Handbook of Psychology

References 607

COMMON THEMES

From a health psychology perspective, several important
themes emerge that concern the shared characteristics of al-
ternative and complementary treatments in the context of an
expanded mind/body rubric. These include:

1.A biopsychosocial model, which incorporates biological,
immunological, psychological, spiritual, interpersonal, and
environmental variables, characterizes an underlying mind/
body philosophy of most complementary and alternative
approaches. Psychological wellness is viewed as a critical
component of health regarding most of these therapeutic
systems. Many psychological interventions, such as cogni-
tive-behavioral therapy, group therapy, and hypnosis, may
provide strategies that increase psychological well-being
and decrease distress.

2.A holistic, individualized case assessment approach is a
common method of diagnosis and treatment. Although
each healing approach may vary in the methodology, such
as use of the interview, physical exam techniques, or tests
that are administered, there is a marked tendency to design
treatment speci“c to the individual case formulation rather
than rely on a standard prescription or dosage strategy.

3.The underlying philosophy on which many complemen-
tary and alternative interventions are based view health as
a state of harmony and energy balance, wherein the phys-
ical, emotional, mental, and spiritual aspects of energy are
all given signi“cant weight and seen as interrelated.

4.Treatment ef“cacy is most often associated with stress-
related disorders and those diseases that have been etio-
logically linked to cognition, behavior, and lifestyle. This
covers a wide range of what have been historically con-
sidered medical disorders, such as cardiac problems,
diabetes, immune functioning disorders, asthma, pain syn-
dromes, and gastrointestinal disorders.

FUTURE DIRECTIONS

Integration of Psychological Interventions and
Complementary and Alternative Therapies

Because psychological health is considered such an integral
part of most complementary and alternative approaches,
there is wide applicability for psychological interventions to
be delivered in conjunction with these approaches as part of
an overall health maintenance strategy. Particularly helpful in
this regard would be the widespread provision of psychoedu-
cation and promotion of a biopsychosocial model, so that

patients can learn to view psychological interventions as part

of a comprehensive treatment, rather than an indication that

health providers have labeled them as •crazyŽ or diagnosed

their problem as •all in their head.Ž Additionally, psycholog-

ical interventions speci“cally shown to be ef “cacious with

comorbid symptoms of anxiety and depression, which occur

with high prevalence in patients with diagnosed dif“culties

such as cancer or heart disease, can be integrated with ongo-

ing treatment aimed at the cancer itself.

A Decision-Making Problem

Because of the wide choice of treatments available, individ-

uals who are interested in pursuing a more holistic approach

to their health and incorporating complementary and alter-

native approaches are faced with the daunting task of sort-

ing through myriad information. Media and technology

have made available to the general public both the access

and marketing of information concerning a wide range of

health choices possible. Thus, when faced with a disease

diagnosis, people are in the position of choosing from

competing philosophies, therapies, and providers. Such de-

cisions are dif“cult enough„when compounded by the

emotional impact of an illness, a person•s decision making

can be further impaired (A. M. Nezu, Nezu, Friedman,

Faddis, & Houts, 1998). Training patients in decision-

making strategies, such as social problem-solving skills, as

a way of coping with the many decisions they must confront

may serve as a particularly useful intervention in this re-

gard. Problem solving, de“ned by D•Zurilla and Nezu

(2001), is a •self-directed cognitive-behavioral process by

which a person attempts to identify and discover effective

and adaptive solutions for speci“c problems encountered in

everyday livingŽ (p. 212). Findings from a variety of studies

have provided support for problem-solving therapy as a po-

tent intervention to reduce stress, increase quality of life,

and perhaps most germane to this discussion, increase sense

of self-ef“cacy and con“dence in making decisions (A. M.

Nezu et al., 1998). Training patients in such skills can in-

crease the likelihood that patients will become active part-

ners with their various health care providers, deriving

maximum bene“t from the range and combination of treat-

ment alternatives available.

REFERENCES

Abenhaim, L., & Bergeron, A. M. (1992). Twenty years of random-

ized clinical trials of manipulative therapy for back pain: A

review.Clinical and Investigative Medicine, 15(6), 527...535.