A Basic Guide To Complementary Therapies And Ethical Practice
This is a matter very close to my heart and equally an area of great concern to me. I am a qualified and accredited hypnotherapist, with additional diplomas in Neuro-Linguistic Programming (NLP), dyslexia and Life Coaching. I am also currently taking further diplomas in mindfulness and autism. These qualifications make me sound qualified to 'treat' people for things like dyslexia, autism and mental health problems... but I am not.
I cannot claim to 'treat', 'cure' or provide 'treatments' for ANY medical or neurological conditions, and as an ethical practitioner I would not make these kinds of claims.
I can claim that hypnotherapy for example, might bring some benefits to a client’s overall health and well-being, and that it might be a useful tool for helping them achieve their personal goals... but it cannot 'cure' medical conditions.
I initially studied these subjects to gain skills and strategies to manage my own difficulties and life-long issues with anxiety. I never viewed any of these subjects as a form of therapy. Instead, I saw them as a way to provide me with new techniques and strategies to help me manage my differences and start to move my life forward positively.
I now use the knowledge and tools I gained from studying these subjects to write self-help blogs for the Neuro-Divergent (ND) community. I attend events and workshops where I offer talks about my own ND differences and the kinds of strategies that have helped me and I also take on occasional clients on a one-to-one basis - so I am myself a complementary therapist.
This blog is not about promoting my own services or about harming the reputations of any 'complementary' practices.
I am writing this blog to give the reader an understanding of what different therapies can and cannot claim to do. Of the kinds of standards all therapists should aspire to. I am exposing the unethical practices that some employ in order to make sales in the hope that everyone who reads this blog can go on to find properly qualified, insured, accredited and ethical therapists or practitioners in the therapies/practices of their choosing.
'Alternative' Vs 'Complementary' Therapies
I prefer to say that I offer a 'complementary' therapy because the word 'Alternative' is in itself problematic. Complementary or additional therapies are NEVER a substitute (or 'alternative'), for medical care. The name 'alternative' implies that these treatments can work in the place of primary medical care when that is NOT the case.
Anyone using the word 'Alternative' to describe their type of therapy would be well advised to consider changing the description to 'complementary' so that they do not give the misleading impression that their therapy is an alternative for medical care.
Here in the UK we are lucky, we have a free at the point of contact National Health Service (NHS) where everyone can see a fully qualified medically trained General Practitioner (GP) or nurse, at their local Doctors Surgery, Health Centre or Hospital. From there they can be referred on, when necessary, to 'specialist' NHS APPROVED services such as; counsellors, psychiatrists, psychologists, psychiatric nurses, rheumatologists, paediatricians, and many more specialists. When you see your own doctor you can be well advised on which therapies, treatments or activities would be considered potentially beneficial for you after paying due consideration to any pre-existing medical conditions. This is something your doctor is capable of doing. A complementary therapist can never be a replacement or alternative for qualified medical advice and support.
* You should therefore always see your GP about any complementary therapy you might want to explore to first ensure there are no contra-indications.
Everyone is entitled to medical treatment, however, waiting lists are long, doctors are overworked and appointments with doctors are reported as becoming increasingly hard to get. I have heard many people say they are disheartened with the system. I have encountered increasing numbers of people who seem to try to self-diagnose and treat their chronic conditions, illnesses and injuries themselves. Many people only want to go to the doctor or hospital when they are no longer able to function. This is not ideal by any stretch of the imagination.
THe Promise Of Complementary Therapies
There are many people who believe that 'medical' intervention is not always necessary, that pharmaceutical companies are becoming too big and too ready to prescribe chemical remedies for things that do not require chemical 'treatments'. There are also those who believe that 'natural' remedies are just as effective as pharmaceutical ones and who prefer to use natural/non-medical interventions. Then there are those who seek medical advice first and foremost, but who will try anything that might help alleviate their symptoms.
Whereas there can be huge waiting lists for NHS appointments - complementary therapists and practitioners tend to offer private practice. This means they can often fit clients in before the NHS can.
The Dangers Of Unethical Practice
An individual holding views that would make them more likely to seek 'alternative' treatments is perfectly acceptable as it is each person's right to choose methods that suit their personal ideals or religious beliefs; however, no ethical complementary therapist or practitioner would imply that with their medication, therapy or treatment a client would no longer need to rely on medical treatments deemed necessary for their wellbeing by qualified doctors.
If a therapist suggests that you can stop using your prescribed medication without checking with your doctor then you should walk away, and walk away fast. You might also want to inform your GP of what was said so that they are made aware of this practitioner.
So Many Different Therapies To Choose From?!?
Every day there seem to be more complementary therapies entering the market. Therefore the following is by no means an exhaustive list:
Acupressure/Acupuncture, Aromatherapy, Ayurveda, Chi-Kung, Chrystal Healing, Coaching, Cognitive Behavioural Therapy, Colour Therapy, Counselling, Herbalism, Homeopathy, Hot Stone Massage, Hypnotherapy, Indian Head Massage, Japanese Holistic Healing, Medicinal Herbs, Mindfulness, Naturopathy, Neuro-Linguistic Programming, Reiki, Shiatsu, Yoga... and many more!
Someone who was new to all these types of 'therapy' might not understand that some of these are simply NOT what they seem to be. In fact, most of these types of therapy are not therapies at all and cannot make 'medical' claims. Some of these therapies or practices are seen as effective 'talking therapies' so the NHS refer clients to some complementary services. Even if the NHS support a 'therapy' it does not at the moment mean it is an evidence based from of 'therapy' or 'treatment'. I will explain more about this later when I look at the case of homeopathy.
When Is A Therapy Not A Therapy?
Each type of therapist or practitioner will claim different results. Some therapies are more in or out of favour than others. Some of the above list are considered effective talking 'therapies' but there are others included which are NOT therapies at all. For example; 'Life Coaching' is not a form of 'therapy', it does not look to help people overcome any medical or neurological conditions or emotional states. Life coaches effectively provide the tools and techniques to help their clients Identify realistic goals for themselves and put strategies in place to help them stay on track to achieving these desired goals. Most people who seek the support of life coaches want to improve their productivity; be it in their studies, work, or another aspect of their life. Life Coaching can be very useful to many who find themselves stuck in a rut, but it is NOT a therapy. Fortunately, I have never seen a Life Coach claiming to 'cure' or 'treat' any medical or neurological conditions.
Many life coaches lack training in medical conditions and few undertake compulsory modules on mental health. The reason for this is that coaches do not deal in 'long term' issues. If you have any form of depression, anxiety disorders, or any other conditions which are regarded as 'mental health' issues a life coach is NOT qualified to advise you, (unless they have gained additional qualifications in these areas). Unfortunately, not all practitioners are ethical in their practice so there are non-accredited coaches out there who will overstep their boundaries and areas of expertise, by working with people who are not medically fit for coaching.
Neuro-Linguistic Programming (NLP), is pretty much discredited as a 'therapy' by the establishment. It is based on the belief that to achieve good results we simply need to model the behaviour and language of those who have achieved greatness in the past. This 'belief' has lead to many using NLP to offer quick phobia 'cures' and similar 'treatments' based on modelling the behaviour of experts in the fields of hypnotherapy, psychology, Cognitive Behavioural Therapy (CBT) and others, as opposed to there being any 'evidence' that NLP works. The name 'Fast Phobia Cure' (which some NLP practitioners still use), implies there is medical benefit to 'patients' but there is no scientific evidence at all that NLP works like this.
There are some really sound principles in NLP which can be used by life coaches, and others; however NLP is NOT a therapy. Therefore anyone claiming to 'cure' any conditions with NLP is only offering you a belief system to buy into - NOT a medically approved course of treatment. NLP practitioners are not qualified to offer medical opinions. Those who work ethically have many satisfied clients. In short NLP can cure/treat NOTHING but it can provide techniques, strategies and belief systems which can help some individuals to better manage some of their difficulties.
Counselling has always been a trusted form of 'talking therapy' amongst medical professionals. Many people who have encountered mental health problems will have been referred to counsellors. Qualified counsellors can take up employment in health sector 'therapy' departments and as such there are minimum standards and regulations those calling themselves counsellors need to follow. It is common practice for only accredited counsellors to be offered work within established health sectors. Not all counsellors will necessarily understand how a client's condition affects them but all should have received enough basic training to know where their boundaries are, when necessary they will refer clients on to more suitably qualified therapists.
CBT practitioners have also been busy over the years as another 'trusted' form of 'talking therapy'. More recently 'mindfulness' has also started taking over as the therapy of the moment (pun intended).
Medical Professionals within the NHS will often refer patients who they believe could benefit from these kinds of treatment to classes or sessions where their client could be provided with this kind of support, sometimes courtesy of the NHS, other times at the patients own expense.
The Case Of Homeopathy
Unfortunately, NHS prescribing and referral system is not in itself a guarantee to effective therapies. There is a large amount of money still being spent by the NHS on prescribing 'treatments' which have no medical evidence of effectiveness at present.
In the last few years many questions have been asked as to why the NHS allows money to be spent on homeopathic treatments when there is no evidence of medicinal effects of the treatments. Homeopathy is available for medical conditions like Asthma, Hay-fever. rashes, and much more. Some NHS doctors will prescribe homeopathic treatments; yet study after study has shown that they are no more effective than a placebo.
There is now a study being undertaken to establish whether the NHS should blacklist homeopathy. More information on this can be found here: http://www.iflscience.com/health-and-medicine/england-wales-could-blacklist-homeopathy
So if some therapies are discredited as therapies, others weren't therapies to begin with and we can't even judge a therapy by NHS current prescribing standards, how is a newcomer meant to understand who can claim what?
What Are Complementary Therapies Not Allowed To Claim?
No complementary therapy or practice can claim to 'cure' or 'treat' certain medical or neurological conditions for which there is no substantial proof of established 'curative' results. If someone does claim their therapy can 'cure' or 'treat' condition they must have a body of evidence that shows this to be the case.
So as an example; any therapist or practitioner who claims to be able to cure or treat Autism, should be challenged about their assertions and where possible reported to the Advertising Standards Authority for misleading potential clients by claiming to 'cure' or 'treat' something for which there is no 'cure'.
*As a ‘therapist’ I abide by the advertising standards authorities rules and rely on the really useful information provided by the Committee of Advertising Practice (CAP) to ensure my adverts are not misleading in any way. For those of you who would like to see more about the CAP rules in regards to ‘health claims’ you can follow this link: https://www.cap.org.uk/Advice-Training-on-the-rules/Help-Notes/Health-Therapies-and-Evidence-QA.aspx#.Vm6car9PZ2l
The Advertising Standards Authority have strict guidelines about what therapists and practitioners can and cannot claim. In order to claim that they can 'cure' or 'treat' any A listed medical condition they MUST have overwhelming evidence to back up the claim. It is my understanding that If the therapist/practitioner cannot back up their claims with 'independently researched findings' then the Advertising Standards Authority can take action against them. If they are found to be breaching the CAP rules then they will look into whether an investigation is warranted.
- If you would like to see more information on the Advertising Standards Agency then you can find their website here: https://www.asa.org.uk/
- If you are interested in seeing other opinions regarding therapies currently available for autistic children you might find the following article written by Shannon Des Roches Rosa to be of interest: http://m.blogher.com/what-kinds-therapies-actually-help-autistic-kids
Why Does Wording Matter?
All therapies and practitioners claim different things and achieve different results from their individual clients; but the rules are simple. No therapist can claim to 'cure' or 'treat' medical conditions if they do not have overwhelming independent 'evidence' that their practice/medication works. Therefore each therapist words things differently, many try to express that their practice/medication can help 'some' to alleviate or reduce certain symptoms but they do not claim to 'cure' medical conditions.
Wording matters because it is unethical to mislead potential clients about the 'benefits' of any treatment. It could in some cases be considered dangerous if the clients are put off getting real medical advice over issues that could affect their health and well-being.
So What Type Of Complementary Therapy Are You Looking For?
Different therapies offer very different results and are designed to help with different aspects of health and well-being. If you need someone to help you get moving positively forward in your job or achieving more in sports then learning techniques like those provided in Coaching, NLP (and similar results based strategy systems), can provide great results.
If you have any medical concerns regarding mental health difficulties, like stress, anxiety, depression, or any other types of neurological conditions, and you struggle to manage your day-to-day chores, these types of results driven strategy systems will NOT do. You must have someone to work with who understands your underlying mental health difficulties and who can always keep your health and well-being at the forefront of their mind. If there are any underlying mental health issues of any kind then the first call is to ask your own GP for advice as to any complementary treatments or practices they could recommend.
Counsellors, CBT practitioners, mindfulness classes and many other complementary therapies, practices and activities can be recommended to you by a medically trained professional who understands your underlying differences. They will be best placed to know if the type of treatment could have any negative impacts on your health.
Quick Complementary Therapies Generally Accepted Ethics Check-List
How to check that the complementary therapist you are considering using is a qualified and ethical practitioner
1. Do they claim to be able to 'cure' something that cannot be cured by modern medicine? If they say yes then my advice is to walk away and look for a more realistic practitioner. Possibly also report them to the Advertising Standards Authority if necessary.
2. Do they claim their therapy can be used as an 'ALTERNATIVE' to seeking medical treatment? Walk away. The only people who can advise you on medical matters are those trained in medical issues.
3. Is the practitioner qualified and insured to practice? Find out more (look at the detailed approach questions to ask therapists).
4. Is The Therapist Accredited By An Awarding Body? Ask to see their ethical code of practice and check whether they are members of the Acreddited Voluntary Register.
A More Detailed Look At The Ethics
1. Do they claim to be able to 'cure' something that cannot be cured by modern medicine?
If the answer is 'yes' then they are most likely preying on vulnerable people and profiting from their misery. *These people should not only be avoided but should be reported to the advertising standards authorities in order to have the misleading message removed from their site/adverts unless they can provide the evidence that their treatment can in fact be shown to medically 'cure' what they are claiming to cure.
2. Do they claim their therapy can be used as an 'ALTERNATIVE' to seeking medical treatment?
If they do this I strongly advise you to walk away. There are practitioners in ALL fields who are more than happy to work with clients in partnership with their medical practitioners in order to provide a multi agency approach. When this is done, the client is assured to continue to receive the medical treatment they require. Anyone selling wares and telling clients that with their treatment they will no longer need to see the doctor is potentially endangering the client's health.
Although there are many people who choose not to use medical/pharmaceutical services that is their choice. No one claiming to be a therapist has the right to try to convince anyone NOT to use medical or pharmaceutical services that are deemed to be necessary to the individual. That could be dangerous to their health and wellbeing. Anyone who tries to convince you that their 'Alternative' medicine/treatment can be used without the knowledge/support of their doctor or as an alternative to medical treatments should be avoided. It is completely unethical to encourage people to not seek medical treatment first and foremost for any conditions.
3. Is the practitioner qualified to practice?
Do they hold ANY qualifications or are they self-taught? Many complementary therapies are not regulated, whereas others have set up their own voluntary accrediting registers so that ethical standards are being practiced (more on this later), but not all practitioners belong to these Voluntary Accredited Registers. In short, anyone can claim to be a therapist. Not being qualified does not prevent many from setting up practice.
Here in the UK there are no government regulations in place for many complimentary therapies and practices, the quality of practitioner courses vary greatly from provider to provider. Someone can do a short, distance course on hypnosis and then claim to be a hypnotherapist. There is no law stopping anyone from doing this. Equally, many life coaches for example, hold no qualifications whatsoever in coaching despite there being some very intensive courses available in the subject, Mindfulness practitioners could have learned about the subject on distance courses where they have never experienced face-to-face work with clients. The qualifications vary so much in quality and depth that consistency across these fields is going to be difficult to measure or monitor. Many courses cannot possibly prepare practitioners for the complex nature of clients difficulties; yet all of these people will claim to be qualified because they have achieved a qualification in the subject.
Qualifications cannot guarantee the professionalism or effectiveness of these therapists but if they claim to be qualified then here are a few questions you can ask them:
* What type of course did you undertake to gain knowledge in the field?
* Was any of your course supervised?
* Do you have ongoing supervision?
* How many contact hours have you logged with clients?
* Do you have an ethical code of practice I can see?
* Are you insured to practice?
Even this cannot guarantee quality, but it does allow honest rapport to develop between client and practitioner. If practitioners/therapists cannot answer these simple questions then it is worth looking elsewhere as they should be able to tell you exactly how they have become qualified and how successful their practice has become.
4. Is The Therapist Accredited By Voluntary Awarding Body?
Take a look at this YouTube link to see what The Professional Standards Authority have to say about Accredited Registers: https://m.youtube.com/watch?v=9GZN-OL-5CI&feature=youtu.be
Although some level of research is necessary to establish which Accrediting Bodies conform to the Professional Standards Authorities Accreddited Register. There is an easy search tool which allows you to quickly search for the Accrediting Membership Organisations here: https://www.professionalstandards.org.uk/accredited-registers/find-a-register
When someone is accredited, it means they have met the criteria to become a member of an awarding body, so they will have proved their qualifications/adequate experience, their professional insurance and agreed to abide by an ethical code of practice (which you should be allowed to view on request). However, the awarding body may not have met the standards for the PSA Accredited Register so by using the above tool it will be easy to establish whether the awarding body meets the high standards demanded of any practitioners or therapists who deal in people's health and well-being.
If the therapist is not accredited it does NOT mean that they are charlatans, they might be fantastic therapists who have simply never bothered to pay for membership of an accrediting body or their organisation may be on-track to getting on the register; however it does mean that if you are not satisfied with the service offered you will probably have no external body to raise the matter with.
Accredited Registers will have a clear complaints procedure and can instigate appropriate actions to ensure their standards are being upheld. Their practitioners have to have received adequate training to meet their high standards.
Be Warned: Some Awarding Bodies are not as good as others. There are genuine awarding bodies who belong to the Voluntary Accredited Register (or who are in the application process), who abide by agreed regulated standards. There are however, acrediting membership bodies that are set up, often by the institution they grant qualifications for, in order to guarantee their students accreditation of some sort. Therefore someone therapists/practitioners can become qualified and accredited without the accrediting body and/or the qualification itself meeting required standards that would be expected of those on the Accredited Register.
How To Spot An Ethical Therapist
An ethical complimentary therapist will want you to continue seeing your GP or medical specialist and will see your therapy or their practice, as a complimentary service and not a replacement for real 'medical' care. Some therapists and practitioners will want to work with doctors and other specialists as part of a multi-agency team approach to helping the client. If their client has existing issues which should have been brought to the attention of their doctor the ethical complimentary therapist WILL ensure they work with the doctor. In some cases they will refuse to continue working with the client until their doctor agrees that any contraindicative conditions have been tackled first.
In some instances it would not be medically recommended to offer certain types of complementary therapy to people with complex, or commonly misunderstood conditions. So an ethical therapist will ensure they take a detailed medical history to be certain that there are no contraindications that would prevent them from offering you this type of treatment. They will want to know what, if any medications you are on and what they are prescribed for. They will need to know that you are not under the influence of any illicit drugs or alcohol during sessions. In short, they will ensure they give due diligence to any medical issues which they are not qualified to deal with.
An ethical therapist will either confirm they are qualified to work with you or refer you on to another specialist. Even if they are qualified to work with you they may still ask you to see your doctor in order to get a consent form signed saying that it is okay to proceed with this kind of treatment or practice. Only if the client's doctor confirms that in their 'medical' opinion the client does not have any contraindications and are okay to continue with the treatment or practice, would the client then be taken on.
An Alternative To Seeking A Therapist
For those of you who are interested in self-help complementary therapies - there is an alternative to spending out lots of money on finding a complementary practitioner or therapist who understands your specific differences (whatever they may be). It might be an idea to do some searches on the internet regarding therapies that interest you. Ask friends what has worked for them, do Google searches and YouTube searches as they can provide great insight into all the different types of therapy. There are a lot of free tutorials on YouTube that will at the very least give you some insight into the subject. There are many of us are who are only qualified to practice because we wanted to learn the skills for ourselves and a lot of us started by learning as much as we could from the internet.
So long as your GP is in agreement with you studying the therapy or practice as a way of empowering yourself, then you do not have to hire a practitioner, you can just read up on the strategies and techniques. You could undertake a basic qualification to help you gain the skills for yourself. There are many online distance diploma courses available and from time to time they are available at very low prices through groupon internet schemes. The majority of these courses have no completion date, so you can take as long as you like to finish them. Some of them will just give you a flavour of the topic whereas others will let you delve deep into many more areas, but if you are doing it just for personal interest, or to add to your own collection of skills then there is no harm done.
Rather than paying for a practitioner, you could enrol on a course to better understand any of the complementary therapies for yourself. That is what I did. The problem is once you are qualified to practice, and you know how helpful some of the techniques have been for you - then it's hard not to want to go into practice. That is when you first realise the importance of becoming accredited by an awarding body who is on the Accredited Register. It is also unfortunately when you realise how many charlatans are out there claiming to do medical things they simply cannot do.
I have come across some amazingly talented practitioners within many complementary fields, but I have also come across more than a few unethical ones. I believe that misrepresenting the medical benefits of a complementary therapy harms all therapists and practitioners as it drags all standards down.
This is this reason I have written this guide.
People will want to seek alternatives when the options they are given do not seem to work, or do not work fast enough. There are some great therapists and practitioners out there who have really helped to turn some of their client's lives around. So for those of you who are looking to find a new way to tackle your personal health and well-being, I hope this guide will lead you to finding the right complementary therapist/practitioner for you.
Don't Judge A Book By Its Cover
If you are still intent on finding a complementary therapist. One more thing I feel I need to warn you about is that sometimes practices can seem more professional and established than they actually are.
There are practitioners and therapists who hire virtual offices in Harley Street, London. Possibly the most prestigious medical street in the world. They can have the virtual office listed as their actual business address and request all their mail be forwarded to them at their chosen (real) address. They can then rent a complementary therapy suite in the building from time-to-time to see clients in. I'm sure there are many well trained and valued practitioners running very ethical and beneficial practices from those offices. If I lived in London I might have looked into it myself, however the cost of the rail fare alone would make my practicing from London totally unrealistic. Yet I have come across people who rent out rooms in Harley Street even though they are also not based near London. I have no issue with professionals renting these rooms for practical reasons but I know some who did it because 'it created the illusion' that their business was more respected and established than it actually was.
Ending On A Positive
Many individuals do benefit immensely from undertaking complementary therapies and practices. It could just be the placebo effect where some of us respond well when we believe we are being taken care of and given something that will make us feel better. My personal opinion is that there is no harm in learning new techniques and trying out new strategies, or following healthier routines, especially if they bring benefit to your health and wellbeing; although I do not see any complementary therapy, practice or activity as having the potential to 'cure' anything medical. I do believe the human mind is an amazing thing and sometimes the positive or negative vibes can lighten or worsen existing conditions. This is where complementary therapies, practices and activities can make a huge impact on individuals' overall health and wellbeing.
The key to successful remedies is having healthy expectations. Do not expect a complimentary therapy to CURE something that modern medicine cannot cure. Instead see it as something that can perhaps target certain symptoms, like; stress, self-esteem, energy levels, mood management, etc. Remember to always make sure the practitioner/therapist is made aware of any pre-existing medical conditions you may have as they may need to understand how it impacts you or it may be a contraindicative condition which they will need to refer you on to a more suitably qualified practitioner.
I wish you good health and hope this guide goes some way to increasing understanding of the different standards available in complementary therapies/practices currently available within the UK.