DMHAS Integrative Medicine Activities: Supporting Mind, Body and Spirit
Integrative or Alternative Modalities
There are many different types of integrative or alternative modalities that are organized in a variety of different categories or models.  The Connecticut Statewide Integrative Medicine and Behavioral Health Collaborative Research and Professional Development Sub-Committees have reviewed these and determined to organize Connecticut activities and modalities in the following manner:
  • Mind Body Modalities: Mindfulness; Meditation; Yoga; Labyrinth*; Hypnosis/Biofeedback; Guided Imagery*; Mindfulness-based Psychotherapy (DBT, EMDR, ACT); Dance/Movement; Art/Music; Pet-Therapy/Animal Assisted Treatment; Massage*

  • Spirituality: Prayer; Labyrinth*; Healing; Guided Imagery*; Compassion Practice

  • Energy Therapies: Reiki; T’ai Chi; Qi Gong; Reflexology; Cranial-sacral/Massage*; Acupuncture; Acupressure; Aromatherapy

  • Complementary Modalities: Traditional Chinese Medicine (TCM); Ayurvedic Medicine; Homeopathy; Naturopathy; Osteopathy; Manipulation/Chiropractic; Nutrition; Exercise/Fitness
*indicates a modality that appears in one or more categories.
Mindfulness Meditation
  • The intentional practice of attending to the stream of awareness in the present moment without judgment
  • Mindfulness meditation is believed to have originated in the yogic contemplative traditions of India, however it is principally associated with the tradition of Siddhartha Gautama, who lived in India  approximately 2500 years ago, and who was known as the “Buddha” or “awakened one”
  • The Buddha recommended that people practice Mindfulness so that they could directly experience how their misperceptions of reality contributed to their own suffering and stress.
  • The fundamental reason for practicing meditation has been to develop a basic sense of acceptance and gentleness toward oneself, and ultimately toward others, since all human beings tend to get caught up in creating their own aggravations and suffering.
Mindfulness Based Stress Reduction (Also known as MBSR)
  • MBSR is the most well-known Western clinical adaptation of mindfulness meditation for use as a wellness strategy
  • It was developed by Jon Kabat-Zinn, a molecular biologist at the University of Massachusetts.
  • MBSR was meant to be a adjunctive or “complementary” treatment to medical care.    Recognizing the role of the mind in physical illness Kabat-Zinn’s approach was to introduce mindfulness disciplines to patients’ treatment regimens as a means for enhancing recovery. 
  • The MBSR program he developed consisted of an 8-week course of meditation type exercises, homework, and class discussions.  Early research showed promising results and the program was successfully disseminated around the world
Mindfulness Based Stress Reduction (MBSR) has been Successfully Adapted Clinical Conditions to Help:
  • Anxiety Disorders
  • Major Recurrent Depression
  • Chronic Headache
  • Chronic Back Pain
  • Substance Abuse Relapse
  • Eating Disorders
  • Impulse Control Issues
  • Aggression
Mindfulness-Based Therapies
As mindfulness has gained popularity, a growing number of therapies have integrated it and other aspects of Buddhist psychology into their approach
Mindfulness training alone might not be sufficient to treat complex trauma and other mental health issues leading to the creation of a “hybrid approach” combining western and mindfulness methods.
  • Acceptance and Commitment Therapy (Hays, 2011) Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy commonly described as a form of cognitive-behavior therapy or of clinical behavior analysis (CBA). Retrieved July 2016, Source: https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy
  • Dialectical Behavioral Therapy (DBT, Linehan, 1993) Dialectical behavior therapy (DBT) is a therapy designed to help people change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, and substance abuse. Retrieved July 2016, Source: https://en.wikipedia.org/wiki/Dialectical_behavior_therapy
  • Mindfulness-based cognitive therapy (MBCT; Segal et al 2002)
  • Mindfulness-based relapse prevention (MBRP; Bowen, Chawla, and Marlatt, 2011)
  • Mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982)
  • EMDR: (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal.  EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. Retrieved July (2016) Source: http://www.emdr.com/what-is-emdr/
Benefits:
  • Increased Mindfulness – especially beneficial for mental health outcomes
  • Reduction in Repetitive Negative Thinking- worry (about future) and rumination (about past)
  • Self-compassion
  • Reduction in cognitive and emotional reactivity – the extent to which mild stress activates/re-activates negative thinking and emotional distress
  • Psychological flexibility – the ability to be fully present with thoughts, feelings, and experiences in the present moment (Gu et al, 2014)
The therapist’s own mindfulness (paying close attention, non-judgmental attitude, and compassion) can positively contribute to a client’s outcome in treatment
  • Increase quality of therapeutic relationship
  • Maintain attunement with client
  • Activates healthy attachment and trust
  • Reduces therapist counter-transference
  • Reduces therapist “burnout”
  • Adapted from “Mindfulness-oriented Interventions for Trauma”; Eds Follette, Briere, Rozelle, Hopper, and Rome, 2015
Yoga
The word "yoga" comes from the Sanskrit root "yuj", which means "to yoke" the spirit and physical body together.
Yoga has evolved over thousands of years to embrace a wide range of styles and disciplines.
It is considered a mindfulness practice with its emphasis on movement and breath.  
Yoga and Mental Health:
  • Yoga can be effective in reducing symptoms of depression, anxiety, PTSD, and Schizophrenia.
  • Yoga-based practices may provide relief for symptoms left untreated through common treatments such as psychopharmacology and psychotherapy.
  • Yoga breathing is probably one of the most important components that can be useful in the treatment of anxiety and PTSD.
  • Yoga breathing (pranayama) requires a person to inhale deeply through the nose into the lungs. This alone is a very calming, mindful activity that can decrease stress.
  • Yoga has few contraindications and few side effects.
  • Yoga may be a helpful complementary treatment for psychiatric disorders.
Hypnosis:
Hypnosis -- or hypnotherapy -- uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of awareness that is sometimes called a trance. The person's attention is so focused while in this state that anything going on around the person is temporarily blocked out or ignored. In this naturally occurring state, a person may focus his or her attention -- with the help of a trained therapist -- on specific thoughts or tasks. Source: http://www.webmd.com/anxiety-panic/guide/mental-health-hypnotherapy
Biofeedback:
Biofeedback is a method that uses the mind to control a body function that the body normally regulates automatically, such as skin temperature, muscle tension, heart rate, or blood pressure.
When you are first learning biofeedback, you will have sensors attached to your body and to a monitoring device. This provides instant feedback on a body function (for example, your skin temperature). The biofeedback therapist will then teach you physical and mental exercises that can help you control the function. The results are displayed on the monitor while you learn how to control that function. The monitor beeps or flashes when you achieve the desired change in that body function (such as increasing skin temperature or reducing muscle tension).
Two types of biofeedback are:
  • Electromyography (EMG). This type of biofeedback uses a device that measures muscle tension while you practice a relaxation technique, such as meditation, progressive muscle relaxation, or visualization.
  • Peripheral temperature or hand temperature biofeedback. This type of biofeedback uses a device that measures the skin temperature of your hands while you try to increase it, often through visualization or guided imagery. For instance, you may listen to a tape that stirs images of blood flowing to your hands. Increasing blood flow to the hands makes the hands warmer.
Learning biofeedback requires several sessions in a biofeedback lab or other setting. Most people can have success with biofeedback by the time they complete 12 sessions. Home feedback units are also available. With practice, many people may be able to learn to influence their muscle tension or blood flow without the help of the feedback monitor. People most often use biofeedback to control problems related to stress or blood flow, such as headaches, high blood pressure, and sleep disorders. Using it may also help control long-term (chronic) pain.
Labyrinths:
A labyrinth is a pattern of pathways that weave in a circle around a central point. You walk through the pathways to get to the center retrieved July 2016. Source: http://www.webmd.com/balance/guide/labyrinths-for-modern-stresses. Labyrinths are often utilized by spiritual care practitioners and health care clinicians in order to support reflection, stress reduction, and the exploration of personal wellness in a sacred setting. Heard CP1, Scott J2, Yeo S. (2015.) “Walking the Labyrinth: Considering Mental Health Consumer Experience, Meaning Making, and the Illumination of the Sacred in a Forensic Mental Health Setting.” J Pastoral Care Counsel. Dec;69(4):240-50. doi: 10.1177/1542305015616102. Retrieved July 2016. Source: http://www.ncbi.nlm.nih.gov/pubmed/26631524
Massage:
Gentle, nurturing touch reduces stress, promotes relaxation and quiets and calms the mind and body. Massage is known to improve circulation, support the immune system, and promote healing.
Dance/movement therapy (DMT) in USA/ Australia or dance movement psychotherapy (DMP) in the UK is the psychotherapeutic use of movement and dance to support intellectual, emotional, and motor functions of the body. As a form of expressive therapy, DMT looks at the correlation between movement and emotion. Source: https://en.wikipedia.org/wiki/Dance_therapy
Art therapy: is defined by the American Art Therapy Association as “a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. Source: http://www.psychiatrictimes.com/bipolar-i-disorder/art-therapy-patient-bipolar-disorder-pictures-speak-more-thousand-words.
Animal Assisted Therapy/Pet Therapy: a goal-directed intervention in which an animal is incorporated as an integral part of the clinical health-care treatment process. AAT is delivered or directed by a professional health or human service provider who demonstrates skill and expertise regarding the clinical applications of human-animal interactions.” Source: http://psychcentral.com/lib/the-truth-about-animal-assisted-therapy/
Prayer: Prayer is the spiritual exercise that allows people to communicate directly with an object of worship, a greater being, or their God. Prayer is used by many to have a positive impact on mood and mental health; diminish feelings of loneliness and reduce stress and anxiety. Sources: http://psychcentral.com/blog/archives/2014/09/18/new-study-examines-the-effects-of-prayer-on-mental-health/; and, http://adrenalfatiguesolution.com/faith-and-stress/
Guided imagery therapy is a cognitive-behavioral technique in which a client is guided in imagining a relaxing scene or series of experiences. http://www.minddisorders.com/Flu-Inv/Guided-imagery-therapy.html
Compassion: is defined as the emotional response when perceiving suffering and involves an authentic desire to help. Practicing compassion has been demonstrated to increase daily positive emotions, reduce depressive symptoms, and increase life satisfaction. Source: http://www.psychologicalscience.org/index.php/publications/observer/2013/may-june-13/the-compassionate-mind.html
Labyrinths: A labyrinth is a pattern of pathways that weave in a circle around a central point. You walk through the pathways to get to the center retrieved July 2016 Source: http://www.webmd.com/balance/guide/labyrinths-for-modern-stresses. Labyrinths are often utilized by spiritual care practitioners and health care clinicians in order to support reflection, stress reduction, and the exploration of personal wellness in a sacred setting. Heard CP1, Scott J2, Yeo S. (2015.) “Walking the Labyrinth: Considering Mental Health Consumer Experience, Meaning Making, and the Illumination of the Sacred in a Forensic Mental Health Setting.” J Pastoral Care Counsel. Dec;69(4):240-50. doi: 10.1177/1542305015616102. Retrieved July 2016. Source: http://www.ncbi.nlm.nih.gov/pubmed/26631524
Massage: Gentle, nurturing touch reduces stress, promotes relaxation and quiets and calms the mind and body. Massage is known to improve circulation, support the immune system, and promote healing.
Energy Therapy: Healing Touch, Reiki, Qi Gong, T’ai Chi Chuan, Acupuncture, Acupressure, Psychological Acupressure, Reflexology:
Energy work is based on a fundamental understanding that everything in the universe is made up of energy. It is the life force of our cells, glands, and systems of our body. Energy practices work to enhance the body’s own ability to bring its energy to balance, restoring a sense of ease and well-being.
Reiki:  A healing technique based on the principle that the therapist can channel energy into the patient by means of touch, to activate the natural healing processes of the patient's body and restore physical and emotional well-being.
Reflexology: An ancient therapeutic practice of applying light pressure and gentle stimulation to sensor reflexes on the feet, inducing a natural state of relaxation that helps to improve the flow of energy and promote the healing process.
T’ai Chi and Qi Gong: Tai chi and qi gong (say "chee goong") are traditional Chinese movement exercises. They are based on two ideas:
  • Energy, called qi or chi, flows through the body along "energy pathways" called meridians. If the flow of chi is blocked or unbalanced at any point on a pathway, it is thought that you may become ill. You do tai chi and qi gong to increase energy (chi or qi) flow and improve health through gentle, graceful, repeated movements.
  • Nature, including the body, consists of opposing forces called yin and yang. Good health results when these forces are in balance. You do tai chi and qi gong movements in an attempt to help restore the body's balance of yin and yang.
Tai chi is a series of movements done either very slowly or quickly to help move the body's chi. People use tai chi as a way to combine meditation and movement and to improve and maintain health.
Qi gong involves different movements that may be done in different orders. Some common qi gong movements include raising and lowering the arms, moving the head from side to side, and gently rubbing the ears, feet, and hands.
People may use tai chi and qi gong to improve posture, balance, coordination, endurance, and flexibility and to maintain good health and quality of life. Source: http://connecticut.networkofcare.org/mh/library/article.aspx?hwid=aa106255spec&search=tai chi
Acupuncture and Acupressure: Acupuncture is a form of traditional Chinese medicine that has been practiced for centuries. It's based on the theory that energy, called chi (say "chee"), flows through and around your body along pathways called meridians.
Acupuncturists believe that illness occurs when something blocks or unbalances your chi.
Acupuncture is a way to unblock or influence chi and help it flow back into balance.
Acupuncture is done by putting very thin needles into your skin at certain points on your body. This is done to influence the energy flow. Sometimes heat, pressure, or mild electrical current is used along with needles.
People use acupuncture to relieve pain and treat certain health conditions. You can use it by itself or as part of a treatment program. Studies have found promising results for the use of acupuncture to treat nausea and vomiting related to pregnancy, chemotherapy, and post-surgery pain. Acupuncture also may be useful for drug addiction. Acupuncture may help reduce symptoms of withdrawal after a person stops taking a drug he or she is addicted to. It may also help prevent a relapse. More studies are needed to learn about the benefits of acupuncture. Source: http://connecticut.networkofcare.org/mh/library/article.aspx?hwid=aa77639spec&search=acupuncture

Traditional Chinese Medicine: TCM is considered a Complementary Alternative Modality, and TCM principles are applicable to the treatment of psychiatric disorders. Acupuncture and other TCM treatments are dependent on restoration of balance. It is asserted that the nature of any entity, living or not, is determined by the intrinsic balance between opposing states, Yin and Yang. Disturbances in balance result in changes in nature, often expressed in living systems in the form of symptoms or signs of disease. TCM treatments are intended to restore balance. Balance is accomplished by influencing the vital energy, the Qi. Steven K.H. Aung, MD, OMD, PhD, FAAFP, CM,1 Heather Fay, MD,2 and Richard F. Hobbs,III, MD, FAAFP, FAAMA. (2013.) “Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases.” Med Acupunct. Dec 1; 25(6): 398–406.
doi:  10.1089/acu.2013.1007 PMCID: PMC3870484 Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870484/
Ayurvedic medicine: was developed in India over 3000 years ago and is the oldest medical system to have survived until the present time.  It sees each individual as having a unique mind-body constitution and set of life circumstances. It is similar to traditional Chinese medicine in believing that matter and energy are the same thing. Treatment in an ayurvedic system is holistic, involving natural medicine, massage, diet and the regulation of lifestyle. Ayurveda has been used for the treatment of schizophrenia.  Retrieved: July 2016. Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014192/
Homeopathy: Homeopathy, or homeopathic medicine, is a medical philosophy and practice based on the idea that the body has the ability to heal itself. Homeopathic medicine views symptoms of illness as normal responses of the body as it attempts to regain health. Source: http://www.webmd.com/balance/guide/homeopathy-topic-overview

Naturopathy: Naturopathic medicine (or naturopathy) is based on the belief that the body can heal itself. It aims to improve health, prevent disease, and treat illness through the use of organic foods and exercise; a healthy, balanced lifestyle; and the use of treatments from other areas of complementary medicine. (These treatments include ayurveda, homeopathy, and herbal therapies.) http://www.webmd.com/allergies/tc/naturopathic-medicine-topic-overview

Osteopathy: Osteopathic medicine emphasizes overall health and the relation among the body's nerves, muscles, bones, and organs. Osteopathic physicians (also called doctors of osteopathic medicine, or DOs) base diagnosis and treatment on the idea that the body's systems are interconnected. Instead of treating specific symptoms or illnesses, DOs regard and treat the body as an integrated whole. Osteopathic medicine focuses on disease prevention and health maintenance. http://www.webmd.com/arthritis/tc/osteopathy-topic-overview

Manipulation/Chiropractic: Chiropractors use hands-on spinal manipulation and other alternative treatments, the theory being that proper alignment of the body's musculoskeletal structure, particularly the spine, will enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support.

Nutrition: Recent evidence suggests that good nutrition is essential for our mental health and that a number of mental health conditions may be influenced by dietary factors.  Evidence indicates that food plays an important contributing role in the development, management and prevention of specific mental health problems such as depression, schizophrenia, attention deficit hyperactivity disorder, and Alzheimer’s disease https://www.mentalhealth.org.uk/a-to-z/d/diet-and-mental-health.
Exercise/Fitness: Exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem and cognitive function. Exercise has also been found to alleviate symptoms such as low self-esteem and social withdrawal. Health benefits from regular exercise include the following:
1. Improved sleep
2. Increased interest in sex
3. Better endurance
4. Stress relief
5. Improvement in mood
6. Increased energy and stamina
7. Reduced tiredness that can increase mental alertness
8. Weight reduction
9. Reduced cholesterol and improved cardiovascular fitness