This document summarizes a study that examined the effects of distance healing as an adjunct treatment for patients with major depression. 40 patients receiving standard antidepressant medication and psychotherapy were randomly assigned to either receive daily distance healing for 6 weeks from trained healers (experimental group), or to only receive standard treatment (control group). Outcome measures including depression scores, general psychopathology, and functioning were assessed weekly for 6 weeks and biweekly for 6 more weeks. Results showed a nonsignificant trend for the experimental group to show greater improvement, and favorable outcomes in the experimental group were correlated with number of healing sessions and healers' ratings of session strength.
Cognitive behavioral therapy (CBT) improved quality of life more than standard treatment alone in patients with chronic musculoskeletal pain. A randomized clinical trial assigned 93 patients to either CBT or standard treatment control groups. After 10 weeks, CBT resulted in a 54% reduction in pain levels compared to 28.9% for control. CBT also reduced depressive symptoms and improved physical limitations, general health, and limitations due to emotional problems domains of quality of life more than standard treatment alone. CBT was shown to be an effective addition to standard treatment for improving aspects of chronic pain.
This randomized clinical trial compared the effectiveness of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and usual care for treating chronic low back pain. 342 adults with chronic low back pain were randomly assigned to receive MBSR, CBT, or usual care. At 26 weeks, participants receiving MBSR or CBT reported significantly greater improvement in back pain and functional limitations compared to usual care. There were no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for chronic low back pain.
Acupuncture has become more widely used in sports medicine to treat pain and hasten recovery from injuries. Modern acupuncture uses sterile, disposable needles inserted at specific points along "meridians" to balance the flow of life energy in the body. Treatment sessions typically involve 6-12 needles placed for 10-30 minutes. While generally safe, serious risks include infection and organ puncture. Research shows acupuncture effective for osteoarthritis knee pain and some studies find it can improve immune function after exercise. The largest trial to date found acupuncture helped reduce knee pain more than education or sham acupuncture.
The Psychological Changes of Horticultura Therapy Intervention for Elderly Women of Earthquake-Related Areas
`
For more information, Please see websites below:
`
Organic Edible Schoolyards & Gardening with Children
http://scribd.com/doc/239851214
`
Double Food Production from your School Garden with Organic Tech
http://scribd.com/doc/239851079
`
Free School Gardening Art Posters
http://scribd.com/doc/239851159`
`
Increase Food Production with Companion Planting in your School Garden
http://scribd.com/doc/239851159
`
Healthy Foods Dramatically Improves Student Academic Success
http://scribd.com/doc/239851348
`
City Chickens for your Organic School Garden
http://scribd.com/doc/239850440
`
Simple Square Foot Gardening for Schools - Teacher Guide
http://scribd.com/doc/239851110
This study aimed to examine the impact of acupuncture on pain, nausea, anxiety and coping in women undergoing mastectomy surgery. The study involved a randomized controlled trial where women were assigned to either receive acupuncture post-surgery or usual care. Results found that acupuncture was effective in reducing anxiety, improving coping ability, and decreasing pain and nausea, with statistically significant differences between the acupuncture and usual care groups. Limitations included a small sample size and lack of diversity. Future research could involve a larger, more diverse population and exploring optimal timing of acupuncture interventions.
This randomized controlled trial investigated whether acupuncture or sham acupuncture was more effective than no acupuncture in reducing migraine headaches in 302 patients. The trial found that both acupuncture and sham acupuncture led to greater reductions in moderate or severe headache days compared to the waiting list control group. However, acupuncture was not found to be more effective than sham acupuncture for reducing headache days. The proportion of "responders", defined as at least a 50% reduction in headache days, was similar between the acupuncture (51%) and sham acupuncture (53%) groups, and higher than the waiting list group (15%). The trial concluded that acupuncture was no more effective than sham acupuncture for reducing migraine headaches, although both were more
Spinal manipulation therapy (SMT) was more effective than medication for relieving acute or subacute neck pain in both the short and long term. Home exercise with advice (HEA) resulted in similar pain outcomes to SMT at most time points. For 272 participants with neck pain lasting 2-12 weeks, SMT had statistically significantly less pain than medication after 8 weeks and up to 1 year later. HEA was superior to medication for pain relief at 26 weeks. No important differences in pain were found between SMT and HEA. The trial demonstrated that SMT and HEA were both more effective than medication for acute or subacute neck pain.
This document discusses key terms used to describe outcomes in antidepressant treatment research and clinical practice, specifically response, remission, recurrence, and recovery. It notes that while remission is now considered the optimal treatment goal, implying wellness, definitions of remission have varied inconsistently across studies. True wellness should be determined by a lack of symptoms, good functional status, and reduced pathophysiology. The document calls for clinical trials to better reflect the treatment goal of sustained wellness through longer durations, larger sample sizes, and assessment of functional outcomes.
Cognitive behavioral therapy (CBT) improved quality of life more than standard treatment alone in patients with chronic musculoskeletal pain. A randomized clinical trial assigned 93 patients to either CBT or standard treatment control groups. After 10 weeks, CBT resulted in a 54% reduction in pain levels compared to 28.9% for control. CBT also reduced depressive symptoms and improved physical limitations, general health, and limitations due to emotional problems domains of quality of life more than standard treatment alone. CBT was shown to be an effective addition to standard treatment for improving aspects of chronic pain.
This randomized clinical trial compared the effectiveness of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and usual care for treating chronic low back pain. 342 adults with chronic low back pain were randomly assigned to receive MBSR, CBT, or usual care. At 26 weeks, participants receiving MBSR or CBT reported significantly greater improvement in back pain and functional limitations compared to usual care. There were no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for chronic low back pain.
Acupuncture has become more widely used in sports medicine to treat pain and hasten recovery from injuries. Modern acupuncture uses sterile, disposable needles inserted at specific points along "meridians" to balance the flow of life energy in the body. Treatment sessions typically involve 6-12 needles placed for 10-30 minutes. While generally safe, serious risks include infection and organ puncture. Research shows acupuncture effective for osteoarthritis knee pain and some studies find it can improve immune function after exercise. The largest trial to date found acupuncture helped reduce knee pain more than education or sham acupuncture.
The Psychological Changes of Horticultura Therapy Intervention for Elderly Women of Earthquake-Related Areas
`
For more information, Please see websites below:
`
Organic Edible Schoolyards & Gardening with Children
http://scribd.com/doc/239851214
`
Double Food Production from your School Garden with Organic Tech
http://scribd.com/doc/239851079
`
Free School Gardening Art Posters
http://scribd.com/doc/239851159`
`
Increase Food Production with Companion Planting in your School Garden
http://scribd.com/doc/239851159
`
Healthy Foods Dramatically Improves Student Academic Success
http://scribd.com/doc/239851348
`
City Chickens for your Organic School Garden
http://scribd.com/doc/239850440
`
Simple Square Foot Gardening for Schools - Teacher Guide
http://scribd.com/doc/239851110
This study aimed to examine the impact of acupuncture on pain, nausea, anxiety and coping in women undergoing mastectomy surgery. The study involved a randomized controlled trial where women were assigned to either receive acupuncture post-surgery or usual care. Results found that acupuncture was effective in reducing anxiety, improving coping ability, and decreasing pain and nausea, with statistically significant differences between the acupuncture and usual care groups. Limitations included a small sample size and lack of diversity. Future research could involve a larger, more diverse population and exploring optimal timing of acupuncture interventions.
This randomized controlled trial investigated whether acupuncture or sham acupuncture was more effective than no acupuncture in reducing migraine headaches in 302 patients. The trial found that both acupuncture and sham acupuncture led to greater reductions in moderate or severe headache days compared to the waiting list control group. However, acupuncture was not found to be more effective than sham acupuncture for reducing headache days. The proportion of "responders", defined as at least a 50% reduction in headache days, was similar between the acupuncture (51%) and sham acupuncture (53%) groups, and higher than the waiting list group (15%). The trial concluded that acupuncture was no more effective than sham acupuncture for reducing migraine headaches, although both were more
Spinal manipulation therapy (SMT) was more effective than medication for relieving acute or subacute neck pain in both the short and long term. Home exercise with advice (HEA) resulted in similar pain outcomes to SMT at most time points. For 272 participants with neck pain lasting 2-12 weeks, SMT had statistically significantly less pain than medication after 8 weeks and up to 1 year later. HEA was superior to medication for pain relief at 26 weeks. No important differences in pain were found between SMT and HEA. The trial demonstrated that SMT and HEA were both more effective than medication for acute or subacute neck pain.
This document discusses key terms used to describe outcomes in antidepressant treatment research and clinical practice, specifically response, remission, recurrence, and recovery. It notes that while remission is now considered the optimal treatment goal, implying wellness, definitions of remission have varied inconsistently across studies. True wellness should be determined by a lack of symptoms, good functional status, and reduced pathophysiology. The document calls for clinical trials to better reflect the treatment goal of sustained wellness through longer durations, larger sample sizes, and assessment of functional outcomes.
This study surveyed behavioral health clinicians with experience using stellate ganglion block (SGB) as an adjunct treatment for trauma-related disorders like PTSD. Of the 23 respondents, 95% would recommend SGB to colleagues. Respondents rated SGB as at least as useful as the highest rated standard PTSD interventions. SGB was seen as most helpful for reducing arousal/reactivity symptoms. The majority would refer patients for SGB at any stage of therapy, including before starting other treatments.
This article discusses the need to increase openness and discussion about death and dying in society. A lack of discussion can negatively impact end-of-life care and leave the bereaved feeling unprepared. While surveys show public support for assisted dying, most people prefer to die at home if possible and welcome advance care planning discussions with healthcare providers. Attitudes vary depending on demographics, and increasing awareness of palliative care options through public education initiatives could improve end-of-life experiences.
This randomized controlled trial compared the effectiveness of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain. The trial found that:
1) SMT had a statistically significant advantage over medication in reducing pain up to 1 year after treatment based on participant-reported pain levels.
2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
- A study evaluated the effects of brief visits with a therapy dog versus waiting room time alone on symptoms in fibromyalgia patients at an outpatient pain clinic.
- 106 patients had therapy dog visits averaging 12 minutes, while 49 patients spent an average of 17 minutes in the waiting room.
- Patients reported significant improvements in pain, mood, fatigue and other measures after the therapy dog visit but not after waiting room time. Clinically meaningful pain relief occurred in 34% after therapy dog visits and 4% after waiting room time.
- Brief therapy dog visits may provide benefits for fibromyalgia patients as a complementary therapy to help reduce pain and improve mood.
This document summarizes the results of moderator analyses from a large randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) for chronic pain from osteoarthritis. The trial compared 10 sessions of Pain Coping Skills Training (PCST), a form of CBT, delivered by nurse practitioners to a usual care control group. Several demographic and clinical variables were examined as potential moderators of treatment response. The analyses found that patients' pain coping style, expectations for treatment, disease severity, age, and education level significantly moderated outcomes, with some subgroups showing stronger responses to PCST. Sex, race, BMI, and depression did not impact treatment response. Specifically, patients with interpersonal pain coping problems did not benefit much from
This randomized clinical trial tested the effectiveness of stellate ganglion block (SGB) treatment compared to a sham procedure for reducing posttraumatic stress disorder (PTSD) symptoms over 8 weeks. 113 active-duty service members with PTSD symptoms were randomly assigned to receive either 2 SGB treatments 2 weeks apart or a sham procedure. The primary outcome was change in PTSD symptom severity scores measured by the CAPS-5 scale from baseline to 8 weeks. Participants receiving SGB had a greater reduction in symptoms scores compared to the sham group, with adjusted mean decreases of 12.6 vs 6.1 points respectively, indicating SGB treatment may help reduce PTSD symptoms.
This study compared patient pain scores to those assessed by emergency healthcare providers (doctors and triage nurses) in the emergency department of a large Malaysian hospital. The mean patient pain score on arrival was 6.8 out of 10, significantly higher than scores assessed by doctors (5.6) and triage nurses (4.3). Significant differences were found for 5 specific conditions: soft tissue injury, headache, abdominal pain, fracture, and abscess/cellulitis. Upon discharge or admission, nearly half of patients still reported moderate pain, suggesting undertreatment of pain in the emergency department. Accurately assessing patient-reported pain scores is important for effective pain management in emergency medicine.
This study compared chronic pain patients whose symptoms were considered medically unexplained (cases) to those whose symptoms had clear medical explanations (controls). The key findings were:
1. Medically unexplained symptoms were associated with higher rates of psychiatric morbidity, including a 3.4 times higher odds of any psychiatric diagnosis.
2. Cases reported more potential iatrogenic factors like over-investigation and over-treatment from healthcare providers compared to controls.
3. There were no significant differences between cases and controls in rates of medication abuse or dependence.
Cognitive conflicts in major depression: Between desired change and personal ...Guillem Feixas
Article in British Journal of Clinical Psychology (early view). Abstract:
Objectives
The notion of intra-psychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma, and on a new way of identifying these conflicts by means of the repertory grid technique. Our aim is to explore the relevance of cognitive conflicts among depressive patients.
Design
Comparison between persons with a diagnosis of major depressive disorder and community controls.
Methods
161 patients with major depression and 110 non-depressed participants were assessed for presence of implicative dilemmas and level of symptom severity. The content of these cognitive conflicts was also analysed.
Results
Repertory grid analysis indicated conflict (presence of implicative dilemma/s) in a greater proportion of depressive patients than in controls. Taking only those grids with conflict, the average number of implicative dilemmas per person was higher in the depression group.
In addition, participants with cognitive conflicts displayed higher symptom severity. Within the clinical sample, patients with implicative dilemmas presented lower levels of global functioning and a more frequent history of suicide attempts.
Conclusions
Cognitive conflicts were more prevalent in depressive patients and were associated with clinical severity. Conflict assessment at pre-therapy could aid in treatment planning to fit patient characteristics.
Practitioner Points
• Internal conflicts have been postulated in clinical psychology for a long time but there is little evidence about its relevance due to the lack of methods to measure them.
• We developed a method for identifying conflicts using the Repertory Grid Technique.
• Depressive patients have higher presence and number of conflicts than controls.
• Conflicts (implicative dilemmas) can be a new target for intervention in depression.
Cautions/Limitations
• A cross-sectional design precluded causal conclusions.
• The role of implicative dilemmas in the causation or maintenance of depression cannot be ascertained from this study.
A workshop on spirituality and medicine was piloted for medical students and residents to determine if the content was relevant and preliminary evaluation was promising. The 2-hour student workshop and 1.5-hour resident workshop covered topics like distinguishing spirituality from religion, research on spirituality and health, barriers to addressing spirituality, and techniques for spiritual assessment. Learners reported increased agreement that inquiring about spiritual beliefs is appropriate, and increased perceived competence in spiritual history taking and knowledge of pastoral resources after the workshops. The workshops had a modest effect in improving attitudes and perceived skills.
This randomized controlled trial investigated the effects of remote intercessory prayer on 990 patients admitted to a coronary care unit (CCU). Patients were randomly assigned to either receive remote prayer from outside intercessors (prayer group) or usual care without prayer (control group). Blinded retrospective chart review found that the prayer group had lower mean weighted and unweighted CCU course scores compared to the control group, indicating fewer adverse outcomes. However, there were no differences in CCU or hospital length of stay between the groups. The results provide preliminary evidence that remote intercessory prayer may be associated with lower adverse clinical outcomes for CCU patients.
This systematic review examined the clinimetric properties of the Illness Perception Questionnaire-Revised (IPQ-R) and Brief Illness Perception Questionnaire (Brief IPQ) in patients with musculoskeletal disorders. Eight studies were included and evaluated for methodological quality using the COSMIN checklist. The IPQ-R was found to have good reliability except for the illness coherence dimension. Internal consistency was good except for the causal domain. The IPQ-R demonstrated good construct validity but an unstable factor structure. The Brief IPQ showed moderate overall test-retest reliability. No studies examining the validity of the Brief IPQ were identified. Further research is needed on the content and criterion validity of the IPQ
This document summarizes a study that evaluated the long-term effects of a three-phase health education program on blood pressure control and mortality in hypertensive patients over 5 years. The study involved 400 patients randomized into groups that received different combinations of three interventions: an exit interview, a family support session, and small group sessions. Results showed the educational program had a positive effect on appointment keeping, weight control, and blood pressure control over 5 years. Mortality rates were also significantly lower in the experimental group that received the interventions compared to the control group. The results provide evidence that educational programs can benefit long-term management and control of high blood pressure.
1) The study investigated the differences in cerebral activity and clinical efficacy between acupuncture and sham acupuncture treatment for functional dyspepsia (FD).
2) 72 FD patients were randomly assigned to receive either real acupuncture or sham acupuncture for 4 weeks. 10 patients from each group also underwent PET scans before and after treatment.
3) Results showed acupuncture was more effective at reducing dyspeptic symptoms compared to sham acupuncture based on clinical scores. Acupuncture also produced greater deactivation of brain regions like the brainstem, anterior cingulate cortex, insula, thalamus, and hypothalamus compared to sham acupuncture. Deactivation of these regions correlated with improvement in clinical scores for
The document provides revised recommendations for the management of fibromyalgia based on a review of evidence from systematic reviews and meta-analyses published since the original 2005 guidelines. Key findings include:
- Exercise is the only therapy strongly recommended based on meta-analyses showing benefit for pain, sleep, and functioning.
- A graduated four-stage approach is proposed, beginning with patient education and non-pharmacological therapies.
- If non-response, further therapies such as psychological therapies, pharmacotherapy, or rehabilitation may be tailored to the individual. However, meta-analyses only found weak evidence for all potential pharmacological therapies.
- Most treatments show relatively modest effects. Future research priorities are identifying who benefits from specific interventions,
The document provides revised recommendations for the management of fibromyalgia based on a review of evidence from systematic reviews and meta-analyses published since the original 2005 guidelines. Key findings include:
- Exercise was the only intervention with a "strong for" recommendation based on meta-analyses showing benefits for pain, fatigue, sleep and functioning.
- A graduated four-stage approach is proposed, beginning with patient education and non-pharmacological therapies. Pharmacological therapies (amitriptyline, pregabalin, cyclobenzaprine, duloxetine, milnacipran) received "weak for" recommendations for severe pain or sleep issues.
- Growth hormone, sodium oxybate, NSAIDs, S
The Relation between Happiness and Life Expectancy among the Nurses in TehranAli Moghadam
This study examines the relationship between happiness and life expectancy among nurses in Tehran, Iran. 97 nurses were randomly selected from hospitals in Tehran to complete the Oxford Happiness Questionnaire and HERTH Hope Scale. The results of the Pearson correlation analysis showed a relationship between happiness and life expectancy among the nurse participants. Specifically, higher levels of happiness were correlated with higher levels of life expectancy.
INFLUENCE OF DEMOGRAPHIC FACTORS ON PAIN KILLER USAGE AND ADDICTION SYMPTOMSJing Zang
Pain killers have been a necessity for humans since their skin has been laden with pain receptors to signal them against any invasion or unusual going on in the body.This pain when exceeds the limits of tolerance has to be alleviated to reduce suffering. Since ancient times numerous natural substances like herbs and oils have been used to relieve pain, but in modern era more refined ways to relieve pain have been discovered that exactly target the precise pain. This research identifies the factors that govern painkiller usage and addiction and the people who, in majority fall prey to pleasures of pain killers. The research was carried out through a questionnaire and results were statistically analyzed by fishers exact test. Males, employed people, non medics and graduates are most attracted to pain killers and are susceptible to long term addiction. The reasons for these people falling prey to pain killers are work load, mental stress and physiological responses to the drug. These factors can be managed through proper intervention by health professionals. The role of friends and family too here cannot be ignored.
Dimensional versus categorical classification of mental disorders in the fift...Chloe Taracatac
This document discusses the limitations of categorical classification of mental disorders in the DSM and argues for incorporating dimensional elements. It suggests introducing dimensional severity ratings to existing diagnostic categories as an initial step. This would help address issues like failing to capture individual differences in severity and clinically significant subthreshold features. The document also discusses determining the optimal level for incorporating dimensions, such as at the disorder construct level or for higher order dimensions, and developing an assessment system that can be reliably implemented.
Health Psychology: Chronic Pain Rotation and Training Syllabus Michael Changaris
According to NIH data, Chronic Pain Clinic affects more than 24 million Americans. Pain is often untreated in mental health settings due to a lack of clinical skills. The combination of opiate use disorder and chronic pain have reduced the life expectancy nationwide. The 2016 national pain strategy has indicated that integrated behavioral psychology into pain management is a central goal, but current plans have shown no changes in access. Developing chronic pain and opiate risk clinical rotation provides ways to reduce the training to treatment pipeline issues. Pain management is needed both in health and mental health settings.
Leaders with pain psychology skills can provide a high level of care and address public health needs. Most psychologists are trained in a single professional siloed context. This training rotation is a collaborative care approach to treatment that supports work with medical professionals at a high level of embedded clinical skills growing interprofessional skills in internship year that can be foundational in the development of clinical professionals.
This training rotation was established to develop skills in assessment, treatment, and interdisciplinary treatment of chronic pain. Interns in this rotation will be assigned to a weekly chronic pain clinic paired with a medical provider who is a specialist in chronic pain management and develop integrated treatment plans to address patient care needs.
There are four components to the training rotation in chronic pain; these are a. precepted clinic rotation with monthly or more direct supervision of clinical consultation and intervention in a high-risk pain management clinic, b. Weekly group supervision and didactic training, c. Supervised individual pain treatment post-mid-year, d. Orientation training on the clinic and chronic pain.
La visión humana percibe las radiaciones de luz y las traduce en colores, los cuales se pueden clasificar en tonos, saturación y luminosidad. Existen también colores primarios, secundarios, terciarios, complementarios y análogos.
This study surveyed behavioral health clinicians with experience using stellate ganglion block (SGB) as an adjunct treatment for trauma-related disorders like PTSD. Of the 23 respondents, 95% would recommend SGB to colleagues. Respondents rated SGB as at least as useful as the highest rated standard PTSD interventions. SGB was seen as most helpful for reducing arousal/reactivity symptoms. The majority would refer patients for SGB at any stage of therapy, including before starting other treatments.
This article discusses the need to increase openness and discussion about death and dying in society. A lack of discussion can negatively impact end-of-life care and leave the bereaved feeling unprepared. While surveys show public support for assisted dying, most people prefer to die at home if possible and welcome advance care planning discussions with healthcare providers. Attitudes vary depending on demographics, and increasing awareness of palliative care options through public education initiatives could improve end-of-life experiences.
This randomized controlled trial compared the effectiveness of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain. The trial found that:
1) SMT had a statistically significant advantage over medication in reducing pain up to 1 year after treatment based on participant-reported pain levels.
2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
- A study evaluated the effects of brief visits with a therapy dog versus waiting room time alone on symptoms in fibromyalgia patients at an outpatient pain clinic.
- 106 patients had therapy dog visits averaging 12 minutes, while 49 patients spent an average of 17 minutes in the waiting room.
- Patients reported significant improvements in pain, mood, fatigue and other measures after the therapy dog visit but not after waiting room time. Clinically meaningful pain relief occurred in 34% after therapy dog visits and 4% after waiting room time.
- Brief therapy dog visits may provide benefits for fibromyalgia patients as a complementary therapy to help reduce pain and improve mood.
This document summarizes the results of moderator analyses from a large randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) for chronic pain from osteoarthritis. The trial compared 10 sessions of Pain Coping Skills Training (PCST), a form of CBT, delivered by nurse practitioners to a usual care control group. Several demographic and clinical variables were examined as potential moderators of treatment response. The analyses found that patients' pain coping style, expectations for treatment, disease severity, age, and education level significantly moderated outcomes, with some subgroups showing stronger responses to PCST. Sex, race, BMI, and depression did not impact treatment response. Specifically, patients with interpersonal pain coping problems did not benefit much from
This randomized clinical trial tested the effectiveness of stellate ganglion block (SGB) treatment compared to a sham procedure for reducing posttraumatic stress disorder (PTSD) symptoms over 8 weeks. 113 active-duty service members with PTSD symptoms were randomly assigned to receive either 2 SGB treatments 2 weeks apart or a sham procedure. The primary outcome was change in PTSD symptom severity scores measured by the CAPS-5 scale from baseline to 8 weeks. Participants receiving SGB had a greater reduction in symptoms scores compared to the sham group, with adjusted mean decreases of 12.6 vs 6.1 points respectively, indicating SGB treatment may help reduce PTSD symptoms.
This study compared patient pain scores to those assessed by emergency healthcare providers (doctors and triage nurses) in the emergency department of a large Malaysian hospital. The mean patient pain score on arrival was 6.8 out of 10, significantly higher than scores assessed by doctors (5.6) and triage nurses (4.3). Significant differences were found for 5 specific conditions: soft tissue injury, headache, abdominal pain, fracture, and abscess/cellulitis. Upon discharge or admission, nearly half of patients still reported moderate pain, suggesting undertreatment of pain in the emergency department. Accurately assessing patient-reported pain scores is important for effective pain management in emergency medicine.
This study compared chronic pain patients whose symptoms were considered medically unexplained (cases) to those whose symptoms had clear medical explanations (controls). The key findings were:
1. Medically unexplained symptoms were associated with higher rates of psychiatric morbidity, including a 3.4 times higher odds of any psychiatric diagnosis.
2. Cases reported more potential iatrogenic factors like over-investigation and over-treatment from healthcare providers compared to controls.
3. There were no significant differences between cases and controls in rates of medication abuse or dependence.
Cognitive conflicts in major depression: Between desired change and personal ...Guillem Feixas
Article in British Journal of Clinical Psychology (early view). Abstract:
Objectives
The notion of intra-psychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma, and on a new way of identifying these conflicts by means of the repertory grid technique. Our aim is to explore the relevance of cognitive conflicts among depressive patients.
Design
Comparison between persons with a diagnosis of major depressive disorder and community controls.
Methods
161 patients with major depression and 110 non-depressed participants were assessed for presence of implicative dilemmas and level of symptom severity. The content of these cognitive conflicts was also analysed.
Results
Repertory grid analysis indicated conflict (presence of implicative dilemma/s) in a greater proportion of depressive patients than in controls. Taking only those grids with conflict, the average number of implicative dilemmas per person was higher in the depression group.
In addition, participants with cognitive conflicts displayed higher symptom severity. Within the clinical sample, patients with implicative dilemmas presented lower levels of global functioning and a more frequent history of suicide attempts.
Conclusions
Cognitive conflicts were more prevalent in depressive patients and were associated with clinical severity. Conflict assessment at pre-therapy could aid in treatment planning to fit patient characteristics.
Practitioner Points
• Internal conflicts have been postulated in clinical psychology for a long time but there is little evidence about its relevance due to the lack of methods to measure them.
• We developed a method for identifying conflicts using the Repertory Grid Technique.
• Depressive patients have higher presence and number of conflicts than controls.
• Conflicts (implicative dilemmas) can be a new target for intervention in depression.
Cautions/Limitations
• A cross-sectional design precluded causal conclusions.
• The role of implicative dilemmas in the causation or maintenance of depression cannot be ascertained from this study.
A workshop on spirituality and medicine was piloted for medical students and residents to determine if the content was relevant and preliminary evaluation was promising. The 2-hour student workshop and 1.5-hour resident workshop covered topics like distinguishing spirituality from religion, research on spirituality and health, barriers to addressing spirituality, and techniques for spiritual assessment. Learners reported increased agreement that inquiring about spiritual beliefs is appropriate, and increased perceived competence in spiritual history taking and knowledge of pastoral resources after the workshops. The workshops had a modest effect in improving attitudes and perceived skills.
This randomized controlled trial investigated the effects of remote intercessory prayer on 990 patients admitted to a coronary care unit (CCU). Patients were randomly assigned to either receive remote prayer from outside intercessors (prayer group) or usual care without prayer (control group). Blinded retrospective chart review found that the prayer group had lower mean weighted and unweighted CCU course scores compared to the control group, indicating fewer adverse outcomes. However, there were no differences in CCU or hospital length of stay between the groups. The results provide preliminary evidence that remote intercessory prayer may be associated with lower adverse clinical outcomes for CCU patients.
This systematic review examined the clinimetric properties of the Illness Perception Questionnaire-Revised (IPQ-R) and Brief Illness Perception Questionnaire (Brief IPQ) in patients with musculoskeletal disorders. Eight studies were included and evaluated for methodological quality using the COSMIN checklist. The IPQ-R was found to have good reliability except for the illness coherence dimension. Internal consistency was good except for the causal domain. The IPQ-R demonstrated good construct validity but an unstable factor structure. The Brief IPQ showed moderate overall test-retest reliability. No studies examining the validity of the Brief IPQ were identified. Further research is needed on the content and criterion validity of the IPQ
This document summarizes a study that evaluated the long-term effects of a three-phase health education program on blood pressure control and mortality in hypertensive patients over 5 years. The study involved 400 patients randomized into groups that received different combinations of three interventions: an exit interview, a family support session, and small group sessions. Results showed the educational program had a positive effect on appointment keeping, weight control, and blood pressure control over 5 years. Mortality rates were also significantly lower in the experimental group that received the interventions compared to the control group. The results provide evidence that educational programs can benefit long-term management and control of high blood pressure.
1) The study investigated the differences in cerebral activity and clinical efficacy between acupuncture and sham acupuncture treatment for functional dyspepsia (FD).
2) 72 FD patients were randomly assigned to receive either real acupuncture or sham acupuncture for 4 weeks. 10 patients from each group also underwent PET scans before and after treatment.
3) Results showed acupuncture was more effective at reducing dyspeptic symptoms compared to sham acupuncture based on clinical scores. Acupuncture also produced greater deactivation of brain regions like the brainstem, anterior cingulate cortex, insula, thalamus, and hypothalamus compared to sham acupuncture. Deactivation of these regions correlated with improvement in clinical scores for
The document provides revised recommendations for the management of fibromyalgia based on a review of evidence from systematic reviews and meta-analyses published since the original 2005 guidelines. Key findings include:
- Exercise is the only therapy strongly recommended based on meta-analyses showing benefit for pain, sleep, and functioning.
- A graduated four-stage approach is proposed, beginning with patient education and non-pharmacological therapies.
- If non-response, further therapies such as psychological therapies, pharmacotherapy, or rehabilitation may be tailored to the individual. However, meta-analyses only found weak evidence for all potential pharmacological therapies.
- Most treatments show relatively modest effects. Future research priorities are identifying who benefits from specific interventions,
The document provides revised recommendations for the management of fibromyalgia based on a review of evidence from systematic reviews and meta-analyses published since the original 2005 guidelines. Key findings include:
- Exercise was the only intervention with a "strong for" recommendation based on meta-analyses showing benefits for pain, fatigue, sleep and functioning.
- A graduated four-stage approach is proposed, beginning with patient education and non-pharmacological therapies. Pharmacological therapies (amitriptyline, pregabalin, cyclobenzaprine, duloxetine, milnacipran) received "weak for" recommendations for severe pain or sleep issues.
- Growth hormone, sodium oxybate, NSAIDs, S
The Relation between Happiness and Life Expectancy among the Nurses in TehranAli Moghadam
This study examines the relationship between happiness and life expectancy among nurses in Tehran, Iran. 97 nurses were randomly selected from hospitals in Tehran to complete the Oxford Happiness Questionnaire and HERTH Hope Scale. The results of the Pearson correlation analysis showed a relationship between happiness and life expectancy among the nurse participants. Specifically, higher levels of happiness were correlated with higher levels of life expectancy.
INFLUENCE OF DEMOGRAPHIC FACTORS ON PAIN KILLER USAGE AND ADDICTION SYMPTOMSJing Zang
Pain killers have been a necessity for humans since their skin has been laden with pain receptors to signal them against any invasion or unusual going on in the body.This pain when exceeds the limits of tolerance has to be alleviated to reduce suffering. Since ancient times numerous natural substances like herbs and oils have been used to relieve pain, but in modern era more refined ways to relieve pain have been discovered that exactly target the precise pain. This research identifies the factors that govern painkiller usage and addiction and the people who, in majority fall prey to pleasures of pain killers. The research was carried out through a questionnaire and results were statistically analyzed by fishers exact test. Males, employed people, non medics and graduates are most attracted to pain killers and are susceptible to long term addiction. The reasons for these people falling prey to pain killers are work load, mental stress and physiological responses to the drug. These factors can be managed through proper intervention by health professionals. The role of friends and family too here cannot be ignored.
Dimensional versus categorical classification of mental disorders in the fift...Chloe Taracatac
This document discusses the limitations of categorical classification of mental disorders in the DSM and argues for incorporating dimensional elements. It suggests introducing dimensional severity ratings to existing diagnostic categories as an initial step. This would help address issues like failing to capture individual differences in severity and clinically significant subthreshold features. The document also discusses determining the optimal level for incorporating dimensions, such as at the disorder construct level or for higher order dimensions, and developing an assessment system that can be reliably implemented.
Health Psychology: Chronic Pain Rotation and Training Syllabus Michael Changaris
According to NIH data, Chronic Pain Clinic affects more than 24 million Americans. Pain is often untreated in mental health settings due to a lack of clinical skills. The combination of opiate use disorder and chronic pain have reduced the life expectancy nationwide. The 2016 national pain strategy has indicated that integrated behavioral psychology into pain management is a central goal, but current plans have shown no changes in access. Developing chronic pain and opiate risk clinical rotation provides ways to reduce the training to treatment pipeline issues. Pain management is needed both in health and mental health settings.
Leaders with pain psychology skills can provide a high level of care and address public health needs. Most psychologists are trained in a single professional siloed context. This training rotation is a collaborative care approach to treatment that supports work with medical professionals at a high level of embedded clinical skills growing interprofessional skills in internship year that can be foundational in the development of clinical professionals.
This training rotation was established to develop skills in assessment, treatment, and interdisciplinary treatment of chronic pain. Interns in this rotation will be assigned to a weekly chronic pain clinic paired with a medical provider who is a specialist in chronic pain management and develop integrated treatment plans to address patient care needs.
There are four components to the training rotation in chronic pain; these are a. precepted clinic rotation with monthly or more direct supervision of clinical consultation and intervention in a high-risk pain management clinic, b. Weekly group supervision and didactic training, c. Supervised individual pain treatment post-mid-year, d. Orientation training on the clinic and chronic pain.
La visión humana percibe las radiaciones de luz y las traduce en colores, los cuales se pueden clasificar en tonos, saturación y luminosidad. Existen también colores primarios, secundarios, terciarios, complementarios y análogos.
Ricardo Monezi Julião de Oliveira realizou um estudo para avaliar os efeitos da impostação de mãos sobre os sistemas hematológico e imunológico de camundongos. Ele analisou amostras de sangue de camundongos que receberam impostação de mãos ou não para comparar variáveis como contagem de glóbulos brancos, vermelhos e plaquetas. Os resultados sugeriram que a impostação de mãos pode ter efeitos benéficos sobre esses sistemas.
Germ theory of disease states that microorganisms cause infectious disease. Pasteur and Koch conducted experiments identifying disease-causing agents and determining that each disease is caused by a specific microorganism. Koch's postulates provided steps to identify the organism causing a specific disease. The immune system protects the body from pathogens through non-specific defenses like skin and mucous membranes, and specific defenses involving white blood cells and antibodies that target specific pathogens.
The document appears to be a list of slides or sections for a presentation by Pablo Céspedes Vargas on EcoGardens. It includes 14 slides with the title "EcoGardens" followed by a number and 4 questions about equipment such as the width of a mower machine, the horsepower of a mower, the function of a backpack blower, and something included on a wheelbarrow.
This document provides information on Healing Touch, an energy therapy practice that uses gentle touch to balance physical, mental, emotional, and spiritual well-being. The document discusses what Healing Touch involves, its uses in treating conditions like stress, pain, and surgery recovery, and several research studies that have found Healing Touch can reduce anxiety, pain, and length of hospital stays. The document aims to educate about integrative medicine options and provides takeaways on the benefits Healing Touch can provide patients.
The document summarizes a systematic review of 23 randomized controlled trials that examined the efficacy of distant healing, which includes prayer, Therapeutic Touch, and other forms of spiritual healing. The trials involved a total of 2774 patients. 13 of the trials, representing 57% of studies, found statistically significant treatment effects of distant healing. While methodological limitations make definitive conclusions difficult, the authors found that given over half of trials showed benefits, further research is warranted.
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed trajectories of each person's experience over time. The study provides insight into how Healing Touch may help people emerge from a state of disconnection associated with depression.
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed trajectories of each person's experience over time. The study provides insight into how Healing Touch may help people emerge from a state of disconnection associated with depression.
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed reductions in depression scores after Healing Touch therapy. The study provides insight into how energy-based therapies like Healing Touch may help treat depression.
A Single Case Experiment For Cognitive-Behavioral Treatment Of Auditory Hallu...Richard Hogue
This document describes a single-case experiment that evaluated the impact of a new cognitive treatment for schizophrenia. The treatment integrated rational-emotive therapy and cognitive therapy for hallucinations and delusions. It was found to significantly reduce anxiety and depression, and increase quality of life and insight in a 37-year old female patient with schizophrenia. Gains were maintained at 3, 6, and 12 month follow-ups. The treatment shows promise for simultaneously targeting hallucinations and delusions.
The document summarizes 3 experiments on the effect of "laying on of hands" on transplanted breast cancer in mice. In the first experiment, 5 mice with breast cancer received daily 1-hour treatments from the researcher for 1 month. Their tumors blackened, ulcerated, and closed, and the mice lived normally. Control mice died as predicted. Two replications using skeptical volunteers also found high cure rates. Histological studies found viable cancer cells throughout remission. Reinjections of cancer into cured mice did not take, suggesting an immune response. The experiments suggest "laying on of hands" can cure cancer in mice in a reliable and reproducible way by stimulating immunity, without the need for belief.
Conversion disorder is a psychiatric condition in which psychologi.docxmaxinesmith73660
Conversion disorder is a psychiatric condition in which psychological stress manifests as some physical dysfunction. For example, stress associated with divorce proceedings might result in development of headaches, dermatological problems, breathing difficulties, and the like. In extreme cases, conversion disorder can result in abnormal movements, paralysis, or non-epileptic seizures. Poole, Wuerz and Agrawal (2010) recently reported that conversion disorder most frequently occurs in women, with a mean age of onset of approximately 29 years. One interesting feature of conversion disorder is that, in some cases, the effects of one individual can induce stress in other individuals, resulting in symptom manifestation in numerous people within an intimate population such as a school, workplace, or military squad (For review see: Bartholomew & Sirois, 2000). The phenomenon of multiple related cases of conversion disorder, once referred to as epidemic hysteria, is more commonly now referred to as mass psychogenic illness (MPI).
A variety of treatments for conversion disorder have been reported ranging from hypnosis (Moene, Spinhoven, Hoogduin & van Dyck, 2002) to drug therapy (Stevens, 1990). Moene and colleagues (2002) note that behavior therapy with operant conditioning may be successful in reducing symptoms in conversion disorder patients. It is reasonable to assume that such behavior therapy could be effectively administered in a group of patients. Furthermore, given the nature of social cue influences on this disorder, as seen with MPI, successful treatment of one or more individuals in a group setting could have residual positive effects on others within the group.
It is well established that positive behaviors can be shaped through modeling in a therapeutic setting. Researchers have shown, for example, that phobic behaviors can be reduced when one phobic individual watches another phobic individual (or a confederate acting as a phobic individual) calmly engaging in the fear provoking behavior (e.g. Geer & Turteltaub, 1967). Furthermore, it is possible for a single individual to evoke modeling behavior among a group, particularly when the behavior being exhibited is viewed positively by the members of that group (Peterson, Kaasa & Loftus, 2008).
With all of this information considered, the present study was designed to determine if individuals exhibiting effects of MPI would respond positively to behavior therapy in a group setting. It was further hypothesized that using a confederate, acting as a patient within the group, could enhance positive effects of therapy if that confederate reported positive influences of the therapy that could then be modeled by other members of the group. To test this hypothesis, a group of women, all diagnosed with chronic conversion disorder manifesting in abnormal movements and facial tics, were assigned to one of three groups. The first group received behavior therapy in a group setting that.
The document summarizes 10 research breakthroughs from the last decade that support chiropractic care. Some of the key findings include:
1) Seeing a chiropractor as a first contact provider was associated with decreases in hospital admissions, days, surgeries, and pharmaceutical costs compared to conventional medicine.
2) One study found that upper cervical chiropractic care was associated with marked and sustained reductions in blood pressure similar to two-drug combination therapy.
3) A wellness program implemented by chiropractors improved various health metrics such as weight, blood pressure, and strength.
The document concludes that these and other studies provide evidence that chiropractic care can positively impact multiple dimensions
This document summarizes research into using psilocybin-assisted psychotherapy to treat anxiety and depression in patients with terminal illnesses. Several studies have found psilocybin can help reduce anxiety and depressive symptoms for months after a single session. Psilocybin appears to occasion mystical or spiritual experiences that patients report as being highly meaningful. Ongoing research at Johns Hopkins University and NYU involving over 100 participants total has found psilocybin can safely relieve anxiety and depression in cancer patients when administered in a controlled medical setting with psychological support. However, larger samples and more research are still needed to fully understand psilocybin's therapeutic potential and mechanisms of action.
This study examined longitudinal outcomes for female veterans enrolled in the Renew sexual trauma treatment program over 12 months. It found that symptoms of PTSD and negative cognitions decreased after treatment, while self-esteem and quality of life increased, with improvements sustained at 12 months. Specifically:
1) Post-traumatic symptoms decreased and positive factors like self-esteem increased immediately after the 12-week Renew program.
2) These beneficial changes were maintained when assessed at 6, 9, and 12 months post-treatment.
3) The Renew program, which incorporates principles of holographic reprocessing therapy, appears to be an effective long-term treatment for female veterans with histories of multiple traumas.
Therapeutic change an object relations perspective 1994Sandra Nascimento
This document provides an overview of the book "Therapeutic Change: An Object Relations Perspective" which evaluates long-term intensive psychotherapy treatment of very disturbed patients at the Austen Riggs Center. The study found impressive changes in patients over 15 months of treatment based on ratings of clinical records and psychological tests, including decreased symptoms, improved relationships, increased intelligence, and decreased unrealistic thinking. Patients were categorized as having either anaclitic or introjective personality types, and changes occurred in different ways for each group consistent with their personality organization. Certain Rorschach responses at intake also predicted greater therapeutic change.
1) The document discusses a study that explored the daily routines and quality of life of 10 individuals with chronic pain through interviews and assessments. 2) A grounded theory called the "Paradigm of Life" emerged from the data, which found that chronic pain disrupts individuals' occupations and impacts their quality of life. 3) The theory shows how engaging in meaningful occupations can enhance quality of life by providing distraction from pain and a sense of control.
The document summarizes alternative healing techniques, specifically Reiki and energy healing touch therapy. It discusses that illness is caused by energy imbalance and blockages in the body's subtle energy channels (nadis). Reiki and touch therapy work to remove these blockages and uplift energy levels, bringing relief. Research shows these therapies emit electromagnetic signals from practitioners' hands and can accelerate wound healing, reduce pain, stress, and symptoms of various illnesses. Side effect risks are low as these are non-invasive energy-based methods. Studies demonstrate their effectiveness through measures like improved blood work, accelerated healing, relief of conditions like asthma, headaches, and progress in cancer patients.
This randomized controlled trial found that subcutaneous methylnaltrexone effectively treated opioid-induced constipation in terminally ill patients. 48% of patients receiving methylnaltrexone had a bowel movement within 4 hours, compared to 15% of placebo patients. Pain scores and adverse events were similar between groups. While an effective treatment, methylnaltrexone's subcutaneous route and cost may limit its use in some settings like home hospice care. The study demonstrates the value of rigorous research methods to inform palliative care practice.
A pilot study of the hospital setting perception testGiovanni Senzi
A Pilot Study of the Hospital Setting Perception Test:
The Use of Pictures With Cancer Patients - Donata Milloni, Giovanni Senzi, Laura Bellotti, Franco Pasti, Roberta Perfetto, elaine Poggi, Massimo Rosselli
This document summarizes experimental evidence for the existence of an "energetic" component in psychic healing. It discusses Wilhelm Reich's discovery of "orgone energy" through experiments showing that this energy could prolong the lives of cancer mice exposed to an "orgone energy accumulator". The document then compares Reich's findings to experiments by healer Bill Bengston who found cancer tumors were anomalously sequestered from mice bodies through inflammatory healing reactions, similar to mice exposed to orgone accumulators. The document hypothesizes that orgone energy acts as the primary agent in both healing by psychic means and exposure to orgone accumulators, facilitating healing through "radiation hormesis".
This document discusses integrative medicine and its principles. It defines integrative medicine as patient-centered care that uses both conventional and alternative therapies. The document outlines the history of complementary and alternative medicine in the US healthcare system. It was largely pushed out after the Flexner Report in 1910 but continued growing. The document discusses the principles of integrative medicine, which include treating the whole person, using natural therapies when possible, and emphasizing prevention and health promotion. It provides a case study of how integrative medicine helped an 18-year-old with persistent headaches by using osteopathic manipulation rather than just medications. The document recommends a patient-centered model with a primary practitioner coordinating a team to meet all patient needs.
This document discusses integrative medicine and its principles. It defines integrative medicine as patient-centered care that uses both conventional and alternative therapies. The document outlines the history of complementary and alternative medicine in the US healthcare system. It was largely pushed out after the Flexner Report in 1910 but continued growing. The document discusses the principles of integrative medicine, which include treating the whole person, using natural therapies when possible, and emphasizing prevention and health promotion. It provides a case study of how integrative medicine helped an 18-year-old with persistent headaches by addressing physical and lifestyle factors. The document advocates for a healthcare system grounded in these integrative principles.
This document provides a scientific foundation for the biofield hypothesis. It introduces concepts from nonlinear dynamics and complexity theory that provide a biophysical basis for understanding living systems and energy medicine interventions. The key points are:
1) Living systems are nonlinear, dynamic, and self-organizing open systems far from equilibrium, constantly exchanging energy and information with their environment.
2) According to these principles, subtle energy medicine interventions could interact with an organism's regulatory processes and internal dynamics to promote healing by nudging the system into a new stable state.
3) This provides a scientific framework for understanding how alternative therapies involving subtle field interactions, like acupuncture and homeopathy, may work rapidly and holistically.
This document discusses subtle energies and anomalous phenomena that cannot be explained by the four accepted fundamental forces. It proposes that subtle energies, including mind, must be included to account for phenomena like remote viewing, psychokinesis, anomalous healing effects, and homeopathy. The document suggests that subtle energies may originate from interactions with the quantum vacuum state, and that the magnetic vector potential may act as a bridge between subtle and physical energies by controlling the phase of quantum wave functions. It provides several examples of experimental data that seem to require consideration of subtle energies.
Este documento apresenta uma dissertação de mestrado sobre a prática terapêutica alternativa Reiki. A pesquisa analisa como o Reiki vem sendo incorporado aos serviços oficiais de saúde em Campinas, SP, compreendendo como as práticas alternativas deslocam a problemática do indivíduo para a esfera das terapias. A dissertação aborda a história do Reiki, seus fundamentos como ritual terapêutico e seu papel no contexto das redes e espaços alternativos de Campinas.
1) Reiki is presented as a good starting point for physicians and patients new to integrative medicine due to its safety, self-administration, and ability to help patients feel better quickly.
2) For physicians, learning Reiki provides an experiential introduction to concepts of subtle energy and spirituality in healing. It can also improve self-care among physicians.
3) While experienced Reiki practitioners are needed for complex conditions, Reiki may be challenging to integrate into conventional medicine due to differences in training models and assessment standards compared to other therapies. However, its inclusion in integrative healthcare is an important part of reform.
Distance healing of patients with major depression
1. Journalof Scient$c Exploration,Vol. 10, NO.4, pp. 447-465, 1996 0892-3310196
O 1996Societyfor ScientificExploration
Distance Healing of Patients With Major Depression
BRUCE GREYSON'
Dept. of Psychiatry, University of Connecticut Health Center, Farmington, CT,06030
Abstract- The therapeutic effect of distance healing as an adjunct to stan-
dard antidepressant medication was examined in a study using a randomized,
double-blind, longitudinal design. Adult patients (N= 40) admitted to an in-
patient psychiatric unit for major depression, aged 19-81 years, were ran-
domly assigned to either an experimental or control group. All subjects re-
ceived standard treatment for depression; in addition, experimental group
subjects received distance healing daily for 6 weeks by volunteers trained in
LeShan's meditation techniques. Outcome was measured weekly for 6 weeks
and then biweekly for 6 more weeks, using the Hamilton Rating Scale for De-
pression, Brief Psychiatric Rating Scale, Global Assessment of Function, and
visual analog scale for depression. Results indicated a nonsignificant trend
for experimental subjects to show greater improvement than control subjects
in depression, general psychopathology, and overall subjective distress.
Among experimental subjects, favorable outcomes were significantly corre-
lated with number of healing sessions received and with healers' ratings of
the "strength" of the healing sessions.
Introduction
Conservative estimates of the number of Americans experiencing diagnosable
depressive episodes in a given year range between 10 and 20 million, while the
overall prevalence for major depressive episodes is between 3 and 5% of the
population (Cancro, 1985). The American Psychiatric Association guidelines
for treatment of major depression note that, although moderate to severe major
depression generally requires treatment with medication or electroconvulsive
therapy coupled with psychotherapy, those approaches do not guarantee suc-
cessful outcomes, nor should they exclude other approaches (American Psy-
chiatric Association, 1993). In fact, 10 to 15% of patients with major depres-
sion drop out of antidepressant medication trials in the first three weeks; of the
remaining patients only 60 to 70% can be expected to show eventual therapeu-
tic responses, and substantially fewer experience a complete remission
(American Psychiatric Association, 1993). Researchers have studied the aug-
mentation of antidepressant medication by a number of treatment modalities,
including the addition of potentiating medications that are not antidepressants
in themselves, electroconvulsive therapy, and a variety of individual and
'Reprint requests should be addressed to Bruce Greyson, M.D., Division of Personality Studies, Box
152, Health Sciences Center, University of Virginia, Charlottesville, VA 22908.
2. 448 B. Greyson
group psychotherapies. Another therapeutic option yet unexplored is the aug-
mentation of antidepressant medication by psychic healing techniques.
A variety of controlled and uncontrolled studies have suggested that some
forms of psychic healing can augment the therapeutic effects of traditional
medical treatments (Braud, 1990; Grad, 1967, 1971-72; Grad, Cadoret, and
Paul, 1961; Goodrich, 1974; Winston, 1975); Benor (1990) has identified 140
controlled trials of healing, of which 61 (44%) documented therapeutic effects
at a significance level less than p = 0.01. Studies have demonstrated the ap-
parent ability of healers to alter the ultraviolet light absorption of water in
sealed test tubes (Dean, 1983) and to alter in vitro enzyme activity (Smith,
1968).
Experiments have indicated that a healer's efforts result in faster recovery of
rodents from wounds (Grad, Cadoret, and Paul, 1961) and from anesthesia
(Watkins and Watkins, 1971). A double-blind study of the effect of interces-
sory prayer in a cardiac care unit showed patients randomly assigned to the
experimental group required fewer traditional medical interventions and had a
more benign course than those randomly assigned to the control group (Byrd,
1988). In a single-blind study, healers at a distance were able to reduce elec-
trodermal activity of highly anxious subjects who did not know when the
healing sessions were to occur (Braud and Schlitz, 1983, 1989).
Therapeutic touch, a purported healing technique that relies on the con-
scious intent of the healer but not on that of the patient, was derived from the
ancient practice of laying on of hands (Krieger, 1979, 1981). That technique
has been shown to increase the rate of wound healing in mice (Grad, 1965),to
elevate in vivo serum hemoglobin in humans (Krieger, 1972, 1973, 1974,
1975), to increase in vitro trypsin activity (Smith, 1972), and to accelerate
plant growth (Grad, 1963, 1964). Therapeutic touch has also been attempted
on psychological and psychosomatic conditions: it has been shown to induce
alterations in electroencephalogram, electrocardiogram, and galvanic skin re-
sponse reflecting a state of deep relaxation (Krieger, Peper, and Ancoli, 1979),
to diminish self-rated anxiety states (Heidt, 1981; Quinn, 1982, 1984), and to
decrease tension headache pain (Keller, 1983).
Quinn (1982) demonstrated that physical touch between healer and patient
was not essential for this kind of healing to be effective. "Noncontact thera-
peutic touch" has been shown to induce relaxation in neonates (Fedoruk,
1984) and to reduce post-operative pain (Connell-Meehan, 1985) and tension
headache (Keller, 1986). A double-blind study of noncontact therapeutic
touch documented the effectiveness of this technique in accelerating surgical
wound healing (Wirth, 1990).
In the late 1960s LeShan developed a method for training individuals in a
meditation technique that seemed to facilitate healing of medical conditions
(Goodrich, 1974, 1975, 1976; LeShan, 1974, 1975, 1976). Since that time,
over a thousand people have been trained in this method, originally by LeShan
and since 1977 by Goodrich (Goodrich, 1978, 1993; Nester, 1980). This
3. Distance Healing of Depressed Patients 449
method is used as an adjunct to ordinary medical procedures, and not as a sub-
stitute for them. This purported healing technique can be performed either at a
distance or in the presence of the patient. It was developed as a teachable skill
based on LeShan's scientific analysis and theoretical work, which suggested
that this technique taps a normal human ability to stimulate a patient's natural
capacity for self-healing to function more quickly and efficiently than usual.
This healing technique, rather than targeting a specific dysfunction, is hy-
pothesized to help all of a patient's systems and bodily functions move toward
greater balance and self-healing in a holistic and organismic manner, correct-
ing imbalances caused by disease or trauma and supporting and enhancing the
positive effects of traditional medical interventions. Unlike healing tech-
niques that purport to transfer energy from the healer to the patient, in this
method the healer accesses a state of consciousness that seems to facilitate an
altered state for the patient, in which the patient's own self-healing abilities are
stimulated and enhanced.
In addition to its physical effects, the LeShan healing process is said to
evoke a milieu of humanism and care, a quality of spirit and of pure and deeply
powerful compassion. Patients who are subjects of these healings report expe-
riencing a sense of being unafraid and more fully at home in the universe, even
when they may be extraordinarily stressed by threatening situations. Informal
observations indicate that these effects appear to counteract shock and, among
other things, to help the body ameliorate the negative side effects of general
anesthesia.
Two unpublished doctoral dissertations have specifically addressed Le-
Shan's technique for distance healing. Goodrich (1974) elicited subjective de-
scriptions of this type of healing from both the healers and the patients under
three conditions: (1) healing in the presence of the patient; (2) synchronous
distance healing, in which the healer and patient knew when the healing was to
occur; and (3) nonsynchronous distance healing, in which the patient expected
the healing at a time other than when it occurred (both healer and patient were
blind to the nonsynchronous condition). These data were then examined
blindly by three independent judges, who were able to differentiate the three
conditions significantly, based on the subjective descriptions of physical and
emotional states of healers and patients.
A second dissertation, by Winston (1 975), studied the effect of the relation-
ship between healer and patient on this type of distance healing. Four healing
conditions in this study varied in the kind of healer-patient interaction preced-
ing the healing itself. In the first, healer and patient were able to talk with each
other and get to know one another briefly. In the second, healer and patient
met but did not talk. In the third, the healer was given only a photograph and a
letter from the patient, but the two never met. And in the fourth, the healer
was given only a lock of the patient's hair.
Independent blind judges rating the patients' daily records of physical and
mental changes were able to differentiate some of these conditions to a statisti-
4. 450 B. Greyson
cally significant degree. The condition in which healer and patient met but did
not talk reliably received the highest ratings from the judges; while that in
which the healer was given only a photograph and a letter reliably received the
lowest ratings. The intermediate rating of the condition in which healer and
patient got to know each other was consistent with Goodrich's hypothesis
(1974) that ego involvement on the part of the healer may distort and interfere
with the healing process.
Uncontrolled observations of patients with whom this noninvasive form of
healing was done have suggested accelerated recovery rates and fewer compli-
cations or side effects in patients undergoing a wide variety of surgeries and
receiving medical treatment for leg ulcers and fractures. However, despite
more than 25 years of such observations on anecdotal cases, there have been
no double-blind controlled studies that might provide statistical evidence, if it
exists, of the effectiveness of this nonintrusive type of adjunctive healing. The
current study of the recovery of patients receiving antidepressant medication
for major depression was a part of that effort to assess with appropriate con-
trols the effectiveness of distance healing.
Rationale forthis Study
This was the first double-blind prospective experimental study of the effect
of distance healing on patients being treated for a psychiatric disorder. While
anecdotal studies of this healing technique have been published, there have
been no prior attempts to assign subjects randomly to experimental and con-
trol groups and to collect outcome data in a double-blind manner.
The LeShan healing technique was selected for study primarily because
there is a pool, accessible through the Consciousness Research and Training
Project, Inc., of individuals who have received extensive training in this tech-
nique, and because it has been demonstrated over a 20-year period to be a skill
teachable to individuals with no prior experience or skill in healing or medita-
tion. In contrast to purported psychic healing by individuals selected for their
apparent spontaneous healing abilities, demonstration of the effectiveness of
this type of healing would therefore have significant implications for wide-
spread applications in healthcare.
In addition to a standard measurement of depression, we chose to monitor
standardized measures of general mental health or psychopathology and of
functional abilities, since the LeShan healing technique is purported to work
not on specific target symptoms or disorders but rather on the patients' gener-
al health and self-healing capacities. We chose a treatment period of 6 weeks
for each subject in keeping with the consensus view that adequacy of response
to traditional medical treatment for major depression cannot be judged until
after a 4- to 6-week period (American Psychiatric Association, 1993). We
chose to continue monitoring subjects' clinical status and functional capacity
5. Distance Healing of Depressed Patients 451
sess relapse after the cessation of healing sessions, should there be a signifi-
cant therapeutic effect in the 6-week treatment period.
Methods
This study used a double-blind prospective experimental protocol to investi-
gate the effect of distance healing on patients with major depression receiving
traditional treatment with antidepressant medication and psychotherapy. Sub-
jects were recruited from patients admitted to the inpatient psychiatric unit at
the University of Connecticut Health Center and diagnosed as having a major
depressive disorder. They were randomly assigned either to an experimental
group that received distance healing for 6 weeks in addition to the standard
treatment, or to a control group that received only the standard treatment. The
investigator and the subjects, both blind to group assignment, rated therapeu-
tic progress periodically for 12 weeks.
Subjects
Prospective subjects for this study included all patients admitted to the inpa-
tient psychiatric unit at the University of Connecticut Health Center who met
criteria for major depression but not for organic mental disorders (American
Psychiatric Association, 1994),and whose treatment plan included antidepres-
sant medication and psychotherapy but not electroconvulsive therapy. The
nature, potential benefits, and potential risks of participation in this study were
explained to prospective subjects by the investigator, and were detailed on a
written informed consent form; those patients who signed the informed con-
sent form were included as subjects. Demographic and diagnostic information
about these subjects is presented in the Results section below.
Initial Data Collection
Subjects were given a structured interview by the investigator, which pro-
vided data for completion of the Hamilton Rating Scale for Depression
(HRSD) (Hamilton, 1960; Williams, 1988),which quantifies intensity and fre-
quency of depressive symptoms and is the most widely used measure of sever-
ity of depression; the Brief Psychiatric Rating Scale (BPRS) (Overall and
Gorham, 1962), which quantifies severity of symptoms of psychopathology
and is widely used for assessment of patient change; and the Global Assess-
ment of Functioning (GAF) (American Psychiatric Association, 1994), which
quantifies the clinician's overall judgment of a patient's psychological, social,
and occupational functioning and is generally regarded as reflecting need for
treatment.
At the time of this structured interview, the subject was asked to indicate his
or her general level of distress by marking a 10-cm visual analog scale, the
ends of which were labeled "the best I've ever felt" (0) and "the worst I've ever
felt" (10). Some statisticians claim that visual analog scales provide more de-
6. 452 B. Greyson
tailed data than categorizing scales, which lose some information by limiting
the response categories (McCormack, de Home, and Sheather, 1968).
HRSD scores were used as the criterion for presence and severity of depres-
sion. Since the distance healing technique employed was posited to enhance
general health and self-healing rather than to target specific disorders or
symptoms, the BPRS, GAF, and visual analog scale of distress were included
as measures of general well-being or psychopathology.
Assignment to Experimental or Control Group
Following the initial data collection, the investigator prepared a one-para-
graph narrative description of the subject, including first name or nickname
and outstanding personal characteristics, current psychosocial situation, and
most prominent symptoms. These brief descriptions were faxed to a research
collaborator (G.S.) in another city, who assigned subjects either to the experi-
mental group, who received distance healing, or to the control group, who did
not. The first subject in each sequentially enrolled pair was assigned to one of
the two groups by a random process, and the subsequently enrolled second
subject in that pair was assigned to the opposite group. Subjects were paired
sequentially rather than being matched on selected parameters (e.g., initial
HRSD scores) to minimize the influence of season on depression.
After group assignment, the brief narrative description for each subject in
the experimental group only was then faxed by that research collaborator
(G.S.) to a second collaborator (J.G.) in another city, who never learned of
subjects assigned to the control group.
Healing
The second research collaborator (J.G.) maintained a roster of individuals
who had been trained by the Consciousness Research and Training Project,
Inc., who had extensive experience with LeShan's distance healing technique,
and who had volunteered to participate in this study. None of the participants
in this study was a "professional healer" (although many are employed as tra-
ditional healthcare professionals); a condition of receiving training from the
Consciousness Research and Training Project, Inc., is that one not accept com-
pensation for healing activities.
Upon receiving a subject's brief narrative description, this second collabo-
rator (J.G.) forwarded the description to at least two healers selected from that
roster, maintaining a record of such assignments. Three subjects were as-
signed to 2 healers, 15 subjects were assigned to 3 healers, and 2 subjects were
assigned to 4 healers. Numbers of healers varied so that the assigning research
collaborator (J.G.) could be reasonably assured that each subject would re-
ceive a healing session each day, despite healers' intervening illnesses or con-
flicting schedules, and would be assigned to at least one healer with whose cur-
rent work the research collaborator was personally familiar.
7. Distance Healing of Depressed Patients 453
The healers assigned to each subject in the experimental group coordinated
their healing sessions, which involved meditating on the assigned subject daily
for the subsequent 6 weeks. In these daily sessions, healers attempted to in-
duce through meditation a particular altered state of consciousness for which
they had been trained, described as "nonlocal mind". While in that state, they
included the subject in their minds in a nondirective manner, excluding any
other mental content or focus in a state of deep, intense compassion.
Following each daily healing, healers rated their satisfaction with that ses-
sion on a 3-point scale (3 = "exceptionally strong", 2 = "moderate", and 1 =
"one of my least strong") and sent the ratings to the second research collabora-
tor (J.G.).
Healers and subjects never met, nor learned each other's names. Subjects in
both experimental and control groups received standard interventions of anti-
depressant medication and psychotherapy as prescribed by their attending psy-
chiatrists, for the entire 12 weeks of data collection. Group assignment did not
influence clinical decisions a6out subjects' antidepressant medication or psy-
chotherapy treatment, as neither the subjects nor their treating psychiatrists
knew which subjects had been randomly selected to receive distance healing
until the conclusion of the study.
Outcome Data Collection
The investigator, who remained blind to subjects' assignment to the experi-
mental or control group, assessed their clinical condition and progress weekly
for the first 6 weeks following enrollment in the study, and every other week
for the next 6 weeks, using a structured interview and review of relevant med-
ical records, including status as inpatient or outpatient and suicidal behavior.
While subjects were hospitalized, these weekly assessments were conducted
on the inpatient psychiatric unit. Weekly assessments following discharge
were conducted in the investigator's office or at the office of the subject's out-
patient therapist. In order to maximize subjects' availability for follow-up,
each subject was asked prior to hospital discharge to provide an address and
telephone number for himself or herself, for a family member who would
know how to reach the subject, and for the subject's outpatient therapist.
A structured interview at these weekly assessments provided data for the
completion of the HRSD, BPRS, and GAF. In addition, at the time of each in-
terview the subject again was asked to indicate his or her general level of dis-
tress by marking a 10-cm visual analog scale.
Data Analysis
The weekly clinical ratings and treatment parameters were used to compare
the recovery rate of experimental and control groups. or-the 14-month dura-
tion of the study, the investigator accumulated data from weekly assessments,
and the second research collaborator (J.G.) accumulated healers' ratings of
8. 454 B. Greyson
their satisfaction with their healing sessions. At the end of the 14 months of
data collection, the first research collaborator (G.S.) identified group assign-
ments for each subject and the second research collaborator (J.G.) identified
healer-subject pairings.
At the conclusion of the study, scores on the HRSD, BPRS, GAF, and visual
analog scale for weeks 1-12 were calculated and mean scores of experimental
and control groups compared, using t tests and repeated measures analyses of
variance. Incidence of rehospitalization and incidence of suicidal behavior
during those 12 weeks were also compared between the two groups, using
t-tests. All data collected, including those from subjects who subsequently
dropped out of the study, were included in the statistical analyses.
In addition, healers' summed ratings of their satisfaction with their healing
sessions were compared with HRSD, BPRS, GAF, and visual analog scale
scores.
Data Interpretation
The primary hypothesis tested was that distance healing would enhance the
antidepressant effect of standard treatment of patients with major depression.
Data used to test this hypothesis were comparisons between the experimental
and control groups in terms of weekly HRSD scores, and incidence of rehospi-
talization and suicidal behaviors.
A secondary hypothesis tested was that distance healing would enhance the
general mental health and functional capacity of patients with major depres-
sion. Data used to test this hypothesis were comparisons between the experi-
mental and control groups in terms of BPRS, GAF, and visual analog scale
scores.
A tertiary hypothesis tested was that healers' ratings of satisfaction with
their healing sessions would be positively correlated with beneficial outcomes.
Data used to test this hypothesis were correlations between healers' satisfac-
tion ratings and HRSD, BPRS, GAF, and visual analog scale scores.
Results
Subjects
Enrollment of subjects began March 15, 1994, and continued until 40 sub-
jects had been recruited (February 2, 1995). Of the 40 subjects enrolled, 34
(85%) were non-Hispanic white, 3 (7.5%) were Hispanic, and 3 (7.5%) were
African-American; these proportions are consistent with the ethnic composi-
tion of the general inpatient psychiatric population at this hospital.
Of the 40 subjects, 29 (72.5%) were female and 11 (27.5%) male; the gener-
al population on the inpatient psychiatric unit was 65% female and 35% male.
Among subjects assigned to the experimental group, 15 (75%) were female
and 5 (25%) male, while among subjects in the control group, 14 (70%) were
9. Distance Healing of Depressed Patients 455
female and 6 (30%) male. The gender difference between the two groups was
not significant (x2= 0.13, df = 1).
The mean age of the 40 subjects was 39.3 years (S.D. = 12.5 years), with a
range of 19-81 years. The mean age of subjects assigned to the experimental
group was 39.7 years (S.D. = 12.5 years), and of subjects in the control group,
38.9 years (S.D. = 12.7 years). The age difference between the two groups
was not significant ( t = 0.21, df = 38).
The 40 subjects' major depressive disorders fell into three diagnostic cate-
gories: 28 subjects (70%) received a diagnosis of Major Depressive Disorder,
Recurrent, Severe, Without Psychotic Features; 8 (20%) received a diagnosis
of Major Depressive Disorder, Recurrent, Severe, With Psychotic Features;
and 4 (10%) received a diagnosis of Bipolar Disorder, Depressed. The distrib-
ution of depressive diagnoses was identical in the two study groups.
In addition to the primary diagnosis of major depression, 10 subjects (25%)
also received a secondary diagnosis of an anxiety disorder: 6 were diagnosed
as having Posttraumatic Stress Disorder, 2 as having Panic Disorder, 1 as hav-
ing Generalized Anxiety Disorder, and 1 as having Social Phobia. Each of the
two study groups included 5 subjects with a diagnosed anxiety disorder.
Furthermore, 10 subjects (25%) received a secondary diagnosis of a sub-
stance abuse disorder: 5 were diagnosed as having Alcohol Abuse or Depen-
dence, 3 as having Polysubstance Dependence, and 2 as having Opioid Abuse
or Dependence. Four subjects in the experimental group and 6 subjects in the
control group received substance abuse disorder diagnoses; that difference
was not significant (x2= 0.67, df = 1).
Finally, 13 subjects (32.5%) received a secondary diagnosis of a personality
disorder: 9 subjects were diagnosed as having Borderline Personality Disorder,
2 as having Dependent Personality Disorder, 1 as having Antisocial Personali-
ty Disorder, and 1 as having Personality Disorder Not Otherwise Specified.
Five subjects in the experimental group and 8 in the control group received
personality disorder diagnoses; this difference was not significant (x2= 2.44,
df =1).
Despite the precautions instituted to maximize subjects' availability for fol-
low-up, 8 of the 40 subjects (20%) were lost to follow-up before the end of the
intervention period (week 6); no additional subjects were lost beyond that pe-
riod. Two subjects were lost in the first week, 1 by week 2, l by week 3, l by
week 4, 2 by week 5, and 1 by week 6. Each of the two study groups initially
included 4 subjects who were subsequently lost.
Depression
The initial mean HRSD score for the 40 subjects was 25.25 (S.D. = 5.5l),
with a range from 15 to 37. The initial mean HRSD score for experimental
group subjects was 24.70 (S.D. = 4.47) and for control group subjects, 25.80
(S.D. = 6.46). This initial difference in depression was not significant
(t = 0.63, df = 38).
10. i 456 B. Greyson
The primary hypothesis to be tested was that scores on the HRSD would be
lower among the experimental group than among the control group, suggest-
ing a correlation between distance healing and remission from depression. As
shown in Figure 1, mean HRSD scores of the experimental group were lower
than those of the control group for most of the 12 weeks; however, these dif-
ferences never reached statistical significance.
At the end of the 6-week intervention period, the mean HRSD score of the
experimental group was 12.81 (S.D. = 8.36), and that of the control group,
15.56 (S.D. = 9.46); that difference, however, was not significant (t = 0.87,
df = 30). By the end of the 12-week monitoring period, the mean HRSD score
of the experimental group was 13.63 (S.D.=7.06), and that of the control
group, 14.94 (S.D.= 11.93); that difference also was not significant (t = 0.38,
df = 30). A repeated measures analysis of variance for HRSD scores over the
12-week study period did not suggest a significant difference between the two
groups (F= 0.61, df = 130).
Ten of the 40 subjects in this study had been admitted to the hospital initial-
ly following a suicide attempt. Five of those suicide attempts were made by
subjects later randomly assigned to the experimental group, and 5 by subjects
assigned to the control group. Five subjects subsequently made one or more
suicide attempts during the 12 weeks of monitoring. The mean number of
weeks in which the average experimental group subject attempted suicide was
0.13 weeks (S.D. = 0.34), and for the average control group subject, 0.31
weeks (S.D.= 0.87); this difference was not significant (t= 0.80, df = 30).
The initial length of hospitalization beyond enrollment in the study aver-
aged 6.43 days (S.D. = 4.61 days) for the 40 subjects. Among the experimen-
tal group, mean length of stay was 6.20 days (S.D.= 4.28), and among the con-
U control
Fig. 1. Plot of Hamilton Ration Scale for Depression (HRSD) scores vs. week, by study group.
11. Distance Healing of Depressed Patients 457
trol group, 6.65 days (S.D. = 5.02). This difference in length of initial hospital
stay was not significant (t = 0.31, df = 38).
Ten of the 40 subjects required readmissions to the hospital for depression
during the 12 weeks of monitoring. The mean total number of weeks of hospi-
talization for subjects in the experimental group was 0.94 weeks (S.D.= 1.00),
and for the control group, 0.88 weeks (S.D.= 1.15); this difference was not sig-
nificant (t = 0.16, df = 30).
General Psychopathology
The initial mean BPRS score for the 40 subjects was 37.00 (S.D. = 7.1 I),
with a range from 26 to 55. The initial mean BPRS score for experimental
group subjects was 36.65 (S.D. = 5.71) and for control group subjects, 36.35
(S.D. = 8.43). This initial difference in general psychopathology was not sig-
nificant (t = 0.31, df = 38).
The secondary hypothesis to be tested was that scores on the BPRS and visu-
al analog scale would be lower among the experimental group than among the
control group, and scores on the GAF higher among the experimental than the
control group, suggesting a correlation between distance healing and enhanced
well-being. As shown in Figure 2, mean BPRS scores of the experimental
group were lower than those of the control group for most of the 12 weeks;
however, these differences never reached statistical significance.
At the end of the 6-week intervention period, the mean BPRS score of the
experimental group was 25.94 (S.D. = 5.42), and that of the control group,
30.19 (S.D. = 7.56); that difference was not significant (t = 1.83, df= 30). By
the end of the 12-week monitoring period, the mean BPRS score of the experi-
mental group was 26.31 (S.D. = 4.76), and that of the control group, 29.50
+ healee
-CS- control
Fig. 2. Plot of Brief Psychiatric Rating Scale (BPRS) scores vs. week, by study group.
12. 458 B. Greyson
(S.D.= 9.58); that difference was also not significant (t= 1.19,df = 30). A re-
peated measures analysis of variance for BPRS scores over the 12-week period
did not suggest a significant difference between the two groups (t = 2.80,
df = 130).
Global Functioning
The GAF was unique among measures used in this study in that higher
scores are desirable, reflecting a higher level of functioning. The initial mean
GAF score for the 40 subjects was 24.38 (S.D.= 8.01), with a range from 10to
41. The initial mean GAF score for the experimental group was 24.40
(S.D.= 8.07) and for the control group, 24.35 (S.D.= 8.17). This initial differ-
ence in global level of functioning was not significant (t= 0.02, df = 38).
As shown in Figure 3, mean GAF scores between the two groups were com-
parable throughout the study period. At the end of the 6-week intervention pe-
riod, the mean GAF score of the experimental group was 56.44 (S.D.= 16.46),
and that of the control group, 55.13 (S.D.= 17.52); this difference was not sig-
nificant (t = 0.22, df = 30). By the end of the 12-week monitoring period, the
mean GAF score of the experimental group was 54.25 (S.D.= 20.1 I), and that
of the control group, 57.31 (S.D.= 23.68); this difference also was not signifi-
cant (t = 0.39, df = 30). A repeated measures analysis of variance for GAF
scores over the 12-week study period did not suggest a significant difference
between the two groups (F=0.00, df = 130).
-+- healee
-0- control
Fig. 3. Plot of Global Assessment of Functioning (GAF) scores vs. week, by study group.
13. Distance Healing of Depressed Patients 459
General Level of Distress
The initial mean score on the visual analog scale, on which subjects rated
their overall level of distress, was 8.75 (S.D. = 1.39), with a range from 5 to 10.
The mean visual analog scale score of the experimental group was 8.58 (S.D. =
1.48), and that of the control group, 8.92 (S.D. = 1.30). This initial difference
in level of distress was not significant (t = 0.77, df = 38).
As shown in Figure 4, mean visual analog scale scores of the experimental
group were lower than those of the control group for most of the 12 weeks;
however, these differences never reached statistical significance. At the end of
the 6-week intervention period, the mean visual analog scale score of the ex-
perimental group was 4.75 (S.D. = 2.61), and that of the control group, 5.06
(S.D. = 1.83); this difference was not significant (t = 0.39, df = 30). By the end
of the 12-week monitoring period, the mean visual analog scale score of the
experimental group was 4.19 (S.D. = 3.13), and that of the control group, 4.94
(S.D. = 3.14); this difference also was not significant ( t = 0.68, df = 30). A re-
peated measures analysis of variance for visual analog scale scores over the
12-week study period did not suggest a significant difference between the two
groups (F= 0.59, df = 130).
Healers' Ratings of Healing Sessions
The third hypothesis to be tested in this study was that subjects' clinical im-
provement would be associated with healers' ratings of the "strength" of their
healing sessions.
The healers who had volunteered to participate in this study were asked to
hold healing sessions daily for 6 weeks for their assigned subjects. However,
many of them skipped some sessions because of their own illnesses, schedul-
+ healee
. U control
14. 460 B. Greyson
ing conflicts that made intense meditation impractical on certain days, or sim-
ply forgetting or feeling unable to participate on certain days; and other heal-
ers exceeded the requested number of sessions, and extended them beyond the
6-week intervention period. As a result, the number of healing sessions actual-
ly conducted was not the same for each subject in the experimental group, nor
was the number of healers participating in each session constant. The mean
number of healing sessions received by each experimental group subject -
counting those sessions in which only 1 healer meditated as a single session,
those in which 2 healers meditated as 2 sessions, etc. - was 116.70 sessions
(S.D.= 61.03), with a range from 79 to 171.
The total number of healing sessions received by a subject showed a signifi-
cant negative correlation with HRSD scores (r = 0.110; F = 4.20; df = 1,346;
p<.05), with BPRS scores (r =0.244; F = 21.89; df = 1,346; p< 0.0001), and
with visual analog scale scores (r= 0.130; F= 5.95; df = 1,346; p <0.02). That
is, the greater the number of healing sessions a subject received, the lower his
or her ratings were of depression, general psychopathology, and overall level
of distress. Number of healing sessions did not show a significant correlation
with GAF scores (r = 0.028; F = 0.26; df = 1,346); that is, number of sessions
was not significantly associated with subjects' level of functioning.
As described above, healers rated their satisfaction with each healing ses-
sion on a 3-point scale; the mean rating of all sessions was 2.16 (S.D.= 1.lo),
with 3 indicating the "strongest" healing session and 1 indicating the "least
strong." Adding the ratings of all the sessions received by any given subject
yields an estimate of the cumulative "strength" of healing sessions that subject
received. The total cumulative healing session ratings for experimental group
subjects averaged 252.0 (S.D.= 132.3),with a range from 142.5 to 348.0.
Total cumulative healing session ratings showed a significant negative cor-
relation with HRSD scores (r = 0.113; F = 4.51; df = 1,346; p < 0.04), with
BPRS scores (r = 0.244; F = 21.92; df = 1,346; p < 0.0001), and with visual
analog scale scores (r = 0.118; F = 4.88; df = 1,346; p < 0.03). That is, the
higher the cumulative rating of the "strength" of the healing sessions a subject
received, the lower his or her ratings were of depression, general psy-
chopathology, and overall distress. Cumulative healing session ratings did not
show a significant correlation with GAF scores (r = 0.026; F = 0.23;
df = 1,346); that is, cumulative healing "strength7
' ratings were not significant-
ly associated with subjects' level of functioning.
Discussion
The primary and secondary hypotheses tested in this study, that distance
healing would enhance the therapeutic effect of antidepressant medication and
that it would enhance the general mental health and functional capacity of pa-
tients with major depression, were not supported by the data. Patients who re-
ceived distance healing were in fact rated as having less depression and less
15. Distance Healing of Depressed Patients 461
than matched patients who did not receive distance healing, both during the 6-
week intervention period and during the subsequent 6-week monitoring peri-
od, but in no case was that difference statistically significant.
The failure to find a statistically significant effect of distance healing in this
study may be attributed to one or more of five.factors. First, it may be a func-
tion of the healing technique itself. Although the LeShan technique for dis-
tance healing has been shown to be effective for a variety of purely physiolog-
ical medical conditions, it might not be effective for psychiatric disorders.
However, given that the technique purports to help all of a patient's bodily
functions move toward greater balance in a holistic manner and evoke a milieu
of humanism and care, it would be surprising if it were found to work only on
purely physiological disorders and not on ones with an emotional component.
Second, the failure to find significant results may be attributed to the healers
themselves. It is plausible to assume that healers might differ in their effec-
tiveness, despite having received the same standard training, as a result both of
pre-training factors and of the frequency and recency of practice subsequent to
training. Healers in this study were volunteers, and while the research collabo-
rator who maintained the roster of healers attempted to assign each subject to
at least one healer with whose recent work she was familiar, there was no rig-
orous measure of the healers' efficacy based on previous healings.
Third, the failure to find significant results may be attributed to the nature of
depressive disorders. While the compassion and humanistic care evoked in the
LeShan technique may facilitate healing in straightforward physiological dis-
orders, it may be that the complex psychodynamic factors involved in depres-
sion are more responsive to some response other than unconditional positive
regard. Furthermore, in monitoring recovery from a physiological disorder, it
may be possible to ensure conditions conducive to healing, such as immobi-
lization of a fractured bone or sterile dressings on a skin lesion. In the follow-
up of depressed patients, however, it is impossible to measure, let alone en-
sure, conditions conducive to healing, such as experiences that promote
self-esteem or protection from overwhelming stressors.
A related possibility is that it was not the depressive disorders that interfered
with the putative therapeutic response to distance healing, but the additional
mental disorders diagnosed in a substantial proportion of the subjects. Many
of these patients were diagnosed as having comorbid psychotic features, bor-
derline personality disorder, or substance abuse, all of which may complicate
the therapeutic response to any antidepressant treatment.
Fourth, the failure to find significant results may be attributed to the nature
of the bond between the healers and depressed patients. In the LeShan tech-
nique, the healer attempts to access a state of consciousness that facilitates an
altered state for the patient; but that may require some degree of rapport be-
tween healer and patient and some openness on the part of the patient to the al-
tered state. It may be that the healers find the emotional state of the depressed
patient too toxic to deal with effectively; or that the pervasiveness of the de-
16. 462 B. Greyson
pressed emotional state prevents the patient from entering the altered state of
consciousness necessary to benefit from the healing; or that the discrepancy
between the emotional states of the healer and the patient is too great to be
bridged by this technique. These speculations on potential problems within
the healer-patient bond, it should be mentioned, are not ones with which most
of the healers would concur.
Finally, the failure to find significant results may be attributed to the study
methodology. The fact that nonsignificant trends were seen in three of the
four outcome measures suggests that a larger sample size might have yielded a
more robust difference between experimental and control groups. Both the
experimental and control groups in fact showed dramatic improvement, pre-
sumably due to the standard antidepressant treatments administered; it is pos-
sible that the drug treatment effect swamped and concealed any significant ef-
fect of the distance healing. The brief narratives faxed to the healers may have
been inadequate to convey a meaningful enough sense of the patient to permit
the healing relationship to develop (although none of the healers offered that
complaint). The weekly follow-up interviews (and biweekly interviews dur-
ing weeks 7-12) may have provided too few data points to capture the full im-
pact of the healing. And the specific measures used to monitor depression,
psychopathology, global functioning, and overall distress may have been too
superficial or inaccurate in their focus to pick up subtle effects of the healing
on general well-being.
Despite the failure to confirm the primary and secondary hypotheses by
demonstrating differences between the experimental and control groups, this
study did confirm the tertiary hypothesis by finding statistically significant ef-
fects of healing within the experimental group. The positive correlation be-
tween beneficial outcomes and both number of healing sessions and cumula-
tive "strength" of healing suggests that the distance healing did exert some
therapeutic effect on these patients.
These mixed data provide the rationale for a more broadly-based study that
would examine more effectively the effects of distance healing both on depres-
sion and on other psychiatric disorders. Outcome measures that permit more
individualized responses, and a larger sample size, comprised of patients
whose depression is not severe enough to require treatment with antidepressant
medications and who do not have comorbid psychosis, personality disorders,
or substance abuse, may lead to more robust findings. Assuming that the in-
vestigator's brief narratives describing the patients conveyed insufficient in-
formation to allow the healers to bond with their assigned patients, it may be
advisable to ask the patients themselves to write brief narrative descriptions,
in their own handwriting, of themselves, their symptoms, and their psychoso-
cia1 situations. Participating healers might be recruited on the basis of prior
demonstrated success, rather than relying on volunteers from among individu-
als who had completed the training. Greater control over the number of heal-
17. Distance Healing of Depressed Patients 463
sions and of healers in each session to be assured. Significant correlations
should be sought between outcome measures and "strength" of healing, as
rated by the healers, rather than simply between group means.
If these modifications yield evidence of significant therapeutic effect of
healing upon patients with major depression, then similar studies might be un-
dertaken with other psychiatric disorders, such as anxiety disorders or somato-
form disorders, and/or other modes of psychiatric treatment, such as different
types of psychotherapy or somatic treatments.
Acknowledgements
Financial support for this study was provided by a research grant from the
Consciousness Research and Training Project, Inc. The author gratefully ac-
knowledges the help of Joyce Goodrich, Ph.D., Project Director of the Con-
sciousness Research and Training Project, Inc., and of Gertrude Schmeidler,
Ph.D., Emeritus Professor of Psychology at the City University of New York,
in the design and implementation of this study. Dr. Goodrich coordinated the
efforts of the healers in this study, while Dr. Schmeidler assigned subjects to
experimental and control groups, allowing the author and Dr. Goodrich to re-
main blind to group assignments. The author also gratefully acknowledges
the pool of healers who volunteered their time and effort for this study, and the
helpful comments on earlier drafts of this manuscript by Drs. Goodrich and
Schmeidler and by Ian Stevenson, M.D.
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