460 Module 2, Winter 2006 Philosophy and Basis for Alt / Comp [ ** Note: there are a few slides with notes below them ] Street Lamp Interference SLI & SLIders Appliances such as lamps and TVs go on and off
without being touched Light-bulbs constantly blow when the SLIder tries to turn them off or on Volume levels change on TVs, radios, and CD players Watches stop working Children's electronic toys start by themselves when the SLIder is present Credit cards and other magnetically encoded cards are damaged or erased when in their
possession Mind-Body Medicine implications re chapter 3 ancient Egyptian vaginal speculum Historical Background & Precedents re HealthMedicine
Flexner Report of 1910 Cited as THE most important event in the history of Cdn and American med educ Abraham Flexner was sec school teacher who went on to do grad work in educ research w Carnegie Foundation Historical Background &
Precedents Report was effort to reform med schools that were without standards and more forprofit than educ Virtually guillotined all other forms of med ed toward German tradition of strong biomed sciences and hands-on clinical tr Thus in N America, western medicine flourished, trad medicine/healing went underground
1970s Resurgence of interest in altern thers Chiropractic med took initiative along with osteopathic MDs Mainstream allopathic med continued to ignore alt med 1993 & 1998 Eisenberg US Studies classic in the
field NEJM in 93 natl phone survey to determine prevalence of use of unconventional therapies (ex: acu or chiro) Random sample of 1539 adults 16 commonly used interventions 1 in 3 persons used 1 or more Utherapies and 1/3 of these saw an Utherapy provider 1993 Eisenberg US Study
This 1/3 made 19 visits per year with avg cost of $27.60 per visit Use varied by SES: white, 25-49 yrs with hier educ & hier income leaders in usage Majority used U-ths for chronic conditions 72% did not tell their MD about U-th visits Extrap to US pop means 425 million visits to alt med vs 388 mill to allo med in 1990
98 Eisenberg JAMA follow-up from 93 Used same process as 93, w 2055 adults Incr from 33 to 42 % in 97 used herbal, massage, megavits, self-help groups, folk remedies, energy healing & homeopathy chronic conditions
A 47 % incr in use of alt med 98 Eisenberg Incr was due to incr proportion seeking alt med, not to more visits by those already using alt med 629 million total visits by US pop to alt med practitioners in 97 Probably a $27 billion out-of-pocket on alt med in 97 thus equal to all
out-of-pocket MD expenses in US The Prevalence of CAM in Cdn Med Schools: 1998 CMAJ Study 98 survey of all 16 Cdn med schools to determine what educ is provided re UG med ed in alt med Covered 18 comp therapies selected from Office of Alt Med, Natl Institutes of Health (acupunc
to reflex) Most schools do teach alt med but in one course; done via lectures 1998 CMAJ Study Most consistently taught are acupunc and homeopathic med (10 schools) Then, in descending order: herbal; chiro; naturop; TCM and biofeedback; osteopathy; shamanism, mass ther &
therap touch; finally, yoga, aromatherapy, reflex and native trad healing only 1 used spiritual healing 1998 CMAJ Study Only 2 schools provide instruction in use of alt meds (yoga, mt, chiro) w most stating MD could seek tr by pref Schools felt they should provide general conceptual overview
**Need to understand alt med as part of patients health care belief system Very little alt med tr in UK; most of USs 125 med schools incorp some alt courses Readings to Date Read for Module 1: Text chapters 1 & 3 1st reading on web site under Links,
Folk Remedies (pdf) Print the Glossary of Terms from Links on web site Read for Module 2: Text chapters 2 & 4; read 2 for Thursday Are you Considering Using CAM from Links Irwin & Morrow article Folk Remedies Among Ethnic Subgroups ~ reading
Folk medicine in 99 included ? Data source for the study ? Importance of individuals cultural beliefs and practices ~ used Health Belief Model (HBM) to summarize these [ perceived benefit vs perceived threat factor in selecting health action] Folk Remedies Among Ethnic Subgroups ~
commonalities: Understanding illness & making decisions about treatment action: ~ cause of illness an imbalance ~ emphasis on personal responsibility ~ complex, multicausal or holistic view of dis-ease etiology
~ various kinds of energy Folk Remedies Among Ethnic Subgroups ~ interpretations: Findings re SES factors ? Effectiveness of Folk Rs ? Note problems of cost in study designs for effectiveness data *lack of scientific evidence
-?? Folk Remedies Among Ethnic Subgroups ~ clinical implics: Cultural beliefs MUST be considered Open communic betw clinicians and patients is critical Safety and efficacy of concern to both Major conclusion: Folk medical practices
arise out of the synergy of individual beliefs, cultural beliefs, and biomedical concepts about illness and treatment Most folk remedies harmless bias? And some serious side effects Note the recommendations to the Am Medical Assoc Text chapter 1: Basic Principles
The Hippocratic Oath ~ Dr Louis Lasagna! outdated, degrading, and inappropriate for the modern reality of medicine ? Note distinctions betw holistic and reductionistic; Flexner Report; Heroic medicine; resurgence of traditional med Key factors etc in the concept of Integrative Medicine ~ any questions about those ?
Text chapter 3: Mind-Body Medicine What is the essence or basic premise of M-B Med ? How has it become AND how is it integrative ? What are some examples of M-B Med ? What are the characteristics of M-B Med? What evidence do we have re M-B Med ? What can you interpret about M-B Med from
the 4 cases presented in the chapter ? Text Chapter 3: Mind-Body Med: 4 Primary Human Intelligence Systems Thought; Emotions; Body; Perceptions These 4 are congruent Means a change in one is mirrored in all others Just another way of looking at mindbody as more than an intellectual mind
in a physical body Behavioural Interventions: Asking Questions Coaching Example Defeat [ defeet !] For every winner, there
are dozens of losers: odds are youre one of them The key to life is balance Life Coaching Counselling, or therapy, often looks to the past
in order to discover, heal and understand. Life coaching, on the other hand, looks to the future in order to make a good life even better. In coaching, the starting point is the client's desire for personal and /or professional change Coaching focuses on forwarding all aspects of the client's ordinary life toward an extraordinary life Coaching is not about how you came to be who you are; it's about getting you from where you
are now to the future that you want What we have in our lives _______________________________ -10 +10 MUST eliminate REALLY want
0 really, ? Most fulfilling ? life possibilities ?
L I F E with Style Stress & Struggles Relationshi p Client
Coach Co-Active Coaching: Either/or vs AND Co-active means acting in concurrence, united in action Co-active coaching like hiring a friend, having a personal navigator Fundamental skill in co-active
coaching is The Co-Active Coaching Model Dance in the moment Agenda from client
Listening Curiosit y Intuitio n Fulfillment Balance Process
Self-management Whole life is Designed Alliance Action / learning
The Coaches Training Institute NRCW Evidence Base for Coaching ? Thousands of testimonials Irwin-Morrow reqd reading What validates this model
according to your reading ? Fulfillment, Balance, & Process Person is always somewhere in her/his life and always in flow of that life Coach takes client somewhere juicy or rich or compelling, that is into: ~ Fulfillment, or
~ Balance, or ~ Process The Bigger Game Company The SIZE and quality of the game you play designs who you are becoming
So, what skills for coaching ? Listening Curiosity Intuition Forwarding into action / deepening athletes learning [ self management ] For the sake of what ? living fully
into the life each person wants Coaching and CAM / Integration Coaching as an alternative for healthy living, living into full human potential More a behavioural intervention than a therapy reading offers a way of providing
evidence for efficacy of coaching Cannot do randomized, double-blind study We do need more ways to validate coaching
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