Full Title: Group cognitive-behavioral therapy for depression in Spanish: culture-sensitive manualized treatment in practice

The authors applied cognitive-behavioral therapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-language CBT group for depression. They highlighted the challenges and satisfactions of working with a Spanish-speaking population in the public sector, and focused on how culture and socioeconomic status influence patients, and how to adapt treatment to these factors. Last, they demonstrated how technological advances integrate with culture-sensitive, evidence-based treatments to better serve this population and reduce disparities. (c) 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1-11, 2010.

J Clin Psychol. 2010 Aug;66(8):857-67. Aguilera A, Garza MJ, Muñoz RF. University of California, San Francisco.

A great hypnosis stress relief process. Learn more at www.hypnocoachlisa.com.

Burn can be among the most severe physical and psychologic traumas a person may face. Patients with burns commonly have severe itching and pain. Severe itching has also been associated with anxiety, sleep disturbance, and disruption of daily living activities. The addition of complementary treatments to standard care may lead to improved pain management and may offer a safer approach for reducing pain and procedural anxiety for patients with burns. The authors conducted an experimental study to examine whether the effects of massage therapy reduced burned adolescents' pain, itching, and anxiety levels. Sixty-three adolescents were enrolled in this study shortly after admission (mean days = 3 +/- 0.48) at a burn unit in a large university hospital from February 2008 to June 2009. The measures including the pain, itching, and state anxiety were collected on the first and last days of the 5-week study period. The participants had an average age of 14.07 +/- 1.78 years and came usually from the lower socioeconomic strata. The authors observed that massage therapy reduced all these measures from the first to the last day of this study (P < .001). In most cultures, massage treatments are used to alleviate a wide range of symptoms. Although health professionals agree on the use of nonpharmacologic method for patients with burns, these applications are not yet common.

J Burn Care Res. 2010 May-Jun;31(3):429-32. Parlak Gürol A, Polat S, Akçay MN. Department of Pediatric Nursing, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey.

"There is virtually nothing in which I delight more," says Albert Ellis, "than throwing myself into a good and difficult problem." Rational emotive behavior therapy is a direct and efficient problem-solving method, well suited to Ellis' personality. His self-assurance -- some would even say arrogance -- enables him to confront his clients about their beliefs and tell them what is rational and what isn't. The success of his clinical practice, his training institute, and his books testify that his methods work for many and that he is one of America's most influential therapists.

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by Tim Brunson, PhD

Few words in the English language garner the level of mystic, misunderstanding, and misuse as the word imagination. Used by bards, song writers, and self-help gurus to represent an expansion of the mind beyond the limits created by perception and programming, it is bantered around both as a complement and criticism. While Albert Einstein proclaimed that it is more important than knowledge, still scientists – to include those of a medical ilk – continue to cast suspicion on the value of a vivid imagination. Yet, as it is in many ways the centerpiece of the clinical hypnotherapy, it deserves a serious explanation and exploration.

All animals are capable of misperceiving a threat. However, it is the primate who seems to be the most capable of using the frontal lobes' ability to anticipate and simulate. This faculty of imagining helps us form mental visual, auditory, and kinesthetic illusions that are the direct creation of our abilities to convert perceptions into understanding. Our greatly enhanced capability to create an imagined "reality" merely by our thoughts is indeed a unique human characteristic.

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Full Title: The effect of cultural background on the usage of complementary and alternative medicine for chronic pain management

BACKGROUND: Chronic pain is a debilitating problem with significant impact on healthcare utilization in the US. Many chronic pain patients use complementary or alternative medicine (CAM) in addition to standard pharmacologic therapy. OBJECTIVE: The aim of our study was to identify differences in the characteristics of usage of CAM for chronic pain control among several ethnic groups. DESIGN: We recruited 92 consecutive patients seeking treatment at the pain clinic and interviewed them using a questionnaire. RESULTS: The most common pain complaint was back pain (55.4%) and the mean pain duration for all chronic pain problems was 9.8 years. Approximately 81% of respondents were using or have used CAM before. The commonest CAM used by patients in our study included massage therapy, spiritual healing as well as the consumption of mineral and vitamin supplements. Sixty-three percent of them were satisfied with CAM treatment compared to 56% of patients who were satisfied with prescription therapy. However, there was no difference in the use of CAM among the different ethnic groups (P > 0.05). CONCLUSION: Our study demonstrates that CAM is used very frequently in patients with chronic pain. However, it did not show any ethnic or racial differences in CAM utilization.

Pain Physician. 2009 May-Jun;12(3):685-8. Ho KY, Jones L, Gan TJ. Pain Management Centre, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. ho.kok.yuen@sgh.com.sg

Pain following traumatic injuries is common, can impair injury recovery and is often inadequately treated. In particular, the role of adjunctive nonpharmacologic analgesic techniques is unclear. The authors report a randomized, controlled study of 21 hospitalized trauma patients to assess the analgesic efficacy of virtual reality hypnosis (VRH)-hypnotic induction and analgesic suggestion delivered by customized virtual reality (VR) hardware/software. Subjective pain ratings were obtained immediately and 8 hours after VRH (used as an adjunct to standard analgesic care) and compared to both adjunctive VR without hypnosis and standard care alone. VRH patients reported less pain intensity and less pain unpleasantness compared to control groups. These preliminary findings suggest that VRH analgesia is a novel technology worthy of further study, both to improve pain management and to increase availability of hypnotic analgesia to populations without access to therapist-provided hypnosis and suggestion.

Int J Clin Exp Hypn. 2010 Jul;58(3):288-300. Patterson DR, Jensen MP, Wiechman SA, Sharar SR. Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98104, USA. davepatt@u.washington.edu

Full Title: An exploratory study of the contextual effect of homeopathic care. A randomised controlled trial of homeopathic care vs. self-prescribed homeopathic medicine in the prevention of upper respiratory tract infections in children.

OBJECTIVES: The aim of this study was to explore the contextual effect of homeopathic consultation by investigating the effect of homeopathic care compared to self-treatment with self prescribed homeopathic medicine in the prevention of childhood upper respiratory tract infections (URTI). METHODS: Randomised parallel group trial with 208 children below the age of 10. The children were randomly assigned to receive either homeopathic care (HC: individual homeopathic consultations with any homeopathic medicine in any potency being prescribed) or one of three self-prescribed homeopathic medicines (SPH) in C-30 administered twice weekly, for 12 weeks. RESULTS: There were no significant differences in clinical effects between SPH and HC for primary outcomes. Mean URTI scores over 12 weeks were 39.0 in the HC group and 43.9 in the SPH group (p=0.782, difference -5.0 points (95% C.I.; -20.5 to +10.5)). The mean number of days where the parents rated their child as 'ill with URTI' was 10.0 in the HC group and 13.7 in the SPH group (p=0.394). There was a trend in favour of HC for other outcomes. CONCLUSIONS: In this innovative and exploratory study, there was no evidence for a clinically relevant effect of homeopathic care vs. a homeopathic medicine given by the child's parents and based on a pre-agreed homeopathic treatment protocol.

Prev Med. 2007 Oct;45(4):274-9; discussion 280-1. Epub 2007 Feb 9. Steinsbekk A, Lewith G, Fønnebø V, Bentzen N. Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), MTFS, N-7489 Trondheim, Norway. aslak.steinsbekk@ntnu.no

by Mark Tyrrell

3 tips you can use to help your new client get the most from hypnosis

"Am I doing this right? I can still hear him. For that matter, I can still hear the cars outside. My ear itches. Should I be thinking this much? This isn't what I was expecting!"

A client's first encounter with hypnotherapy can raise all manner of questions. They might have seen a hypnosis stage show or a film featuring hypnosis and come into their first session with any number of misconceptions regarding what they 'should' be doing, feeling, experiencing. When there's a disparity between those expectations and the actual experience, they can begin to wonder if they're 'doing it right'.

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The objectives of the study were: first, to determine the prevalence of traditional medicine (TM) and complementary and alternative medicine (CAM) use in head and neck cancer patients in Ireland; second, to educate ourselves on the plethora of CAM/TM options available to patients outside the dominion of conventional medicine. The study design consisted of a cross-sectional survey carried out in three head and neck cancer centres. Self-administered questionnaires were distributed to 110 head and neck cancer patients attending the three cancer centres and data were collected for statistical analysis. A total of 106 patients completed the questionnaire; 21.7% of the participants used CAM/TM since their diagnosis with head and neck cancer. CAM/TM usage was higher in female (34.3%) than in male patients (16.2%). CAM/TM use was more common in the 41-50-year age group, in patients with higher educational levels and those holding strong religious beliefs, and also in married than single patients. The most common types of CAM/TM used were spiritual and laying on of hands. The most common reasons reported for using CAM/TM were to counteract the ill effects of treatment and increase the body's ability to fight cancer. Sources of information on CAM/TM were friends (65%), family (48%) and media (21%). This survey reveals a high prevalence of CAM/TM use in head and neck cancer patients, hence emphasising the need for otolaryngologists to educate themselves on the various therapies available to be able to provide informative advice. There is an urgent need for evidence-based investigation of various CAM/TM therapies currently offered to patients.

Eur Arch Otorhinolaryngol. 2010 Aug;267(8):1291-7. Epub 2010 Mar 14. Amin M, Glynn F, Rowley S, O'Leary G, O'Dwyer T, Timon C, Kinsella J. Department of Otolaryngology, Head and Neck Cancer, St. James's Hospital, Dublin, Ireland. mohamin@rcsi.ie

By Coach Cary Bayer

Norman Vincent Peale, one of the 20th century's great positive thinking gurus, once said: "Change your thoughts and you change your world." To that I would add the following idea; namely, that it's just as wise to change your speech. If you want to lose weight, it's obvious that you have to watch what you eat and change how you exercise. A veritable fortune has been made by Weight Watchers with such a formula. If you want to prosper as an alternative healer, then it's also important that you watch what you say. I call this article Word Watchers.

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During hypnosis, the authors tested repeated weight-related, literal and metaphorical suggestions about the heaviness of the subjects' arms. The purpose was to determine if linguistically varied hypnotic suggestions produced significantly different motor reactions--involuntary pressure forces of the forearms--as assessed by a linguistic biomechanical system. Classic, literal (L) suggestions such as "your right arm is heavy" were used, as well as metaphorical (M) suggestions, such as "your right arm is made of lead." A specific effect on the progressive increase of pressure forces only in the temporal sequence L-M for each forearm (literal suggestions followed by metaphorical suggestions) was found. This effect, termed crescendo image metaphor effect, conceptualized within context-limited simulation theory, explains the findings.

Int J Clin Exp Hypn. 2010 Jul;58(3):350-65. Santarpia A, Blanchet A, Mininni G, Andrasik F, Kwiatkowski F, Lambert JF. Laboratoire de psychopathologie et de neuropsychologie (EA 2027), University of Paris 8, Saint-Denis, Cedex, France. asantarpia@yahoo.it

OBJECTIVE: The worldwide interest in the use of complementary and alternative medicine (CAM) has been established in multiple surveys. Chronic rhinosinusitis (CRS) is often an unremitting disease with frequent troubling relapses, and despite wide use of endoscopic sinus surgery, conventional medicine may have a smaller contribution than expected. Because of prevalent use of CAM among patients, it is important that physicians acquire basic knowledge of this subject. We studied the prevalence of CAM use among CRS patients in Israel. DESIGN: Use of CAM was evaluated in a cohort of consecutive adult patients with CRS. SETTING: An outpatient clinic in a tertiary medical centre. METHODS: Patients were asked to fill out an anonymous questionnaire containing demographic data and data pertaining to allergy, traditional medical and surgical treatment use of CAM, and modalities used. RESULTS: Ninety patients were included. Nineteen of them (21%) reported CAM use. This included herbal medicine, vitamins, homeopathy, acupuncture, massage, reflexology, yoga, and chiropractics. There was a tendency, although not statistically significant, for patients with allergy and a history of sinus surgery to use CAM. CONCLUSIONS: The prevalence of CAM use among patients with CRS in Israel is high and may correlate with the presence of allergies and a history of sinus surgery.

J Otolaryngol Head Neck Surg. 2009 Aug;38(4):517-20. Yakirevitch A, Bedrin L, Migirov L, Wolf M, Talmi YP. Department of Otorhinolaryngology-Head and Neck Surgery, the Chaim Sheba Medical Center, Tel Hashomer, Israel. arkadiyak@gmail.com

The authors tested tailored hypnotic inductions for age regression with an affect bridge to access meaning-laden events. They used emotional intensity, spontaneity, elaboration, and transitional-object measures to assess the genuineness of the topographic shift to primary process characteristic of hypnotic age regression. An affect bridge was used to access stressful events within the age range of 3 to 6 years. The Stanford Hypnotic Susceptibility Scale, Form C was administered to determine high hypnotizables-reals, (n = 8, scores 9-12) and low hypnotizables-simulators, (n = 8, scores 3 or less). The groups behaved differently on frequency of transitional objects, spontaneity, and intensity but not on elaboration. The hypnotizable-reals but not the simulators produced a plethora of primary-process childlike affective responses that could not be produced by the role-playing simulators.

Int J Clin Exp Hypn. 2009 Oct;57(4):402-18. Christensen C, Barabasz A, Barabasz M. Washington State University, Pullman, Washington 99163, USA. ciara_christensen@yahoo.com

Full Title: Interoceptive hypersensitivity as prognostic factor among patients with panic disorder who have received cognitive behavioral therapy

The efficacy of cognitive behavioral therapy (CBT) in the acute-phase treatment of panic disorder is well established. However, there are data to show CBT may not always be able to prevent recurrence after treatment. The central cognitive component of panic disorder psychopathology is thought to be hypersensitivity to physical sensations. The present study reports that some aspects of interoceptive hypersensitivity, gastrointestinal fears in particular, were predictive of the course of panic disorder after end of CBT. Clinically it is suggested that new interoceptive tasks related to gastrointestinal fears are needed. (c) 2010 Elsevier Ltd. All rights reserved.

J Behav Ther Exp Psychiatry. 2010 Sep;41(3):325-9. Epub 2010 Mar 20. Ogawa S, Furukawa TA, Nakano Y, Funayama T, Watanabe N, Noguchi Y, Sasaki M. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. seiogawa1964@nifty.com

BACKGROUND: Infection with human immunodeficency virus (HIV) and acquired immunodeficency syndrome (AIDS) is a pandemic that has affected millions of people globally. Although major research and clinical initiatives are addressing prevention and cure strategies, issues of quality of life for survivors have received less attention. Massage therapy is proposed to have a positive effect on quality of life and may also have a positive effect on immune function through stress mediation. OBJECTIVES: The objective of this systematic review was to examine the safety and effectiveness of massage therapy on quality of life, pain and immune system parameters in people living with HIV/AIDS. SEARCH STRATEGY: A comprehensive search strategy was devised incorporating appropriate terms for HIV/AIDS, randomised controlled trials (RCTs), massage therapy and the pertinent measures of benefit. All electronic databases identified were searched in November 2008, including Cochrane Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE, AIDSearch, CINAHL, HEALTHSTAR, PsycLIT, AMED, Current Contents, AMI, NLM GATEWAY, LILACS, IndMed, SOCIOFILE, SCI, SSCI, ERIC and DAI. We also reviewed relevant published and unpublished conference abstracts and proceedings andscrutinised reference lists from pertinent journals. There were no language or date restrictions. SELECTION CRITERIA: Studies were identified by two reviewers based on trial design (RCTs) and participants (ie, people of any age with HIV/AIDS, at any stage of the disease) who had undergone an intervention that included massage therapy for the identified aims of improving quality of life and activity and participation levels, improving immune function, reducing pain and improving other physiological or psychological impairments. DATA COLLECTION AND ANALYSIS: Two reviewers independently identified included studies and extracted relevant data. Two other reviewers independently reviewed the included studies for risk of bias. All data and risk of bias judgements were entered into Revman (v5) and meta-analyses were conducted where appropriate. MAIN RESULTS: Twelve papers were identified, from which four were included. The remaining eight papers were excluded predominantly due to inappropriate methodology. The four included studies were highly clinically heterogenous, investigating a range of age groups (ie, children, adolescents and adults) across the disease spectrum from early HIV through late-stage AIDS. The settings were either community or palliative care, and the outcome measures were a combination of quality of life and immunological function. The trials were judged to be at moderate risk of bias mostly because of incomplete reporting. For quality of life measures, the studies reported that massage therapy in combination with other modalities, such as meditation and stress reduction, are superior to massage therapy alone or to the other modalities alone. The quality of life domains with significant effect sizes included self-reported reduced use of health care resources, improvement in self-perceived spiritual quality of life and improvement in total quality of life scores. One study also reported positive changes in immune function, in particular CD4+ cell count and natural killer cell counts, due to massage therapy, and one study reported no difference between people given massage therapy and controls in immune parameters. Adverse or harmful effects were not well reported. AUTHORS' CONCLUSIONS: There is some evidence to support the use of massage therapy to improve quality of life for people living with HIV/AIDS (PLWHA), particularly in combination with other stress-management modalities, and that massage therapy may have a positive effect on immunological function. The trials are small, however, and at moderate risk of bias. Further studies are needed using larger sample sizes and rigorous design/reporting before massage therapy can be strongly recommended for PLWHA.

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007502. Hillier SL, Louw Q, Morris L, Uwimana J, Statham S. Centre for Allied Health Evidence, University of South Australia (City East), North Terrace, Adelaide, SA, Australia, 5000.

E. Thomas Dowd, Ph.D., ABPP, is a professor of Clinical Psychology at Kent State University, Kent, Ohio. His interests include application of cognitive-behavioral/developmental therapy to a wide variety of psychological disorders with adults. This includes hypnosis and hypnotherapy and its integration into CBT. He has an ongoing investigation into the effect of individual differences in psychological reactance on the therapy process. Currently he is investigating memory processes and tacit knowledge structures (including tacit cultural assumptions) in psychological functioning and malfunctioning.

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The 21 muscles that cross the hip provide both triplanar movement and stability between the femur and acetabulum. The primary intent of this clinical commentary is to review and discuss the current understanding of the specific actions of the hip muscles. Analysis of their actions is based primarily on the spatial orientation of the muscles relative to the axes of rotation at the hip. The discussion of muscle actions is organized according to the 3 cardinal planes of motion. Actions are considered from both femoral-on-pelvic and pelvic-on-femoral perspectives, with particular attention to the role of coactivation of trunk muscles. Additional attention is paid to the biomechanical variables that alter the effectiveness, force, and torque of a given muscle action. The role of certain muscles in generating compression force at the hip is also presented. Throughout the commentary, the kinesiology of the muscles of the hip are considered primarily from normal but also pathological perspectives, supplemented with several clinically relevant scenarios. This overview should serve as a foundation for understanding the assessment and treatment of musculoskeletal impairments that involve not only the hip, but also the adjacent low back and knee regions.

J Orthop Sports Phys Ther. 2010 Feb;40(2):82-94. Neumann DA. Marquette University, Physical Therapy Department, Milwaukee, WI 53201-1881, USA. donald.neumann@marquette.edu