Margaret Perry, Jeffrey Barnett, Psy.D., ABPP, Jeffrey M. Lating, Ph.D., Jason Prenoveau, Ph.D.
“Do as I do?”: Psychologists’ Personal and Professional Practices of Complementary and Alternative Medicine (CAM)
This project examines practicing psychologists’ attitudes toward, awareness of research about, and professional utilization of complementary and alternative medicine (CAM). Complementary and Alternative Medicine (CAM) “is a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine," where conventional medicine is medicine practiced by medical doctors (M.D.), doctors of osteopathy (D.O.), and allied health professionals including physical therapists, psychologists, and registered nurses (National Center for Complementary and Alternative Medicine [NCCAM], 2010, para. 2). Research estimates that 38.3% of Americans utilize some form of CAM every year, and thus it is a noteworthy presence in the American health care system (Barnes, Blooms, & Nahin, 2008). In this project, the scholarly literature on 14 of the most widely utilized CAM modalities in the United States is reviewed and the attitudes of CAM users and other health care professionals toward CAM are discussed. While there is research regarding the public’s use of CAM, there is a lack of research on psychologists’ personal and professional use of CAM. It is likely that the epistemological shift among much of the public and medical professionals toward CAM has also occurred among many psychologists, making their attitudes toward health care and their personal practices a predictor of professional behavior (Hughes, 2008).
New information is shared about the professional referral and integration rates of CAM among psychologists, as well as about their attitudes and their personal practices based on results of an email survey of 2,664 psychologists from APA Division 42, Psychologists in Independent Practice. The questionnaire, which was used to examine the associations between psychologists’ reported attitudes toward CAM, their personal use of CAM, and their referral and integration rates of CAM, was developed by the author and was divided into three sections. Section I consists of the 11 questions comprising the Psychologist’s Attitudes toward Complementary and Alternative Therapies (PATCAT) questionnaire (Wilson & White, 2008). This questionnaire is based on questions from two pre-existing scales designed to measure physician’s attitudes toward CAM (Halcon et al., 2003; Lewith et al., 2002). Section II assesses participants’ personal and professional CAM use. It assesses three components of participants’ personal CAM use: what modalities he or she has personally used, how often he or she has personally used each, and his or her subjective appraisal of each modality he or she has used. Section III consists of seven demographic questions, including age, gender, ethnicity, geographic location, theoretical orientation, years in practice, size of practice, and training in CAM.
This study used a correlational design with a cross-sectional methodology. The results show evidence of consistency between the evidence-based scholarly literature on CAM and the personal and professional use of CAM. It also shows that attitudes toward CAM within this sample of the profession are generally positive. Like the evidence-base on CAM, which indicates efficacy among some modalities and lacks such support for others, the data from this study indicate that psychologists choose modalities for both their personal and professional use that have efficacy and do not tend to utilize modalities without evidence either professionally or personally. Specific ethical concerns are discussed in regard to integrating massage, acupuncture, and chiropractic with ongoing psychotherapy clients. The relationship between personal beliefs and the beneficial effects of spirituality and prayer addressed within psychotherapy is explored. The responsibility psychologists hold regarding their clients’ use of dietary supplements is discussed. Implications for practicing psychologists, for supervisors and teachers who train future psychologists, and for the profession of psychology in general are addressed. Concerns practicing psychologists should be aware of when they choose to refer for or integrate CAM into their treatment with clients and which CAM modalities should be included in graduate training and continuing education are discussed.
References
Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative
medicine use among adults and children: United States, 2007. Retrieved from
http://nccam.nih.gov/news/2008/nhsr12.pdf
Halcon, L. L., Chlan, L. L., Kreitzer, M. J., & Leonard, B. J. (2003). Complementary
therapies and healing practices: Faculty/student beliefs and attitudes and the
implications for nursing education. Journal of Professional Nursing, 19, 387-397.
doi:10.1016/S87557223(03)00133-9
Hughes, B. M. (2008). How should clinical psychologists approach complementary and
alternative medicine? Empirical, epistemological, and ethical considerations. Clinical
Psychology Review, 28, 657-675. doi: 10.1016/j.cpr.2007.09.005
Lewith, G. T., Hyland, M. E., & Shaw, S. (2002). Do attitudes toward and beliefs about
complementary medicine affect treatment outcomes? American Journal of Public
Health, 92, 1604-1606. doi:10.2105/AJPH.92.10.1604
NCCAM. (2010). What is CAM? Retrieved from
http://nccam.nih.gov/health/whatiscam/overview.htm.
Wilson, L. M., & White, K. M. (2007). Development of an attitudes toward
complementary therapies scale for psychologists. Clinical Psychologist, 11, 37-44. doi:
10.1080/13284200701411544.