The term “complementary and alternative medicine” or “CAM” refers to the vast array of therapies that people use to enhance health that fall outside of conventional, or “western” medical therapies (such as pharmaceutical drugs, surgery, etc.). The term “complementary” refers to those treatments that are used in conjunction with standard care, whereas “alternative” therapies are used instead of conventional treatments. In recent years, the term “integrative” has been used to refer to the integration of evidence-based CAM therapies with conventional ones for the purpose of enhancing health. 

Popularity of CAM

A 2007 national survey of Americans showed that approximately 38 percent of adults and 12% of children reportedly used CAM. This amounts to approximately $33.9 billion in annual out-of-pocket expenses. Commonly used CAM therapies include movement-based approaches, such as yoga, tai chi, or qigong, visits to CAM providers including acupuncturists, massage therapists, energy healers, chiropractors, and osteopathic physicians, traditional healing approaches such as shamanism or Ayurveda, diet-based therapies, relaxation therapies, oral intake therapies (omega-3 fatty acids, echinacea, St. John’s Wort), and more. 

It is worth noting that the above figure does not include the use of vitamin or mineral supplements for health, or prayer for health reasons (which were once included in CAM expenditures). CAM is most commonly used to alleviate chronic pain, treat symptoms of depression, anxiety, and insomnia, as well as the common cold, but it is also used for a myriad of other conditions and concerns. Although the figure above represents overall CAM use and expenditures, people with medical or mental health concerns tend to use CAM at higher rates than the general population.

Integrative Health Psychology, or CAM and the Psychotherapy Process

The term “integrative” as it relates to psychotherapy can be characterized in three ways: 

1. Drawing upon more than one psychotherapy model when working with clients; 
2. Liaising with other members of patients’ health care teams, if this is relevant (including medical and CAM practitioners, among others); 
3. When appropriate and in cooperation with the patient, the thoughtful addressing and/or inclusion of CAM into the psychotherapy process. 

Number one is the most common understanding of integrative psychotherapy, however, two and three also represent thoughtful and important “integrations” with regard to mental health care. The term “integrative health psychology” can help clarify the emphasis on enhancing health (mental and physical) via psychotherapy plus CAM.

The above are not necessarily new ways of working. Mind-body approaches, such as biofeedback, guided imagery, hypnotherapy, meditation, and relaxation training are used by many to help manage mood, improve feelings of physical energy, and foster a general sense of well being. These techniques can easily be integrated into talk therapy, and a growing number of therapists already do so with good results. Referring to these approaches as CAM may surprise some; however, they are both stand-alone therapies as well as ones that can be integrated fairly easily into psychotherapy.

Similarly, mindfulness training was introduced as a practice that existed outside of the realm of psychotherapy, but its effectiveness at decreasing the experience of emotional and other suffering prompted the development of several psychotherapy approaches that emphasize its use.  Thus, it can also be thought of as CAM, as can the inclusion of relaxing aromas or drawing in to the work. 

Integration of the Psychotherapy Field and CAM

Although non-physician therapists probably should not not “prescribe” oral intake therapies, such as omega-3 fatty acids, SAM-e, or B-vitamin supplementation, many, many patients use one or more of the above to help address mood symptoms, as well as for other health reasons. Discussing current and previous CAM therapies use with one’s therapist is as important as disclosing use of prescribed medications and other substances that can affect the mind and body. Not all CAM therapies should be considered appropriate for all people, and some have greater evidence of benefit (or harm) than others. As such, it is strongly recommended that CAM therapies use be discussed openly with members of one’s health care team.

The field of psychology seems to be ever evolving in response to the needs and desires of patients, as well as the expanding ways in which both patients and providers conceptualize health and well being. A thoughtful, collaborative discussion of CAM therapies can potentially enrich the therapy experience for those who see them as additional tools for emotional and physical healing.

Resources Related to Complementary and Alternative Medicine

• The National Center for Complementary and Alternative Medicine
• American Holistic Medical Association
• Health Journeys - Guided Imagery audio resources

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Last updated: 05-14-2013