Full Title: Massage for Low Back Pain: An Updated Systematic Review Within the Framework of the Cochrane Back Review Group

STUDY DESIGN.: Systematic Review. OBJECTIVES.: To assess the effects of massage therapy for nonspecific low back pain. SUMMARY OF BACKGROUND DATA.: Low back pain is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. METHODS.: We searched MEDLINE, EMBASE, CINAHL from their beginning to May 2008. We also searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, issue 3), HealthSTAR and Dissertation abstracts up to 2006. There were no language restrictions. References in the included studies and in reviews of the literature were screened. The studies had to be randomized or quasi-randomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific low back pain. Two review authors selected the studies, assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group, and extracted the data using standardized forms. Both qualitative and meta-analyses were performed. RESULTS.: Thirteen randomized trials were included. Eight had a high risk and 5 had a low risk of bias. One study was published in German and the rest in English. Massage was compared to an inert therapy (sham treatment) in 2 studies that showed that massage was superior for pain and function on both short- and long-term follow-ups. In 8 studies, massage was compared to other active treatments. They showed that massage was similar to exercises, and massage was superior to joint mobilization, relaxation therapy, physical therapy, acupuncture, and self-care education. One study showed that reflexology on the feet had no effect on pain and functioning. The beneficial effects of massage in patients with chronic low back pain lasted at least 1 year after the end of the treatment. Two studies compared 2 different techniques of massage. One concluded that acupuncture massage produces better results than classic (Swedish) massage and another concluded that Thai massage produces similar results to classic (Swedish) massage. CONCLUSION.: Massage might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low back pain.

Spine (Phila Pa 1976). 2009 Jun 25. Furlan AD, Imamura M, Dryden T, Irvin E. From the *Institute for Work & Health, Toronto, ON; daggerDepartment of Medicine, University of Toronto, Toronto, ON; double daggerToronto Rehabilitation Institute, Toronto, ON; section signDivision of Physical Medicine and Rehabilitation, Department of Orthopaedics and Traumatology, University of São Paulo School of Medicine, São Paulo, Brazil; and paragraph signCentennial College, Applied Research Centre, Toronto, ON.

by Paul G. Durbin, PhD

THE FOUR PHASES OF ADLERIAN COUNSELING ARE:
(1) the relationship,
(2) the investigation of dynamics,
(3) interpretation of the client,
(4) reoinentation.

Adler departed from Freud's method of having the client recline on a couch while the therapist sits behind. Adler preferred to face the client so he could see the client's responses and body movement. He wanted to engage in free discussion with the client. The relationship with the client which the Adlerian seeks to establish is one of friendliness and cooperation.

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Full Title: Paediatric homoeopathy in Germany: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

PURPOSE: Despite growing pressure against homoeopathy, an unexpected resurgence in the use of homoeopathy has been reported. It is of interest to examine the use of homoeopathy and user profiles among children in Germany. METHODS: Last-week homoeopathy use was recorded among 17,450 children aged 0-17 years who participated in the 2003-2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The complex sample method was used to estimate the prevalence of, and factors associated with, homoeopathy use. RESULTS: Nine hundred and fifty-one homoeopathic preparations were used by 718 children (weighted prevalence 4.6%). Nearly half of the homoeopathic preparations were obtained by prescriptions from medical doctors or Heilpraktiker (non-medical practitioners) and used most often to treat certain self-limiting conditions. About 60% of homoeopathy users concomitantly received conventional medicines. Homoeopathy use was closely related to socioeconomic factors, with a significantly higher prevalence rate found in the 0-6 year age group [prevalence 6.2%, odds ratio 2.2, 95% confidence intervals (CIs) 1.7-2.9], among children residing in the former West Germany [5.1%, 2.2(1.5-3.2)] or the south of Germany [6.6%, 1.7(1.3-2.4)], among children with a poor health status [6.8%, 3.0(2.2-4.2)], with no immigration background [5.3%, 3.7(2.2-6.1)], who received breast-feeding >6 months [7.6%, 2.1(1.6-2.9)], were from upper social-class families [7.4%, 1.8(1.1-2.8)] and whose children's mothers were college educated [7.2%, 1.6(1.2-2.2)]. CONCLUSIONS: Paediatric homoeopathy is quite popular in Germany, particularly among children from families with a higher socioeconomic status. The high level of paediatric homoeopathy use in Germany warrants a critical review to determine whether it is evidence based and cost-effective.

Pharmacoepidemiol Drug Saf. 2009 May;18(5):370-9. Du Y, Knopf H. Department of Epidemiology and Health Reporting, Division of Non-Communicable Disease Epidemiology, Robert Koch Institute, Berlin, Germany. DuY@rki.de

Full Title: Exploring the Evidence Base for Acupuncture in the Treatment of Meniere's Syndrome--A Systematic Review

Ménière's syndrome is a long-term, progressive disease that damages the balance and hearing parts of the inner ear. To address the paucity of information on which evidence-based treatment decisions should be made, a systematic review of acupuncture for Ménière's syndrome was undertaken. The method used was a systematic review of English and Chinese literature, from six databases for randomized, non-randomized and observational studies. All studies were critically appraised and a narrative approach to data synthesis was adopted. Twenty-seven studies were included in this review (9 in English and 18 in Chinese languages): three randomized controlled trials, three non-randomized controlled studies and four pre-test, post-test designs. All but one of the studies was conducted in China. The studies covered body acupuncture, ear acupuncture, scalp acupuncture, fluid acupuncture point injection and moxibustion. The studies were of varying quality. The weight of evidence, across all study types, is of beneficial effect from acupuncture, for those in an acute phase or those who have had Ménière's syndrome for a number of years. The review reinforces the importance of searching for studies from English and Chinese literature. The transferability of the findings from China to a Western context needs confirmation. Further research is also needed to clarify questions around the appropriate frequency and number of treatment/courses of acupuncture. The weight of evidence suggests a potential benefit of acupuncture for persons with Ménière's disease, including those in an acute phase and reinforces the importance of searching for published studies in the Chinese language.

Evid Based Complement Alternat Med. 2009 Jun 8. Long AF, Xing M, Morgan K, Brettle A. School of Healthcare, University of Leeds, Room 3.10, Baines Wing, Leeds, LS2 9UT, UK. a.f.long@leeds.ac.uk.

BACKGROUND: Chronic cough is common and medical treatment can be ineffective. Mindfulness is a psychological intervention that aims to teach moment-to-moment non-judgemental awareness of thoughts, feelings and sensations. Method: 30 healthy subjects and 30 chronic cough patients were studied in two sequential trials. For both studies, cough reflex sensitivity to citric acid (C5) was measured on two occasions with urge-to-cough rated following each inhalation; between challenges subjects were randomised to (i) no intervention (ii) mindfulness or (iii) no intervention but modified cough challenge (subjects suppress coughing). For the healthy volunteers, measures were one hour apart and mindfulness was practiced for 15 minutes. For the chronic cough patients measures were 1 week apart and mindfulness practiced daily for 30 minutes. RESULTS: In healthy volunteers, median change (IQR) in cough reflex sensitivity (logC5) for no intervention, mindfulness and suppression was +1.0(0.0 to +1.3), +2.0(+1.0 to +3.0) and +3.0(+2.8 to +3.0) doubling concentrations (dc) (p=0.003); significant reductions for both mindfulness (p=0.043) and suppression (p=0.002) over no intervention. In cough patients, median change (IQR) in logC5 for no intervention, mindfulness training and voluntary suppression was 0.0(-1.0 to +1.0), +1.0(-0.3 to +1.0) and +1.0(+1.0 to +2.0)dc, (p=0.046); significant reduction for suppression (p=0.02) but not mindfulness (p=0.35). Urge-to-cough did not change after mindfulness compared to control in either healthy (p=0.33) or chronic cough subjects (p=0.47). CONCLUSION: Compared to control, mindfulness decreased cough reflex sensitivity in healthy volunteers, but did not alter cough threshold in chronic cough patients. Both groups were able to suppress cough responses to citric acid inhalation.

Thorax. 2009 Aug 12. Young EC, Brammar C, Owen E, Brown N, Lowe J, Johnson C, Calam R, Jones S, Woodcock A, Smith JA. Respiratory Research Group, University of Manchester, United Kingdom.

by Tim Brunson, PhD

There is a cost paid by people who work in the healing professions and occupations. Whether drawn to these vocations by altruism, compassion, or other motivations, each practitioner runs the risk of contracting adverse mental and physical consequences. The ineffective coping strategies used by practitioners – coupled with the necessity of working long hours – may serve to complicate matters. They not only fail to mitigate problems caused by constant exposure to negativity, they in fact further accelerate the onset of the resulting costs that are too often inherent in their work. Furthermore these typical responses detract from the environment and experience of clients and patients, resulting in degradation of speed of healing and even potentially contributing to the continuation of their illnesses.

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Full Title: Cognitive-behavioral therapy based on the Mediterranean diet for the treatment of obesity

OBJECTIVE: The Mediterranean dietary pattern improves cardiovascular disease factors. More research is needed on the usefulness of a Mediterranean dietary pattern in terms of weight loss. The objective of this study was to assess the effectiveness of behavioral therapy based on the Mediterranean diet for the treatment of obesity and to determine the main obstacles to weight loss. METHODS: A total of 1406 obese subjects (body mass index, 31+/-5kg/m(2)), aged 20-65 y, from a Mediterranean area in southeast Spain were subjected to a weight-reduction program. To evaluate effectiveness, weight loss, body fat distribution, biochemical variables, blood pressure changes, mean duration of treatment, percentage of attrition, and the ability to fulfill a Mediterranean diet pattern were assessed. To determine the main barriers to losing weight, a "Barriers to Weight Loss" checklist was completed. RESULTS: The behavioral therapy program was effective for the treatment of obesity. The average weight loss was 7.7kg. The duration of treatment was 34 wk. Eighty-nine percent of subjects fulfilled the Mediterranean principles during the program, and all the variables studied were significantly improved. Attrition was 4-9%, with the main reason being stress (37%). Main obstacles to weight loss were "losing motivation," being "prone to stress-related eating," and being liable to eat when bored. Recording food intake and assisting group therapy were also important tools for losing weight (P< or =0.05). CONCLUSIONS: Dietary/behavioral treatment based on Mediterranean dietary principles is effective in clinical practice. Nutrition professionals should encourage their patients to record food intake and to attend group therapy.

Nutrition. 2009 Jul-Aug;25(7-8):861-9. Corbalán MD, Morales EM, Canteras M, Espallardo A, Hernández T, Garaulet M. Department of Physiology, University of Murcia, Spain.

Full Title: Effect of music therapy on anxiety and depression in patients with Alzheimer's type dementia: randomised, controlled study

BACKGROUND/AIMS: Numerous studies have indicated the value of music therapy in the management of patients with Alzheimer's disease. A recent pilot study demonstrated the feasibility and usefulness of a new music therapy technique. The aim of this controlled, randomised study was to assess the effects of this new music therapy technique on anxiety and depression in patients with mild to moderate Alzheimer-type dementia. METHODS: This was a single-centre, comparative, controlled, randomised study, with blinded assessment of its results. The duration of follow-up was 24 weeks. The treated group (n = 15) participated in weekly sessions of individual, receptive music therapy. The musical style of the session was chosen by the patient. The validated 'U' technique was employed. The control group (n = 15) participated under the same conditions in reading sessions. The principal endpoint, measured at weeks 1, 4, 8, 16 and 24, was the level of anxiety (Hamilton Scale). Changes in the depression score (Geriatric Depression Scale) were also analyzed as a secondary endpoint. RESULTS: Significant improvements in anxiety (p < 0.01) and depression (p < 0.01) were observed in the music therapy group as from week 4 and until week 16. The effect of music therapy was sustained for up to 8 weeks after the discontinuation of sessions between weeks 16 and 24 (p < 0.01). CONCLUSION: These results confirm the valuable effect of music therapy on anxiety and depression in patients with mild to moderate Alzheimer's disease. This new music therapy technique is simple to implement and can easily be integrated in a multidisciplinary programme for the management of Alzheimer's disease. Copyright 2009 S. Karger AG, Basel.

Dement Geriatr Cogn Disord. 2009;28(1):36-46. Epub 2009 Jul 23. Guétin S, Portet F, Picot MC, Pommié C, Messaoudi M, Djabelkir L, Olsen AL, Cano MM, Lecourt E, Touchon J. Service de Neurologie, Centre Mémoire de Ressources et de Recherches (CMRR), Inserm U888, CHRU Montpellier, Montpellier, France. stephane.guetin@yahoo.fr

Anne Arsenault has spent over 15 years studying health related topics, along with numerous courses and counseling people on their health. She is a Certified Nutritional Consultant (CNC), with a Certificate in Reflexology and has also taken many other Holistic Health related courses. She has managed Health Stores and Natural Food Sections in larger stores. One of her goals has always been to simplify health so that everyone can use and understand it. What good is all the knowledge if you cannot educate people in a way they can understand and learn to change and better their life?

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Full Title: A double-blind randomized controlled pilot trial examining the safety and efficacy of therapeutic touch in premature infants

PURPOSE: To explore the hypothesis that nontouch therapy such as therapeutic touch (TT) reduces stress to a clinically important degree and is safe to use in preterm infants. DESIGN: A pilot randomized, double-blind, controlled trial. SUBJECTS: Two groups of 10 infants were enrolled and randomly assigned to treatment or nontreatment groups. Gestational age was less than 29 weeks. Demographic descriptions of the 2 groups were statistically similar. METHODS: The observer and staff were blinded to assignment; the TT practitioner was blinded to observed measurements. Each infant received either TT or no therapeutic touch (NTT) for 5 minutes on 3 consecutive days at the same time of day, behind a curtain. Heart period variability (HPV) was measured 5 minutes before, during, and after the treatment phase. RESULTS: Examination of the parameters of oxygen saturation and episodes of apnea demonstrated no increase in adverse events in TT group compared with NTT group. Repeated-measures multivariate analysis of variance on HPV revealed differences in the interaction of group assignment with low-frequency, high-frequency, and low-to-high- frequency ratio interaction (F2,143 = 8.076, P = .000) and for group, day, and low-frequency, high-frequency, and low-to-high-frequency ratio (F2,288 = 3.146, P = .015), and in the posttreatment time period (F1,16 = 6.259, P = .024), reflective of greater parasympathetic activity in TT group. CONCLUSION: In this pilot trial, HPV showed an increase for the TT group compared with the NTT group. The study reveals no adverse effects of TT in preterm infants.

Adv Neonatal Care. 2008 Dec;8(6):315-33. Whitley JA, Rich BL. Neonatal Nurseries, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada. julie4453@cogeco.ca

by Charles Wm. Skillas, PhD, DD, BCH, FNGH, CI

Hypnotherapy, in addition to being a wondrous healing modality, has great utility in increasing performance in sports; job tasks, memory and artistic ability; and can improve relationships and other people dynamics. This occurs because: the person feels better, self confidence increases and stress is reduced, and: once negative forcing functions and programs are removed from the sub-conscious, it can then be positively re-programmed, changing the persons behavior and response to life. Also, because the sub-conscious cannot differentiate between reality and imagination, it is possible to repeatedly rehearse a desired performance in the imagination, thus creating a program of excellence in the sub-conscious resulting in improvement.

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Full Title: Using art to help understand the imagery of irritable bowel syndrome and its response to hypnotherapy

A medical artist asked 109 patients if they had an image of their IBS pre- and posthypnotherapy, making precise watercolor paintings of any images described. Results were related to treatment outcome, symptoms, anxiety, depression, and absorption (hypnotizability); 49% of patients had an image, and a wide variety were recorded and painted. Imagery was significantly associated with gender (p < .05), anxiety (p < .05), noncolonic symptomatology (p < .05), and absorption (p = .001); 57.8% of responders compared with 35.5% of nonresponders to hypnotherapy had an image of their disease (p < .05) before treatment, and color images were associated with better outcomes (p = .05) than monochrome ones. All images changed in responders, often becoming more nonspecific in nature. Inquiring about IBS imagery helps to identify potential responders and nonresponders to hypnotherapy and may also provide insights into how patients think about their illness.

Int J Clin Exp Hypn. 2009 Apr;57(2):162-73. Carruthers HR, Miller V, Morris J, Evans R, Tarrier N, Whorwell PJ. University of Manchester, United Kingdom.

BACKGROUND: Associated with decreases in quality of life, constipation is a relatively common problem. Abdominal massage appears to increase bowel function, but unlike laxatives with no negative side effects. Because earlier studies have methodological flaws and cannot provide recommendations, more research is needed. OBJECTIVE: This study investigates the effects of abdominal massage on gastrointestinal functions and laxative intake in people who have constipation. DESIGN: Randomized controlled trial. PARTICIPANTS AND METHOD: A sample of 60 people with constipation was included and randomized in two groups. The intervention group received abdominal massage in addition to an earlier prescribed laxative and the control group received only laxatives according to earlier prescriptions. Gastrointestinal function was assessed with Gastrointestinal Symptoms Rating Scale (GSRS) on three occasions; at baseline, week 4 and week 8. The statistical methods included linear regression, Wilcoxon sign rank test, and Mann-Whitney U-test. RESULT: Abdominal massage significantly decreased severity of gastrointestinal symptoms assessed with GSRS according to total score (p=.003), constipation syndrome (p=.013), and abdominal pain syndrome (p=.019). The intervention group also had significant increase of bowel movements compared to the control group (p=.016). There was no significant difference in the change of the amount of laxative intake after 8 weeks. CONCLUSIONS: Abdominal massage decreased severity of gastrointestinal symptoms, especially constipation and abdominal pain syndrome, and increased bowel movements. The massage did not lead to decrease in laxative intake, a result that indicates that abdominal massage could be a complement to laxatives rather than a substitute.

Int J Nurs Stud. 2009 Jun;46(6):759-67. Lämås K, Lindholm L, Stenlund H, Engström B, Jacobsson C. Department of Nursing, Umeå University, Umeå, Sweden. kristina.lamas@nurs.umu.se

by David Kohlhagen LPC, NBCCH

Definitions

Much of the controversy in the field of mind/body healing can be attributed to the way terms are defined. Mind and consciousness are fundamentally non-scientific words and yet mind/body scientists and practitioners still must employ them to describe their results and their work. Any definition will carry an element of the subjective posture of the one giving the definition. The definitions of these words express theoretical constructs that guide research and clinical practice.

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OBJECTIVE: Patients are increasingly attracted to homeopathy despite the unproven effectiveness of homeopathic remedies. Clinical benefit of homeopathy may be due to communication. This review aims to identify and assess effective communication patterns in homeopathy. METHODS: Narrative review and synthesis of published communication patterns, patient narratives and the author's professional experience as a homeopathic practitioner. RESULTS: In the biomedical model, where the focus is on disease, communication is physician-centered with early redirection of patients' concerns, and associated with reduced compliance, increasing risk of malpractice claims and low professional fulfillment. The biopsychosocial and the developing integrative medicine models are based on biomedicine but aim to include the whole person. Patient-centeredness is a behavior that elicits, respects and incorporates patients' wishes, allows active patient participation and is related to improved outcomes. The homeopathic model is based on holism and comprehension of the totality of the patient and uses patient-centered communication with a high degree of physician co-operation, empathy, hopefulness, enablement and narrative competence, all of which can improve outcomes. CONCLUSION: Both biopsychosocial and homeopathic models rely on patient-centered communication. Regardless of conceptual differences, they overlap in their common respect for the totality and individuality of the patient. The study of the homeopathic model shows that respect for the whole person is a basic requirement to entrench patient-centeredness more firmly in medicine. PRACTICE IMPLICATIONS: Medical education should include values such as individual coping strategies, the benefits of a sound and healthy life-style and the necessity of hope and enablement. Health care should be redesigned to honor physicians who practice these values.

Patient Educ Couns. 2009 Apr 14. Hartog CS. Department of Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University, Erlanger Allee 101, D-07747 Jena, Germany.

We report a case of pain management after a meniscal cyst excision, with the use of electroacupuncture (EA). There are a few reports which indicate that postoperative pain management is prerequisite for the patient's optimal recovery, but surveys in the UK and the USA have identified an unacceptable prevalence of poor pain control after surgery, which might increase the risk of a chronic pain state. The conventional treatment of postoperative pain includes systemic medications such as opioids, non-steroidal anti-inflammatory drugs and other non-opioid agents. In our case, the rehabilitation lasted for 6 months without significant benefit. After that period our patient was treated with EA. By the end of the first EA session the relief of pain was notable and after a course of 10 treatments the patient reported complete relief of the symptoms with no recurrence during a 2 year follow up period. In conclusion, this might indicate that EA could be useful for postoperative pain management.

Acupunct Med. 2009 Jun;27(2):79-80. Galanis N, Stavraka C, Boutsiadou T, Kirkos JM, Kapetanos G. Kerasountos 6, Thessaloniki 55131, Greece; kyros@med.auth.gr.

A Review by Tim Brunson, PhD

Over the years mental health clinicians develop unique ideas and procedures, which the find to be extremely effective with their clients. For those who are always on the lookout for new methods Clinical Pearls of Wisdom: 21 Leading Therapists Offer Their Key Insights offers the reader a treasure chest of time-tested concepts. Immediately upon reading this anthology I felt that I had benefitted from the collective experience of many of the professions most competent practitioners. Edited by Michael Kerman, MSW, the founder of Leading Edge Seminars, this volume presents a concise series of chapters in which each therapist shares a few well-chosen pearls, a relevant case history, and a summary.

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Full Title: Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: Replication and extension in the Swiss health care system

BACKGROUND: Mindfulness-Based Cognitive Therapy (MBCT) is a group intervention that integrates elements of Cognitive Behavioural Therapy (CBT) with components of mindfulness training to prevent depressive relapse. The efficacy of MBCT compared to Treatment As Usual (TAU), shown in two randomized controlled trials indicates a significant decrease in 1-year relapse rates for patients with at least three past depressive episodes. The present study is the first independent replication trial comparing MBCT+TAU to TAU alone across both language and culture (Swiss health care system). METHODS: Sixty unmedicated patients in remission from recurrent depression (>/=3 episodes) were randomly assigned to MBCT+TAU or TAU. Relapse rate and time to relapse were measured over a 60week observation period. The frequency of mindfulness practices during the study was also evaluated. RESULTS: Over a 14-month prospective follow-up period, time to relapse was significantly longer with MBCT+TAU than TAU alone (median 204 and 69days, respectively), although both groups relapsed at similar rates. Analyses of homework adherence revealed that following treatment termination, the frequency of brief and informal mindfulness practice remained unchanged over 14months, whereas the use of longer formal meditation decreased over time. LIMITATIONS: Relapse monitoring was 14months in duration and prospective reporting of mindfulness practice would have yielded more precise frequency estimates compared to the retrospective methods we utilized. CONCLUSIONS: Further studies are required to determine which patient characteristics, beyond the number of past depressive episodes, may predict differential benefits from this therapeutic approach.

J Affect Disord. 2009 Aug 8. Bondolfi G, Jermann F, der Linden MV, Gex-Fabry M, Bizzini L, Rouget BW, Myers-Arrazola L, Gonzalez C, Segal Z, Aubry JM, Bertschy G. Depression Program, Department of Psychiatry, Geneva University Hospital, Switzerland.

Full Title: Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders

Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint, endpoint, and 6 months following treatment. Treatment consisted of cognitive-behavioral therapy, supplemented with parent education and group social skills training. The treatment program was effective in reducing anxiety in three of the four subjects and improving the social skills in all four subjects. Recommendations for the assessment and treatment of anxiety youth with ASD such as use of self-report measures to complement clinician and parent-reports and adaptations to traditional child-based CBT, are offered.

J Autism Dev Disord. 2009 Jun 30. White SW, Ollendick T, Scahill L, Oswald D, Albano AM. Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24061, USA, sww@vt.edu.

Joyce-Anne Locking B.Mus. is a member of The Canadian League of Composers. Several of her chamber music compositions are housed in the Hornbake Library, University of Maryland. Other compositions are kept at Halgrims Church, Iceland and The Cleveland Chamber Orchestra Library.

Joyce-Anne was a member of a committee formed by The League of Canadian Poets to launch youngpoets.ca, set up to encourage an appreciation of poetry and aid in teaching budding young poets, resources for teachers are included on this website.

Joyce-Anne recently launched a weekly column in the Life section of the local newspaper and is actively promoting nature, good health and the creative arts.

by Randy Herron, SPHR

Start by Improving Your Organization's Communication Skills

Obviously, people communicating with each other and psychology lay as a blanket over every organization. Communicating with each other and living within the behavioral truths of people are two key elements of our work environment. The degree of integrity, openness, and overall communication skills of its people directly affects productivity and each individual's satisfaction and contribution.

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PURPOSE: Music has been utilized as a therapeutic tool during colonoscopy, but various randomized controlled trials (RCTs) have been inconsistent. We conducted a meta-analysis to analyze the effect of music on patients undergoing colonoscopy. PATIENTS AND METHODS: Multiple medical databases were searched (12/06). Only RCTs on adult subjects that compared music versus no music during colonoscopy were included. Meta-analysis was analyzed for total procedure time, dose of sedative medications (midazolam and mepiridine), and patients' pain scores, experience, and willingness to repeat the same procedure in the future. RESULTS: Eight studies (N = 712) met the inclusion criteria. Patients' overall experience scores (P < 0.01) were significantly improved with music. No significant differences were noted for patients' pain scores (P = 0.09), mean doses of midazolam (P = 0.10), mean doses of meperidine (P = 0.23), procedure times (P = 0.06), and willingness to repeat the same procedure in future (P = 0.10). CONCLUSIONS: Music improves patients' overall experience with colonoscopy.

Dig Dis Sci. 2009 Jan;54(1):19-24. Epub 2008 May 16. Bechtold ML, Puli SR, Othman MO, Bartalos CR, Marshall JB, Roy PK. Division of Gastroenterology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA.

Full Title: Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: a randomized controlled trial

OBJECTIVE: To determine whether participation in a mind-body skills group program based on psychological self-care, mind-body techniques, and self-expression decreases symptoms of posttraumatic stress disorder (PTSD). METHOD: Eighty-two adolescents meeting criteria for PTSD according to the Harvard Trauma Questionnaire (which corresponds with 16 of the 17 diagnostic criteria for PTSD in DSM-IV) were randomly assigned to a 12-session mind-body group program or a wait-list control group. The program was conducted by high school teachers in consultation with psychiatrists and psychologists and included meditation, guided imagery, and breathing techniques; self-expression through words, drawings, and movement; autogenic training and biofeedback; and genograms. Changes in PTSD symptoms were measured using the Harvard Trauma Questionnaire. The study was conducted from September 2004 to May 2005 by The Center for Mind-Body Medicine at a high school in the Suhareka region of Kosovo. RESULTS: Students in the immediate intervention group had significantly lower PTSD symptom scores following the intervention than those in the wait-list control group (F = 29.8, df = 1,76; p < .001). Preintervention and postintervention scores (mean [SD]) for the intervention group were 2.5 (0.3) and 2.0 (0.3), respectively, and for the control group, 2.5 (0.3) and 2.4 (0.4), respectively. The decreased PTSD symptom scores were maintained in the initial intervention group at 3-month follow-up. After the wait-list control group received the intervention, there was a significant decrease (p < .001) in PTSD symptom scores compared to the preintervention scores. CONCLUSIONS: Mind-body skills groups can reduce PTSD symptoms in war-traumatized high school students and can be effectively led by trained and supervised schoolteachers. Copyright 2008 Physicians Postgraduate Press, Inc.

This is quantitative research conducted with 42 students of a public university using the Therapeutic Touch - Krieger-Kunz Method and the application of a questionnaire validated in Brazil to assess anxiety in three sessions. Subjects were divided into two groups: experimental (1), in which the complementary therapy was used; and control (2), in which a mock of the technique, with no therapeutic intention, was applied. The objective was to identify the gradual influence of that health complementary therapy upon the students' state of anxiety. The analysis of the data showed a statistically significant reduction of the state of anxiety in both groups, with pd' 0.05.

Rev Bras Enferm. 2008 Nov-Dec;61(6):841-6. Gomes VM, Silva MJ, Araújo EA. Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP.

by Charles Wm. Skillas, PhD, DD, BCH, FNGH, CI

Back in 1981 when I first started doing energy healing work, I didn't know much about the mind's effect on health. I did acupressure on blocked energy points and achieved some success in helping people feel better. However, the results didn't last. Then, in 1985, I added Hypnotherapy to my healing work and achieved greater success in alleviating people's problems. Nevertheless, my success still wasn't very good. I did everything I was taught to release the traumas in people's subconscious minds and still their problems persisted or the healing didn't last very long. Then, in 1990, I discovered the effects foreign energy attachment had on hypnotherapeutic healing and this discovery not only helped me personally, but since then, I have great success helping people.

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This article provides an overview of a new theory of suggested involuntariness in hypnosis, developed in conjunction with Irving Kirsch. The theory is based on the following ideas. First, high hypnotizable participants enter hypnosis with a conscious intention to feel and behave in line with suggested experiences and movements. Second, people who are easily hypnotized hold firm expectations that they will succeed in following the suggestions of the hypnotist. Third, the intention and expectation in turn function as response sets in the sense that they trigger the hypnotic response automatically. Fourth, given the intention to feel and behave in line with the hypnotist's suggestions, hypnotized individuals show no hesitation to experience the suggested movements as involuntary because (a) these movements are actually triggered automatically, and (b) the intention to cooperate with the hypnotist as well as the expectation to be able to do so create a heightened readiness to experience these actions as involuntary.

Int J Clin Exp Hypn. 1997 Jul;45(3):239-50. Lynn SJ. Psychology Department, State University of New York at Binghamton, NY 13902-6000, USA.

Full Title: Massage and mobilization of the feet and ankles in elderly adults: Effect on clinical balance performance

The aim of this study was to evaluate the effects of a session of plantar massage and joint mobilization of the feet and ankles on clinical balance performance in elderly people. A randomized, placebo-controlled, cross-over trial was used to examine the immediate effects of manual massage and mobilization of the feet and ankles. Twenty-eight subjects, aged from 65 to 95 years (78.8+/-8.5 years - mean+/-SD) were recruited from community nursing homes. Main outcome measures were the performances in three tests: One Leg Balance (OLB) test, Timed Up and Go (TUG) test and Lateral Reach (LR) test. Results demonstrated a significant improvement after massage and mobilization compared with placebo for the OLB test (1.1+/-1.7s versus 0.4+/-1.2s, p<0.01) and the TUG test (0.9+/-2.6s versus 0.2+/-1.2s, p<0.05). Conversely, performances in the LR test did not improve significantly. These results emphasise the positive impact of a single session of manual therapy applied to the feet and ankles on balance in elderly subjects.

Man Ther. 2009 May 7.Vaillant J, Rouland A, Martigné P, Braujou R, Nissen MJ, Caillat-Miousse JL, Vuillerme N, Nougier V, Juvin R. Laboratoire Santé Plasticité Motricité, Université Joseph Fourier-Grenoble 1, Grenoble, France; Ecole de Kinésithérapie du Centre Hospitalier Universitaire de Grenoble, France; Service de Rhumatologie du Centre Hospitalier Universitaire de Grenoble, France.

by Paul G. Durbin, PhD

In 1870, Alfred Adler was born in a suburb of Vienna. In his youth, Adler suffered from rickets and could not walk until he was four. Soon after he was able to walk, he developed pneumonia. These early experiences with illnesses probably accounts for his theory of organ inferiority and finally of the inferiority feelings.

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Introduction: Homeopathy uses information gathered from healthy volunteers taking homeopathic substances (pathogenetic trials) for clinical treatment. It is controversial whether such studies produce symptoms different from those produced by placebo. Objective: To test whether homeopathic preparations produce different symptoms than placebo in healthy volunteers. Methods: Three armed, double-blind, placebo controlled randomised experimental pathogenetic study in 25 healthy volunteers who took either one of two homeopathic remedies, Natrum muriaticum and Arsenicum album in 30CH or identical placebo. Main outcome parameter was the number of remedy-specific symptoms per group. Results: On average, 6 symptoms typical for Arsenicum album were experienced by participants taking arsenicum album, 5 symptoms typical for Natrum muriaticum by those taking natrum muriaticum, and 11 non-specific symptoms by those in the placebo group. Differences were significant overall (Kruskall Wallis test, p = 0.0002,) and significantly different from placebo (Mann-Whitney test, p = 0.001). Conclusion: Homeopathic remedies produce different symptoms than placebo. Copyright (c) 2009 S. Karger AG, Basel.

Forsch Komplementmed. 2009 Apr;16(2):105-10. Epub 2009 Apr 9. Möllinger H, Schneider R, Walach H. Department of Human Sciences, University of Osnabrück, Germany.

This case describes the treatment of severe involuntary movements in a 10-year-old boy suffering from cerebral palsy. Needling GB34 and ST36 bilaterally for 25 minutes resulted in immediate temporary cessation of involuntary extension contractions of the erector spinae muscles for the duration of the treatment, resulting in increased functionality in the patient. This response occurred regularly on repeated treatment, but was not maintained between treatments. Involuntary movements are a major disabling feature of cerebral palsy, which impair quality of life and often prove difficult to treat successfully. This case is reported with the hope that this simple technique may provide relief for other patients suffering similar symptoms.

Acupunct Med. 2009 Jun;27(2):76-8. Watson P. University of Bristol, Bristol, UK; Paul.Watson@doctors.org.uk.

Many meditation exercises aim at increased awareness of ongoing experiences through sustained attention and at detachment, i.e., non-engaging observation of these ongoing experiences by the intent not to analyze, judge or expect anything. Long-term meditation practice is believed to generalize the ability of increased awareness and greater detachment into everyday life. We hypothesized that neuroplasticity effects of meditation (correlates of increased awareness and detachment) would be detectable in a no-task resting state. EEG recorded during resting was compared between Qigong meditators and controls. Using LORETA (low resolution electromagnetic tomography) to compute the intracerebral source locations, differences in brain activations between groups were found in the inhibitory delta EEG frequency band. In the meditators, appraisal systems were inhibited, while brain areas involved in the detection and integration of internal and external sensory information showed increased activation. This suggests that neuroplasticity effects of long-term meditation practice, subjectively described as increased awareness and greater detachment, are carried over into non-meditating states.

Brain Topogr. 2009 Aug 4. Tei S, Faber PL, Lehmann D, Tsujiuchi T, Kumano H, Pascual-Marqui RD, Gianotti LR, Kochi K. Department of Stress Science and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Full Title: Brief Report: Effects of Cognitive Behavioral Therapy on Parent-Reported Autism Symptoms in School-Age Children with High-Functioning Autism

This pilot study tested the effect of cognitive behavioral therapy (CBT) on parent-reported autism symptoms. Nineteen children with autism spectrum disorders and an anxiety disorder (7-11 years old) were randomly assigned to 16 sessions of CBT or a waitlist condition. The CBT program emphasized in vivo exposure supported by parent training and school consultation to promote social communication and emotion regulation skills. Parents completed a standardized autism symptom checklist at baseline and posttreatment/postwaitlist and 3-month follow-up assessments. CBT outperformed the waitlist condition at posttreatment/postwaitlist on total parent-reported autism symptoms (Cohen's d effect size = .77). Treatment gains were maintained at 3-month follow-up. Further investigation of this intervention modality with larger samples and broader outcome measures appears to be indicated.

J Autism Dev Disord. 2009 Jun 27. Wood JJ, Drahota A, Sze K, Van Dyke M, Decker K, Fujii C, Bahng C, Renno P, Hwang WC, Spiker M. University of California, Moore Hall Box 951521, Los Angeles, CA, 90095, USA, jeffwood@ucla.edu.

Brenda, sometimes called "BJ" hails from the Motor City. She and husband Tommy Bee, a former jazz disc jockey in Los Angeles now reside in Phoenix. Brenda is affiliated with self-empowering forums and writes articles for other respected self-help, self-empowering online networks, an expert contributor on self Improvement and has published many articles. Her first e-book, the "Can Do Handbook," will be available soon. As a public service, she conducts Workshops and leads Discussion groups as a community service.

For more information visit http://www.BeeBlessedDaily.com.

The aim of this study was to determine the effect of music alone, aromatherapy alone, and music in addition to aromatherapy on anxiety levels of adults accompanying children to a pediatricemergency department waiting area. METHODS: The study was conducted over 28 consecutive days, assigned to 1 of 4 groups: no intervention, music, aromatherapy, and both music and aromatherapy. Adults accompanying children to the emergency department of an urban pediatric tertiary care referral center were given a survey including a Spielberger state anxiety inventory with additional questions about whether they noticed an aroma or music and if so their response to it. The music was classic ingenre with a tempo of 60 to 70 beats per minute. The aromatherapyused the essential oil Neroli dispersed using 2 aromatherapydiffusers placed in strategic airflow ends of the emergency department. RESULTS: The 1104 surveys were completed. There was a statistically significant decrease in anxietylevel on those days when music was playing (36.3 vs. 39.2; P = 0.017). There was no difference in anxiety levels on those days when aromatherapy was present compared with the nonaromatherapy days (37.3 vs. 38.0; P = 0.347). CONCLUSIONS: Music is an easy and useful way to decrease the anxiety of visitors in an emergency department waiting area. Although no difference was detected for the aromatherapy group, this could be because of environmental conditions or imprecise application of the aromatherapy; further study is needed to either prove or disprove its effectiveness in this setting.

Pediatr Emerg Care. 2008 Dec;24(12):836-8. Holm L, Fitzmaurice L. Department of Pediatrics, Division of Emergency Medical Services, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Holml2@ihs.org

BACKGROUND: Hypnosis has been used clinically for hundreds of years and is primarily a phenomenon involving attentive receptive concentration. Cognitive science has not fully exploited hypnosis and hypnotic suggestion as experimental tools. This study was designed to determine whether a hypnotic suggestion to hinder lexical processing could modulate the Stroop effect. METHODS: Behavioral Stroop data were collected from 16 highly suggestible and 16 less suggestible subjects; both naturally vigilant and under posthypnotic suggestion. Subjects were urged to only attend to the ink color and to impede reading the stimuli under posthypnotic suggestion. RESULTS: Whereas posthypnotic suggestion eliminated Stroop interference for highly suggestible subjects, less suggestible control subjects showed no significant reduction in the interference effect. CONCLUSIONS: This outcome challenges the dominant view that word recognition is obligatory for proficient readers, and may provide insight into top-down influences of suggestion on cognition.

Arch Gen Psychiatry. 2002 Dec;59(12):1155-61. Raz A, Shapiro T, Fan J, Posner MI. Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Medical College of Cornell University, 1300 York Ave, Box 140, New York, NY 10021, USA. amr2006@med.cornell.edu

by Lawrence Gold

Part 2 of 2.

How Our Way of Operating in Life Triggers the Neuromuscular Reflexes of Stress

PROCRASTINATION AND URGENCY
a disorder of beginning and a beginning of disorder

Have you ever procrastinated? Have you noticed that resisting doing something you felt needed doing only added to your tension in life? That once you did it, you felt relieved?

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Understanding written or spoken language presumably involves spreading neural activation in the brain. This process may be approximated by spreading activation in semantic networks, providing enhanced representations that involve concepts not found directly in the text. The approximation of this process is of great practical and theoretical interest. Although activations of neural circuits involved in representation of words rapidly change in time snapshots of these activations spreading through associative networks may be captured in a vector model. Concepts of similar type activate larger clusters of neurons, priming areas in the left and right hemisphere. Analysis of recent brain imaging experiments shows the importance of the right hemisphere non-verbal clusterization. Medical ontologies enable development of a large-scale practical algorithm to re-create pathways of spreading neural activations. First concepts of specific semantic type are identified in the text, and then all related concepts of the same type are added to the text, providing expanded representations. To avoid rapid growth of the extended feature space after each step only the most useful features that increase document clusterization are retained. Short hospital discharge summaries are used to illustrate how this process works on a real, very noisy data. Expanded texts show significantly improved clustering and may be classified with much higher accuracy. Although better approximations to the spreading of neural activations may be devised a practical approach presented in this paper helps to discover pathways used by the brain to process specific concepts, and may be used in large-scale applications.

Neural Netw. 2008 Dec;21(10):1500-10. Epub 2008 Jun 7. Duch W, Matykiewicz P, Pestian J. Department of Informatics, Nicolaus Copernicus University, Grudziadzka 5, 87-100 Torun, Poland. wduch@is.umk.pl

by Charles Wm. Skillas, PhD, DD, BCH, CI, FNGH

People may struggle with a problem for years, perhaps all their lives, without getting to the solution. In hypnotherapy, I find this all the time. If you have a problem, it requires a particular solution. However, if the solution you are working on is for different problem, you will not get anywhere because you have not addressed a solution for the right problem. A case in point....

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Full Title: Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations

A randomized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral (CB) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients (age 5 to 15 years) undergoing bone marrow aspirations. Patients were randomized to one of three groups: hypnosis, a package of CB coping skills, and no intervention. Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline. Hypnosis and CB were similarly effective in the relief of pain. Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group. It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration.

Int J Clin Exp Hypn. 1999 Apr;47(2):104-16. Liossi C, Hatira P. University of Sunderland, United Kingdom.

Environmental enrichment (EE) was shown recently to accelerate brain development in rodents. Increased levels of maternal care, and particularly tactile stimulation through licking and grooming, may represent a key component in the early phases of EE. We hypothesized that enriching the environment in terms of body massage may thus accelerate brain development in infants. We explored the effects of body massage in preterm infants and found that massage accelerates the maturation of electroencephalographic activity and of visual function, in particular visual acuity. In massaged infants, we found higher levels of blood IGF-1. Massage accelerated the maturation of visual function also in rat pups and increased the level of IGF-1 in the cortex. Antagonizing IGF-1 action by means of systemic injections of the IGF-1 antagonist JB1 blocked the effects of massage in rat pups. These results demonstrate that massage has an influence on brain development and in particular on visual development and suggest that its effects are mediated by specific endogenous factors such as IGF-1.

J Neurosci. 2009 May 6;29(18):6042-51. Guzzetta A, Baldini S, Bancale A, Baroncelli L, Ciucci F, Ghirri P, Putignano E, Sale A, Viegi A, Berardi N, Boldrini A, Cioni G, Maffei L. Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris, I-56128 Calambrone, Pisa, Italy.