"I've Only Just Heard About It": Complementary and Alternative Medicine Knowledge and Educational Needs of Clinical Psychologists in Indonesia

Cross-Cultural Patient Counseling and Communication in the Integrative Medicine Setting: Respecting the Patient's Health Belief Model of Care

PURPOSE OF REVIEW

Communicating effectively with patients having a traditional, alternative or complementary medicine-related health-belief model is challenging in today's cross-cultural society. This narrative review explores the integrative medicine setting of care, focusing on insights from the integrative oncology daily practice, while addressing the relevance to the mental health setting. The way in which healthcare providers can enhance cultural-sensitive communication with patients and informal caregivers; recognize and respect health-beliefs to bridge cultural gaps; and generate an open, non-judgmental and mindful dialogue are discussed.

RECENT FINDINGS

Identifying cross-cultural barriers to healthcare provider-patient communication is important in order to address the potential for conflict between conventional and "alternative" health beliefs; difficulties in creating a shared-decision making process; disagreement on therapeutic goals and treatment plan; and finally, the potential for non-compliance or non-adherence to the conventional oncology treatment. Acquiring intercultural competencies is needed at all stages of medical education, and should be implemented in medical and nursing curricula, as well as during specialization and sub-specialization. As with patient-centered paradigms of care, integrative medicine entails a dual patient-centered and sensitive-cultural approach, based on a comprehensive bio-psycho-social-spiritual model of care.

The engagement of psychology with complementary medicine: A critical integrative review

Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.

Use and perception of complementary and alternative medicine among Iranian psychologists

OBJECTIVES

The seeking and use of Complementary and Alternative Medicine (CAM) modalities by people to treat mental disorders has increased and it is necessary for psychologists to have the necessary information in this field. This study aims to evaluate the use and perception of CAM by Iranian psychologists.

METHODS

This cross-sectional study was conducted on 100 psychologists selected by the census in 2019. Data collection tools consisted of four sections of the demographic section, the CAM questionnaire for psychologists, awareness of CAM, and use of CAM. The validity and reliability of this questionnaire were confirmed.

RESULTS

The mean (standard deviation) scores of attitude and educational needs were 40.45 (11.36) and 33.93 (5.96), respectively. Only 19.25% of psychologists had sufficient knowledge of CAM, and most of them (56.34%) reported that there is an educational need for CAM. In this study, 64% of psychologists used CAM for themselves. There was a significant relationship between the attitude toward CAM modalities and the suggestion of CAM to the clients (p=0.025). There was also a significant relationship between the use of CAM by psychologists and the suggestion of these modalities to their clients (p<0.001).

CONCLUSIONS

Psychologists had not sufficient awareness about CAM and had a moderate attitude. Most of the psychologists reported that there is educational need for CAM. Therefore, it is necessary to design and implement appropriate training courses for psychologists toward CAM modalities.

Complementary medicine in psychology practice: an analysis of Australian psychology guidelines and a comparison with other psychology associations from English speaking countries

Background

Psychologists, and their clients, are engaging with complementary medicine (CM). Increasing evidence for CM approaches, such as improved nutrition and St John’s wort, has led to their inclusion in the Royal Australian New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. This research aims to determine in what ways, and to what extent, Australian psychology regulatory bodies and associations consider CM relevant to psychology practice. Specifically, how these regulatory bodies and professional association’s ethical and practice guidelines engage with CM.

Methods

Documents from Australian regulatory bodies and professional associations, that relate to the governance or guidance of psychologists’ clinical practice, were systematically searched for key terms relating to CM.

Results

There were no direct references to CM in the 58 ethical and practice guidelines reviewed. There was also no reference to the relevance of CM to ethnocultural groups, such as Aboriginal and Torres Strait Islander traditional healing practices.

Conclusion

While other mental health care disciplines are working toward integrating CM, the discipline of psychology in Australia is not currently engaged in such developments. Given the exponential rise of CM use amongst those with mental health problems, psychology associations should consider developing resources and guidelines to assist psychologists in navigating CM in relation to clinical practice to help minimise risks, such as patient safety associated with concurrent CM use.

Antipyretic, Antinociceptive, and Anti-Inflammatory Activities from Pogostemon benghalensis Leaf Extract in Experimental Wister Rats

Background:Pogostemon benghalensis leaves have traditionally been utilized for relieving body aches, headaches and fever. Based on its uses, the present study was designed to investigate the antinociceptive, antipyretic and anti-edematogenic activities from P. benghalensis leaves’ methanol extract (PBME) in Wister rats. Methods: The thermal (hot plate) and chemical (acetic acid-induced writhing and formalin test) models for antinociceptive effects, and the Brewer’s yeast induced hyperthermia test for antipyretic action and rat paw edema by carrageenan for anti-edematogenic activity, were applied for PBME at different dose levels. The acute toxicity of PBME through the oral route was performed to determine the lethal dose. Results: PBME significantly and dose-dependently reduced pyrexia and diminished edema volume, which depicted its antipyretic and anti-edematogenic effects respectively. The inhibition of writhing reflex, increased reaction latency and reduced frequency of licking indicated that PBME has significant dose-dependent antinociceptive activity. P. benghalensis methanol extract at 4000 mg/kg shows no sign of toxicity, which is a considerable, good margin of safety. Conclusions: The study illustrated the antipyretic, antinociceptive and anti-inflammatory potential of P. benghalensis leaf extract with a safety margin, and validated its traditional use to alleviate fever, pain, and inflammation.

A comparison of attitudes towards complementary and alternative medicine between psychologists in Australia and Indonesia: a short report

Background

The growth of complementary and alternative medicine (CAM) has been increasing, including amongst psychological clients. Therefore, it is important to investigate psychologists' attitudes towards CAM. Negative attitudes towards CAM among psychologists could be a barrier to CAM integration into psychological services and may prevent clients to trust psychologists. This study aims to compare Indonesian and Australian psychologists' attitudes towards CAM using the previously published study on Psychologists' Attitudes Towards Complementary and Alternative Therapies (PATCAT) scale validation.

Methods

The PATCAT scale was adapted from an Australian study to an Indonesian version using backward-and-forward translation. This scale was used to investigate attitudes towards: (1) CAM knowledge; (2) CAM integration; and (3) the risks associated with CAM. An online survey was sent to all Indonesian psychologists and completed by 247 participants. Afterward, the data were compared with the published data from 115 Australian psychologists.

Results

In general, psychologists in Indonesia and Australia showed relatively similar ambivalent attitudes towards CAM. This uncertainty may stem from the same Western psychology education, which is a basis for the medical models in both nations. They also considered it somewhat important to have an understanding of CAM. Participants in both nations displayed positive attitude towards CAM integration into psychological services. However, they felt that CAM usage for mental health holds some risks.

Conclusion

Australian and Indonesian psychologists reported ambivalent attitudes towards CAM that might be reduced with clear regulation of CAM integration into psychological services from the government and professional organizations.