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Complementary therapies and Placebo Effects - lecture notes

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Lecture notes from the Psychology Applied to Health (NEU3003) module at the University of Exeter. Week 10 - Complementary therapies and Placebo Effects

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Dr mark tarrant
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Complementary therapies and Placebo Effects

Contents:
1. Complementary therapies
2. Placebo effect: what is it?
3. Placebo effect: How does it work?
4. Harnessing placebo effects


What are complementary therapies?
They are also know as Complementary and Alternative Medicine (CAM)
They are a group of treatments that fall outside of mainstream healthcare. You often see the
term ‘alternative therapies’ alongside complementary therapies, and its useful to know what
these are.
- Complementary therapies: therapies that are not within conventional medicine and
healthcare, but used alongside conventional medicine
- Alternative therapies: used instead of conventional medicine (e.g: metabolic therapy
for cancer rather than surgery, chemo etc.)


These therapies take a more holistic approach, focussing on treatment of mind and spirit as
well as the body. There is a systematic review that suggests there’s an increasing prevalence
of these types of therapies in the UK – 50-52% of respondents had used complementary
therapy in their life. (Posadzki et al., 2013). 50% of gp’s provide access to complementary
therapies within NHS.


Examples of Complementary Therapies:
- Acupuncture
- Aromatherapy
- Herbal medicine
- Yoga


What evidence is there?
CAMS are less researched than mainstream medicine.
Often argued that CAM use has been increasing despite lack of good quality data to confirm
this fact (Posadzki et al., 2013). One of the key limitations of surveys that look into use of
CAMS are only getting responses from people who ARE using CAMS, rather than getting
representation from those that are not.

, Use of the therapies doesn’t give evidence that they work, and much fo the work in this area
uses surveys rather than clinical trials on their effectiveness or safety.
Some therapies have more evidence than others: e.g: yoga has lots. But lack of evidence
shouldn’t be taken as evidence that it doesn’t work, it just means we do not fully understand
it yet.
How a therapy is judged also depends on the problem that it is targeting:
- For example, exercise has a lot of research demonstrating its positive health benefits
- However, in the case of depression and other mental health disorderes, it is not
considered a mainstream treatment and is a complementary treatment
- However, in the case of diabetes, exercise is considered a mainstream treatment



Should complementary / alternative therapies be offered in the NHS?
We have an evidence-based culture within the NHS. In order to answer this, we
need to consider whether things work, make sure they are not harmful, make
sure they are not too costly, and consider how they work.


How does our pre-conceptions affect perception of treatment?
Generally, when we think of drugs or surgery, we see this automatically as mainstream
treatment, whereas physical activity or yoga is generally thought of as complementary
medicine. This can continue on even after a previously complementary therapy has been
moved into mainstream medicine.


Asking ourselves the question: How do these complementary therapies
work
We know that in order for a complementary therapy to be seen as a mainstream
medicine, we must consider how these therapies work to bring about benefits. It
is commonly thought that complementary therapies work through a placebo
effect.
The question then is whether we can still consider it as an ;effective therapy’ if
this is the case. It is still showing some beneficial outcomes, so is it still worth
considering?


Part 2: Placebo effect: what is it?
What is a placebo?
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