Objective: Acute low back pain (ALBP) may limit mobility and impose functional limitations in active duty military personnel. Although some manual therapies have been reported effective for ALBP in military personnel, there have been no published randomized controlled trials (RCTs) of osteopathic manipulative treatment (OMT) in the military. Furthermore, current military ALBP guidelines do not specifically include OMT. Methods: This RCT examined the efficacy of OMT in relieving ALBP and improving functioning in military personnel at Fort Lewis, Washington. Sixty-three male and female soldiers ages 18 to 35 were randomly assigned to a group receiving OMT plus usual care or a group receiving usual care only (UCO). Results: The primary outcome measures were pain on the quadruple visual analog scale, and functioning on the Roland Morris Disability Questionnaire. Outcomes were measured immediately preceding each of four treatment sessions and at four weeks post-trial. Intention to treat analysis found significantly greater post-trial improvement in 'Pain Now' for OMT compared to UCO (P50.026). Furthermore, the OMT group reported less 'Pain Now' and 'Pain Typical' at all visits (P50.025 and P50.020 respectively). Osteopathic manipulative treatment subjects also tended to achieve a clinically meaningful improvement from baseline on 'Pain at Best' sooner than the UCO subjects. With similar baseline expectations, OMT subjects reported significantly greater satisfaction with treatment and overall self-reported improvement (P,0.01). Conclusion: This study supports the effectiveness of OMT in reducing ALBP pain in active duty military personnel.
Can the fields of complementary and alternative medicine provide psychologists with new career opportunities in practice, education, and research? With 42% of Americans estimated to be seeking unconventional treatments, collectively spending $21.2 billion annually, it is recommended that psychologists become informed about alternative medical practices, possible benefits and risks of such practices, and relevant licensing laws and education required for complementary medical practitioners. This article introduces psychologists to the emerging new health fields of complementary and alternative medicine; outlines the theoretical perspectives of 4 disciplines-Chinese medicine, Indian Ayurvedic medicine, naturopathy, and homeopathy; presents a brief sample of research literature; and discusses expanded career opportunities and roles for psychologists in interaction with alternative medicine.A 28-year-old woman with postpartum depression revealed to her psychologist fantasies and impulses of throwing her 14-weekold daughter off of a cliff. Envying her friends without children and feeling distant and angry toward her husband as well as her infant, she was mired in a severe clinical depression that had been unresponsive to two trials of antidepressant medication. The psychologist referred the patient to a homeopath, a practitioner of the German-born form of medicine that uses a minute dose of an herb, plant, or other substance to effect healing, reportedly by stimulating a patient's "vital force." Within 4 days of beginning treatment with a remedy called sepia, the woman's depression lifted, and she began bonding with her infant. Homeopaths explain such rapid cures by saying that the energy of the remedy repairs the "leakage" in the patient's "energy balloon" (De Schepper, 1999, p. 13), created by particular traumas or life events. The specific remedy used in this case, sepia, made from the ink of the cuttlefish, reportedly is indicated when a woman is exhausted physically and emotionally from a myriad of responsibilities and work or from too many pregnancies, abortions, or miscarriages. A classic sign of its indication, according to homeopaths, is a person's indifference or aversion to loved ones. "The change was astounding!" her psychologist told the homeopath. "Now she loves the baby and is taking all kinds of photographs and videotapes of her child, and her marital relationship has improved considerably"
Although the field of clinical psychology has strived to build a foundation of evidence-based therapies, patients with psychological disorders have increasingly sought out natural alternatives to prescription drugs and sometimes to psychotherapy, with many of these treatments failing to meet the American Psychological Association's standards for being "efficacious" or "possibly efficacious" at present. Data show that between 36 to 42% of Americans use complementary and alternative medicine (CAM) each year, most commonly for depression, anxiety, headaches, and pain disorders, all problems treated by psychologists. This paper reviews 3 traditions to which many Americans are turning to help with their mental health needs-homeopathy, botanical medicine, and nutrition-and describes what psychologists should know about these disciplines. After considering each tradition's foundations, published literature about its efficacy or lack thereof, and potentials for drug-natural product interactions, the author recommends minimal educational standards in CAM for psychologists in general, and especially for psychopharmacological prescribers.
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