dharmesh82

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COMPLEMENTARY AND ALTERNATIVE THERAPIES IN
PSYCHIATRY
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• INTRODUCTION
• To promote primary health care, WHO recommended
  in 1978 that traditional (alternative) medicine
  be promoted, developed and integrated with modern
  scientific medicine, stressing the necessity to
  ensure respect, recognition and collaboration
  among the practitioners of various systems
  concerned.

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• DEFINITION
• The National Centre for Complimentary and
  Alternative Medicine (NCCAM) defines,
  complementary and alternative medicine (CAM) as
  a group of diverse medical and health care
  system, practices and products that are not
  presently considered to be a part of conventional
  medicine.

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• Complimentary therapies are those used in
  conjunction with conventional medical practice.
• Alternative therapies are those that are used
  instead of conventional medicine.

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• Reasons why people seek CAM therapy
• Wanting greater control over their lives.
• Sense of responsibility for their own health
  care.
• Wanting a more holistic orientation in health
  care.
• Concern over the side effects of conventional
  therapies.
• Finding the result of conventional treatments to
  be inadequate.
• A desire for cultural and philosophical
  congruence with personal belief about health and
  illness.

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• Unwilling to grin and bear the effects of
  diseases .
• Media contributing in consumers awareness of
  alternative therapies.
• Growing evidence on effectiveness of alternative
  therapies.

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• Principles underlying Alternative healing
• In 1999, Eliopoulos identified FIVE basic
  principles underlying CAM
• The body has the ability to heal itself
• Health and healing are related to a harmony of
  body and spirit.
• Basic good health practices build the foundation
  for healing.
• Healing practices are individualized.
• The people are responsible for their own healing.
  

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• Major domains of CAM used in psychiatry
• Alternative medical system
• Mind-Body interventions
• Biological-Based therapies
• Manipulative and Body- Based methods
• Energy therapies

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• Alternative medical system
• Acupuncture
• Ayurveda
• Homeopathy
• Naturopathy
• Siddha

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• Mind body Interventions
• Meditation.
• Relaxation.
• Hypnosis.
• Art, music and dance therapy.
• Prayer.
• Imagery.
• Bio-feedback
• Body-Mind spiritual interventions

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• Biological Based Therapy
• Herbal therapies.
• Aromatherapy.
• Mega doses of vitamin and minerals.
• Special diet therapy

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• Manipulative and body based method
• Tai chi Qi-gong
• Yoga.
• Massage
• Energy therapy
• Therapeutic touch.
• Reflexology.
• Electro-magnetic therapy.
• Light therapy.

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ACUPUNTURE
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• Acupunture
• The Chinese practice of inserting needles into
  the body at specific points which manipulates the
  body's flow of energy to balance the endocrine
  system.
• This manipulation regulates functions such as
  heart rate, body temperature, respiration, sleep
  patterns and emotional changes.

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• Acupuncture is based of energy flow, which puts
  one in harmony with the universe.
• If the energy balance is not restored than
  physical changes occur and diseases become
  present in the body.

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• Acupuncture helps to correct and rebalance the
  energy flow and consequently relieves pain and
  restore health.
• The needles draw energy away from the organs with
  access and redirects it to organs with
  deficiencies.
• Treatment consists of the practitioners inserting
  stainless still needles into Acu-points just
  under the skin and leaving them in place for a
  few minutes to more than a our.

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• The benefits of acupuncture include
• Improvement in the complete blood cell and
  micro-circulation.
• Relaxation of the muscles.
• Release of endorphins, serotonin and
  adreno-cortico-tropic hormones.
• Activation of B and T lymphocytes.

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AYURVEDIC MEDICINE
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• AYURVEDIC MEDICINE
• Traditional medical system of India.
• Based on the theory that illness results from the
  imbalance of the bodys life force, or prana.
• The balancing of this life force is determined by
  the equilibrium of the three bodily qualities,
  called doshas vata, pitta and kapha.
• This balance is believed to lead to satisfaction
  and health and to help in prevention of illness.

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• AIM
• To integrate and balance the body, mind, spirit.
  (holistic)
• .

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• USES
• Ayurveda seeks to remove the root cause of mental
  illness in a holistic way.
• It is a natural antidote to diseases as well as
  powerful healer for stress.
• Ayurveda uses diet, herbs, massage, yoga and
  life-style adjustment to harmonize body, mind and
  spirit.

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• Ayurveda can be applied to a wide range of
  emotional and mental issues like
• Depression
• Bipolar disorders
• Fears
• Anxiety
• Addiction
• Schizophrenia

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HOMEOPATHIC MEDICINE
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• Homeopathic Medicine
• This medical system originated in Europe.
• Homeopathy seeks to stimulate bodys ability to
  heal itself by giving very small doses of highly
  diluted substances.
• That highly diluted substances in larger doses,
  produce the illness or symptoms (an approach
  called like cures like)

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• Uses
• Homeopathy believes that their remedies mobilize
  the bodys vital force to co-ordinated healing
  responses throughout of the body.
• The body translates the information on the local
  physical changes that leads to recovery from
  acute and chronic diseases

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NATUROPATHY
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• Naturopathy
• It focuses on the self healing and health care is
  tailored to the individual needs.
• Naturopathy practitioner establishing and
  maintaining optimal health and balance, treatment
  of the whole person.

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• Naturopathy combines various methods for
  Prevention of diseases through
• Healthy lifestyle
• Therapeutic use of nutrition
• Meditation
• Relaxation technique
• Imagery
• Biofeedback
• Hypnosis

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• SIDDHA
• Siddha is a Tamil word which means achievement.
  
• It is an ancient CAM therapy used in south
  India, specially in Tamilnadu since 4000 to 10000
  BC.
• Its goal is of perfection of human being in
  physically, mentally, socially, morally and
  spiritually.

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• CONCEPT
• Universe and man are made up of five elements
• Earth
• Water
• Fire
• Air
• Sky
• Similar concept like Ayurveda about balance of
  three body quality of Vatta, Pitta and kappa

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• Diagnosis is based on 8 items
• Tongue
• Colour of skin
• Voice
• Eyes
• Touch
• Stool
• Urine
• Pulse
• Treatment is done by Medicines from Herbs,
  Inorganic substance and animal products with
  yoga, meditation, dhyana.

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ART, MUSIC AND DANCE THERAPY
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• Art, music and dance therapy
• Art therapy helps patient to express his
  thoughts, emotions and feelings through his
  drawings.
• Music therapy is the systematic application of
  music in a therapeutic environment to bring about
  desirable changes in behaviour.
• Dance therapy is psychotherapeutic use of
  movement , which furthers the emotional and
  physical integration of the individual.

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SPIRITUAL HEALING AND PRAYER
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• Spiritual Healing and Prayer
• Spiritual intervention focuses on developing a
  sense of meaning, purposes and hope for the
  individuals in their current experiences.
• Spiritual interventions facilitate the person to
  connect to God, a greater power by using
  meditation or prayer.
• This may be a religious or non-religious
  experience depending on the individual own
  spirituality.

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HERBAL THERAPIES
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• Herbal Therapies
• Herbal medicine, the oldest known from of health
  care, uses plants to treat disease and promote
  health.
• Herbal medicine are available as extract,
  tincture, infusions, decoction, pills and
  powders.

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• Nurses should have knowledge of herbal medicine
  to ensure safe and effective practices.
• Nurse should encourage patients to discuss with
  their health care provider about herbal therapies
  as some may potentiate the effects of
  psychotropic drugs while others may block the
  effects.

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AROMATHERAPY
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• Aromatherapy
• It is concerned with the psychological and
  pharmacological effects of the essential oils
  introduced by means of inhalation, olfaction and
  dermal application.
• Essential oils from flowers, roots, bark, leaves,
  wood, resins and lemon or orange peel.
• When these oils are inhaled, aroma travels along
  the olfactory nerve to the brain where they
  thought to play a role in emotions, memory and a
  variety of body functions and immune responses.

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• Role of Nurse in aromatherapy
• Nurse should caution people to be aware that
  aromatic oils vary in quality and some may be
  toxic when inhaled.
• Oils should not be used near the eyes and should
  always be diluted in a suitable oil or water
  before application to skin.
• Skin should always be tested for allergy test
  before applying the whole treatment.

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Special diet therapies, mega doses of vitamins
and minerals
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• Special Diet Therapies, Mega Doses of Vitamins
  and Minerals
• Good nutrition can help in adaptation to the
  inevitable stresses of life, promoting a healthy
  body and feeling of well-being.
• Nutritional deficiencies often first appear in
  the form of mental symptoms.
• Researchers believes that the imbalances in the
  system can be regulated by nutritional
  supplements.

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• Vitamin B complex, Omega3 fatty acids and folic
  acids are helpful for regulating stress and
  balancing mood.
• Nurses should aware about cultural preferences in
  selecting such diets for the patients and some of
  these diets may cause risk in lack of essential
  ingredients and may interact with prescribed
  medications.

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Tai chi
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• Taichi
• Defined as moving meditation, is a Chinese
  blend of exercise and energy work consisting of a
  series of choreographed, continuous slow
  movements performed with mental concentration and
  coordinated breathing.
• Purposes
• Improve circulation, balance, and flow of
  chi(respiration).
• Reduce the stress and anxiety.
• Restore the energy and health.

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• Qi Gong
• It is the therapeutic Chinese practices that
  include gentle exercise for the breath, body,
  mind and voice.

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MASSAGE
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• Massage
• It is a systematic and scientific manipulation of
  the soft tissue of the body
• Benefit
• Decrease stress and anxiety
• Enhanced body-mind connection for greater mental
  clarity, energy and performance.
• Promote the vitality, personal growth and
  emotional release.
• It has sedatives effect on the nervous system,
  promotes voluntary muscles relaxation and
  improves self images through reorganised posture.
  

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THERAPEUTIC TOUCH
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• Therapeutic Touch
• It is a process by which practitioners believe
  that they can transmit energy to a person who is
  ill or injured to potentiate the healing process.
  
• Derived from the religious philosophical
  principle Laying on of hands (the healer passing
  hands over the body without actually touching it,
  to detect the energy imbalances and redirect the
  energy of the therapist )

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• Delores Krieger 1979 coined the term therapeutic
  touch. It relieves mental and emotional tension
  and anxiety, improving blood flow, easing pain
  and stimulating the immune system.

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REFLEXOLOGY
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• Reflexology
• Practiced in India and China (5000 BC) and Egypt
  (2330 BC).
• It involves massaging specific part of the feet
  or hands to relives stress and pain in the
  corresponding related area of the body.
• It is based on the premise that pressure to
  specific parts of the hand and feet can create
  physiologic changes and promote overall well
  being .

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• Goal To provide relaxation by removing tension
  in a zone area.
• Benefit
• Stimulate relaxation which effects autonomic
  response, which in turn affects the endocrine and
  immune systems.
• Helpful in circulatory disorders of the
  extremities.

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Bio-electromagnetic based therapies
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• Bio-electromagnetic based therapies
• It involves the use of magnetic fields in the
  prevention and treatment of diseases.
• Magnetic field therapy uses two methods- static
  and pulsed.
• The static method involves placing magnet belts,
  shoes inserts and mattresses for 2 to 24 hours.

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• The pulse method involves using a machine to
  effect alternating electromagnetic fields.
• Nurses should caution patients with pacemakers,
  defibrillators and other metallic parts in their
  bodies that they should avoid using magnets or
  magnetic bodies.

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• MAJOR
• PSYCHIATRIC DISORDERS
• AND
• RELATED CAM

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• Alcohol Abuse
• Acupuncture.
• Herbal therapy.
• Meditation.
• Yoga.

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• Alzheimer Dementia
• Herbal therapy.
• Massage.
• Medical meditation

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• Anxiety
• Acupressure.
• Biofeedback.
• Breathing and Relaxation techniques.
• Guided imagery.
• Healing touch / Therapeutic touch.
• Self-hypnosis
• Massage
• Meditation

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• Attention deficit hyperactivity disorder
• Biofeedback.
• Depression
• Acupuncture.
• Healing touch.
• Herbal therapy.
• Meditation.
• Transcranial magnetic stimulation

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• Insomnia
• Breathing and relaxation techniques.
• Herbal therapy.
• Meditation.
• Obsessive Compulsive Disorder(OCD)
• Acupuncture.
• Medical meditation.

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• Stress
• Breathing and Relaxation exercises.
• Healing touch.
• Massage.
• Meditation

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• PSYCHIATRIC NURSE AND CAM

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• Psychiatric Nurse and CAM
• 1.Holistic Approach
• Nursing profession is based on Care aspect of the
  health care in which, it care for the whole
  person holistically.
• So the nurses are increasingly interested in use
  of CAM in integrated diverse therapies into plan
  of care to their patients.
• The most frequently employed therapies used by
  the nurse are massage, music, exercise, diet,
  prayer and counselling.

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• 2.Nurses role in integrating CAM in conventional
  settings
• CAM therapies are beneficial, safe,
  cost-effective and easily implemented throughout
  psychiatric settings.
• Nurses role as healers in assisting patients to
  attain and maintain health and serving as a
  bridge between the patient and physician.

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• Different roles of Nurses in CAM therapies are
• Helper
• Facilitator
• Practitioner
• Educator
• Co-ordinator
• Advocate
• Leader

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• Helper
• Nurse identify patients need for CAM therapy and
  suggest CAM therapy to treatment team members,
  patients and their family member.
• Nurse helps the patient to become informed
  consumer and advice an appropriate CAM therapy.

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• B. Facilitator
• Nurses need to integrate CAM in their nursing
  practice by assessment of some factor like
• CAM practices and products being used and sources
• Appropriateness of CAM practices and products
• Side effects and risk associated with CAM
  practices

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• Conditions not allowing CAM use currently but
  could benefit by CAM use in future.
• After assessment nurses identify need and
  appropriateness of CAM therapy for their
  patients.

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• C. Practitioner
• Certified holistic nurses may practice CAM
  therapies in variety of settings like hospitals,
  clinics, home, community etc.
• These CAM therapies are relaxation techniques,
  massage therapies and energy therapies by
  acquiring additional education and training for
  such therapies and ensuring compliance with state
  licensing laws.

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• D. Educators
• BY providing empirical and high quality
  information on CAM therapies to the patients and
  their family members, nurse fulfils her role as
  an educator.

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• E. Co-ordinator
• BY integrating CAM therapies in plan of care,
  enlist support of treatment team, family members
  and help patients to find providers.
• As CAM therapies are integrated with conventional
  care, nurses have to ensure their harmony for the
  patient benefit.

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• F. Advocate
• As patients advocate, nurses must request CAM
  therapies made available for patients in
  healthcare settings, stressing the non-invasive
  and cost-effectiveness of CAM therapies.

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• G. Leader
• Nurses can demonstrate leadership in helping
  conventional clinical settings integrate CAM
  therapies.
• Nurses holistic orientation and co-ordination
  responsibilities enable them for this role.

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