The growing popularity and use of therapeutic touch (TT) is an issue that has generated controversy and concern within the medical community. While anecdotal and traditional scientific evidence suggest that TT would be an advantageous addition for clinics and hospitals to include in their armamentarium of complementary interventions within the realm of traditional medicine, TT has not become widely available in the U.S. One reason for the lack of availability may be the dearth of conclusive scientific support for TT's efficacy and, therefore, its inclusion in clinic and hospital treatment planning would give it the appearance of legitimate practice, which it may not yet deserve. Whether or not deserved, if TT were added to hospital and clinic treatment protocols without substantial scientific support, it would be thought to have the implicit support of the scientific community, at which point the question of its efficacy would be moot in the minds of many people; thus patients would utilize it, because they believe it works rather than because it works. Since TT has not yet been scientifically proven as per Western standards, leaders of the health care community are likely wary of lending support to TT at this time. If TT can be found to be a scientifically sound therapeutic technique, then it will be more readily accepted in the health care community. This paper reviews TT.

ScientificWorldJournal. 2006 Aug 25;6:2188-95. Huff MB, McClanahan KK, Omar HA.

Division of Adolescent Medicine, Department of Pediatrics, University of Kentucky, Lexington, KY, USA.

In order to make a recommendation about the use of hypnosis as adjuvant therapy in the treatment of breast cancer, 2 studies assessing the immunological effects of hypnosis in patients with early stage breast cancer were evaluated: (a) an experiment that taught hypnotic guided-imagery therapy to patients and (b) one that provided participants with home visits and autogenic training. Both investigations demonstrated improvement in depression and increased natural killer (NK) cell counts after 2 months of hypnosis treatment. However, neither study determined the clinical significance of hypnosis in the setting of cancer, and therefore future experiments are needed to relate the immune-mediated effects of hypnosis to hard clinical outcomes like survival rates.

Int J Clin Exp Hypn. 2007 Oct;55(4):411-25

Hudacek KD. University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

There are profound maternal effects on individual differences in defensive responses and reproductive strategies in species ranging literally from plants to insects to birds. Maternal effects commonly reflect the quality of the environment and are most likely mediated by the quality of the maternal provision (egg, propagule, etc.), which in turn determines growth rates and adult phenotype. In this paper we review data from the rat that suggest comparable forms of maternal effects on defensive responses stress, which are mediated by the effects of variations in maternal behavior on gene expression. Under conditions of environmental adversity maternal effects enhance the capacity for defensive responses in the offspring. In mammals, these effects appear to 'program' emotional, cognitive and endocrine systems towards increased sensitivity to adversity. In environments with an increased level of adversity, such effects can be considered adaptive, enhancing the probability of offspring survival to sexual maturity; the cost is that of an increased risk for multiple forms of pathology in later life.

Biol Psychol. 2006 Jul;73(1):72-89. Epub 2006 Feb 28.

Zhang TY, Bagot R, Parent C, Nesbitt C, Bredy TW, Caldji C, Fish E, Anisman H, Szyf M, Meaney MJ.

McGill Program for the Study of Behavior, Genes and Environment, McGill University, Canada.

Hypnosis has been shown to be efficacious in a range of clinical conditions, including the management of chronic pain. However, not all individuals are able to enter a hypnotic state, thereby limiting the clinical utility of this technique. We sought to determine whether hypnotic susceptibility could be increased using three methods thought to facilitate relaxation, with particular interest in an EEG neurofeedback protocol which elevated the theta to alpha ratio. This was compared with progressive muscle relaxation and self-hypnosis. Ten subjects with moderate levels of susceptibility (2-7/12) were randomly assigned to each condition and assessed for hypnotic susceptibility prior to and upon completion of 10 sessions of training. Hypnotic susceptibility increased post-training in all groups, providing further evidence that operant control over the theta/alpha ratio is possible, but contrary to our predictions, elevation of the theta/alpha ratio proved no more successful than the other interventions. Nonetheless, all three techniques successfully enhanced hypnotic susceptibility in over half of the participants (17/30), a similar incidence to that reported using other methods. As previously reported, the majority who were not susceptible to modification were at the lower levels of susceptibility, and the greater increases tended to occur in the more susceptible subjects. However, here enhancement was disclosed in some at low levels, and capability was found of reaching high levels, both features not typically reported. Further research is warranted.

Brain Res Bull. 2006 Dec 11;71(1-3):83-90. Epub 2006 Sep 1.

Batty MJ, Bonnington S, Tang BK, Hawken MB, Gruzelier JH.

Imperial College, London W6 8RP, UK.

Hypnotically assisted treatments have been used to reduce stress, improve gastrointestinal motility, strengthen immune function, and potentially reduce inflammation. Such treatments may also help reduce disease flares and improve quality of life in inflammatory bowel diseases (IBD). The authors report the results of a case series of 8 white female patients with inactive IBD. All participants initiated and completed treatment, supporting the general acceptability of hypnotically assisted treatment among IBD patients. There was a significant improvement in IBD-quality of life scores for the group posttreatment, t(7) = -3.38, p = .01, with a mean improvement in quality of life of 29 points with significant changes in all 4 subscales. No negative effects of treatment were found.

Int J Clin Exp Hypn. 2007 Oct;55(4):457-66

Keefer L, Keshavarzian A. Rush University Medical Center, Chicago, Illinois, USA.

BACKGROUND: Neurofeedback (NF) is a form of behavioural training aimed at developing skills for self-regulation of brain activity. Within the past decade, several NF studies have been published that tend to overcome the methodological shortcomings of earlier studies. This annotation describes the methodical basis of NF and reviews the evidence base for its clinical efficacy and effectiveness in neuropsychiatric disorders. METHODS: In NF training, self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. In frequency training, activity in different EEG frequency bands has to be decreased or increased. Training of slow cortical potentials (SCPs) addresses the regulation of cortical excitability. RESULTS: NF studies revealed paradigm-specific effects on, e.g., attention and memory processes and performance improvements in real-life conditions, in healthy subjects as well as in patients. In several studies it was shown that children with attention-deficit hyperactivity disorder (ADHD) improved behavioural and cognitive variables after frequency (e.g., theta/beta) training or SCP training. Neurophysiological effects could also be measured. However, specific and unspecific training effects could not be disentangled in these studies. For drug-resistant patients with epilepsy, significant and long-lasting decreases of seizure frequency and intensity through SCP training were documented in a series of studies. For other child psychiatric disorders (e.g., tic disorders, anxiety, and autism) only preliminary investigations are available. CONCLUSIONS: There is growing evidence for NF as a valuable treatment module in neuropsychiatric disorders. Further, controlled studies are necessary to establish clinical efficacy and effectiveness and to learn more about the mechanisms underlying successful training.

J Child Psychol Psychiatry. 2007 Jan;48(1):3-16.

Heinrich H, Gevensleben H, Strehl U.

Child & Adolescent Psychiatry, University of Erlangen-Nürnberg, Germany. hheinri@arcor.de

Fatigue is an extremely common side effect experienced during cancer treatment and recovery. Limited research has investigated strategies stemming from complementary and alternative medicine to reduce cancer-related fatigue. This research examined the effects of Reiki, a type of energy touch therapy, on fatigue, pain, anxiety, and overall quality of life. This study was a counterbalanced crossover trial of 2 conditions: (1) in the Reiki condition, participants received Reiki for 5 consecutive daily sessions, followed by a 1-week washout monitoring period of no treatments, then 2 additional Reiki sessions, and finally 2 weeks of no treatments, and (2) in the rest condition, participants rested for approximately 1 hour each day for 5 consecutive days, followed by a 1-week washout monitoring period of no scheduled resting and an additional week of no treatments. In both conditions, participants completed questionnaires investigating cancer-related fatigue (Functional Assessment of Cancer Therapy Fatigue subscale [FACT-F]) and overall quality of life (Functional Assessment of Cancer Therapy, General Version [FACT-G]) before and after all Reiki or resting sessions. They also completed a visual analog scale (Edmonton Symptom Assessment System [ESAS]) assessing daily tiredness, pain, and anxiety before and after each session of Reiki or rest. Sixteen patients (13 women) participated in the trial: 8 were randomized to each order of conditions (Reiki then rest; rest then Reiki). They were screened for fatigue on the ESAS tiredness item, and those scoring greater than 3 on the 0 to 10 scale were eligible for the study. They were diagnosed with a variety of cancers, most commonly colorectal (62.5%) cancer, and had a median age of 59 years. Fatigue on the FACT-F decreased within the Reiki condition (P=.05) over the course of all 7 treatments. In addition, participants in the Reiki condition experienced significant improvements in quality of life (FACT-G) compared to those in the resting condition (P <.05). On daily assessments (ESAS) in the Reiki condition, presession 1 versus postsession 5 scores indicated significant decreases in tiredness (P <.001), pain (P <.005), and anxiety (P<.01), which were not seen in the resting condition. Future research should further investigate the impact of Reiki using more highly controlled designs that include a sham Reiki condition and larger sample sizes.

Integr Cancer Ther. 2007 Mar;6(1):25-35.

Tsang KL, Carlson LE, Olson K.

Department of Psychology, University of Calgary, Alberta, Canada.

To provide a review of the rationale and evidence supporting three frequently used psychosocial interventions for chronic pain: cognitive-behavioral therapy, operant behavioral therapy and self-hypnosis training. We also review recent work in these areas, with an emphasis on the 2006 publishing year. RECENT FINDINGS: Recent clinical trials and laboratory work continue to support the use of cognitive-behavioral therapy and operant behavioral therapy as adjunctive treatments for chronic pain. Notable areas of new research include a novel program of systematic exposure to pain-related fear (such as fear of reinjury) and the adaptation of cognitive-behavioral therapy for special pain groups (e.g. juveniles and those with pain secondary to physical disability). Regarding self-hypnosis training, recent work suggests that hypnosis can provide temporary pain relief to the majority of individuals with chronic pain and that a substantial minority of these patients experience a clinically significant reduction in baseline pain over time. SUMMARY: Cognitive-behavioral therapy and operant behavioral therapy treatments focus on factors that exacerbate or maintain suffering in chronic pain, and should be considered as part of a multidisciplinary treatment paradigm. Self-hypnosis training may also be of benefit, although it appears to be no more (or less) effective than other relaxation strategies that include hypnotic elements.

Curr Opin Anaesthesiol. 2007 Oct;20(5):485-9.

Molton IR, Graham C, Stoelb BL, Jensen MP. aDepartment of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, USA bDepartment of Psychology, Pacific Lutheran University, Tacoma, Washington, USA.

Neurofeedback (NF) is an electroencephalographic (EEG) biofeedback technique for training individuals to alter their brain activity via operant conditioning. Research has shown that NF helps reduce symptoms of several neurological and psychiatric disorders, with ongoing research currently investigating applications to other disorders and to the enhancement of non-disordered cognition. The present article briefly reviews the fundamentals and current status of NF therapy and research and illustrates the basic approach with an interim report on a pilot study aimed at developing a new NF protocol for improving cognitive function in the elderly. EEG peak alpha frequency (PAF) has been shown to correlate positively with cognitive performance and to correlate negatively with age after childhood. The present pilot study used a double-blind controlled design to investigate whether training older individuals to increase PAF would result in improved cognitive performance. The results suggested that PAF NF improved cognitive processing speed and executive function, but that it had no clear effect on memory. In sum, the results suggest that the PAF NF protocol is a promising technique for improving selected cognitive functions.

Clin Neuropsychol. 2007 Jan;21(1):110-29.

Angelakis E, Stathopoulou S, Frymiare JL, Green DL, Lubar JF, Kounios J.

Department of Psychology, Drexel University, Philadelphia, PA 19102-1192, USA.

Touch is considered a core aspect of care provision and therapeutic relationships. Therapeutic touch allows nurses to facilitate healing and forge therapeutic relationships through touch or non-touch and maintain channels of communication often lost in dementia as the disease progresses. This article reports the findings of a research project to examine the effectiveness of therapeutic touch in dementia care.

Nurs Older People. 2006 Dec;18(11):27-30. Related Articles, Links

Doherty D, Wright S, Aveyard B, Sykes M.

Faculty of Health, Staffordshire University, Blackheath.

Recent advances in functional magnetic resonance imaging (fMRI) data acquisition and processing techniques have made real-time fMRI (rtfMRI) of localized brain areas feasible, reliable and less susceptible to artefacts. Previous studies have shown that healthy subjects learn to control local brain activity with operant training by using rtfMRI-based neurofeedback. In the present study, we investigated whether healthy subjects could voluntarily gain control over right anterior insular activity. Subjects were provided with continuously updated information of the target ROI's level of activation by visual feedback. All participants were able to successfully regulate BOLD-magnitude in the right anterior insular cortex within three sessions of 4 min each. Training resulted in a significantly increased activation cluster in the anterior portion of the right insula across sessions. An increased activity was also found in the left anterior insula but the percent signal change was lower than in the target ROI. Two different control conditions intended to assess the effects of non-specific feedback and mental imagery demonstrated that the training effect was not due to unspecific activations or non feedback-related cognitive strategies. Both control groups showed no enhanced activation across the sessions, which confirmed our main hypothesis that rtfMRI feedback is area-specific. The increased activity in the right anterior insula during training demonstrates that the effects observed are anatomically specific and self-regulation of right anterior insula only is achievable. This is the first group study investigating the volitional control of emotionally relevant brain region by using rtfMRI training and confirms that self-regulation of local brain activity with rtfMRI is possible.

Neuroimage. 2007 Apr 15;35(3):1238-46. Epub 2007 Jan 31.

Caria A, Veit R, Sitaram R, Lotze M, Weiskopf N, Grodd W, Birbaumer N.

Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University of Tübingen, Tübingen, Germany. andrea.caria@uni-tuebingen.de

Healing Touch is a complementary therapy that can be used as a nursing intervention for patients in critical care settings. Use of healing touch may facilitate positive patient outcomes. However, further research is needed to adequately evaluate the effectiveness of healing touch in the critical care setting. The use of Healing Touch in critically ill patients is explored in this article.

Dimens Crit Care Nurs. 2007 Jan-Feb;26(1):9-14. Related Articles, Links

Eschiti VS.

College of Nursing, University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190, USA. valerie-eschiti@ouhsc.edu

Behavioral and cognitive improvements in children with ADHD have been consistently reported after neurofeedback-treatment. However, neurofeedback has not been commonly accepted as a treatment for ADHD. This study addresses previous methodological shortcomings while comparing a neurofeedback-training of Theta-Beta frequencies and training of slow cortical potentials (SCPs). The study aimed at answering (a) whether patients were able to demonstrate learning of cortical self-regulation, (b) if treatment leads to an improvement in cognition and behavior and (c) if the two experimental groups differ in cognitive and behavioral outcome variables. SCP participants were trained to produce positive and negative SCP-shifts while the Theta/Beta participants were trained to suppress Theta (4-8 Hz) while increasing Beta (12-20 Hz). Participants were blind to group assignment. Assessment included potentially confounding variables. Each group was comprised of 19 children with ADHD (aged 8-13 years). The treatment procedure consisted of three phases of 10 sessions each. Both groups were able to intentionally regulate cortical activity and improved in attention and IQ. Parents and teachers reported significant behavioral and cognitive improvements. Clinical effects for both groups remained stable six months after treatment. Groups did not differ in behavioural or cognitive outcome.

Appl Psychophysiol Biofeedback. 2007 Jun;32(2):73-88. Epub 2007 Mar 14.

Leins U, Goth G, Hinterberger T, Klinger C, Rumpf N, Strehl U.

Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Osianderstrasse 24, 72076, Tübingen, Germany, Ulrike.leins@med.uni-tuebingen.de.

OBJECTIVES: This empirical study explored the efficacy of using Reiki treatment to improve memory and behavior deficiencies in patients with mild cognitive impairment or mild Alzheimer's disease. Reiki is an ancient hands-on healing technique reputedly developed in Tibet 2500 years ago. DESIGN: This study was a quasi-experimental study comparing pre- and post-test scores of the Annotated Mini-Mental State Examination (AMMSE) and Revised Memory and Behavior Problems Checklist (RMBPC) after four weekly treatments of Reiki to a control group. SETTINGS/LOCATION: The participants were treated at a facility provided by the Pleasant Point Health Center on the Passamaquoddy Indian Reservation. SUBJECTS: The sample included 24 participants scoring between 20 and 24 on the AMMSE. Demographic characteristics of the sample included an age range from 60 to 80, with 67% female, 46% American Indian, and the remainder white. INTERVENTIONS: Twelve participants were exposed to 4 weeks of weekly treatments of Reiki from two Reiki Master-level practitioners; 12 participants served as controls and received no treatment. OUTCOME MEASURES: The two groups were compared on pre- and post-treatment scores on the AMMSE and the Revised Memory and Behavior Problems Checklist (RMBPC). RESULTS: Results indicated statistically significant increases in mental functioning (as demonstrated by improved scores of the AMMSE) and memory and behavior problems (as measured by the RMBPC) after Reiki treatment. This research adds to a very sparse database from empirical studies on Reiki results. CONCLUSION: The results indicate that Reiki treatments show promise for improving certain behavior and memory problems in patients with mild cognitive impairment or mild Alzheimer's disease. Caregivers can administer Reiki at little or no cost, resulting in significant societal value by potentially reducing the needs for medication and hospitalization.

J Altern Complement Med. 2006 Nov;12(9):911-3. Related Articles, Links

Crawford SE, Leaver VW, Mahoney SD.

Passamaquoddy Tribe at Pleasant Point, Perry, ME, USA. phadrus@ptc-me.net

The purpose of this article is to introduce a training program that can help diabetes educators get a fresh approach to assist their clients with the diabetes complication of limited peripheral blood flow. Biofeedback-assisted relaxation training is an educational and integrative intervention that supplements traditional medical care. Biofeedback-assisted relaxation training can be taught to the patient in a single setting. The relaxation training allows peripheral blood vessels to widen, providing enhanced circulation to peripheral tissues, including nerves. The training includes an explanation of relaxation and its effects on the patient, after which the technique is practiced with the assistance of thermal biofeedback. Biofeedback is an effective physiological training modality that teaches the patient what is going on in his or her own body. As the patient relaxes correctly, peripheral blood vessels dilate and blood flow improves, resulting in increased skin temperature. The change in skin temperature is measured with a small alcohol thermometer. Consistent relaxation yields significant outcomes such as improved peripheral blood flow, a reduction in peripheral pain, enhanced healing, improved ambulation, and increased coping skills in the patient's life.

Diabetes Educ. 2007 May-Jun;33(3):442, 444-5, 447-8, 454.

Rice BI.

University of Minnesota, School of Public Health, Epidemiology Clinical Research Center, 1100 Washington Avenue S Suite 201, Minneapolis, MN 55415, USA. ricex016@umn.edu

Electroencephalogram (EEG) biofeedback, also known as neurofeedback, is a promising alternative treatment for patients with attention deficit/hyperactivity disorder (AD/HD). EEG biofeedback therapy rewards scalp EEG frequencies that are associated with relaxed attention, and suppresses frequencies associated with under- or over-arousal. In large-scale clinical trials, the efficacy of EEG biofeedback for AD/HD is comparable to that of stimulant medications. Many different EEG biofeedback protocols for AD/HD are available. Single-channel protocols developed by Lubar and interhemispheric protocols developed by the Othmers are widely practiced and supported by large-scale clinical studies.

Altern Med Rev. 2007 Jun;12(2):146-151.

Friel PN.

Forensic toxicologist; EEG biofeedback training, EEG Institute, Woodland Hills, CA. Correspondence address: Washington State Toxicology Laboratory, Forensic Laboratory Services Bureau Suit 360, 2203 Airport Way South, Seattle, WA 98134. Email: Pat.Friel@wsp.wa.gov.

Barbara has a 30 year background in the Customer Service and Sales professions. She brings with her a real world knowledge of the struggles and changing conditions that effect us all. Her belief is that every area of life should be enjoyable and rewarding, this translates to success on all levels.

She is a graduate of the Cornell University School of Industrial and Labor Relations Certificate Program on Conflict Management. In a testimonial on local television, Barbara attributed her success to incorporating this training into her daily professional and personal life.

She is also certified by the International Association of Counselors and Therapist in Hypnosis, Stress Management, Pain Management, Sales and Sports Performance, and Past Life Guidance. In December of 2002, Barbara completed her certification in Single Incident Stress Resolution.

Having conducted workshops, seminars and private sessions for over 10 years, Barbara takes great joy in passing on the proven techniques that she has fine tuned over 20 years. Her enthusiasm, positive attitude and energy is easily conveyed to participants, many have commented on the powerful changes they have accomplished.

For more information, visit www.stresstechniques.com.

Cranial electrotherapy stimulation (CES) is a well-documented neuroelectrical modality that has been proven effective in some good studies of fibromyalgia (FM) patients. CES is no panacea but, for some FM patients, the modality can be valuable. This article discusses aspects of both CES and FM and how they relate to the individual with the condition. FM frequently has many comorbidities such as anxiety, depression, insomnia and a great variety of different rheumatologic and neurological symptoms that often resemble multiple sclerosis, dysautonomias, chronic fatigue syndrome and others. However, despite long-standing criteria from the American College of Rheumatology for FM, some physicians believe there is probably no single homogeneous condition that can be labeled as FM. Whether it is a disease, a syndrome or something else, sufferers feel like they are living one disaster after another. Active self-involvement in care usually enhances the therapeutic results of various treatments and also improves the patient's sense of being in control of the condition. D-ribose supplementation may prove to significantly enhance energy, sleep, mental clarity, pain control and well-being in FM patients. A form of evoked potential biofeedback, the EPFX, is a powerful stress reduction technique which assesses the chief stressors and risk factors for illness that can impede the FM patient's built-in healing abilities. Future healthcare will likely expand the diagnostic criteria of FM and/or illuminate a group of related conditions and the ways in which the conditions relate to each other. Future medicine for FM and related conditions may increasingly involve multimodality treatment that features CES as one significant part of the therapeutic regimen. Future medicine may also include CES as an invaluable, cost-effective add-on to many facets of clinical pharmacology and medical therapeutics.

Expert Rev Med Devices. 2007 Jul;4(4):489-95.

Gilula MF.

President and Director, Life Energies Research Institute, 2510 Inagua Avenue, Miami, FL 33133, USA. mgilula@mindspring.com.

The purpose of this project is to analyze music therapy (MT) referral trends from palliative care team members across nine Australian inpatient and community-based palliative care settings. For each referral 6 items were collected: referral source, reason and type; time from Palliative Care Program (PCP) admission to MT referral; time from MT referral to death/discharge; and profile of referred patient. Participants (196 female, 158 male) were referred ranging in age from 4-98 years and most were diagnosed with cancer (91%, n = 323). Nurses (47%, n = 167) referred most frequently to music therapy. The mean average time in days for all referrals from PCP admission to MT referral was 11.47 and then 5.19 days to time of death. Differences in length of time to referral ranged from 8.19 days (allied health staff) to 43.75 days (families). Forty-eight percent of referrals (48.5%, n = 172) were completed when the patient was rated at an Eastern Cooperative Oncology Group Performance (ECOG) of three. Sixty-nine percent (n = 244) were living with others at the time of referral and most were Australian born. Thirty-six percent (36.7%, n = 130) were referred for symptom-based reasons, and 24.5% (n = 87) for support and coping. Implications for service delivery of music therapy practice, interdisciplinary care and benchmarking of music therapy services shall be discussed.

J Music Ther. 2007 Summer;44(2):139-55.

Horne-Thompson A, Daveson B, Hogan B.

Calvary Health Care Bethlehem, Melbourne, Australia. thompson_anne@optusnet.com.au

Wound care is an important step in promoting wound healing, but it may cause wound care pain. This article aims to explore factors influencing wound care pain and the effectiveness of various interventions to alleviate it. Five major factors that influence wound care pain include inappropriate dressing change techniques, inflammation response, emotion, cognition, and social-cultural factors. Nurses should apply appropriate dressings and dressing change techniques to relieve wound care pain. Music therapy and aromatherapy can alleviate wound pain after dressing change. But distraction techniques should be used in conjunction with consideration of the needs of the individual subject.

Hu Li Za Zhi. 2007 Jun;54(3):87-91.

[Article in Chinese]

Chin YF.

School of Nursing, Chang Gung University, ROC. yenfan@mail.cgu.edu.tw.

The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries.

Holist Nurs Pract. 2006 Nov-Dec;20(6):263-72; quiz 273-4.

Vitale AT, O'Connor PC.

Community Medical Center, Toms River, NJ, USA. annern2@gmail.com

Primary objective: Examining the evidence from contrasting epistemological sources a case is made for the use of music as an assessment medium with patients in low awareness states. Profound brain damage can result in long-term states of altered consciousness such as vegetative and minimally conscious states. Differential diagnosis with this population is immensely complex requiring diverse approaches. Neuroimaging alone is not, as yet, sufficient to establish diagnosis in this population and must be supplemented by repeated behavioural observation methods from a skilled and diverse treatment team, as there are enormous medico-legal and ethical implications. Evidence from research in neuroimaging and the behavioural health sciences indicates that auditory stimulation can reveal residual functioning and elicit optimal behaviours in such patients, particularly when the stimulation has emotional significance. Main outcomes and results: Behavioural assessment is complicated by limbic behaviours which can be misinterpreted as purposeful emotional responses. A case vignette using music therapy in a complex case illustrates such complications. Conclusions: Given the evidence for residual auditory functioning in patients in low awareness states, music is recommended as a medium for assessment. However, professionals involved in diagnosis must take caution against misinterpreting limbic responses and attributing greater meaning to such behaviours.

Brain Inj. 2007 Jun;21(6):593-9.

Magee WL.

London and Department of Palliative Care, Institute of Neuropalliative Rehabilitation. London. UK.

This pilot study assessed the role of Healing Touch (HT), an energy-based therapy, in modulating chronic neuropathic pain and the associated psychological distress from post spinal cord injury. Twelve veterans were assigned to either HT or guided progressive relaxation for six weekly home visits. The instruments selected showed sensitivity, although there was a large variation among the groups. There was a significant difference in the composite of interference on the Brief Pain Inventory (t = -2.71, p = .035). The mean score of the fatigue subscale of the Profile of Moods decreased (ns) in the HT group and in the subscale of confusion yet remained stable in the control group. The Diener Satisfaction With Life Scale showed increased well-being in the HT group and no change in the control group. Participants reported various experiences with HT sessions indicating that it may have benefit in the complex response to chronic pain.

J Holist Nurs. 2006 Dec;24(4):231-40; discussion 241-4.

Wardell DW, Rintala DH, Duan Z, Tan G.

University of Texas Houston Hhealthcare system, USA.

This article reports on findings from a study of the accounts of people participating in music therapy as part of a programme of complementary and alternative medicine (CAM) in supportive cancer care. The article outlines the perceived effects of music therapy, which shares many characteristics with CAM therapies as well as offering a distinct contribution as a creative therapy. Hence in this article we draw on theories and writings from the sociology of CAM as well as those relating to music, healing and aesthetics in order to explore participants' accounts. The importance of identity and the role of creativity in processes of individuation are key themes emerging from the analysis.While music and creativity are often seen uncritically as resources for health and well-being, we draw attention to the challenges and complexity of diverse responses to music, framed by personal biographies that are in turn often situated within socially constructed notions of aesthetics. We argue that in research on music therapy, as well as other CAM therapies, issues of identity can be key to an understanding of questions of therapeutic impact.

Health (London). 2007 Jul;11(3):349-70.

Daykin N, McClean S, Bunt L.

University of the West of England, UK. norma.daykin@uwe.ac.uk.

Study Design. We conducted a structured review of eight mind-body interventions for older adults with chronic nonmalignant pain. Objectives. To evaluate the feasibility, safety, and evidence for pain reduction in older adults with chronic nonmalignant pain in the following mind-body therapies: biofeedback, progressive muscle relaxation, meditation, guided imagery, hypnosis, tai chi, qi gong, and yoga. Methods. Relevant studies in the MEDLINE, PsycINFO, AMED, and CINAHL databases were located. A manual search of references from retrieved articles was also conducted. Of 381 articles retrieved through search strategies, 20 trials that included older adults with chronic pain were reviewed. Results. Fourteen articles included participants aged 50 years and above, while only two of these focused specifically on persons aged >/=65 years. An additional six articles included persons aged >/=50 years. Fourteen articles were controlled trials. There is some support for the efficacy of progressive muscle relaxation plus guided imagery for osteoarthritis pain. There is limited support for meditation and tai chi for improving function or coping in older adults with low back pain or osteoarthritis. In an uncontrolled biofeedback trial that stratified by age group, both older and younger adults had significant reductions in pain following the intervention. Several studies included older adults, but did not analyze benefits by age. Tai chi, yoga, hypnosis, and progressive muscle relaxation were significantly associated with pain reduction in these studies. Conclusion. The eight mind-body interventions reviewed are feasible in an older population. They are likely safe, but many of the therapies included modifications tailored for older adults. There is not yet sufficient evidence to conclude that these eight mind-body interventions reduce chronic nonmalignant pain in older adults. Further research should focus on larger, clinical trials of mind-body interventions to answer this question.

Pain Med. 2007 May;8(4):359-75.

Morone NE, Greco CM.

Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a mindfulness procedure, Meditation on the Soles of the Feet , were tested as a cognitive behavioral intervention for verbal and physical aggression in 3 individuals who had frequently been readmitted to an inpatient psychiatric hospital owing to their anger management problems. In a multiple baseline across subjects design, they were taught a simple meditation technique, requiring them to shift their attention and awareness from the anger-producing situation to the soles of their feet, a neutral point on their body. Their verbal and physical aggression decreased with mindfulness training; no physical aggression and very low rates of verbal aggression occurred during 4 years of follow-up in the community.

Behav Modif. 2007 May;31(3):313-28.

Singh NN, Lancioni GE, Winton AS, Adkins AD, Wahler RG, Sabaawi M, Singh J.

ONE Research Institute, Midlothian, VA 23112, USA. nirbsingh52@aol.com

Kay is the Founder and Director of the Self-Empowerment Education Center (SEEC) located in Annandale, VA. She is also the Founder and International Director of the International Council for Medical and Clinical Therapists (ICMCT). She is an Instructor certified by the National Guild of Hypnotists, World Institute of Cognitive Sciences, and the National Board of Hypnotic Anaesthesology, and has presented at their conventions. Kay teaches an introduction to hypnosis course at the Northern Virginia Community College, Annandale Campus, Annandale, VA.

She writes a monthly column in Your Health Magazine (formerly The Medical News) to educate the public about the benefits of hypnosis. She has performed various workshops for several federal and state government agencies in the Washington, DC,\Baltimore, MD, metropolitan area. A few of the organizations are: US District Court for the District of Columbia; Federal Aviation Administration; Georgetown University School of Law; George Mason University; Loudon County VA Suicide Prevention Coalition; the Department of Labor; the World Bank and the Susan G. Koman Breast Cancer Foundation. She actively promotes hypnosis in the community and is a member of the Fairfax Chamber of Commerce. She is a certified Forensic Hypnotist as well as a Meridian Therapist. She completed a professional training course taught by Dr. Brian Weiss of the Weiss Institute, in Past Life Regression Therapy and has currently graduated a two-year program with Dr. Roger Woolger, Woolger Training International, in Matrix Therapy and Deep Memory Processing. Dr. Woolger is recognized world-wide for his unique regression techniques.

Mindfulness-based Cognitive Therapy (MBCT) is a meditation-based intervention designed to reduce recurrence in people with histories of relapsing unipolar major depression. MBCT is an eight-session course delivered to groups of participants who are currently not (or only mildly) depressed. We sought to determine whether MBCT is suitable for older people, and what modifications they may require. We recruited 38 participants aged over 65, of whom 30 completed an MBCT course. Their responses at assessment, post-course and one-year follow-up interviews, plus comments at three-monthly 'reunion' meetings, provided data for thematic analysis. Main themes emerging for participants as a group are considered, as are individuals' understandings and uses of MBCT, and how these developed during and following the course. We found MBCT promising as a cost-effective addition to clinicians' repertoire for addressing depression in old age, and identified issues for further research. Participants' comments indicated that they considered MBCT a helpful intervention for older sufferers from recurring depression.

Aging Ment Health. 2007 May;11(3):346-57.

Smith A, Graham L, Senthinathan S.

Psychological Services, Lancashire Care NHS Trust, Chorley, Lancashire, UK. alistair.smith@lancashirecare.nhs.uk

This study investigated the effects of a meditation-based treatment for preventing relapse to depression, mindfulness-based cognitive therapy (MBCT), on prefrontal alpha-asymmetry in resting electroencephalogram (EEG), a biological indicator of affective style. Twenty-two individuals with a previous history of suicidal depression were randomly assigned to either MBCT (N=10) or treatment-as-usual (TAU, N=12). Resting electroencephalogram was measured before and after an 8-week course of treatment. The TAU group showed a significant deterioration toward decreased relative left-frontal activation, indexing decreases in positive affective style, while there was no significant change in the MBCT group. The findings suggest that MBCT can help individuals at high risk for suicidal depression to retain a balanced pattern of baseline emotion-related brain activation.

Neuroreport. 2007 May 7;18(7):709-12.

Barnhofer T, Duggan D, Crane C, Hepburn S, Fennell MJ, Williams JM.

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK. thorsten.barnhofer@psych.ox.ac.uk

OBJECTIVE: To find out efficacy and benefits of early starting of stimulation therapy in coma patients. DESIGN: Randomized controlled trial. METHOD: Sixty children admitted to the Department of Pediatrics, having coma due to non-traumatic neurological insult were randomly selected. Both study and control groups had 30 patients each. Children in the study group were given stimulation therapy while those in control group received no stimulation. The level of consciousness was assessed before and two weeks after giving stimulation therapy. RESULTS: Improvement in level of consciousness was better in study group as compared to control after two weeks of stimulation therapy. CONCLUSION: Stimulation therapy was found to be highly effective in coma patients.

Indian Pediatr. 2006 Oct;43(10):856-60. Karma D, Rawat AK.

Department of Pediatrics, Shyam Shah Medical College and Associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India.

The information processing capacity of the human mind is limited, as is evidenced by the so-called "attentional-blink" deficit: When two targets (T1 and T2) embedded in a rapid stream of events are presented in close temporal proximity, the second target is often not seen. This deficit is believed to result from competition between the two targets for limited attentional resources. Here we show, using performance in an attentional-blink task and scalp-recorded brain potentials, that meditation, or mental training, affects the distribution of limited brain resources. Three months of intensive mental training resulted in a smaller attentional blink and reduced brain-resource allocation to the first target, as reflected by a smaller T1-elicited P3b, a brain-potential index of resource allocation. Furthermore, those individuals that showed the largest decrease in brain-resource allocation to T1 generally showed the greatest reduction in attentional-blink size. These observations provide novel support for the view that the ability to accurately identify T2 depends upon the efficient deployment of resources to T1. The results also demonstrate that mental training can result in increased control over the distribution of limited brain resources. Our study supports the idea that plasticity in brain and mental function exists throughout life and illustrates the usefulness of systematic mental training in the study of the human mind.

PLoS Biol. 2007 May 8;5(6):e138 [Epub ahead of print]

Slagter HA, Lutz A, Greischar LL, Francis AD, Nieuwenhuis S, Davis JM, Davidson RJ.

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P=.008, P=.004) and SF-36 Physical Function (P=.03). An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function.

Pain. 2007 May 31; [Epub ahead of print]

Morone NE, Greco CM, Weiner DK.

Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

The present study evaluated whether Posttraumatic Stress Disorder (PTSD) symptom severity was associated with participation and treatment outcomes comparing a Vipassana meditation course to treatment as usual in an incarcerated sample. This study utilizes secondary data. The original study demonstrated that Vipassana meditation is associated with reductions in substance use. The present study found that PTSD symptom severity did not differ significantly between those who did and did not volunteer to take the course. Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems.

J Trauma Stress. 2007 Jun;20(3):239-49.

Simpson TL, Kaysen D, Bowen S, Macpherson LM, Chawla N, Blume A, Marlatt GA, Larimer M.

VA Puget Sound Health Care System and Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA.

Fiona Biddle has been in professional practice since 1993 and has undertaken many courses to continually improve her skills. She has also developed a new model of therapy: the Motivational Model of Hypnotism. A book on this co-authored with Shaun Brookhouse was published in June 2005.

In addition to her private practice, which has recently expanded to include London, She is also Chair of the National Council for Hypnotherapy and Vice Principal of the UK Academy of Therapeutic Arts and Sciences . She has co-written a number of therapeutic course manuals and "Building a Successful and Ethical Therapy Practice" and "Hypnotic Coaching", as well as "Motivational Hypnotism".

For more information, visit www.fionabiddle.co.uk

BACKGROUND: Infant massage is increasingly being used in the community for low-risk babies and their primary care givers. Anecdotal claims suggest benefits for sleep, respiration, elimination and the reduction of colic and wind. Infant massage is also thought to reduce infant stress and promote positive parent-infant interaction. OBJECTIVES: The aim of this review was to assess the effectiveness of infant massage in promoting infant physical and mental health in population samples. SEARCH STRATEGY: Searches were undertaken of CENTRAL 2005 (Issue 3), MEDLINE (1970 to 2005), PsycINFO (1970 to 2005), CINAHL (1982 to 2005), EMBASE (1980 to 2005), and a number of other Western and Chinese databases. SELECTION CRITERIA: Studies in which babies under the age of six months were randomised to an infant massage or a no-treatment control group, and utilising a standardised outcome measuring infant mental or physical development. DATA COLLECTION AND ANALYSIS: Weighted and standardised mean differences and 95% confidence intervals are presented. Where appropriate the results have been combined in a meta-analysis using a random effects model. MAIN RESULTS: Twenty-three studies were included in the review. One was a follow-up study and thirteen were included in a separate analysis due to concerns about the uniformly significant results and the lack of dropout. The results of nine studies providing primary data suggest that infant massage has no effect on growth, but provides some evidence suggestive of improved mother-infant interaction, sleep and relaxation, reduced crying and a beneficial impact on a number of hormones controlling stress. Results showing a significant impact on number of illnesses and clinic visits were limited to a study of Korean orphanage infants. There was no evidence of effects on cognitive and behavioural outcomes, infant attachment or temperament. The data from the 13 studies regarded to be at high risk of bias show uniformly significant benefits on growth, sleep, crying and bilirubin levels. AUTHORS' CONCLUSIONS: The only evidence of a significant impact of massage on growth was obtained from a group of studies regarded to be at high risk of bias. There was, however, some evidence of benefits on mother-infant interaction, sleeping and crying, and on hormones influencing stress levels. In the absence of evidence of harm, these findings may be sufficient to support the use of infant massage in the community, particularly in contexts where infant stimulation is poor. Further research is needed, however, before it will be possible to recommend universal provision.

Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005038.

Underdown A, Barlow J, Chung V, Stewart-Brown S.

Warwick Medical School, Institute of Education, University of Warwick, Coventry, UK. angela@underdown5.freeserve.co.uk