Complementary therapies are a diverse range of health-related treatments which are not part of mainstream medical care. Generally speaking they are thought to increase well-being, aid relaxation and promote good mental health in all. They are also known as alternative, natural, non-conventional and holistic and can also be known as medicine, e.g complementary medicine.
•Rethink Mental Illness believes that complementary therapies can be beneficial to people experiencing mental health problems when used in addition to medical treatment.
•The effectiveness of complementary therapies is not well researched.
•There is evidence that St Johns Wort can be effective in treating depression.
•The National Institute of Health and Clinical Excellence (NICE) has recommended the use of mindfulness based CBT (meditation) for depression.
•We look at a small selection of complementary therapies which are popular for the treatment of mental health problems but there are many more available.
These pages are created by Rethink Mental Illness’ Advice and Information Service in accordance with the Information Standard. Last reviewed in January 2013. Next review January 2015.
Why use complementary therapy for mental illness?
It is widely thought that complementary therapies can provide a sense of relaxation and increased well being which can contribute positively to a person’s mental health.
Furthermore, many complementary therapies involve a more holistic approach to treating people which means to treat the whole person and consider physical, psychological and spiritual needs rather than focussing on the symptoms of the illness. Many people with mental illness find this beneficial and Rethink Mental Illness supports a holistic approach to treating patients.
We will look at some of the most popular and established complementary therapies, in alphabetical order, and consider their usefulness for some mental illness. However, please note that this is not an exhaustive list and there may be other therapies available which work for you.
TYPES
Acupuncture
Acupuncture is part of what is often referred to as Traditional Chinese Medicine (TCM). Acupuncturists believe that illness occurs when the body’s “qi”, or “vital energy”, cannot flow freely. By inserting ultra-fine sterile needles into specific acupuncture points, an acupuncturist seeks to re-establish the free flow of “qi” to restore balance and trigger the body’s natural healing response
A review was carried out into the use of acupuncture to treat depression. Two of the trials reviewed found that acupuncture could provide an added benefit to medication, when compared to medication alone. Overall, there was not enough evidence for the review to recommend acupuncture as a treatment for depression.
A review was also carried out into the use of acupuncture for people with schizophrenia. Some of the studies did suggest that acupuncture combined with antipsychotic medication may be more effective than antipsychotics alone. However, the research reviewed was uncertain so there was not enough evidence for the review to recommend acupuncture for people with schizophrenia.
Aromatherapy
Aromatherapy is the use of aromatic (pleasant-smelling) essential oils which are extracted from plants such as flowers, leaves, roots or bark. It is thought that each oil has a different therapeutic property which can be used to improve health and well being. Certain oils are historically linked to symptom relief for a wide variety of mental and emotional symptoms such as depression, anxiety and insomnia. Aromatherapy oils are absorbed through massages, bathing or direct inhalation.
A small study looked at a group of people with anxiety and/or depression who received massages with oil that contained essential oils associated with symptoms such as anxiety and depression. This group was compared with another group of people with anxiety and/or depression who received massages with oil that did not contain these essential oils. The results suggested that the group that received the essential oils showed more improvement in their anxiety and/or depression symptoms than the other group.
There is very little research into the effects that aromatherapy can have on conditions such as schizophrenia.
Homeopathy
Homeopathy is based on the theory that an illness can be treated by using tiny amounts of a substance which causes similar symptoms to it. Homeopathy is also based on the principles of treating the whole person and a consultation would involve a thorough assessment of a person’s lifestyle, personality and physical health. A treatment is then selected based on all the information gathered and is tailored for the individual
A recent NHS review of evidence concluded there was still not enough evidence to recommend the use in depression.
Massage
Massage is a form of structured and pressurised touch, or kneading, of the body which is generally used to relax and to relieve muscle pain. There are many different types of massage ranging from “Swedish massage” which involves light strokes aiming to relax the muscles in order to relieve tension to “Shiatsu” which, like acupuncture, believes that putting pressure on certain points will help to balance a person’s energy. Often massage is combined with aromatherapy which is thought to enhance the well being effects of the treatment.
Spiritual/Energy Healing
People who practice energy healing believe that in addition to a physical body we also have an energy body. This is made up of individual chakras which are responsible for different aspects of our emotional and physical well being. When there is emotional or physical disharmony in a person these chakras become blocked or unbalanced. It is believed the practitioner acts as a channel and harnesses universal healing energy to unblock and balance the chakras. They do this by placing their hands above the body at certain positions throughout a treatment. One of the most well known forms of energy healing in England is Reiki.
Anecdotally many people report a strong sense of relaxation during the treatment and a feeling of well being afterwards. A study found that people who received Reiki appeared to have reduced symptoms of depression and stress after 6 weekly sessions compared a group of people that did not had placebo sessions. This difference was also present a year later.
There is little research into the effects of energy healing for people with mental illness.
Western Herbal medicine
This the use of plant extracts to treat medical problems including mental illness. The most well known herbal medicine for treating mental health problems is St. John’s Wort (hypericum). A review of studies that looked at St John’s Wort as a treatment for depression found that St John’s Wort is just as effective as anti-depressants and has fewer side effects.
However, the active ingredient in St. Johns Wort can be harmful for some people if combined with the substance tyramine which is found in some foods such as:
•extracts of meat and yeast (e.g. Oxo, Marmite)
•broad bean pods, smoked or pickled fish
•hung poultry or game
•some cheeses
•some red wines
•some beers.
Also, St John’s Wort can interact with other prescribed medicines such as the oral contraceptive pill. You should check with your doctor before taking St John’s Wort.
Reviews have been carried out to look at whether other herbal medicines, could be useful in treating anxiety. Valerian has been found to be as effective as diazepam, but only one small study could be reviewed. More research is needed to be able to say if this is an effective and safe treatment option for anxiety disorders. Kava may be an effective treatment for anxiety but again, more research is needed and its long-term safety needs to be studied.
Meditation and Mindfulness based CBT (MCBT)
There are different types of meditation however most share the practice of sitting quietly and focusing your mind on either your breath, a mantra (a repeated phrase) or an object. When thoughts arise the person is encouraged to gently note them without judgement and let them drift away whilst the attention is then returned to the breath or object. It is claimed that with practice people can learn to quieten a busy and stressful mind and gain a stronger connection to the present moment without unwanted thoughts intruding. This practice is widely known as “mindfulness” or “mindfulness meditation” and can be practiced at home on your own or in a group.
More recently the practice has been combined with some techniques of cognitive behavioural therapy to treat depression and this has come to be known as mindfulness based CBT (MCBT). Based on the principle that recurring depression is associated with the return of negative thinking, feeling and behaving, participants learn to recognize these ‘automatic pilot’ modes, step out of them and respond in healthier ways.
It is now recommended by the National Institute of Clinical Excellence (NICE) as a treatment option for depression . MBCT should be an 8-week group program with each session lasting 2 hours, and four follow-up sessions in the year after the end of therapy.
There has been little research into the use of meditation in other mental illnesses.
Yoga is form of meditative and physical exercise which has its routes in India as a spiritual practice. Movements and postures are performed slowly and coordinated with an emphasis on controlling the breath. There are different types of yoga which often differ on how much emphasis is placed on aspects such as the physical exercises or the breathing.
Yoga practitioners claim that yoga can enhance all aspects of a person’s well being included mental health by reducing stress and improving mood.
TRYING
How can I try complementary therapy?
Most complementary therapies are delivered by practitioners operating privately. Before you make an appointment with a private therapist it is recommended you read the section on choosing a therapist here.
Private therapists can often be expensive, ranging from £35 – £60 for an average hourly session. If you are looking for free or low cost options, sometimes the NHS provides complementary therapies in certain areas, particularly if the therapy is recommended by NICE (the National Institute of Health and Clinical Excellence), so it is worth checking with your GP first or contacting your local Patient Advice and Liaison Service (PALS) who deal with enquiries and concerns from member of the public about local NHS services.
Local mental health charities or alternative therapy centers may provide free or low cost complementary therapies. Search http://www.mind.org.uk or explore what is available in your local area.
THERAPIES
Choosing a private complementary therapist
Unlike mainstream medical practitioners, complementary therapists do not have to register with a statutory body to practice.
However, in 2008 The Complementary and Natural Healthcare Council (CNHC) was established, with support from the Department of Health, as the main regulatory body for a selection of complementary therapies which include massage, aromatherapy, shiatsu and yoga as well as others not mentioned in this section.
The CNHC works with professional bodies to regulate the sector by:
•setting nationally recognised qualification standards to practice
•having a voluntary register of practitioners that have those standards
•having an independent disciplinary procedure to deal with complaints.
To register with the CNHC practitioners must also undergo criminal and disciplinary record checks and provide a character reference. Once a person is registered they are able to use the CNHC kite mark on all their publicity material.
Many individual therapies also have professional bodies which represent the interests of the practitioners in their field and also make recommendations for qualification standards needed to practice. They also hold registers for practitioners who have recognised qualifications. See below for contact details of these.
As the CNHC is relatively new and membership is voluntary not all qualified practitioners will be registered at the moment. If your chosen therapist is not a member of the CNHC, you could at least make sure they are members of their professional body and have recognised qualifications.
In Britain, acupuncture has its own self-regulatory body with a register of members who have been trained to meet industry agreed standards. Their details are in the Useful Contacts section below.
Other points to consider when choosing a complementary therapist include:
•Check the cost of treatment beforehand to make sure you are being fairly charged. You may have to shop around a bit.
•Ask about the qualifications, membership of professional bodies and how long they have been practising.
•Always make sure the practitioner has appropriate insurance. Membership criteria for CHNC and other professional bodies normally include a practitioner being appropriately insured.
•Talk it over with your doctor or nurse and ask for their advice, especially if you are going to have a therapy which involves taking pills or medicines.
•Choose the complementary therapy that suits your individual needs. Other people may be able to give you an idea of what worked for them.
•Don’t be misled by promises of cures. No reputable therapist would claim to be able to cure severe mental illness.
