Sunday, April 22, 2012

Complementary and Alternative Medicine: A Psychologists Perspective

According to The National Center For Complimentary and Alternative Medicine (NCCAM) defining CAM is difficult because the field is very broad and constantly changing. NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Conventional medicine (also called Western or allopathic medicine) is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathic medicine) degrees and by allied health professionals, such as clinical psychologists, and registered nurses. The boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted.

“Complementary medicine” refers to use of CAM together with conventional medicine, such as using acupuncture in addition to Traditional Medicine (TM) care to help lessen pain. Most use of CAM by Americans is complementary. 

“Alternative medicine” refers to use of CAM in place of conventional medicine. 

“Integrative medicine” combines treatments from conventional medicine (TM) and CAM for which there is some high-quality evidence of safety and effectiveness. It is also called integrated medicine. 

Almost all American Medical Schools have incorporated CAM into their curriculum.  According to a 2007 study (Med Educ. 2007 Feb;41(2):205-13.), the overall response to the integration of CAM curricular elements into the medical school curriculum was positive among all faculty and graduating medical students. Participant experiences were often dependent on the perceived rigor of alternative approaches to a presenting patient problem, along with the importance attributed to openness to patient perspectives as part of evidence-based practices. There was an appreciation of the importance of developing increased awareness and utilization of CAM in medical practice, as well as a recognition of resistance by some medical school faculty to CAM approaches. 

In essence CAM may include Acupuncture, Chiropractic, Massage, Yoga, Meditation, and the use of herbaceuticals and dietary supplements (OTC compounds found in most pharmacies and health food stores).

Having had the opportunity to teach graduate level courses on psychology in medical settings and psychopharmacology, I've found myself drawn even closer to the use of CAM in the treatment of both psychological disorders and traditional medical diseases.  I recall with a smile, my eagerness as a graduate student when I purchased my first book on vitamins and supplements.  Dr. Earl Mindells "Vitamin Bible" was, at the time, the holy grail of OTC's (over the counter vitamins, minerals and herbs).  Thankfully much has been learned since then and positive changes have happened that I fully support.

It makes sense to me and is supported by research that massage in the hospital is a plus, Yoga has benefits for both psychological and medical disorders, acupuncture has benefits in pain relief over and above traditional pain medications, and that the judicious use of botanicals (OTC's) can have significant benefits in both prevention of and alleviation of borderline disease processes.

I know that in many European Countries the typical prescription for depression or anxiety is likely to be an herb and not a medication formulated by a pharmaceutical company, with the same or even greater effectiveness than the expensive antidepressants or addictive anti-anxiety agents prescribed in the US.

It is hypothesized that CAM treats the whole person while TM treats only the disease process and because of this there is better acceptance, lower medical costs, and increased treatment adherence when CAM in incorporated into treatment programs.

The next time you seek TM for a psychological or medical problem take the time to ask about CAM.  Your practitioner should be able to tell you about multiple functional and beneficial options.  If they can't you might want to consider an alternative practitioner who is open to treating the whole person and not simply a disease process.    

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