Integrating Research?

Hello, All!  I'm currently a PhD student in Clinical Health Psychology at a heavily research-focused program.  Before that, I was a Licensed Clinical Social Worker, doing individual and group therapy.  When I had clients ask me about CAM, I never failed to encourage them to explore their options.  I believe strongly in many forms of CAM, and that many of today's common research methodologies many not be sufficient to explore some of these modalities.

 However… I also have some significant concerns about some forms of CAM, and the claims some practicioners may make.  When research is not involved and ideas are not tested, I worry that confusion, inappropriate recommendations, and that (rare but possible) outright opportunism may harm my clients.  Especially now, when I work with people who are sometimes chronically and/or critically ill, and desperate to believe promises that various practicioners make, I've been the unfortunate witness to watching several people seriously harmed by inappropriate applications of CAM. 

So my dilemma:  How do I support CAM with my clients, encourage their explorations, and work in conjunction with their CAM providers, while acknowledging and managing these concerns?  Have other people had experience in these areas?  Do any CAM practicioners out there have advice about integrating research and CAM?

Thanks! Alisa

Re: Integrating Research?

I generally agree that research is a great tool for helping us weed out ineffective or harmful medications and treatments. Unfortunately, research is a Western discipline, and thus modeled to study Western medicine. In that venue, it works very well.

But running effective, double blind studies on something like energy work is nearly impossible. Even when you have someone “pretending” to do energy work, they will still be transferring energy to the patient…and it may actually be negative energy.  Or the patient may intuitively pick up that the “intention” is not there, and will thus react in a negative manner (I am very in tuned with intention, so I can really get that this could be an obstacle in researching many CAMs).

However, there ARE studies out there that are giving many CAM's good press. Every month I get information about Massage and cancer, alzheimers, ADHD, and other illnesses. You just have to either look for them or ask  in the right places….(like here ;-) ) for experiences.

I originally intended that the group I am trying to organize here (locally) to be a professional organization. I am learning that it is hard for many CAM-minded healers to see themselves in this manner…For instance, this group would rather meet for breakfast and just talk about what we do than to actually organize and advertize and bring in guest lectureres and other “professional” type activities. So it looks like I will have to try to pull the people out who are more professionally minded and start a sub-group and we are likely going to form a partnership together. And the others will continue to meet and greet….

This is the other “problem” that I see in trying to get research.  Many non-western healers are not research minded. We just work on our intention and belief that the body is quite capable of healing itself, so why do we need research??? And to some extent, they are right….many of these methods go back thousands of years. What I find here is that it is important to try to find a practitioner who, in a funny way, is totally “professional” about their specific area of expertise….one who continues to study with the top teachers and practitioners so that they can continue to hone their skills. Again, you have to do your own research here…encourage your clients to ask around about that person, to ask the healer if they continue to train, what their particular area of training is (including specialties within that area), and then to research what that specialty entails.

Finally, what works for one person may not work for another. Sometimes it is the technique, sometimes it's how it's delivered. You wouldn't believe the number of patients Ihave who come in after having a “bad” massage experience….Or  you just click with one practitioner and not another, even tho both are equally well trained. And then there is “healing without feeling”. Some people are more sensitive than others, and may not realize till much later tht they are feeling better.  

As a Psych major, you obviously know alot about the placebo idea of medicine. Perhaps with some of the CAMs, this is a large component of the healing process. If so, so what? If the person feels better, and especially if their symptoms lessen or disappear, WHO CARES ABOUT HOW IT HAPPENED???? or whether it was “real” medicine?

Westerners want the answer to everything. Eastern thinking tends to be more about finding the QUESTION.  And that, I believe, is why there will alway be some discrepancy between the two methodologies……

Re: Integrating Research?

Hi, Dancer!  Thanks for such a thoughtful and helpful reply.  I certainly agree with you that western research methods just… don't necessarily combine well with a lot of CAM (though I guess some things would fit more easily than others).  I had to laugh, too, when you talked about how many members of the group you've been forming aren't necessarily interested in the “professional” type activities.  I've found that this idea of the “western professional” has also influenced my clients.  I had one come and report to me, horrified, about an awful experience she'd had with a CAM provider.  When I inquired what made it so bad, it wasn't actually the the practice, but rather that when she walked into the office, she “wasn't even given paperwork to fill out.”  (As if it's the paperwork that's going to heal someone! :)  I think a lot of people trying out CAM get may become anxious because it's such a different experience, from start to finish, than what they're used to in the western tradition of medicine.

It is difficult, though, as I try to sort of  advocate for both traditions in my work… my colleagues at the hospital want to see the research, and have difficulty understanding some of the issues you've raised.  There's very much the, “… if it's not backed up in the literature, it might as well not exist” mentality.   In my Placebo research, we have the same difficulty in convincing them that the Placebo is a very valuable and real reaction, and should in many cases be encouraged and reinforced… if someone can heal themselves through belief and intention… that's a GOOD thing! :)

You raised some very good points about how seeking out people who continue to study with teachers and develop their abilities.  Do you have any ideas about ways I can educate my clients to find those people?  With a western practioner, it's usually all about the license, which theoretically at least may ensure a baseline competency (which is, I'll grant you, a matter of debate… but at least it's one way to check).  My understanding, though, is that a lot of CAM providers (chiropracters and massage therapists aside) don't have formal licensing or continuing education processes.  Are there resources (maybe registries or such) that a client can look for?  Are there questions they should ask to ensure a good fit with a knowledgable provider?

Thanks so much for you help! 

Re: Integrating Research?

if someone can heal themselves through belief and intention… that's a GOOD thing! :)

 Amen to that!!!! 

As for finding out about continuing education, (As well as lisencing requirements), every state is different. For instance, NY requires 1000 hrs for LMT's and a state exam - the majority of states require about 500-600hrs, with the National exam. 10 states have NO laws for licensure (Mass, Vt, Ok, Kan, Penn, Ind, Mich, Co, Why,and Mt). In Canada, they require 2-3000hrs of training. In addition, each state has differing CEU requirements for each profession. NY has no CEU requirement…(which I think is nuts…)

So first I would recomend that  people learn to search the web and find out about their own states licensing laws. Try googling 'state health licensing requirements” or something like that.

You  can also google the professional associations (Like the AMTA for massage therapists) and use their “find a practitioner” services.

Of course, you can also “interview” prospective pratitioners. I would ask what their training was, how long they have practiced, and what therapies they specialize in (there are dozens of massage therapies, some which are lighter than others or have differing intents like relaxation or sports massage…in chiropractic, they have traditional, activator, network, and many other practices as well as machines like muscle stimulators and ultrasound). Learn what you can about thier specialty and see if it sounds like a fit for you (for instance, Rolfing is a very deep, usually painful massage which has profound effects but isn't for everyone..for others, the lighter Swedish massage would not be a fit because they like deeper work).  Ask friends about what they have experienced. 

Finally, view your first visit as a trial run. Be sure to express what it is that you want from their treatments - both in the outcome and also your preference for pain tolerance, room temperature, music, whatever - If your gut tells you that this person doesn't fit YOUR needs, try another. It doesn't hurt my feelings if someone wants a different practitioner - I have a very distinct style and it is not for everyone. I'd rather help them find  a good fit than have them leave and feel that massage is not for them….when in fact MY massage is not for them… ;-)   

Finaly, remember that we are humans - we are health practitioners, not Gods - and altho we may feel that one thing is good for you, if you are not comfortable with it, let us know. If the person does not respect that or cannot provide that, find another practitioner. Your placebo effect will work better - the body will more likely heal itself or at least not fight the healing process, if you are comfortable and trust your therapist.