Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic ... more Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatm...
Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation ... more Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation training for three types of complementary and alternative medicine (CAM) practitioners (acupuncture/Traditional Chinese Medicine [TCM], chiropractic, and massage). Methods: Researchers administered a mail survey to all licensed acupuncturist, chiropractors, and massage therapists in Tucson, Arizona. N=356 practitioners responded (acupuncturists, n=63, chiropractors, n=56, massage therapists, n=237). Results: Most respondents practice more than one CAM modality (mean 2.6, SD 1.9) with acupuncturists practicing 4.8 (SD 1.9), chiropractors, 2.9 (SD 1.9) and massage therapists, 2.0 (SD 1.4). For example, over 50% of acupuncturists report using herbs, energy therapies, and nutritional counseling in practice. When asked if they had training in tobacco cessation, 64.5% report none. Respondents who report training, 19.9% had professional training (73% acupuncturists, 18% chiropractors, 7% massag...
ObjectivesThe purpose of this study was to evaluate an energy healing treatment for possible incl... more ObjectivesThe purpose of this study was to evaluate an energy healing treatment for possible inclusion as a Kaiser Permanente Northwest (KPNW) Pain Clinic provided therapy, and to identify the appropriate number of treatment sessions for a Pain Clinic protocol, should the intervention prove successful. In addition, our intent was to document the full range of outcomes experienced by patients undergoing energy healing, including whole-person and transformative outcomes should they occur.SettingThe setting for this study was Kaiser Permanente Northwest Pain Clinic.ParticipantsThirteen (13) patients with chronic headache who were members of the KPNW Health Plan were recruited through flyers or mailings.MethodsThirteen (13) participants received at least three energy healing sessions at approximately weekly intervals. Assessments were based on pre- and post-treatment qualitative interviews.InterventionThe treatment consisted of three Healing Touch sessions provided by a Certified Healing Touch Practitioner. Treatments contained elements common to all sessions, and elements that were tailored to the individual subject.ResultsTwelve (12) of 13 participants experienced improvement in frequency, intensity, or duration of pain after three treatments. In addition, 11 of 13 participants experienced profound shifts in their view of themselves, their lives, and their potential for healing and transformation. These changes lasted from 24 hours to more than 6 months at follow-up.ConclusionsEnergy healing can be an important addition to pain management services. More in-depth qualitative research is needed to explore the diversity of outcomes facilitated by energy healing treatments. Furthermore, the development of new instrumentation is warranted to capture outcomes that reflect transformative change and changes at the level of the whole person.
This paper considers how the full range of human experience may catalyze a placebo response. The ... more This paper considers how the full range of human experience may catalyze a placebo response. The placebo effect has been characterized as something to control in clinical research, something to cultivate in clinical practice, and something present in all healing encounters. We examine domains in which the term ‘placebo’ is used in discourse: clinical research, clinical practice, media representations of treatment efficacy, and lay interpretations of placebo—an under-researched topic. We briefly review major theoretical frameworks proposed to explain the placebo effect: classical conditioning, expectancy, the therapeutic relationship, and sociocultural ‘meaning.’ As a corrective to what we see as an over-emphasis on conscious cognitive approaches to understanding placebo, we reorient the discussion to argue that direct embodied experience may take precedence over meaning-making in the healing encounter. As an example, we examine the neurobiology of rehearsing or visualizing wellness as a mode of directly (performatively) producing an outcome often dismissed as a ‘placebo response.’ Given body/mind/emotional resonance, we suggest that the placebo response is an evolutionarily adaptive trait and part of healing mechanisms operating across many levels—from genetic and cellular to social and cultural.
the United States, accounting for 1 of every 4 deaths.1 Nutritional status has long been speculat... more the United States, accounting for 1 of every 4 deaths.1 Nutritional status has long been speculated to play a significant role in certain cancers. One theory holds that oxidative damage to cells contributes to carcinogenesis. In laboratory experiments, the antioxidant vitamins, vitamin C, vitamin E (alpha-tocopherol), and beta-carotene, counteract damage to biomolecules due to oxidants,2 raising the possibility that increased intake of these vitamins might prevent cancer. Vitamin A (retinol), which acts within the cell to control gene expression, and folic acid,3 which is involved in DNA methylation and purine and pyrimidine synthesis, may also have a role in preventing cancer.4
Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic ... more Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatm...
Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation ... more Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation training for three types of complementary and alternative medicine (CAM) practitioners (acupuncture/Traditional Chinese Medicine [TCM], chiropractic, and massage). Methods: Researchers administered a mail survey to all licensed acupuncturist, chiropractors, and massage therapists in Tucson, Arizona. N=356 practitioners responded (acupuncturists, n=63, chiropractors, n=56, massage therapists, n=237). Results: Most respondents practice more than one CAM modality (mean 2.6, SD 1.9) with acupuncturists practicing 4.8 (SD 1.9), chiropractors, 2.9 (SD 1.9) and massage therapists, 2.0 (SD 1.4). For example, over 50% of acupuncturists report using herbs, energy therapies, and nutritional counseling in practice. When asked if they had training in tobacco cessation, 64.5% report none. Respondents who report training, 19.9% had professional training (73% acupuncturists, 18% chiropractors, 7% massag...
ObjectivesThe purpose of this study was to evaluate an energy healing treatment for possible incl... more ObjectivesThe purpose of this study was to evaluate an energy healing treatment for possible inclusion as a Kaiser Permanente Northwest (KPNW) Pain Clinic provided therapy, and to identify the appropriate number of treatment sessions for a Pain Clinic protocol, should the intervention prove successful. In addition, our intent was to document the full range of outcomes experienced by patients undergoing energy healing, including whole-person and transformative outcomes should they occur.SettingThe setting for this study was Kaiser Permanente Northwest Pain Clinic.ParticipantsThirteen (13) patients with chronic headache who were members of the KPNW Health Plan were recruited through flyers or mailings.MethodsThirteen (13) participants received at least three energy healing sessions at approximately weekly intervals. Assessments were based on pre- and post-treatment qualitative interviews.InterventionThe treatment consisted of three Healing Touch sessions provided by a Certified Healing Touch Practitioner. Treatments contained elements common to all sessions, and elements that were tailored to the individual subject.ResultsTwelve (12) of 13 participants experienced improvement in frequency, intensity, or duration of pain after three treatments. In addition, 11 of 13 participants experienced profound shifts in their view of themselves, their lives, and their potential for healing and transformation. These changes lasted from 24 hours to more than 6 months at follow-up.ConclusionsEnergy healing can be an important addition to pain management services. More in-depth qualitative research is needed to explore the diversity of outcomes facilitated by energy healing treatments. Furthermore, the development of new instrumentation is warranted to capture outcomes that reflect transformative change and changes at the level of the whole person.
This paper considers how the full range of human experience may catalyze a placebo response. The ... more This paper considers how the full range of human experience may catalyze a placebo response. The placebo effect has been characterized as something to control in clinical research, something to cultivate in clinical practice, and something present in all healing encounters. We examine domains in which the term ‘placebo’ is used in discourse: clinical research, clinical practice, media representations of treatment efficacy, and lay interpretations of placebo—an under-researched topic. We briefly review major theoretical frameworks proposed to explain the placebo effect: classical conditioning, expectancy, the therapeutic relationship, and sociocultural ‘meaning.’ As a corrective to what we see as an over-emphasis on conscious cognitive approaches to understanding placebo, we reorient the discussion to argue that direct embodied experience may take precedence over meaning-making in the healing encounter. As an example, we examine the neurobiology of rehearsing or visualizing wellness as a mode of directly (performatively) producing an outcome often dismissed as a ‘placebo response.’ Given body/mind/emotional resonance, we suggest that the placebo response is an evolutionarily adaptive trait and part of healing mechanisms operating across many levels—from genetic and cellular to social and cultural.
the United States, accounting for 1 of every 4 deaths.1 Nutritional status has long been speculat... more the United States, accounting for 1 of every 4 deaths.1 Nutritional status has long been speculated to play a significant role in certain cancers. One theory holds that oxidative damage to cells contributes to carcinogenesis. In laboratory experiments, the antioxidant vitamins, vitamin C, vitamin E (alpha-tocopherol), and beta-carotene, counteract damage to biomolecules due to oxidants,2 raising the possibility that increased intake of these vitamins might prevent cancer. Vitamin A (retinol), which acts within the cell to control gene expression, and folic acid,3 which is involved in DNA methylation and purine and pyrimidine synthesis, may also have a role in preventing cancer.4
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