Alternatives to Psychotropic Medication
-By Timothy Lyons
By 2008 over 38% of adults and 12% of children were engaged in the use of Complementary and Alternative Medicine and it is believed that number was as high as 50% by 2015 (National Center for Complementary and Integrative Health, 2015; USA Today, n.d.) .
Review of Subject
There are many times in which a client will not want to use traditional western therapeutic methods involving psychotropic medication in treatment. Fear of side effects, dependence issues and even continual use of medications are often a factor in this type of decision. Although it might seem that there is a recent movement which ascribes to the school of thought that desires alternative treatments, this has been in progress for quite some time.
In current literature and studies, there is discussion on both sides of the fence both for and against the use of alternative treatments. There are alternative treatments to many of the western style procedures that clinicians and doctors use to treat mental health issues. These alternatives involve yoga, acupuncture, herbal remedies, holistic medicines biofeedback and Eye Movement Desensitization and Reprocessing (EMDR) amongst others. This paper will attempt to elucidate both sides of the matter.
Complementary and Alternative Medicine
Arguments for.
The (National Center for Complementary and Integrative Health, 2015) defined Complementary and Alternative Medicine as an array of practices and systems or products that are not considered to be part of the standard medical system. Complementary is seen as that which while being a part of treatments, also enhances treatment. Alternative would be those tools, practices or products that replace conventional techniques and medications.
There are any number of reasons that have been given for the use of Complementary and Alternative Medicine treatments. The arguments for the use of Complementary and Alternative Medicine are stated as such. (Everydayhealth.com, n.d.) notes that Complementary and Alternative Medicine treatments, unlike conventional medicine treat the whole person. This is sometimes known as holistic medicine.
The treatment of the whole person takes into account all aspects of the human being whereas in traditional medicine there is a tendency to have specializations that distance the practitioner from other issues. In this case the lack of strength based approach in conventional medicine has the focus on just the disease while the Complementary and Alternative Medicine approach tends to see balance and views the strengths of the person as important as the disease (Furnham, 2015). A good example of this can be seen in (Tyrer et al., 2011) where the focus is not only on the treatment of the specific issues in this case mental illness, but also on the entire social environment. This type of complementary treatment empower the individual by allowing them full access to assist in decision making as to the socio-environmental changes needed to help with treatment.
Another positive attribute of Complementary and Alternative Medicine is that there is a great deal of personal attention that is given to patients. In traditional medicine, there are often time constraints due to scheduling and insurance. In the Complementary and Alternative Medicine setting, practitioners deal in the philosophy that is quite different and do not have to adhere to rigidity due to these constraints (Everydayhealth.com, n.d.). This can be read in (Clobert, Saroglou, & Van Pachterbeke, 2015) where the clients are seen through a lens of consideration for congruence with their belief systems. This is also a factor in (Eddie, Kim, Lehrer, Deneke, & Bates, 2014) where the system of substance use disorder is seen as biobehavioral and is treated with biofeedback to deal with subconscious aspects of cravings. These can result in greater attention to the patient. This attention is far different in conventional practice when the doctor sees the patient, asks what their symptoms are and sends them home with a prescription.
There is often a focus from Complementary and Alternative Medicine that is prevention oriented. The use of conventional medicine to treat illness is an intervention that targets the illness once it happens. In Complementary and Alternative Medicine the deterrence of illness happens prior to and throughout any problems (Furnham, 2015); National Center for Complementary and Integrative Health, 2015; Everydayhealth.com, n.d.).
This is notable in the (Logie, 2014) when eye movement desensitization and reprocessing (EMDR) is used with many mental health issues with an overarching focus on comprehensive treatment. Another example is (Holden, Gardiner, Birdee, Davis, & Yeh, n.d.) with advocating for health behavior changes in pregnant women using Complementary and Alternative Medicine treatments outside of the normal medical routines. This is performed in the service of managing medical and mental health issues before there is a problem. It is also an area where a practitioner’s awareness of Complementary and Alternative Medicine use is also the manner in which integration takes place.
One notable argument that crops up is that many of the psychotropic medications that are used to treat problems with mental illness have negative side effects. There are so many side effect warnings that the Commission on Human Rights International has web pages filled with listings (Psychiatric Drug Side Effects, n.d.). This watch dog group points out one of the most prominent arguments to date. Some of these side effects can alter life in a negative way as opposed to something like yoga and biofeedback.
Arguments against.
The Complementary and Alternative Medicine industry is one that is beset with problems. The fact that treatments happen for nonexistent diseases is just one such issue. Current medical science experts say that chronic Lyme disease doesn’t exist. This is just one fringe treatment that the alternative treatment industry offers (USA Today, 2013). This industry is using people’s fear of western medicine to prop up its 34 billion dollar head. It is an industry that uses lawsuits, lobbying and marketing to win favor. Not only is this the case but the some of the treatments like crystal healing and homeopathic remedies are highly questionable and have no proof behind them (USA Today, 2013).
In many of the studies that were presented in scientific journals that sound to be reputable, there is a question of the scientific value of the testing done in regard to Complementary and Alternative Medicine treatments. From one case there were only twenty patients used to test efficacy of alternative treatments with ADHD (Fibert, Relton, Heirs, & Bowden, 2016). In another study, the treatments for alcoholism using alternatives had such small samples that the conclusion admitted that the only proof of efficacy was that the study corroborated basic case studies without any other scientific proof (Shah & Gupta, 2015). There is very little evidence that Complementary and Alternative Medicine works yet even more that points to its inefficacy (USA Today, 2013;Furnham, 2015).
The reaction to the limited scientific research has had a groundswell of activity in the area of Cam. By 2009 the government had spent nearly 2.5 billion dollars testing and studying alternative medicine (Wahl-Stephens, 2009). In this article it was noted that even with proof many of these treatments do nothing more than sham treatments. The government continues to pump large sums at the issue. Further findings show that the herbs that in use in Complementary and Alternative Medicine have no regulations. They are often different substances than purported and may even have other more dangerous ingredients.
Another argument against the Complementary and Alternative Medicine industry involves the herbal remedies in use. At times the companies that manufacture these supplements confuse people with words like natural or safe. The industry has no regulations and the medicines are the same as food. These are not regulated by the Food and Drug Administration and do not have to go through rigorous testing to be placed into the market (Vann & Jones, 2009).
Complementary and Alternative MedicineS are not without their dangers. Many herbal remedies can be dangerous with supplements and active ingredients that are not on the label. Needles used in acupuncture have given infections and chiropractic methods have done severe damage to spinal cords. There have even been incidences of vitamin poisoning in cases where people did not seek treatment from traditional medical channels (Swan, Skarsten, Heestacker, & Chambers, 2015).
(Swan, Skarsten, Heestacker, & Chambers, 2015) goes on to suggest that there may be opportunity costs involved in the delay of normal services if the client puts off conventional treatment. From the standpoint of psychology there may also be ethics violations due to lack of informed consent. In this case if the practitioner cannot reasonably cite information that conforms to any acceptable standard and they allow the client to believe that it may help them when there is no proof or even proof to the contrary, then the client will not be able to make proper decisions about their care (American Psychological Association, 2010).
My own view.
If I were to completely dismiss every Complementary and Alternative Medicine I might be doing a disservice to my client. The client might have a worldview that includes the use of certain Complementary and Alternative Medicine therapies. Perhaps even a cultural bias toward something that they absolutely believe. As suggested in (Clobert, Saroglou, & Van Pachterbeke, 2015), it would be an error if I did not consider the importance of ones views, desires and beliefs in their treatment. As a whole, if the industry of psychology rejects all non evidenced-base practices then how will new methods be found?
I believe that the best way to handle any situation where a client wants to deal with me and also utilize alternatives is to help them stay informed so they can consent (American Psychological Association, 2010). As long as the client is sure of the risks and any other possibilities then they should be able to make their own decisions.
If I did not know about this I could educate myself. If there were no science behind it I could inform the client. The best therapeutic relationship is one in which the client has the say in their own treatment. If the client prefers to utilize Complementary and Alternative Medicine then it should be their choice. One of the best lessons that I learned recently was from an associate who told me that they often work within a community that uses shamans and believes in shamanistic practices. For this therapist to be the most effective, there was a mixture of these mystical practices combined with evidenced based practices. Who am I to say that the mind does not believe so that it can help correct itself? I believe there is proof of it in the placebo effect.
Conclusion.
There are may many ideas in treatment for which science does not account. In every study there are allowances for placebo effect. If a person’s mind attempts to heal itself through whatever means, this might be the most natural route to take. The arguments for and against Complementary and Alternative Medicine divide groups who seem to see each other as a threat. This does not need to be the case. If the client can make informed decisions they should be able to do so. There are no guarantees that psychotherapy will work just as in the case of Complementary and Alternative Medicine. If the client believes and wants a treatment then they should be able to choose this. This could even be like religious prayer. How much does one need? It’s about faith. What therapist would discourage a client from praying if the client believed it would help?Top of Form
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