Complimentary and alternative medicines in psychiatric illnesses for nurses

COMPLEMENTARY AND ALTERNATIVE
THERAPIES IN PSYCHIATRY
1/10/2022 1
Dharmesh Chaturvedi M.Sc.Nursing

1/10/2022 2

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.
1/10/2022 3

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”.
1/10/2022 4

• Complimentary therapies are those used in
conjunction with conventional medical
practice.
• Alternative therapies are those that are
used instead of conventional medicine.
1/10/2022 5

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.
1/10/2022 7

Principles underlying Alternative healing
In 1999, Eliopoulos identified FIVE basic
principles underlying CAM:
1. The body has the ability to heal itself
2. Health and healing are related to a harmony of
body and spirit.
3. Basic good health practices build the foundation
for healing.
4. Healing practices are individualized.
5. 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
1/10/2022 19

AYURVEDIC MEDICINE
• Traditional medical system of India.
• Based on the theory that illness results from the
imbalance of the body’s 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 body’s 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 body’s 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.
1/10/2022 28

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.
1/10/2022 33

ART, MUSIC AND DANCE THERAPY
1/10/2022 34

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
1/10/2022 36

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
1/10/2022 38

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.
1/10/2022 39

• 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.
1/10/2022 40

AROMATHERAPY
1/10/2022 41

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.
1/10/2022 42

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.
1/10/2022 43

Special diet therapies, mega doses of
vitamins and minerals
1/10/2022 44

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.
1/10/2022 45

• 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.
1/10/2022 46

T`ai chi
1/10/2022 47

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.
1/10/2022 48

Qi Gong
• It is the therapeutic Chinese practices that
include gentle exercise for the breath, body,
mind and voice.
1/10/2022 49

MASSAGE
1/10/2022 50

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.
1/10/2022 51

THERAPEUTIC TOUCH
1/10/2022 52

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 )
1/10/2022 53

• 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.
1/10/2022 54

REFLEXOLOGY
1/10/2022 55

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 .
1/10/2022 56

• 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.
1/10/2022 64

• 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.
1/10/2022 65

MAJOR
PSYCHIATRIC DISORDERS
AND
RELATED CAM
1/10/2022 66

Alcohol Abuse
Acupuncture.
Herbal therapy.
Meditation.
Yoga.
1/10/2022 67

Alzheimer Dementia:
Herbal therapy.
Massage.
Medical meditation
1/10/2022 68

Anxiety
Acupressure.
Biofeedback.
Breathing and Relaxation techniques.
Guided imagery.
Healing touch / Therapeutic touch.
Self-hypnosis
Massage
Meditation
1/10/2022 69

Attention deficit hyperactivity disorder
–Biofeedback.
Depression:
–Acupuncture.
–Healing touch.
–Herbal therapy.
–Meditation.
–Transcranial magnetic stimulation
1/10/2022 70

Insomnia:
Breathing and relaxation techniques.
Herbal therapy.
Meditation.
Obsessive Compulsive Disorder(OCD):
Acupuncture.
Medical meditation.
1/10/2022 71

Stress
–Breathing and Relaxation exercises.
–Healing touch.
–Massage.
–Meditation
1/10/2022 72

PSYCHIATRIC NURSE AND CAM
1/10/2022 73

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.
1/10/2022 74

2.Nurse’s role in integrating CAM in
conventional settings
• CAM therapies are beneficial, safe, cost-
effective and easily implemented throughout
psychiatric settings.
• Nurse’s role as healers in assisting patients to
attain and maintain health and serving as a
bridge between the patient and physician.
1/10/2022 75

Different roles of Nurses in CAM therapies are
A. Helper
B. Facilitator
C. Practitioner
D. Educator
E. Co-ordinator
F. Advocate
G. Leader
1/10/2022 76

A. 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.
1/10/2022 77

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
patient’s 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.
1/10/2022 82

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.
1/10/2022 83

G. Leader:
• Nurses can demonstrate leadership in
helping conventional clinical settings
integrate CAM therapies.
• Nurse’s holistic orientation and co-
ordination responsibilities enable them for
this role.
1/10/2022 84

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