therapies in Mood Disorders)
History of yoga and how it has been "westernized"
different forms?
Mood disorders that can benefit from using yoga as a complementary therapy...
acceptance of using yoga in mental health field
There are a number of complementary and alternative thera- pies with increasing levels of acceptance within the medical community, with the majority of Australian doctors consid- ering non-medicinal complementary therapies, such as yoga, meditation, and acupuncture, to be both mainstream and effective (Cohen, Penman, Pirotta, and Da Costa, 2005). (integrating complementary and alternative therapies into psychological practice- a qualitative analysis-p. 2)
Qualitative study with grad students in counseling programs- did yoga and MBSR themselves- results what it did for them, and if or how or why they would incorporate it
(integrating complementary and alternative therapies into psychological practice- a qualitative analysis-p. 2)

(Complementary and Alternative Medicine Therapies in Mood Disorders)

a multi-component yoga-based, breathe intervention….

inding the body: yoga, embodiment, and well-being

Yoga and PTSD-interview

Teaching mindfulness to counseling students through yoga, meditation and qigong

yoga for anxiety and depression – health. Harvard.edu

Yoga therapy for schizophrenia

Yoga for Children

The effects of yoga on elevated depressive and somatic symptoms in young adults.

Exploring the therapeutic effects of yoga and its ability to increase quality of life

Yoga and Post-Traumatic Stress Disorder: An Interview with Bessel van der Kolk, M.D. - Integral Yoga Magazine (2009), pp.12-13

Multi-Component Yoga Breath Program for Vietnam Veteran Post Traumatic Stress Disorder: Randomized Controlled Trial

The effects of yoga on elevated depressive and somatic symptoms in young adults.
(the references I have used so far-Jessie)
- Yogajournal.com - at least 20 different styles of yoga

- Hatha yoga- most widely practiced style of yoga in the west and foundation of all yoga styles
-there are different styles within Hatha

- The underlying concept or focus of the Hatha styles is calming the mind through postures , breathing techniques, and meditation

(part of handout-chart on different styles)

influenced by Buddhist philosophy and associated with rituals of Hindu spirituality
Traditional purpose = provide a guide for wholeness, happiness, and well-being, as well as integrate mind, body, and spirit
Feuerstein, G. (2003). The deeper dimension of yoga. Boston: Shambhala.
Swami Vivekananda, 1893
modified parts of the practice to meet the needs and sensibilities of western students
DeMichelis, E. (2004). A history of modern yoga.New York: Continuum.
emotional/mental effects yoga has on the body
physcial effects yoga has on the body
german study-
New hampsire
grad school students

-increases self-awareness and mindfulness
-teaches the use of breath for self-regulation
-increases clarity of thought and capacity for reflection
-lessens tension, anger, and hositlity,
-focuses and slows down the mind to facilitate relaxation

- stimulates the Parasympathetic nervous system to calm us down and restore balances after a major stressor is over
-calms fight-or-flight and stress response system
-increases levels of the "feel-good brain chemicals" like GABA, serotonin, and dopamine
-increases alpha waves (a type of brain wave found during periods of wakeful relaxation) and decreases cortisol levels
-increases blood flow to the frontal lobe, endocrine glands, digestive organs, and lymphatic circulation
-helps with hormone functioning and endocrine dysfunctions

----- all of which have effects on mood disorders. In addition to these effects that directly affect mood disorders, yoga has proven to be beneficial in helping other stress-related medical issues that tend to lead to or be associated with mood disorders such as depression and anxiety??)

-increases circulation, uptake of oxygen, and can correct menstrual disturbances
-some say it improves immune system so you get sick less frequently
-Irritable bowel syndrome, cancer, insomnia, pain, obesity,
Mental health concerns such as depression and anxiety are among the most common reasons that individuals seek treat- ment with complementary therapies such as yoga
A pilot study of Vinyasa yoga (a style of yoga that includes flowing from one posture to another) as an adjunctive treatment for depressed patients who were not responding adequately to AD medication found that over a 2-month period, participants exhibited significant decreases in depression symptoms and significant increases in an aspect of mindfulness and in behavior activation. (Uebelacker LA, Tremont G, Epstein-Lubow G et al. Open trial of Vinyasa yoga for persistently depressed individuals, evidence of feasibility and acceptability. Behav. Modif. 34(3), 247–264 (2010).
The decreased depression found in these yoga studies may relate to the changes in brain waves and the decreased cortisol levels reported during yoga postures and programs.
In a compre- hensive review of 35 studies on yoga and depression, Pilkington, Kirkwood, Rampes, and Richardson (2005) concluded that yoga-based interventions may have poten- tially beneficial effects on depressive disorders. In partic- ular, they highlighted five randomized controlled trials, each of which used a different yoga intervention. For instance, one study found that young adults with elevated symptoms of depression who were randomly placed in a 5-week Iyengar yoga intervention reported significant decreases in symptoms of depression and trait anxiety relative to young adults in a wait-list control group (minding the body...)
german study
A study of 31 adults (ages 18-65) was conducted to evaluate the efficacy and tolerability of Sudarshan Kriya Yoga (SKY) course in generalized anxiety disorder (GAD) outpatients, who after eight weeks of an appropriate dose of traditional therapy had not yet achieved remission. the results suggest that the yoga course represents a potentially valuable adjunct to standard pharmacotherapy in patients with GAD or treatment-resistant GAD
- Another recent review evaluated the effectiveness of yoga for the treatment of anxiety and anxiety disorders (Kirkwood, Rampes, Tuffrey, Richardson, & Pilkington, 2005). The authors reported the results of eight controlled trials with participants who suffered from anxiety or had a diag- nosed anxiety disorder and documented positive findings for the use of yoga in certain specific anxiety disorders. For instance, two hospital-based studies conducted in India showed, respectively, greater improvements for partici- pants in a yoga intervention group compared with those in a placebo control group (Sharma, Azmi, & Settiwar, 1991) and with those receiving a commonly prescribed anxiolytic (Sahasi, Mohan, & Kacker, 1989).
yoga shown as a good option because the current pharmacology for GAD can cause troublesome side effects and depndence. they are also not meant to be used for tlong-term use. Yoga can have the same benefits without the sideeffects and risk of dependence and can be practiced long-term.
Yoga has also been shown to reduce anxiety. A wait-list control study of women with self-reported anxiety demonstrated that compared with controls, those in the yoga group showed decreased stress, anxiety, fatigue and depression, as well as increased well-being and vigor, after attending two weekly 90-min yoga sessions. [82] Yoga led to reductions of anxiety in women with breast cancer. [83] A systematic review of the effects of yoga on anxiety treatment identified five trials of individuals with clinically diagnosed anxiety disorders. [84] While the studies were small and methodologically flawed, the results were consistently positive. One trial showed substantial improvement in participants with obsessive–compulsive disorder [85] and another trial showed significant improvements in patients with mixed anxiety and depression. [86]
fair amount of research regarding PTSD and yoga.
military/veterans studies
-austrailian veterans
their scores on the clinician administered PTSD scale went from moderate to severe to mild to moderate after 5 wk course

Mamtani & Cimino (2002) suggest the following guidelines:
other trauma studies/ Bessel Vander Kolk
-trauma sotored in body
-most ppl witht ramuma hard to be in body
-yoga helps build tolerance, awareness, regulating skills, changes neuropathways, teaches that uncomfortable feelings (poses) come to an end, etc.
"CAM therapies are becoming too known to successfully ignore in our practices as therapists" ... quote :)
1. Evaluation of the Patient
2. Proposed Treatment Plan
3. CAM Education
4. Accurate Medical Records

Integrated approach common in early times - 19th century
Modern science decreased popularity
Integrative approaches have made a recent comeback (Latorre, 2000)
1960s & 1970s "Counterculture" Movement
Increase in US from 1990-2002 (Su & Li, 2011)
In 2007 38.3% of adults reported using CAM (Barnett & Shale, 2012)
Consistent yoga practice improves depression and can lead to significant increases in serotonin levels coupled with decreases in the levels of monamine oxidase, an enzyme that breaks down neurotransmitters and cortisol.[5] A range of therapeutic approaches is available for the management of depressive disorders, but many patients turn to complementary therapies due to the adverse effects of medication, lack of response or simply preference for the complementary approach.
concluionideas: Rapidly emerging in the Western world as a discipline for integrating the mind and body into union and harmony, when adopted as a way of life, yoga improves physical, mental, intellectual and spiritual health. Yoga offers an effective method of managing and reducing stress, anxiety and depression and numerous studies demonstrate the efficacy of yoga on mood related disorders.
Currently, treatment for anxiety and depression involves mostly psychological and pharmacological interventions; however, mind-body interventions are becoming increasingly popular as a means to reduce stress in individuals. Yoga, a form of mind-body exercise, has become an increasingly widespread therapy used to maintain wellness, and alleviate a range of health problems and ailments.

Yoga should be considered as a complementary therapy or alternative method for medical therapy in the treatment of stress, anxiety, depression, and other mood disorders as it has been shown to create a greater sense of well-being, increase feelings of relaxation, improve self-confidence and body image, improve efficiency, better interpersonal relationships, increase attentiveness, lower irritability, and encourage an optimistic outlook on life.

Researchers are only beginning to understand how disciplines such as yoga promote personal growth, health and well-being.

By acknowledging the unity of mind, body and spirit, mind-body fitness programs (i.e. yoga) can assist people in their pursuit of peace, calmness, and greater wholeness and integration in their lives. Health care professionals, health educators and the like, need to be aware of the potential of yoga as an important component of a personal wellness plan.

Why CAM?
Ernst & White suggest positive & negative motivations
Acceptance of the biopsychosocial model (Park,2013)
Increased cost of conventional health care (Barnett & Shale, 2012)
Diverse demographic trends in the US (Barnett & Shale, 2012)
Lack of sufficient empirical research
Potential adverse interaction between conventional & CAM treatments
Lack of knowledge about CAM in patients & care providers
What is Equine Assisted Psychotherapy (EAP)?
Utilizes horses
1969 - North American Riding for the Handicapped Association (NARHA)

1996 - Equine Facilitated Mental Health Association

1999 - Equine Assisted
Growth and Learning
How does EAP work?
Typical EAP session:
Horses in arena
Ground work
Demographics of CAM Users
Use increases with education
Middle-aged people
Chronically Ill people
People with poorer psychological health (Park, 2013)

It will be easy for us all to become kind of static in whatever therapy or modes we get into, but it will be really helpful to keep complimentary and alternative techniques in mind when we come to a block in what to do with difficult clients
roughly 1950's and 60's yoga becomes widespread among americans
and is "westernized"
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