Integrative Therapy Research Articles

Integrative Eco Art Therapy: Addressing Humanity’s Fractured Attachment to Nature

Integrative Eco Art Therapy: Addressing Humanity’s Fractured Attachment to Nature

Grief-Specific Cognitive Behavioral Therapy vs Present-Centered Therapy: A Randomized Clinical Trial.

Prolonged grief disorder (PGD) is included as a new diagnosis in international classification systems. Treatments following a cognitive behavioral model are most effective, but comparisons with active control treatments are scarce. To examine whether integrative cognitive behavioral therapy for prolonged grief (PG-CBT) is superior to present-centered therapy (PCT). This was a rater-blinded, multicenter, randomized clinical trial (stratified by center and relationship to the deceased) with enrollment from April 2017 to May 2022. The setting included 4 university outpatient clinics in Germany. Eligible participants were aged 18 to 75 years and had PGD based on the Prolonged Grief Disorder 13 (PG-13) interview. Participants were randomized 1:1 to PG-CBT and PCT. PG-CBT focused on the exposure to the worst moment of the loss and cognitive restructuring of grief-related cognitions in combination with solution-focused and experiential methods (eg, walk to the grave exercise). PCT was adapted in session length and number to PG-CBT and focused on a supportive relationship and coping with daily problems that may have arisen from the loss or grief symptoms. All outcomes were assessed at baseline, after treatment, and 12 months after randomization at follow-up. The primary outcome was a blinded assessment of the PG-13 severity score at follow-up. Secondary outcomes were self-reported depressive, somatic, and overall psychopathological symptoms. Of 544 treatment-seeking individuals experiencing bereavement, 212 eligible participants (mean [SD] age, 51.8 [13.3] years; 173 female [82%]) with PGD based on the PG-13 interview were randomized to PG-CBT and PCT (n = 106 in each condition). In the intention-to-treat analysis, both treatments yielded high reductions in PGD severity at follow-up (PG-CBT: Cohen d = 1.64; 95% CI, 1.31-1.97; PCT: Cohen d = 1.38; 95% CI, 1.09-1.66). After treatment, participants receiving PG-CBT demonstrated significantly greater reductions in PGD severity than those receiving PCT (Cohen d = 0.31; 95% CI, 0.03-0.57). At follow-up, this effect was only visible on a trend level (Cohen d = 0.28; 95% CI, -0.02 to 0.57), whereas participants in the PG-CBT group had significantly less depressive and general psychopathological symptoms. Twenty-three participants (20%) discontinued PG-CBT treatment, and 17 participants (16%) discontinued PCT. This randomized clinical trial demonstrates that PG-CBT was superior to PCT after treatment and at follow-up with regard to comorbid symptoms. Both treatments were shown to be effective and acceptable, showing the potential for dissemination and increasing patient choice. German Clinical Trials Register (DRKS) identifier: DRKS00012317.

Targeted Sonodynamic Therapy Platform for Holistic Integrative Helicobacter pylori Therapy.

Helicobacter pylori (H. pylori) is a primary pathogen associated with gastrointestinal diseases, including gastric cancer. The increase in resistance to antibiotics, along with the adverse effects caused by complicated medication protocols, has made the eradication of H. pylori a more formidable challenge, necessitating alternative therapeutics. Herein, a targeted nanoplatform is reported based on sonodynamic therapy, the chitosan-conjugated fucose loaded with indocyanine green (ICG@FCS). It penetrates the gastric mucosa and homes in on H. pylori through dual targeting mechanisms: molecular via fucose and physical via ultrasound. Upon ultrasound activation, it generates singlet oxygen, effectively attacking planktonic bacteria, disrupting biofilms, and facilitating the clearance of intracellular bacteria by promoting autophagy, including multidrug-resistant strains. The ICG@FCS nanoplatform minimally affects the gut microbiota and aids in gastric mucosa repair. a holistic integrative H. pylori therapy strategy is proposed that targets eradication while preserving gastrointestinal health. This strategy emphasizes the importance of maintaining patient health while eradicating the pathogen. This advancement is set to refine the comprehensive antibacterial approach, offering a promising horizon in the ongoing battle against antibiotic resistance and more effective gastric cancer prevention strategies.

Fatigue and Sleep-related Impairment as Predictors of the Effect of Nonpharmacological Therapies for Active duty Service Members With Chronic Pain: A Secondary Analysis of a Pragmatic Randomized Clinical Trial.

First-line treatments for chronic pain include selected complementary and integrative health therapies, including spinal manipulation, acupuncture, yoga, and massage; and standard rehabilitative care, including physical and occupational therapies. This study aimed to uncover critical factors that contribute to pain impact and the effectiveness of complementary and integrative health therapies and standard rehabilitative care among people with chronic pain, with a focus on the role of sleep-related impairment. We conducted a secondary analysis of data from a pragmatic randomized clinical trial of 280 U.S. active duty service members with chronic pain. Our study's multiple mediation analysis examined the indirect effect of complementary and integrative health therapies on pain impact through fatigue (β = - 0.43; 95% CI, -0.99 to -0.07). When stratified by sleep-related impairment, participants with T scores above the median of 62 demonstrated a significant negative indirect effect of complementary and integrative health therapies through fatigue (β = - 0.80; 95% CI, -2.31 to -0.14). This negative indirect effect was not significant for participants with sleep-related impairment T scores below the median (β = - 0.64; 95% CI, -1.48 to 0.07). These findings suggest that complementary and integrative health therapies are particularly effective in reducing pain impact for individuals with higher levels of sleep-related impairment, and that the effect of complementary and integrative health therapies is supported primarily by reducing fatigue.

How initial perceptions of the effectiveness of mind and body complementary and integrative health therapies influence long-term adherence in a pragmatic trial.

Beliefs and perceptions about pain intervention effectiveness when initiating a therapy may influence long-term engagement. This study examines how early perceived effectiveness of complementary and integrative health therapies impacts long-term engagement in a pragmatic trial context. Veterans with chronic musculoskeletal pain participating in a pragmatic trial of provider-delivered complementary and integrative health therapies (acupuncture, chiropractic care, or massage therapy) used alone compared to combining those therapies with self-care therapies (yoga, Tai Chi/Qigong, or meditation). This analysis focuses on 1713 participants using self-care therapies at baseline. 18 Veterans Healthcare Administration Medical Facilities. Prospective cohort study. Predictors of total self-care complementary and integrative health therapy sessions over a 6-month assessment period were assessed using linear regression to determine how strongly perceptions of initial therapy effectiveness was associated with total utilization. Perception of initial therapy effectiveness was assessed at study entry across four domains (pain, mental health, fatigue, and general well-being). In total, 56% (1032/1713) of Veterans reported a positive perceived effectiveness of their recent complementary and integrative health therapy use at study initiation. Older individuals and those using meditation were more likely to report early positive perceptions. Mean number of therapy sessions over the 6-month study was 11 (range 1 to 168). Early positive perceptions had a small effect on overall use, increasing mean sessions by 2.5 (1.3 to 3.6). Other factors such as recent physical therapy use and distance to primary care explained more variation in total utilization. Pragmatic pain trials should examine factors associated with engagement across assigned treatment protocols, especially if any of the treatment protocols being tested are sensitive to long-term engagement.

Traditional, complementary and integrative medicine therapies for the treatment of mild/moderate acute COVID-19: protocol for a systematic review and network meta-analysis

BackgroundIncreasing evidence has emerged for traditional, complementary and integrative medicine (TCIM) to treat COVID-19 which requires systematic summaries of the net benefits of interventions against standard care and one another....

INTEGRATIVE COMMUNITY THERAPY: REPERCUSSIONS ON WORKERS IN A MUNICIPALITY IN PARAÍBA

Objective: To understand the repercussions of integrative community therapy (ICT) on professionals in a city in Paraíba. Methodology: This is an exploratory-descriptive study with a qualitative approach, using Bardin's content analysis technique. Workers from the Specialized Social Assistance Reference Center, Social Assistance Reference Center, Family Health Support Center, and Popular Education Center in the city of Nova Palmeira, Paraíba, participated in the research. Results: After analyzing the speeches, the following empirical categories emerged: Benefits of ICT: Redefining the way of being, in which it was observed that there were positive repercussions on both the personal and professional lives of workers; and ICT Circles and their main limitations according to the participants. Conclusion: The activity enables new ways of relating collectively to others. It is noticeable that the use of this tool provides the development of empathy, resilience, self-esteem, among others. Therefore, it is necessary to promote TCI circles more widely among workers and the community in general, thus allowing them to become a means of social inclusion.

Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions

Integrative Medicine (IM), which includes therapies such as acupuncture, herbal medicine, yoga, and meditation, is gaining attention for managing chronic pain conditions. However, concerns about the quality of evidence supporting the use of these interventions persist. The 5th Annual Jaseng Academic conference 2024, in Seoul, South Korea, themed "Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions," addressed these concerns by focusing on advancements in study design, evidence synthesis, and open science practices. This conference proceeding summarizes key insights from the conference, emphasizing the role of pragmatic randomized controlled trials (pRCTs) in evaluating real-world effectiveness, and addressing the complexities involved in IM research such as sham controls. The integration of IM therapies into comprehensive pain management strategies (particularly in Korea), supported by government-backed research and policy initiatives was also discussed. Advancements in methodologies were addressed, such as bibliometric analysis, evidence mapping, and the development of clinical practice guidelines (CPGs) for integrative therapies. These methodologies offer valuable insights but face challenges due to the heterogeneity of IM interventions, and potential synergistic or antagonistic effects when combined with conventional medicine. Finally, the potential of open science to enhance transparency, reporting, and reproducibility in IM was explored, emphasizing the increased role of adherence to reporting guidelines (CONSORT and PRISMA). The future of IM research is built upon the continued efforts of refined study designs, rigorous evidence synthesis, and the integration of open science principles, for a robust and more credible evidence base.

Problem-Oriented Integrative Therapy: Maximizing Clinical Flexibility in Treating Complex Psychiatric Conditions.

Although integrative therapies are increasingly popular in clinical psychology, their dissemination in the psychiatric literature has been limited. To care for patients living with complex psychiatric problems, the authors formulated a flexible, pragmatic, problem-oriented integrative therapy (PIT). The aims of this article are to increase psychiatric attention to the value of integrative therapies, authorize their use, and present the authors' PIT approach. PIT combines common factors, theoretical synthesis, and technical eclecticism. After delineating patients' problems and goals, clinicians apply discrete therapeutic elements derived by unbundling numerous theories and practices. Clinicians improvise and pivot their practice in response to patients' shifting problems and goals, as well as to advances in the field. Practicing PIT requires familiarity with numerous therapeutic theories and models and a willingness to continually expand skill sets. PIT's effectiveness may be assessed by comparing results obtained with PIT with those obtained via conventional psychotherapeutic modalities.

Unani Integrative Approach for the Management of Sciatica, Employing Pharmacotherapy with Regimenal Therapy: A Case Report

Sciatica, a subtype of low back pain (LBP) is one of the most common clinical complaints in primary care which is characterized by pain that originates in the lower back or buttocks and radiates down one or both legs along the distribution of the sciatic nerve. It commonly results due to nerve root compression by a prolapsed lumbar disc. Sciatica affects both genders equally and has an annual incidence of 1-5%, most common in 30-65 years of age. The management of sciatica includes non-pharmacological, pharmacological and surgical approaches. Combining these management techniques can help in pain reduction and thereby can lead to an overall wellbeing of the individual. In this case report we present the case of a 52 year old male patient with lower back pain radiating to left lower limb who came to Department of Regimenal therapies, National Institute of Unani Medicine, Bengaluru. The patient had taken NSAIDs and other measures for pain management from last 6 months. Despite taking exhaustive measures, no significant improvement was seen. The symptoms have gotten worse over the past two months. After complete clinical examination and diagnosis, the patient underwent treatment for 4 weeks using integrative approach in the form of unani pharmacotherapy, coupled with regimenal therapy. Many objective parameters were used to evaluate the patient both before and after the intervention. The assessment parameters after the intervention reported a significant amelioration of the symptoms. Our study suggested that, management of sciatica with an integrative strategy can be considered. Keywords: Sciatica, LBP, lumbar disc, Integrative therapy, NSAIDs, Regimenal therapy.

Integrative Therapies in Metabolic Syndrome

Integrative Therapies in Metabolic Syndrome

Acupuncture, a Promising Therapy for Insulin Resistance and Non-Alcoholic Fatty Liver Disease.

Insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) are representative metabolic diseases, and no pharmacological therapeutic strategies have been developed worldwide. In recent studies, acupuncture has increasingly been used as an integrative or complementary therapy for IR and NAFLD. In this review, we summarized 18 clinical trials and 25 animal studies to reveal the function and potential molecular mechanisms of acupuncture for IR and NAFLD treatment. We found that acupuncture can be a first-line treatment strategy for IR and has a positive therapeutic effect on NAFLD. Thus, this review provides clinicians with a deeper understanding of the scientific evidence for acupuncture treatment of IR and NAFLD. Finally, we highlighted three potential limitations of existing studies on acupuncture for the treatment of IR and NAFLD, including small sample sizes and inconsistent operating techniques.

Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for Integrative and Complementary Therapies

Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for <i>Integrative and Complementary Therapies</i>

Preventive and therapeutic effects of molecular iodine in a model of diabetes mellitus induced by streptozotocin

Diabetes mellitus (DM) is a multifactorial condition that involves oxidative alterations and dysbiosis of the gut microbiota associated with an imbalance in glucose metabolism. Therefore, the need to develop integrative therapies that are both effective and have fewer side effects has become evident in recent years. Molecular iodine (I2) has antioxidant effects in preclinical hyperglycemic models. The present work analyzes the preventive and therapeutic effects of oral I2 supplementation in a DM model induced by low doses of streptozotocin (STZ). Male CD1 mice (12 weeks old) were divided into the following groups: control, STZ (20 mg/kg/day, i.p., for 5 days), I2 (0.2 mg/Kg in drinking water), preventive (STZ + I2), and therapeutic (I2 supplementation from day 35 to day 90; STZ + I2(Ther)). The supplementation with I2 prevented and normalized hyperglycemia, hypercholesterolemia, and hypertriglyceridemia associated with STZ, preserving pancreatic, liver, muscle, and adipose tissue morphology and normalizing inflammatory gene induction (TLR2, TLR4, NFkβ, TNFα) in several tissues. Furthermore, compared to the STZ group, the presence of I2 favored a more significant abundance of beneficial bacteria that support the integrity of the intestinal epithelial barrier and higher α-diversity. In conclusion, the I2 supplement has preventive and therapeutic effects, reducing oxidative damage and reestablishing microbiota diversity following STZ exposure.

Client-Centered and Multidisciplinary Approaches in School-Based Occupational Therapy: Perceptions of Therapists and Parents

This study aimed to explore the perspectives of occupational therapists and parents who receive therapeutic support services for their children with special needs in school. We focused on school-based occupational therapy (SBOT) service goals, delineating how participants prioritize necessary services and perceive multidisciplinary collaboration. In this cross-sectional study, we employed an online survey methodology. We used a purposive sampling method to reach all school-based therapists registered in therapeutic support centers and a snowball sampling method to recruit parents. The final sample included responses from 29 therapists and 120 parents. We found that parents reported a greater need for service provision and multidisciplinary collaboration compared to school-based occupational therapists. Although therapists felt competent in their service provision, there is an urgent need to address the service needs expressed by parents. The participating therapists reported working with lower-functioning students and prioritized goals such as “providing task skills through Individualized Education Programs (IEPs)” and “enhancing student participation in educational activities.” In contrast, parents reported supporting higher-functioning children and prioritized goals such as “therapeutic activities within school environments” and “helping with important learning activities in natural environments.” This study underscores the need for ongoing research to develop integrative occupational therapy services in the school environment.

Integrating drumming, body percussion, sound therapy, and trance therapy into Subconscious Energy Healing Therapy (SEHT) for Peak Performance

This comprehensive concept note delves into the potential of combining drumming, body percussion, sound therapy, and trance therapy within the framework of Subconscious Energy Healing Therapy (SEHT) to enhance peak performance. By leveraging the distinct and synergistic effects of rhythmic and sound-based interventions, along with the deep transformative power of trance states, this approach aims to optimize mental, emotional, and physical well-being. Each component is explored in detail, emphasizing their individual contributions to the mind-body connection, emotional release, and subconscious healing. The note further addresses the current gaps in their application and offers strategic recommendations for the adoption of this integrative therapy by corporations and the general public, highlighting its wide-ranging benefits on both the mind and body.

Management of Knee Osteoarthritis (KOA) with Integrative Therapy: A Case Report

Knee osteoarthritis (KOA) is a serious public health concern and is described as a disorder characterised by degradation of articular cartilage, bone remodeling and inflammation, leading to pain, stiffness and functional impairment, primarily affecting weight bearing joints and hands. KOA affects more than 650 million individuals worldwide and is a leading cause of disability. In India, 28.7% of adults ≥ 40 years of age and 45.5% of adults ≥ 60 years of age have KOA. The annual incidence rate of KOA in India is 2.4%. The management of KOA involves a comprehensive approach, including non-pharmacological management, pharmacological management, surgical management, alternative therapies and lifestyle changes. By combining these management strategies, individuals with KOA can effectively reduce pain, improve function, and enhance their quality of life. We present the case of a 55-year-old female patient with bilateral KOA, who presented to Department of Regimenal therapies, National Institute of Unani Medicine, Bengaluru. The patient had taken NSAIDs and other measures intermittently for pain management from last 3 years. The symptoms have worsened from last 2 months despite taking medicines. The patient was assessed and examined clinically prior to intervention. The patient underwent treatment for 30 days with integrative therapy comprising of pharmacotherapy coupled with regimenal therapy. Prior and post intervention, the patient was assessed using multiple objective parameters. The patient reported amelioration of symptoms, which was also reflected by assessment parameters post intervention. The study found that integrative approach can be effective treatment for KOA. Keywords: KOA, Integrative therapy, NSAIDs, Regimenal therapy.

Are Virtual Complementary and Integrative Therapies as Effective as In-Person Therapies? Examining Patient-Reported Outcomes Among Veterans with Chronic Musculoskeletal Pain.

Background: Virtual complementary and integrative health (CIH) therapy availability increased during the COVID-19 pandemic, but little is known about effectiveness. We examined the perceived effectiveness of in-person and virtual CIH therapies for patients with chronic musculoskeletal pain who recently started using CIH therapies. Methods: The sample included Veterans (n = 1,091) with chronic musculoskeletal pain, identified in the Veterans Health Administration's electronic health record based on initiation of CIH therapy use, who responded to VA's Patient Complementary and Integrative Health Therapy Experience Survey during March, 2021, to August, 2022. Using multivariable models with self-guided virtual (apps or videos) delivery as the reference, we compared patient-reported outcomes (pain, mental health, fatigue, and general well-being) associated with any yoga, Tai Chi/Qigong, or meditation use delivered: (1) only in-person, (2) only virtually with a live provider, (3) only virtually self-guided, (4) virtually self-guided + virtually provider-guided, or (5) hybrid in-person + virtual (self-or provider-guided). Results: Under 10% of Veterans reported only in-person use; 54% used only virtual formats and 36% a hybrid of in-person and virtual. Forty-one percent reported improvement in general well-being, 40.6% in mental health, 37.1% in pain, and 22.7% in fatigue. Compared with Veterans using only self-guided virtual CIH therapies, Veterans using only in-person therapies were more likely to report improvement in fatigue (odds ratio [OR]: 1.8, confidence interval [CI]: 1.1-3.1) and general well-being (OR: 1.7, CI: 1.0-2.6). Conclusions: Many patients perceived health improvements from CIH therapies, with in-person users reporting more improvement in fatigue and well-being than those using virtual sessions and similar improvements in pain and mental health for in-person and hybrid users.

Hope for all? Investigating the moderating effect of social inhibition on the association between hope and outcome in an integrative group therapy program.

Existing research supports the therapeutic value of hope in different therapies and for diverse patient groups. Patients who are socially inhibited tend to have a particularly difficult time in group therapy, and the experience of hope in that context may be especially poignant for them. The present study investigated the impact of hope on the outcome of a group-based treatment and whether this impact differed for patients depending on their level of social inhibition. The sample consisted of 49 consecutively admitted patients who completed treatment in an intensive, integrative group therapy program. Patients completed four self-report measures to assess hope, social inhibition, quality of life, and depression. Regression with moderation analysis was employed. The analyses revealed that social inhibition significantly moderated the impact of hope on treatment outcome, indicating that hope had a more pronounced effect among those patients with relatively higher levels of social inhibition.

Patients Experience Improvements in Pain and Quality of Life When Treated at a Physician Led Integrative Medicine Clinic at a Large Air Force Military Treatment Facility

ObjectiveA large percentage of military treatment facilities (MTFs) offer at least one type of complementary medicine and 80% of patients surveyed felt that integrative therapies should be routinely offered at all MTFs. We are the first to offer the breadth of modalities outlined below in a dedicated MTF Integrative Medicine Clinic (IMC). The purpose of this study was to determine whether the basket of services offered at our IMC improved patient pain and quality of life. Design and SettingPatient outcomes over a three-year period were retrospectively evaluated from a single cohort. Patients referred to the IMC for chronic pain at the MTF recorded pain scores using the Defense and Veterans Pain Rating Scale (DVPRS) and completed the Dallas Pain Questionnaire (DPQ), a 16-item visual analog quality of life questionnaire, at each visit. They also completed a non-validated quality of life question on discharge from the clinic. Modalities used include microcurrent therapies, extracorporeal shockwave therapy, medical Acupuncture, myofascial release techniques, low-level laser therapy, and the AllCore360. Results761 patients were seen from August 2019 to October 2022 in over 3,280 clinic visits. On average per visit, DVPRS scores were reduced from 4.4 to 1.5 (MD 2.9; 95%CI, 2.7-3.1). Total DPQ scores were reduced by 16.5% (MD 27.7; 95%CI 22.7-32.7). On discharge from the clinic 81% of patients reported their quality of life was either “a lot better” or “somewhat better.” ConclusionsIf implemented, we believe comparable clinics across the Department of Defense can replicate these improvements in patient-oriented outcomes.