CAM Culture

The importance of cultural awareness in CAM

Cultural awareness is simply the ability of a person to be aware of the differences in culture around them and to understand the importance that culture has to each person (Berg, 2003). 

The importance of cultural awareness in CAM becomes especially important based upon the vast array of CAM types.  The myriad of cultures that many CAM types come from also legitimize the importance for any CAM practitioner to be well versed in cultural issues. 

The following are some examples of CAM interventions and their cultural roots (Freeman, 2009):

• Biofeedback - United States
• Hypnosis - traces back to Egypt and Greece but was also seen in many part of the world
• Chiropractic - originated in multiple areas but largely seen in Indian cultures.  Later seen more prominently in Greek culture.
•  Acupuncture - from Chinese medicine
• Massage - can be traced to ancient cultures in the middle east, Greece as well as Chinese medicine
• Aroma therapy - all over the globe--many middle east nations used as well as European and South America
• Herbal medicine - all cultures but currently European nations such as Germany have a succinct system to test the safety of herbs used as medicine
• Reiki and Therapeutic Touch - has roots in Japanese medicine
• QiJong - Chinese medicine
• Yoga - India

Certainly it is important to understand some history of CAM interventions but it is also important to know the individual patient's cultural desires.  For example, if a patient desires a more natural approach which has been a part of their culture and heritage, this needs to be assessed in the beginning.  This type of patient will not want the more traditional American medicine techniques such as medications.  Instead they may be desiring help in finding the right herbal supplements to help.  They may also be open to natural ways of dealing with stress (e.g. exercise, yoga). 

Prior to working with patients or clients and trying to assess their cultural desires, it is imperative that you as a practitioner assess your own feelings regarding different cultures.  Are you open to other people's views? Are you open to learning about various cultures? If you cannot say yes to either question, you may struggle to be a culturally competent practitioner. 

For more information on cultural competence and assessing yourself see the following website to help guide you http://nccc.georgetown.edu/index.html 

References

Berg, D. (2003). Culture, Faith Traditions, and Health. Center for Spirituality and Healing. Retrieved from http://www.csh.umn.edu/Integrativehealingpractices/culture/comp/cp01.html

National Center for Cultural Competence. (2011). Retrieved from http://nccc.georgetown.edu/index.html

 

All Cracked Up!

Chiropractic

What do you think of when you think of a chiropractor? You might think of someone who cracks your back or neck.  Chiropractic is more than this.  It is considered a form of CAM and can greatly help in some circumstances.

 

 

Chiropractic focuses on the musculoskeletal system and nervous system. The "back cracking" may be part of adjustments that are made to the musculoskeletal system but there are multiple interventions that chiropractors use. The following are some included interventions that chiropractors might incorporate:

• manipulation of joints and spine
• muscle tension assessment
• massage
• physical therapy
• heat and ice
• electrical stimulation
• exercise
• relaxation techniques
• posture advice
• nutritional and self-care

Typical chiropractic practice includes a combination of the above interventions.  There is however, a small subset of chiropractors who adhere to a strictly vertebral subluxation approach.  This is an assessment and adjustment of the spinal cord where this group believes that many disorders originate from (Freeman, 2009).

 

The research on how effective chiropractic is said to be poor by some.  See http://www.sciencebasedmedicine.org/top-10-chiropractic-studies-of-2013/ for information on one person's assessment on the top 10 studies on chiropractic in 2013.  Based upon the factors of a solid study design, these do not look promising. 

 

So the question remains-- is chiropractic a valid intervention? The research and the opinions are vast. From personal experience, I have had both positive and negative experiences from chiropractic intervention specific for back pain.  Doing some research and talking with multiple physicians regarding your condition is the best path to follow.  It may lead to hearing and reading various views but an informed decision is better than taking a chance. 

 

 

References

 

Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach. (3rd ed). Mosby.

To herb or not to herb...

Herbal Supplements

Herbal supplements are a huge industry.  It may be considered a type of CAM but it could be separated into a different category.  Consider this--in 2009 it was estimated that the sales of herbal supplements topped 5 billion dollars and was rising steadily (Nutraceuticals World, 2010).  It is also estimated that tens of millions of Americans are using some form of herbal supplement (Marinac et al., 2007).

Herbal supplements are sold and advertised to treat just about anything from legitimate health issues (e.g. diabetes, high blood pressure) to more self-fulfilling reasons (e.g. body part growth, appearance) and everything in between.  One of the most widely used subtypes of supplement is a dietary supplement.  The Center for Disease Control (2011) estimated that nearly 50% of Americans used a dietary supplement between the years 2003 and 2006.  But there are reasons to be mindful of dietary herbal supplements.

According to the National Institutes of Health (2013) there are five areas to be aware of:

• Dietary supplements contain  a number of different ingredients -- not all have been confirmed as having health benefits.
• Always read the labels and follow instructions of supplements.  They are not always safe.  Supplements may be supplemented with other substances.
• There may be some negative interactions between some supplements and some medications.  Many supplements have not been tested for pregnant women, nursing mothers, or children.
• The U.S. Food and Drug Administration (FDA) is responsible for regulating foods and drugs and this includes dietary supplements, however  the regulations for dietary supplements are much less strict than prescription and over the counter medications. 
• Be sure to coordinate with your primary care physician on any type of CAM which includes using any sort of herbal supplements. 

The bottom line is this--read, consult, and be patient when considering herbal supplements.  It may take more time to consult with your physician but the ramifications of interactions with your medications or a supplement that has harmful additives is not worth the added stress on your life. 

References

 

Center for Disease Control and Protection. (2011). Dietary supplement use among U.S. adults has increased since NHANES III (1988–1994). Retrieved from http://www.cdc.gov/nchs/data/databriefs/db61.htm

 

National Institutes of Health. (2013). Using dietary supplements wisely. Retrieved from http://nccam.nih.gov/health/supplements/wiseuse.htm

 

Nutraceuticals World. (2010). U.S. Herbal Supplement Sales Reach $5 Billion. Retrieved from http://www.nutraceuticalsworld.com/issues/2010-06/view_industry-news/u-s-herbal-supplement-sales-reach-5-billion/      

 

Marinac, J.S., Buchinger, C.L., Godfrey, L.A.,  Wooten, J. M., Sun, C., & Willsie, S.K. (2007).

Herbal products and dietary supplements: A survey of use, attitudes, and

knowledge among older adults. View shared postThe Journal of the American Osteopathic Association, 107, 13-23. Retrieved from http://www.jaoa.org/content/107/1/13.full.pdf

 

 

 

 

 

 

 

 

 



Touch Me?

The Value of Therapeutic Touch (TT)

There are many types of touches:

• A greeting (i.e. handshake, high-five, fist bump)
• A consoling light touch to let someone know you are with them
•     An affectionate hug or kiss
•     A strike of violence rooted in anger
•     A therapeutic manipulation or assessment from a healthcare professional
•     A massage to help one feel better

But consider the value of therapeutic touch.  Some may not understand the term.  TT can be differentiated from massage, consoling touches, assessment and manipulations.  TT is defined as a healing technique that does involve hands but where touching is not involved.  The direct human energy from one's hands are used in a process to help the patient heal (Therapeutic Touch, 2011).

TT basically involves four phases: 1.) Centering - the therapist clears their mind to focus on the energy levels of the patient. 2.) Assessment - the therapist runs their hands palm down a few inches from the patients body up and down searching for irregularities in the energy levels. 3.) Extinguishing - the therapist runs their hands over the patient's body several times and gets rid of the negative energy by flicking them off when at the end of the body.  4.) Transferring - the therapist then transfers their own healthy energies to the patient using a similar motion of the hands over the body (Therapeutic Touch, 2011).

 

While Therapeutic Touch is a safe procedure, many people still question if it is a real and effective method treatment.  Numerous studies have assessed it but many of these studies have been criticized for small sample sizes, lack of random sampling and poor overall design (Freeman, 2009).  One must be careful with such a treatment not to delay other forms of evidence based treatment for the condition.  This is where the problems may lie. 

I have my doubts about the effectiveness of TT at least at the level that most in the field claim.  There may be some value in the proximity of the practitioner to the patient--an intimacy factor.  But the root of TT is the manipulation of the energy field--a completely different area than intimacy.  Don't let my opinion sway you.  Do you own research. 

References

 

American Cancer Society. (2011). Therapeutic Touch. Retrieved from  
          http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/manualhealingandphysicaltouch/therapeutic  touch



Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach. (3rd ed). Mosby.

Is Spiritual/Religious therapy really a CAM?

Christian counseling.  Spiritual advising. Pastoral counseling. Religious institutions.  Prayer with your physician. Pastoral visits while in the hospital. Biblically based addictions treatment. Church based support/recovery groups.
 

The above are all examples of religious or spiritual types of treatment for physical, mental,
emotional, relational and spiritual issues.  But should they be considered Complementary or
Alternative modes of treatment? Or are they a primary source of treatment for many people?

 
Spirituality is on some lists of CAMs (see http://nccam.nih.gov/health/atoz.htm).  To really make
any statements about whether this type of treatment is a CAM or should be considered a primary treatment, we should first define spiritual or religious therapy.  Religion is often seen as a moral set of standards one adheres to that might include participating in a group like setting (i.e. church) to help exercise these standards (Dictionary.com, 2014).  Spirituality has been more difficult to define.  Spirituality in general can be seen as more experiential whether this pertains to religious activities or non-religious activities (Culliford, 2014).  

Furthermore, for the sake of this discussion we need to differentiate between including spirituality or religion into healthcare and therapy that is considered spiritual (or religious).  A patient attends a physicians appointment looking to get treatment for a specific issue (e.g. seeing an oncologist due to cancer).  The physician can include spiritual or religious aspects to treatment and even refer out to someone who has more expertise.  But some people seek spiritual or religious therapy specifically to receive that approach to help with a specific issue (i.e. addiction, depression, relationship issues, etc.). 

Now let's go back to the original question.  Should spiritual or religious therapy be considered a CAM or a primary treatment for some? This is really a matter of opinion.  Some might be offended to say that seeking out a spiritual advisor or a Christian counselor is alternative to anything.  For some, it is the only choice dependent upon the issue to be addressed.  Based on lists of CAMs, it seems to fit.  But it does not make it any less important than traditional forms of therapy. 
 
 

References

Culliford, L. (2014). PsychologyToday.com. What is Spirituality? Retrieved from   

     http://www.psychologytoday.com/blog/spiritual-wisdom-secular-times/201103/what-is-spirituality

Dictionary.com (2014). Religion. Retrieved from http://dictionary.reference.com/browse/religion

 

 

 

Biofeedback

Biofeedback is a bit of mystery.  For years, some have questioned if and how this intervention works.  Many have the image of a child hooked up with electrodes to their head--possibility being pumped full of electrical currents.

 

 

So what exactly is Biofeedback?

 

Biofeedback is a process in which you can observe, become aware, and change your own body responses that you previously felt no control over.   Through this process, you will be able to address the unwanted thoughts, feelings or behaviors that hinder you (Freeman, 2009).

 

Some areas that are addressed through Biofeedback

 

Anxiety

ADHD

Chronic Pain

Migraines

High Blood Pressure

Irritable Bowel Syndrome

Adjustment Disorder

Epilepsy

Raynaud disease

Fibromyalgia

PTSD

Anger issues

Depression

Sleep issues

 

Three main types of Biofeedback

 

• Electromyography (EMG) gives feedback about muscle tension and can help with relaxation as well as can teach you to take control over certain body functions.

• Thermal biofeedback gives feedback on skin temperature which can help to assess and change your physical state.  

 

• Skin-Conductance feedback measures the sweat gland activity which can help with assessing points of arousal and can help you learn to control some unwanted anxiety (Freeman, 2009). 

                                                
                                                                                                                                   

How do I decide if Biofeedback is right for me?
 

One of the first things and most important factors is being open to alternative methods of medicine.  If you are not open to CAM, it will be difficult to benefit from interventions (Caspi, Koithan, & Criddle, 2004). 

Next, if other more traditional forms of treatment have not worked or are not working as well as expected then CAM interventions might be a good venue to consider (Frank, Khorshid, Kiffer, Moravec, & McKee, 2010). 

Specifically considering biofeedback, you must look at the areas that biofeedback has been shown to improve (e.g. see list above). 

I would strongly suggest researching how biofeedback has worked with your particular issue. 

If you feel compelled to take the next step, I would suggest making an appointment with a biofeedback clinician to discuss questions and concerns. 


See the research on Biofeedback for much more information.   

 
 

References

Caspi, O., Koithan, M. & Criddle, M.W. (2004). Alternative medicine or "alternative" patients: A qualitative study of patient-oriented decision-making processes with respect to complementary and alternative medicine. Medical Decision Making, 24, 64-79. doi:10.1177/0272989X03261567

 

Frank, D. L., Khorshid, L., Kiffer, J. F., Moravec, C. S., & McKee, M. G. (2010). Biofeedback in medicine: who, when, why and how? Mental Health in Family Medicine, 7(2), 85-91. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939454/

 Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach. (3rd ed). Mosby.

 

Relaxation Techniques or Meditation Techniques?

 

Relaxation and meditation have both been shown as effective methods of dealing with a multitude of issues such as mood type disorders, stress related physical conditions and pain associated with physical conditions (Freeman, 2009).

 

Relaxation Therapy

Relaxation techniques that we know today are a much abbreviated version from Edmund Jacobson's original Jacobson's Progressive Relaxation Therapy (JPRT) in which it took many sessions to learn the tensing and relaxing of muscle groups.  Other more abbreviated versions based upon Jacobson's model helped to move relaxation therapy into a more practical technique (Freeman, 2009). 

 

Relaxation therapy has been shown to improve immune system functions in older adults.  Relaxation techniques have been shown to have an opioid response in the body--a response that is thought to help in natural decrease of pain.  Relaxation therapy has shown positive effects on calming some of the side-effects of cancer and cancer treatment.  A further benefit of relaxation techniques has been the decrease of blood pressure in those with hypertension.   Furthermore, relaxation has been a good resource for alcoholism, irritable bowel syndrome, epilepsy, reflux disease, and mood states to name a few (Freeman, 2009).

 

See relaxation therapy for more information on individual relaxation techniques. 

 

Meditation  

Meditation can trace its roots back to Eastern Mysticism.  It made its way to the Western world through adapting forms of Transcendental Meditation and Mindfulness Meditation.  Two other forms of meditation that the Western world has embraced are Herbert Benson's respiratory one method (ROM) and clinically standardized meditation (CSM) (Freeman, 2009).

 

Meditation has been associated with a number of positive physiologic functions such as decreased heart rates, blood lactate levels, increased positive moods, frontal alpha activity, and a positive influence on numerous hormone function (Freeman, 2009).  Meditation has been shown to be effective in helping in those with high blood pressure, mood disorders, cardiovascular disease, and chronic pain among others (Freeman, 2009). 

See the official US site for more info on Transcendental Meditation. See some tips on Mindfulness Meditation.   

Relaxation Techniques or Meditation Techniques?
Glancing quickly at the information, it appears that relaxation therapy and meditation techniques are similar enough in regards to benefits.  So how does one choose which is best?  There are numerous techniques involved in both categories so even if you decide on one or the other, there is still a choice to make.  Here are a few tips to help narrow it down:

1.) Do the research to ensure that the issue you want to address has been studied and that there is empirical evidence that it works.

2.) Choose a technique that you would feel comfortable doing.  This does not mean that you should not try new things, but if you don't feel comfortable doing it after a short time then move on to the next technique.

3.) Choose a technique that fits your schedule.  Some techniques are quick and easy while others take time and practice to master.  But remember, quick and easy does not necessarily mean it is right for you.

4.) Choose a technique that fits your budget.  There are free techniques (i.e. learning a simple breathing technique through a website) and there are techniques that involve learning from a certified instructor/clinician (i.e. yoga or JRPT). 

 

References

 

Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach. (3rd ed.). St. Louis, Missouri: Mosby.