604 Complementary and Alternative Therapies
TT (e.g., Olson, et al., 1997). A literature review and meta-
analysis highlights the poor methodology implemented in TT
studies but calculated an average effect size of .39 for TT
(Winstead-Fry & Kijek, 1999).
Reiki,another type of energy mobilization, means •uni-
versal life force energy.Ž Whereas TT involves the mobiliza-
tion of energy in the client•s body, Reiki entails transferring
or mobilizing energy from the clinician to the client. It is
based on the concept that all living creatures possess energy
and that the human body is programmed to heal itself. Practi-
tioners of Reiki report positive effects of this technique on
mood, psychological distress, pain, and functional abilities,
but these results are based on patient case history reports.
A similar energy-based approach, polarity therapy,is
based on the concept that the body holds an electromagnetic
force, with a positive charge located cephalically and a nega-
tive charge situated toward the toes. The clinician•s hands are
believed to be conductors of energy. When they are placed in
certain areas of the client•s human energy “eld, the clinician
attempts to facilitate energy movement in the client•s body.
This facilitation is believed to enhance energy ”ow and
relaxation throughout the mind and body. Scienti“c studies
regarding its ef“cacy are absent.
Movement Therapies
Movement therapies are complementary approaches to health
that emphasize changes in the client•s bodily positions.
Leisure activity(e.g., casual walking) has been demonstrated
to buffer anxiety in the face of stressors (Carmack,
Boudreaux, Amaral-Melendez, Brantley, & de Moor, 1999).
Active perimenopausal women reported less psychosomatic
symptoms (e.g., irritability, headaches) and fewer sexual
problems than those who were more sedentary (Li, Gulanick,
Lanuza, & Penckofer, 1999).
Some literature exists supporting the psychological bene-
“ts of aerobic exercise.Correlational studies predominantly
endorse positive psychological health in people who partici-
pate in aerobic exercise. One study assessing more than 3,400
participants found that those who engaged in exercise two or
more times each week reported less depressive symptoms,
anger, cynical distrust, and stress compared to those exercis-
ing less or not at all (Hassmen, Koivula, & Uutela, 2000).
This former group also reported a greater sense of social
integration and perceived health. Similarly, meta-analytic
reviews revealed that those who exercise are signi“cantly
less likely to be depressed (Craft & Landers, 1998) and to
report distress (Crews & Landers, 1987). However, other
meta-analyses demonstrate little (i.e., only one-half standard
deviation; North, McCullagh, & Tran, 1990) or no (e.g.,
Schlicht, 1994) difference in psychological distress between
exercisers and nonexercisers.
Intervention studies provide stronger evidence for the psy-
chological bene“ts of aerobic exercise regarding psychologi-
cal distress. One study randomly assigned participants with
dysphoric mood to cognitive therapy, aerobic exercise, or
a combination of these two interventions over a 10-week
period (Fremont & Craighead, 1987). Although no signi“cant
differences were noted between the groups, all three demon-
strated signi“cant decreases in depressive symptoms. Simi-
larly, older patients with major depressive disorder were
randomly assigned to aerobic exercise (3 times per week),
antidepressant medication (sertraline hydrochloride), or both
for 16 weeks (Blumenthal et al., 1999). Results demonstrated
all three groups signi“cantly improved on measures of
depression, anxiety, self-esteem, life satisfaction, and dys-
functional attitudes from pre- to posttreatment, but no differ-
ences were noted between the groups following intervention.
Those receiving antidepressant medications did, however,
demonstrate quicker enhancement of mood compared to
those participating in aerobic exercise only.
A meta-analytic study demonstrated the effects of rehabili-
tative exercise programs on anxiety and depression in patients
with coronary disease (Kugler, Seelbach, & Kruskemper,
1994). Speci“cally, exercise resulted in moderate decreases in
both anxiety and depressive symptoms and did not differ
signi“cantly from psychotherapy. Similarly, breast cancer
survivors randomly assigned to exercise or exercise plus
behavior modi“cation demonstrated comparably signi“cant
decreases in depressive symptoms and anxiety (Segar et al.,
1998). The waitlist control (WLC) group in this study did not
initially exhibit such declines in distress. However, following
the waiting period, those participants in the WLC who partook
in the exercise program also exhibited signi“cantly dimin-
ished anxiety and depressive symptoms. In addition to aerobic
exercise,resistance exercise(e.g., weight lifting) has also
demonstrated bene“cial effects on health (Tsutumi et al.,
1998).
Fox•s (1999) review of the literature on exercise and men-
tal health supports the following conclusions: Exercise (a) is
an effective treatment for clinical depression; (b) decreases
state and trait anxiety; (c) enhances self-perceptions and,
perhaps, self-ef“cacy; (d) improves mood; and (e) may
improve cognitive functioning, especially in older adults.
Possible mechanisms of action may be in the physiological
(e.g., release of endorphins), psychological (e.g., diversion,
improved self-image), and/or social (e.g., social interactions,
receiving attention) domains.