Celebrating National Complementary Therapy Week 2020

This week, we are celebrating National Complementary Therapy Week for the first time and we could not have picked a worst week. But who could have foreseen the unprecedented situation we all find ourselves in even 3 months ago, let alone 12 months ago when we booked this in with the national awareness days program of events. Needless to say, all therapists have had to close their practices in order to safeguard their clients and themselves and all our accredited training establishments have had to suspend classes for the time being. Only this morning at the CHP office, we have had to cancel exams set for July as students are unable to complete case studies on anyone except their partners. We had events planned at the Mulberry Centre, as we were supporting complementary therapies in cancer this year as of course other planned events therapists had in place to celebrate their profession and promote their services have had to be cancelled. As most therapists are self-employed, they are all effectively out of work at the moment and many are worried that the government is not supporting them in the same way as employed people are. These are in fact very difficult times for our profession. However, we can still celebrate the amazing therapies we all practice from the comfort of our homes, where we are all practising social distancing. Like me, many therapists are offering online support for their clients, even if it is just the offer of phone support for anyone who is one of the 1.5 million who have been told by the NHS this week to self-isolate for 12 weeks. Many of our elderly clients live alone and a friendly supportive voice or video chat can be really helpful.

What is Complementary Therapy?

If you have never tried any of the complementary therapies you may be forgiven for thinking they are nothing more than a luxury or for people who are a bit weird! Once you have tried it for yourself you will soon realise that therapists are highly trained professionals who work alongside conventional medicine to support your wellbeing in a way that a medical profession cannot, and does not have the time for. We support mainstream medicine. Our profession is therefore quite different to the beauty therapy industry whose work is just as important in making you feel good about yourself, but they are not necessarily trained to work with complex medical conditions as we are.

According to Richard Eaton (2018) in an article published by the College of Medicine and Integrated Health, "there is evidence that the CAM can and does deliver cost-effective and valued therapies within the UK health and social care sectors". Integrated health is the way forward in the long term, where Complementary & Alternative Medicine (CAM) is used within mainstream healthcare settings to support the health and well-being of everyone who can benefit from it. Incidentally, the acronym CAM is already slightly outdated now as we do not consider ourselves "alternative" to medicine, which would be something outside of mainstream healthcare but more "complementary", in other words, working alongside it. In our profession, we do get rather frustrated when people spell complementary incorrectly! We often see it written as "complimentary", which of course has a whole other meaning, and as I said earlier, most of us are self-employed and despite many offering to volunteer their services for cancer services etc., we do have to make a living and cannot work for free! Complimentary means either "offering a praise or a compliment", or "given or supplied free of charge" (dictionary .com), so please spell our profession correctly!

There is a great deal of evidence available to prove the efficacy of our therapies and these are readily available on the internet and one really good source is Positive Health Magazine. There is also a huge amount of anecdotal information available from individual therapists who can share their success stories and the positive feedback from their clients. The majority of therapists rely of word of mouth for their businesses, which is why the really successful ones are always difficult to book in with. However clinicians within hospitals seem reluctant to accept any of the evidence and access to complementary therapies on the NHS is quite limited, although some do offer it such as the Royal Marsden in London (royalmarsden.nhs.uk/supportive-therapies/massage-therapy-and-reflexology). We need more of this and if a patient-led NHS is to become a reality, NHS professionals need to cede the power that they wield with evidence rhetoric and acknowledge the legitimacy of patient preferences, views and alternative sources of evidence (Wye et al 2009). This year we as an association are supporting the European Congress for Integrative Medicine 2020, which is scheduled to take place in London between 11th - 13th September (www.ecimcongress.com). This is all good for our profession and for more recognition of our therapies and how much they benefit people.

Choosing a therapist

We do not have statutory regulation in the UK for complementary therapists in the same way as other healthcare professionals. Instead, after some nine years of hard work and collaboration, in which I personally participated on behalf of the aromatherapy profession, we have a system of voluntary self-regulation under a body called the Complementary and Natural Healthcare Council (CNHC). Whilst it is great to have some form of unified standards, these cannot be enforced. As a result, there is a plethora of what we would describe as sub-standard training out in the public domain. This makes it difficult for users to know the quality of training their local therapist has undertaken. Some people have done beauty therapy that includes massage, reflexology and aromatherapy, but their training does not include working alongside medicine as we do in the complementary therapy sector. There are also people who have only undertaken online training and never set foot in a classroom. We strongly discourage anyone from undertaking these online diplomas for anything other than personal interest as you need tutor supervision to ensure you are working safely and effectively. In the main, those offering accredited training that is approved by us and the CNHC usually lasts around 9 months part time in order to develop the practical skills required for safe and effective practice and to learn all of the detailed theory, which includes anatomy, physiology and pathology. We are not saying that online training is not valuable and we do accredit online training for theory and CPD that is high quality and properly assessed, but you cannot learn a therapy properly without supervision of your practical skills. It takes time to develop these skills to the point where you are proficient and safe to work on the general public. You need to take examinations and a practical examination with an external examiner too.

You should also check that a therapist is a member of professional association such as Complementary Health Professionals that works with the CNHC and the reason for this is twofold. Firstly, you are assured that the individual has done the right training as we have the same criteria for membership as the CNHC has for Registration. Secondly, out members all have to undertake continuing professional development annually, just like all other healthcare professionals have to do. This demonstrates commitment to their profession as they continually improve their skills and knowledge in order to best serve the needs of their clients. If you would like to join our association, please click the red link above to take you to the online application form.

Most therapists are multi-disciplined, meaning they have trained in more than one therapy or modality. This is actually quite desirable as they are able to assess your individual needs and tailor a treatment that suits. If they are unable to help, they will refer you to someone who can, meaning they will always work to the limitations of their training. The CNHC only regulates 16 complementary therapies and there are many more outside of this. As a multi-disciplinary professional association, we are able to assess and set standards of training for all therapies and for continuing professional development courses in these therapies that is rigorous and properly assessed. Within our profession, we are known for high quality standards and professionalism and we are very proud of that. We do have to turn people away sometimes who apply for membership but we always do this with information and advice on how and where to go to train properly and bridge any gaps in their skills. If you would like to have your course accredited by us, please do get in touch and otherwise, please see the list of accredited course providers on our website.

What types therapies are there?

There are actually a great many of techniques that people train in. Therapists are constantly adding to their skills so that they can be more effective and specialise in certain areas of healthcare. We see a huge range of chronic conditions such as arthritic and neurological disorders as well as supporting musculoskeletal disorders and cardiovascular issues. We can support women through pregnancy and childbirth (Chitty 2009) and people who are going through cancer treatments. In cancer care, people use complementary therapies to boost their physical or emotional health or to relieve symptoms or side effects of conventional treatments (Macmillan 2020). Many of the therapies can be used to support general emotional and mental health and let's face it, everyone suffers from stress. As stated by MIND (2020), complementary therapists take a "holistic" approach to your wellbeing, which means they "consider all aspects of your physical and emotional wellbeing as a whole, rather than treating particular symptoms separately".

There are many more "mainstream" therapies that people have heard of and probably used, such as massage (and all the various types; Swedish, deep tissue, trigger point therapy, myofascial release, neuromuscular technique, Lomilomi, Indian Head Massage, Chair or seated massage etc.), aromatherapy that uses massage with essential oils customised for the individual, reflexology that stimulates specific reflexes in the feet and hands that corresponds to the body, and reiki that works energetically to bring about balance. There are also essential oil practitioners who have completed the same course as aromatherapists but without the massage training and they can offer bespoke blends in various products for your specific needs. There is also acupuncture, osteopathy, chiropractic, homeopathy, herbal medicine, nutritional therapy, hypnotherapy, naturopathy, shiatsu, sports therapy, craniosacral therapy, kinesiology and healing. Healing can include lots of other modalities within it, such as Crystal Therapy, Colour Therapy and so on. As well as these more commonly known therapies, we also accredit some less well known, although there is a huge amount of supportive evidence to show their effectiveness, specifically for back pain and joint problems. These include some specialised light touch therapies that have come from Australia, such as Neuroskeletal Re-alignment Therapy, The EMMETT Technique and Bowen Therapy. From the Czech Republic we have Spiral Stabilization, a form of simple exercises that was invented by a medical doctor and has shown to be very effective for spinal disorders and scoliosis. One of our accredited centres in Cambridge is having success with an incredible therapy known as Inner Energy Healing that uses basic kinesiology and various correction techniques to help bring the body back into balance. We also have an amazing course in Song Therapy where music is used to promote well-being and health by singers and musicians running recreational groups in their locality. There is a wealth of research that shows how effective music is in treatment for reducing depression, anxiety, and chronic pain (Friedman 2014).

So despite the country being in lockdown and access to complementary therapies being temporarily suspended, you can spend this time reviewing the different therapies out there and finding out about therapists in your area. We are all going to need support once this crisis is over but with the strain on the NHS, let's hope that complementary therapies will be used more and more in the coming years. Many GPs already recommend complementary therapies (Wellspring n.d.) but it would be great to see complementary therapists working in GP practices or certainly alongside them to help people. In the words of Dr Michael Dixon GP "“I used to dread appointments with patients with conditions from back pain to allergies, where modern medicine has little to offer. Now I’m able to steer people towards approaches that help them to get better. Long-term disease takes up 80% of our workload as doctors, yet it only affects 20% of the patients.” Mainstream medicine is not the only answer and we need to acknowledge that there is a place for effective complementary therapies with properly trained therapists. Of course there is a cost implication to consider and in a research undertaken in 2018 (Sharp et al 2018) few of the people interviewed were willing to pay the full cost (approximately £60 per visit in the UK) of CAM, but 13% said they would consider CAM if it was partly NHS-funded. Co-payment by patients is a contentious issue but, where the evidence base is good, the NHS may need to respond to a changing, consumerist society. Let's hope this week's celebrations, no matter how muted because of the dreaded Coronavirus Covid-19, helps move things forward in the right direction for the benefit of all.

References

Chitty A 2009, Review of evidence: complementary therapies in pregnancy National Childbirth Trust available at https://www.nct.org.uk/sites/default/files/related_documents/New%20Digest%2046%20(Chitty).pdf <accessed 23/03/2020>

Eaton R. 2018 Complementary Medicine Roundup - October 2018 College of Medicine and Integrated Health available at https://collegeofmedicine.org.uk/complementary-medicine-roundup-october-2018/ <accessed 22/03/2020>

Friedman M. Ph.D 2014 Does Music have Healing Powers? available at https://www.psychologytoday.com/us/blog/brick-brick/201402/does-music-have-healing-powers <accessed 23/03/2020>

Macmillan Cancer Support ©2020 About Complementary Therapies available at https://www.macmillan.org.uk/cancer-information-and-support/treatment/coping-with-treatment/complementary-therapies/about-complementary-therapies <accessed 23/03/2020>

MIND ©2020 Complementary and alternative therapies available at https://www.mind.org.uk/information-support/drugs-and-treatments/complementary-and-alternative-therapies/about-complementary-alternative-therapies/ <accessed 23/03/2020>

Sharp D, Lorenc A, Morris R, et al. 2018;2 Complementary medicine use, views, and experiences: a national survey in England BJGP Open available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348322/ <accessed 23/03/2020>