"Placebo effect is probably what we refer to as patient healing power": A qualitative pilot study examining how Norwegian complementary therapists reflect on their practice

Abstract

BackgroundComplementary therapists spend considerable time with their patients, especially in the first consultation. The communication between patients and their therapists is important for raising consciousness and activation of the patient’s self-healing power. Thus, the aims in this study were to delineate what complementary therapists regard as essential in patient consultations, their view of the healing process, and how the therapists understand the placebo effect and its position in the healing process.MethodsSemi-structured individual interviews (n = 4), focus group interview (n = 1) and participant observation were conducted among four different complementary therapists in a Norwegian community. The text data was transcribed verbatim and the analysis of the material was conducted according to conventional and direct content analysis. Some codes were predefined and others were defined during the analysis.ResultsThe pilot study showed that the implemented methods seems feasible and fit well with the aims of this study. Complementary therapists (chiropractor, naprapath (musculoskeletal therapist), acupuncturist and acupuncturist/homeopath) representing four different complementary modalities participated. A combination of the conversation and examination during the first consultation formed the basis for the therapist’s choice of treatment. A successful consultation was characterized by a fruitful relationship between the therapist and the patient. Moreover, the therapist needs to be humble and show the patient respect. Patients’ positive beliefs and expectations about the treatment play a significant role in the healing process. The more hope the therapist can bring about, the more easily the patient can start believing that it is possible to get well.ConclusionThis was a pilot study. Therefore the findings should be appreciated as limited and preliminary. Therapists’ and patients’ mutual understanding and treatment goals were essential for a successful consultation. The therapists emphasized their professional skills and therapeutic competence as important when building fruitful relationships with their patients. Exerting authority and making the patient feel confident were essential factors for a successful healing process. The complementary therapists understood the placebo effect as the patient’s self-healing power, resulting from establishing trust and belief in the treatment process.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-017-1770-8) contains supplementary material, which is available to authorized users.

“The prayer circles in the air”: a qualitative study about traditional healer profiles and practice in Northern Norway

“…This study found that the patients’ positive beliefs and expectations about the treatment play a significant role in the self-healing process. The CAM providers understood placebo effect as the patient’s self-healing power, resulting from establishing trust and belief in the treatment process [30]. Moreover, the therapist–patient relationship becomes more equitable if both parties respect one another.…”

“…According to Helman [29], curing and healing are both included in practical clinical work. CAM therapists, as opposed to doctors, often spend more time with their patients [30]. This enables them to maintain the emotional aspects to a greater extent, which makes the patients feel like whole persons rather than purely biological phenomena.…”

Placebo by proxy expectations toward acupuncture change over time: a survey comparing parental expectations to acupuncture pre- and postoperatively

“…A systematic review by Colagiuri and Smith [ 15 ] demonstrated a significant association between patients’ expectancies and acupuncture treatment outcomes, and, as to alternative therapists, they did indeed appreciate the placebo effect as part of treatment outcome. Patients’ expectancy, modulated by contextual setting and patients’ experience during the therapy, is considered crucial to a successful treatment [ 16 ]. This notion may also be applied to parents, as their expectancy also plays an important role [ 17 , 18 ].…”

Mesmer, the placebo effect, and the efficacy paradox: lessons for evidence based medicine and complementary and alternative medicine

“…The features that characterize many CAM practices, the conditions CAM clients tend to seek help for, as well as the comments of both practitioners and clients, all suggest that this may be the case. While it is difficult to make generalizations with regards to CAM treatments, given their number and diversity, features that are common to many of these practices include long consultations, expressions of warmth and empathy from practitioners, time devoted to the mutual development of explanation, as well as the instillation of hope (Carter, 2003;Ernst, 2001;Kaptchuk & Eisenberg, 1998;Stub, Foss, & Liodden, 2017). These features are known to increase placebo responses across a variety of conditions (Friesen & Blease, 2018;Howe, Goyer, & Crum, 2017;Kaptchuk et al, 2008).…”

“…Finally, interviews with CAM practitioners and clients reveal that aspects of these treatments that are likely to enhance placebo responses are often seen as central to the practices (e.g. understanding and explanation, holistic care, a meaningful therapeutic alliance, belief in the treatment) (Astin, 1998;Sirois, Salamonsen, & Kristoffersen, 2016;Stub et al, 2017).…”