Ordered, immediately called back and the same day delivered the order.Very pleased with the work. Thank you for prompt and accurate work buy antibiotics online great prices, delivered on the day of the order. Pleasant managers consult by phone.
Advance Access Publication 25 August 2006
Healing by Gentle Touch Ameliorates Stress and OtherSymptoms in People Suffering with Mental Health Disordersor Psychological Stress
Clare Weze1, Helen L. Leathard2, John Grange3, Peter Tiplady4 and Gretchen Stevens1
1The Centre for Complementary Care, Muncaster Chase, Ravenglass, Cumbria, CA18 1RD, 2Faculty of Health andSocial Care, St Martin’s College, Lancaster, Lancashire LA1 3JD, 3Centre for Infectious Diseases and InternationalHealth, Royal Free and University College Medical School, 46 Cleveland Street, London W1P 6DB and4Meadow Croft, Wetheral, Carlisle, Cumbria CA4 8JG, UK
Previous studies on healing by gentle touch in clients with various illnesses indicated substantialimprovements in psychological well-being, suggesting that this form of treatment might be helpful forpeople with impaired quality of mental health. The purpose of this study was to evaluate theeffectiveness and safety of healing by gentle touch in subjects with self-reported impairments in theirpsychological well-being or mental health. One hundred and forty-seven clients who identifiedthemselves as having psychological problems received four treatment sessions. Pre- to post-treatmentchanges in psychological and physical functioning were assessed by self-completed questionnaireswhich included visual analogue scales (VAS) and the EuroQoL (EQ-5D). Participants recordedreductions in stress, anxiety and depression scores and increases in relaxation and ability to cope scores(all P < 0.0004). Improvements were greatest in those with the most severe symptoms initially. Thisopen study provides strong circumstantial evidence that healing by gentle touch is safe and effective inimproving psychological well-being in participants with self-reported psychological problems, and alsothat it safely complements standard medical treatment. Controlled trials are warranted.
Keywords: alleviation of symptoms – complements medical treatments – gentle touch – healing –psychological well-being – relaxation – stress
frequently imperfect due to inadequacies in dosage and duration(6,7). Adherence to prescribed medication may be erratic (7,8)
Anxiety and depression are among the most common mental
due in part to adverse effects, which usually begin before the
health disorders encountered in primary care (1), with episodes
therapeutic effect is achieved (9) and medication is tolerated less
of depression typically lasting for 12–20 weeks (2). Psycho-
well by patients with mild to moderate depression (10). Poor
logical stress resulting from bereavement, major life events or
expectations of improvement are a consequence of the negative
stressors in the external environment has been associated with
cognitive set; namely, the tendency to view self, future and world
depressive disorders in some individuals (3,4), and contributes
in a negative manner (11), which is associated with depressive
considerably to general morbidity and health care resource use
disorders and which contributes to non-adherence (12). Further-
more, many patients with major depression require long-term
Although evidence of the efficacy of antidepressants is robust,
maintenance therapy to prevent relapse or recurrence (13–15) and
current pharmacotherapeutic management of depression is
for these people adverse effects of medication are particularlyproblematic.
Depression is now conceptualized as a syndrome with
For reprints and all correspondence: Clare Weze, St Martin’s College,Bowerham, Lancaster, Lancashire LA1 3JD, UK. Tel: þ44-1524-221718;
biological, psychological and social influences (16), and is
2006 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License by-nc/2.0/uk/) which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Healing by gentle touch in mental health disorders
perhaps, therefore, likely to respond to a multidimen-
According to Dixon (39) this type of approach to healing
sional treatment strategy. Favorable outcomes have already
appears to trigger or enhance physiological healing processes,
been associated with combinations of treatment modalities
and this notion is consistent with our own understanding as
(17,18), where synergistic effects are likely. The character-
discussed in detail by Weze et al. (40). In a preliminary study,
istic remit–recur cycle of depression (19–21) means that
Tiplady (41) reported that healing at The Centre improved
appropriate treatment approaches must be ongoing, safe,
physical and psychological functioning in the majority of
acceptable to patients and as free from adverse effects as
110 subjects with various ailments. A further study of 300
possible. Healing by gentle touch as described by MacMan-
clients with a wide range of ailments has confirmed benefits to
away and Turcan (22), and practiced at the Centre for
both psychological and physical functioning (25). Analysis of
Complementary Care in Cumbria (The Centre) and else-
data from people with specific categories of ailments has
where, meets these criteria and merits evaluation as a
revealed psychological benefits of healing in people with
treatment modality for people with mental health disorders
musculoskeletal disorders (23) and with cancer (24). We have
also identified a subgroup of 147 clients who attended TheCentre with psychological problems, identified as described
Complementary Therapies and Mental Health Care
below, occurring alone or as part of more complex illness, andthe analysis of their data is presented here. In describing this
Although there is increasing use of various complementary
work we will use the term ‘psychological problems’ to
encompass the whole range of (often ill defined) mental
health disorders (26–29), little published research focuses on
health-related ailments reported by the clients and detailed
the effects of touch therapies (which include Reiki and
Therapeutic Touch), on such populations, or on healing suchas that carried out at The Centre. The safety of manycomplementary modalities is, however, an area lackingrobust investigation (30,31) particularly in relation to mental
Table 1. Characteristics of the study population of 147 subjects with
mental health disorders who completed entry and post-treatmentquestionnaires (percentages in parentheses)
Interestingly, improved psychological functioning in both
healthy participants and in those with a variety of ailments is
a common outcome of many touch therapies (32–34). One
study, using healthy participants and a single group repeated
measures design, found that Reiki Touch significantly reduced
a state of anxiety and increased IgA levels, indicating
modulation of the stress response (35). Other workers have
measured the effects of guided imagery, meditation, Homeop-
athy, Ayurvedic medicine and Reiki, and found that subjects
with serious mental illness (including schizophrenia, bipolardisorder and depressive disorder) reported improvements in
emotional stability, well-being and concentration following
treatment (36). Outcomes of such therapies for subjects
with mental health problems are therefore worthy of
Healing at The Centre for Complementary Care
The Centre where the current evaluation was conducted has
been serving an area of rural and urban social deprivation and
poor health for 12 years and, functioning as a charity, has a
history of treating all those who attend, regardless of their
ability to pay. It is known as a place in which measurable, self-
functioning are achieved regularly (23–25,37,38). Some of
the clients visiting The Centre are referred formally by medical
practitioners but most are self-referred, attending as a result of
recommendations by either local health care professionals or
The Centre’s principal therapeutic modality is healing by
gentle touch, as described below. It is non-invasive, applicable
to any health deficit and complementary to medical treatments.
this current or to change energy flows. The practitioner workson an intuitive level, trusting the body’s own self-healing
mechanisms to re-establish balance, mentally, physically andpsychologically. The requirement for both client and practi-
New clients with self-reported psychological problems attend-
tioner is for openness and concentration rather than willed
ing The Centre for treatment between 1995 and 2001 were
results. ‘‘Getting our hands off the steering wheel’’ allows the
invited to participate in the ongoing program of evaluation of
body to do its own fine tuning. The gentle touch is like a
healing. Inclusion criteria were as follows: willingness and
battery charger that boosts the energy needed to do this, and
ability to participate by filling in questionnaires, age at least 16
interestingly, the person relaxes ever more deeply as this
years, notification of depression/anxiety/psychological stress/
other mental health problems on the questionnaire, completing
This touch provides a point of contact between healer and
a post-treatment questionnaire after four treatments that were
client. By moving progressively around the body, from head to
feet on one side and then feet to head along the other, the
Exclusion criteria were as follows: previous treatment at The
healer is attentive to each area of the person in turn. From a
Centre, failure to complete the course of four sessions and
client’s perspective, the touch enables awareness of the
failure to complete both entry and post-treatment question-
healer’s attentiveness to each area of their body in turn. The
naires. The present study, as a continuation of that reported by
lingering of the healer on places where disease has been
Tiplady, (41) received ethical approval from the local Health
reported by the client, or recognized by the healer, evidences
Authority. Furthermore, the research process was consistent
the especial attention being paid to those places.
with St Martin’s College ‘Ethical Principles and Guidelines for
Informal conversation concerning the health and well-being
Research Involving People’ (2002). The purpose and require-
of the client, along with reports of any physical, mental,
ments of the study were explained to each subject both
emotional or spiritual changes since the previous session,
verbally and in writing. Confidentiality, anonymity and
take place while the treatment is occurring. Clients may also
permission to withdraw from participation without any
drowse, sleep or talk as they feel inclined. A 10 min rest
detriment to treatment were assured, and consent was
concludes the session. Although a simple, repeating pattern of
evidenced through their completion of the questionnaires.
touch is followed by the therapist at each session, successfultreatment depends not upon an exact physical routine, but onsensitive response to the altering circumstances of the subject,
concentration as in meditation or contemplative prayer, and
The research participants received four 1 h healing sessions
the ability to listen sympathetically both to the voice and the
within a 4–6 week period, undertaken by either of two
body of the client. Healing treatment is more truly defined
therapists, although one treated 90% of the subjects in this
study. The Centre’s standard practice commences with awelcoming and evaluative conversation during which the
therapist ascertains the client’s views of the presentingproblem and describes what the treatment will involve.
The main research tool was a questionnaire incorporating
Although it is conceivable that some people might have
visual analogue scales (VAS), and the EuroQoL (EQ-5D), an
reservations about being touched by the therapist none has
extensively used and validated generic state of health mea-
been expressed by clients attending The Centre. After these
sure (42–44). VAS were used to monitor clients’ subjective
preliminaries the evaluation study is explained and the client is
scores of their degrees of physical (pain, disability, immobi-
invited to complete as much as they wish of the pre-treatment
lity, sleep disturbances, reliance upon medication, ability to
questionnaire. The treatment then involves lingering, firm but
participate in usual activities) and psychological (stress,
gentle, non-invasive touch on the head, chest, arms, legs and
panic, fear, anger, relaxation, coping, depression/anxiety)
feet for approximately 40 min, most usually while the client
lies comfortably on a treatment bed, or while seated
End point descriptors were used to help clients to locate
their position on the scale, for example: 0 ¼ ‘no stress’ to 10 ¼
The touch is described by the Director of The Centre as
‘severe stress’; 0 ¼ ‘coping badly’ to 10 ¼ ‘coping well’.
follows: ‘Gentle Touch is not derived from the techniques of
In the case of sleep disturbances, 0–3 ¼ ‘sleeping too much’,
Reiki, Therapeutic Touch or Massage. It is a light touch, with
4–7 ¼ ‘sleeping well’ and 8–10 ¼ ‘sleeping badly’. Prior
no greater pressure than one would exert in soothing a child’s
expectation of treatment effect was assessed on a VAS where
brow or laying a hand on a forehead to test temperature. The
0 ¼ ‘expect nothing’, 5 ¼ ‘see what happens’ and 10 ¼ ‘expect
hands do touch the (clothed) body, sometimes with fingertips
a lot’. The EQ-5D asked participants to choose statements that
only and sometimes with the flat palm of the hand. There is no
best described their state of health at that moment from self-
manipulation, stroking or kneading. The length of time a hand
care, usual activities, pain/discomfort and anxiety/depression
is held in one place depends upon the response, which is felt as
subscales. Finally, they indicated their general health status on
a current or magnetic connection. There is no attempt to direct
a VAS where 0 ¼ ‘worst possible state’ and 100 ¼ ‘best
Healing by gentle touch in mental health disorders
possible state’. The use of more than one scale to assess
key variables provided a means of triangulation by whichconsistency and, therefore, reliability of the participants’
self-assessments could be monitored.
One hundred and forty-seven participants, of whom 66% were
Additional factors that were monitored included demo-
women, completed both entry and post-treatment question-
graphic characteristics of participants, the duration of any
naires. Sixteen percent were referred formally by local general
medical condition that led to their attendance at The Centre,
practitioners (GPs) and the remainder were self-referred
medical history, prior expectation of treatment effect, post-
following word of mouth recommendation by friends or health
treatment satisfaction and previous experiences of comple-
care professionals. Their characteristics are summarized in
mentary therapies. Participants taking medication at entry
Table 1, where it can be seen that anxiety, depression and
were asked to circle statements indicating any or no changes
psychological stress were the most common reasons for the
in consumption of their medicines on the post-treatment
participants attending The Centre. Although 41 participants
(28%) failed to disclose the duration of their condition, 50% ofthe total study population had a duration of illness extending
beyond 1 year, of which 23 (16%) had suffered for more than5 years.
The analysis presented is based on data that is collected as The
Most subjects had received medical or related treatments,
Centre’s normal means of monitoring the effectiveness of its
and of those who had been prescribed medication 11% named
provision. The data set extracted for the present statistical
an antidepressant, with fluoxetine being most common.
analysis was simply of a group of clients who were relatively
Responses did not distinguish reliably between current and
homogeneous in having attended for four sessions of healing
former use of medication. Twelve percent had used a
within 4–6 weeks and completed their follow-up question-
combination of medication and counselling/psychotherapy.
naire at that time. Four sessions is the usual minimum
Fifty-seven percent had previous experience of a complement-
number of sessions attended by clients. The experience of the
ary therapy, of which massage and aromatherapy were most
Director attests to this number providing the clearest indi-
common. Nineteen percent of participants reported comorbid
cation of whether or not people are benefiting from their visits,
conditions, which included asthma, headache, skin disorders,
and therefore whether or not there is any point in them
gastrointestinal disorders, high blood pressure, musculo-
skeletal pain, throat problems, exhaustion and extreme
The participants completed the full questionnaire provided
tension. Data relating specifically to these are not presented
for all clients of The Centre but the present analysis will
focus specifically on psychological and related (pain, sleep)parameters. Subjects completed the questionnaire beforetheir first treatment and completed a second one after their
fourth treatment. Questionnaires were anonymized by mark-ing each with a unique number allocated at the start of the
Differences between entry and post-treatment scores were
Pre- and post-treatment scores are summarized as median
(interquartile ranges) in Table 2, which shows changes
matched pairs and signed ranks test for paired data. The EQ-
that were highly significant statistically (all P < 0.0004)
5D data were analyzed by assigning each category (no
towards improvement during the study period. Before treat-
problems, moderate problems, severe problems) a score from
ment, stress was the most severe symptom, with a median
1 to 3, respectively, and using pre- to post-treatment
score of 8, which fell to 4 after treatment. Median scores for
differences in category choice for each subject as the basis of
panic, fear, anger and pain were moderate before treatment
and fell by 2–3 points. Sleep scores improved only a little
In separate analyses, participants were subdivided according
but the change was consistent. The ability of participants to
to baseline (at entry) severity of stress, pain, panic, fear, anger,
relax and to cope showed improvements of 4 and 3 points,
sleep disturbance and coping ability. Changes after treatment
respectively. Median general health improved by 24 points.
were assessed comparatively in order to determine whether or
Most Severe Symptoms Showed Greatest Improvement
not the degree of benefit they experienced was influenced bythe initial extent of their distress, discomfort or other disease.
Table 3 shows the results of a separate analysis in which
Data collected on subjects’ prior use of complementary
participants were subdivided according to severity of stress,
therapies were analyzed via subgroup comparisons, to deter-
pain, panic, fear, anger, sleep disturbance and coping
mine any effect of prior experience on outcomes.
ability at the time of entry. Following treatment, the most
The Statistical Package for Social Sciences (SPSS Chicago,
substantial improvement was seen in those with scores
IL, USA, 1998) version 9.0 for Windows was used for all
indicating the greatest severity at entry, in all symptom
categories, with severe stress, panic, fear, anger and inability
Table 2. Median scores on entry and change (all improvements) following
to cope showing the greatest improvement (P < 0.004).
four healing sessions (interquartile ranges in parentheses)
There were no statistically significant changes in thosesymptoms with mild entry scores (Table 3). Median expecta-
tions of treatment did not exceed 6 (‘see what happens’) for
any group, regardless of the severity of symptoms at the time
Severity of Quality of Life Impairments is Reduced by
The Fig. 1 shows the number of participants responding in
each EuroQoL (EQ-5D) questionnaire category before and
after treatment. Anxiety and/or depression showed the
most substantial improvements following treatment, with the
number of participants reporting no problems increasing from
3 to 42, and the number of participants experiencing severe
#The numbers are less than 147 because some participants did not complete all
problems fell from 58 to 14. By contrast those reporting
moderate problems increased from 75 to 80 but this was
*Wilcoxon matched pairs, signed ranks test for paired data.
because some downgraded from the severe to moderate rating.
Changes in anxiety/depression, pain and ability to carry out
Table 3. Median change following four healing sessions for participants
usual activities all proved highly statistically significant (P <
with mild, moderate and severe entry levels of stress, pain, sleep
0.0004) when paired entry and post-treatment scores were
disturbances and coping ability (interquartile ranges in parentheses)
compared for all individuals. The most impressive improve-
ment in pain rating was shown by the number of participants
reporting severe pain falling from 25 to 11. Improvements
in ability to carry out usual activities after treatment are
indicative of a substantial resumption of functioning by many
participants. It is of interest that there was also statistically
significant improvement (P ¼ 0.001) in self caring ability,even though most participants also reported no problems
There were no reports of adverse effects of the healing
sessions. Of those taking medication at the time of entry
(n ¼ 73), 16% ceased taking their medication, 37% reduced,
40% maintained and 7% increased their usage of medication.
Visual inspection of responses relating to ‘prior expectations
of outcome’ (median 6; interquartile range 5–8, ‘see what
happens’) and ‘previous experiences of complementary
therapies’ revealed no indication of relationship to outcome
measures and no statistical analysis was attempted.
This evaluation demonstrates that healing by gentle touch,when used alone or in addition to any conventional medical
treatment, is a safe and effective method of improving
psychological well-being in people with psychological pro-
blems of the varieties encountered at The Centre. Although
the treatment is referred to as ‘healing by gentle touch’, the
relative contributions to benefit provided by the touch per se,
the attentive presence of the healer and the pleasant, caring
*Wilcoxon matched pairs, signed ranks test for paired data.
ambience of The Centre cannot be discerned and they may
Healing by gentle touch in mental health disorders
Anxiety/depression (N = 136)
Pain/discomfort (N = 127)
Self care (N = 127)
Usual activities (N = 131)
Figure 1. The number of participants with Mental Health Disorders responding in each EuroQoL (EQ-5D) questionnaire category. Numbers of participants (N)with ‘severe problems’ decreased and numbers of participants with ‘no problems’ increased after healing, while changes in the numbers of participants with ‘someproblems’ represents the balance between numbers moving in from the ‘severe’ category or out into the ‘no problems’ group. For anxiety/depression and pain/discomfort the numbers of participants with ‘some problems’ increased because the numbers changing from ‘severe’ to ‘some’ problems exceeded the numbersmoving from ‘some’ to ‘no’ problems. Statistical significance of post-treatment changes, using Wilcoxon matched pairs, signed ranks test for paired data: anxiety/depression, P < 0.0004; pain/discomfort, P < 0.0004; self-care, P < 0.001; usual activities, P < 0.0004.
well synergize. The substantial post-treatment reductions in
measures has provided a more comprehensive picture than
subjective ratings of the predominant symptoms of the
would have been supplied by depression/anxiety measures
majority of participants (stress, anxiety and depression) in
alone, and has enabled participants to indicate the factors of
this study are consistent with the findings of the earlier
most importance to them. No concurrent controls were used so,
analysis made by the local Health Authority (41), and with
although there was clearly a strong association between
the findings of research on similar treatment modalities
participants experiencing the healing sessions and improve-
ment in their reported symptoms, causality regarding the
The recorded improvements in sleep patterns (particularly
apparent beneficial effects of healing by gentle touch cannot
in the subgroup with severe problems) are highly relevant
be established definitively. Furthermore, the episodic, remit-
since depression and anxiety in particular are characterized
ting and recurring nature of depressive disorders and their
by sleep disturbance (45). Improved sleep is likely to have
characteristic acute response to treatment (21) also limits
had a profound effect on other dimensions with consequent
increases in energy which probably improved their ability
Nevertheless, strong circumstantial evidence of benefit is
to cope, and this in turn enhancing self-esteem, thereby
provided by the findings that a high proportion of people with
further reducing stress and increasing the ability to relax.
an illness duration exceeding 1 year reported substantial
Furthermore, the fact that substantial benefits were recor-
benefits after only four healing sessions over 4–6 weeks, and
ded by a population of participants, at least 50% of which
those with the most severe symptoms at the time of entry
had experienced their symptoms for more than a year, is
showed the greatest improvements. Interestingly, in placebo
strongly indicative of the ability of healing by gentle touch
controlled trials of antidepressants, participants with mild
to engender changes in refractory or chronic ill health.
depression typically showed higher responses to placebo than
Demonstration of the greatest benefit in participants with
those with severe symptoms (46). Although the present study
the most severe symptoms is also of considerable interest,
was not placebo controlled, the lack of statistically significant
particularly as evidence against a simple placebo effect as
changes following treatment in participants reporting mild
stress, pain, panic, fear, anger, sleep disturbances and copingdifficulties is contrary to those observations. Therefore,the improvements recorded in the present study can be
differentiated from placebo responses.
This study resembles Phase 2 clinical trials in that it was open
Moreover, prior expectation of treatment effect was not
in design. The utilization of health-related quality of life
particularly high (median score 6—‘see what happens’), a
finding that is consistent with findings for other subgroups of
associated with tension, headache, skin and gastrointestinal
clients of The Centre (23,24,40), which indicates that out-
disorders and exhaustion. These improvements in somatic
comes were not greatly influenced by anticipation of benefit.
comorbidities indicate that benefits of healing by gentle touch
This finding is encouraging, since if anticipation was central to
extend beyond the temporary psychological ‘boost’ which may
the mechanism of action, healing would, theoretically, not be
accompany relaxation. The contention that physical changes
applicable to depression, because hopelessness and low
also occur during healing is supported by the biochemical
expectations of treatment effect are common features of the
and autonomic nervous system changes following treat-
ment with Reiki reported respectively by Wardell and
Chronic depression is more resistant to treatment than acute
Engebretson (35) and Mackay et al. (54). Other relaxation
illness, is less responsive to single therapies (47) and placebo
response-based interventions have also shown physiological
(48) and is less likely to remit spontaneously (13). The number
of participants with chronic illness of various types yet
A further strength of the study relates to the client population
showing improvement in the present study is, therefore,
from which the research participants were drawn. Zollman and
noteworthy, as is the reduction in medicines usage by more
Vickers (56) found that complementary medicine users were
than half the participants during the study period because these
typically highly educated with favorable socioeconomic
ancilliary observations reinforce the improvements discerned
backgrounds. In contrast, the participants recruited to the
present study were typical of local West Cumbrian people,many of whom are economically disadvantaged. The diversity
Possible Contribution of the Relaxation Response
of the research participants in this respect increases the
The mechanism of action of healing remains to be elucidatedfully. It is, nevertheless, conceivable that the intensely caring
nature of treatment, engendering a relaxation response (49),
The present findings provide strong evidence that a short series
could effectively facilitate processes responsible for initiating
of healing sessions is associated with significant improve-
recovery, possibly by reversing the hypothalamo–pituitary–
ments in a wide range of parameters of psychological well-
adrenal (HPA) hyperarousal processes involved in depression
being. Notwithstanding the desirability of further randomized,
(50,51). Reid and Stewart (52) have proposed interactions
controlled studies, the quality of evidence presented above is
between stress and the neurobiology of depression involving
equivalent to or better than that which currently underpins a
alterations in the plasticity of neural networks, which results in
number of conventional and complementary therapies. There
cognitive and emotional disturbances and, in some cases,
is, therefore, a strong case for carefully monitored, funded
neural damage and neuroanatomical change.
referrals of patients with significant psychological health
Depression is frequently characterized by abnormal regula-
deficits for healing as an adjunct to conventional treatments.
tion of glucocorticoids, which are released during stress and
While the mechanism of action of ‘healing’ remains to be
strongly influence processes in the hippocampus (52,53).
established, it seems appropriately cautious to restrict such
Although the extent to which stress is linked to depression
referrals to centers that can provide evidence of the safety and
appears to differ greatly between individuals and is currently
effectiveness of their interventions.
under debate (4), the physiological outcomes of stress
The evidence presented in this report indicates that heal-
reduction are clearly important in mental health (3,51).
ing is likely to be helpful in treating people with anxietyor depression and/or ‘psychological stress’. It might be of
Considerations of Diagnoses and the Study Population
particular benefit for people with chronic illness who are
It is both a strength and a weakness of the study that the
unwilling or unable to take long-term pharmacotherapy, for
diagnostic distinction between various categories of psycho-
those for whom pharmacotherapy has yielded inadequate
logical problems cannot be drawn more precisely, nor can the
benefit or undesirable side-effects, and for those with
participants’ data be analyzed in discrete subgroups: a
comorbid conditions in which antidepressants are contra-
weakness because it does not align with prevailing medical
indicated. It could be particularly useful as adjunctive therapy
models but a strength because healing from the holistic
during the slow onset of clinical benefit of antidepressants,
perspective has been shown to be effective in people with a
when easing of symptoms could enhance patients’ adherence
range of diagnostic labels, providing evidence that it can be
used without need to establish a definitive diagnosis in a
Furthermore, as symptoms decrease in severity and cogni-
clinical area where clear distinctions are rare.
tive and physical functioning recover, synergistic effects of
Nevertheless, the comprehensive nature of the standard
healing with other treatments are conceivable, particularly
questionnaire from which the data for this paper have been
with psychotherapeutic modalities, which frequently require
drawn was valuable because several participants reported
active participation. The manifold dysfunctions and remit–
improvements in the problems they had been experiencing in
relapse tendencies associated with depressive disorders (57)
various physical dimensions, including musculoskeletal pain
commonly require multiple treatment approaches. Future
Healing by gentle touch in mental health disorders
treatment strategies could be based on a combination of
14. Hirschfeld RMA, Schatzberg AF. Long-term management of depression.
pharmacotherapy to address neurobiological aspects, psycho-
Am J Med 1994;97 (Suppl 6A): 33S–8S.
15. Hirschfeld RMA. Clinical importance of long-term antidepressant
logical therapies to modify maladaptive thought processes
treatment. Br J Psychiatry 2001;179 (Suppl 42): 4S–8S.
(58) and healing by gentle touch, to enhance both aspects by
16. Hagerty BM, Williams AR. The effects of sense of belonging, social
promoting well-being and stress reduction.
support, conflict and loneliness on depression. Nurs Res 1999;48:215–9.
17. Malt UF, Robak OH, Madsbu H-P, Bakke O, Loeb M. The Norwegian
(NORDEP)—I: randomised double blind study. Br Med J 1999;318:1180–4.
Healing has been demonstrated to be associated with safe and
18. Hollon S, De Rubeis RJ, Evans M, Wiemer MJ, Garvey MJ, Grove WM,
et al. Cognitive therapy and pharmacotherapy for depression: singly and in
effective alleviation of some of the major symptoms associated
combination. Arch Gen Psychiatry 1992;49:774–81.
with a number of mental health disorders and has contributed
19. Evans MD, Hollon SD, DeRubeis RJ, Piasecki JM, Grove WM,
to a considerable decrease in the morbidity of the participants
Garvey MJ, et al. Differential relapse following cognitive therapy andpharmacotherapy for depression. Arch Gen Psychiatry 1992;49:802–8.
in this study. The treatment complements current approaches
20. Shea MT, Elkin I, Imber SD, Sotsky SM, Watkins JT, Collins JF, et al.
to the management of mental health disorders and is
Course of depressive symptoms over follow-up. Findings from the
acceptable to clients. The absence of adverse effects makes
National Institute of Mental Health Treatment of Depression Collabora-tive Research Program. Arch Gen Psychiatry 1992;49:782–7.
this form of treatment particularly suitable for people with
21. Andrews G. Should depression be managed as a chronic disease? Br Med J
chronic disorders who may have experienced problems with
pharmacotherapy. Due to the remitting and relapsing nature of
22. MacManaway B, Turcan J. Healing: The Energy that Can Restore Health.
Wellingborough, Northamptonshire, UK: Thorsons Publishers Ltd, 37–43.
some of the mental health disorders, a prospective, controlled,
23. Weze C, Leathard HL, Stevens G. Evaluation of healing by gentle touch
long-term trial is essential to determine whether or not
for the treatment of musculoskeletal disorders. Am J Public Health
24. Weze C, Leathard HL, Grange J, Tiplady P, Stevens G. Evaluation of
healing by gentle touch in thirty-five clients with cancer. Eur J Oncol Nurs
25. Weze C, Leathard HL, Grange J, Tiplady P, Stevens G. Evaluation of
Funding from North Cumbria Health Authority and Cumbria
healing by gentle touch. Public Health 2004;119:3–10.
County Council Social Services (Joint Finance) is gratefully
26. Unutzer J, Klap R, Sturm R, Young AS, Marmon T, Shatkin J, et al.
Mental disorders and the use of alternative medicine: results from a
national survey. Am J Psychiatry 2000;157:1851–7.
27. Gallagher SM, Allen JJB, Hitt SK, Schnyer RN, Manber R. Six-month
depression relapse rates among women treated with acupuncture.
Complement Ther Med 2001;9:216–8.
1. Craig TKJ, Boardman AP. ABC of mental health: common mental health
28. Kessler RC, Soukup J, Davis RB, Foster DF, Wilkey SA, Van Rompay MI,
problems in primary care (Clinical review). Br Med J 1997;314:1609.
et al. The use of complementary and alternative therapies to treat anxiety
2. Soloman DA, Keller MB, Leon AC, Mueller TI, Shea MT, Warshaw M,
and depression in the United States. Am J Psychiatry 2001;158:289–94.
et al. Recovery from major depression: a 10-year prospective follow-up
29. Collinge W, Wentworth R, Sabo S. Integrating complementary therapies
across multiple episodes. Arch Gen Psychiatry 1997;54:10001–6.
into community mental health practice: an exploration. J Alternat
3. Herbert J. Fortnightly review: stress, the brain and mental illness. Br Med J
30. Ernst E, Barnes J. Methodological approaches to investigating the
4. Cowen PJ. Cortisol, serotonin and depression: all stressed out? Br J
safety of complementary medicine. Complement Ther Med 1998;6:
5. van der Klink JJL, Blonk RWB, Schene AH, van Dijk FJH. The benefits of
31. Nahin RL. Research into complementary and alternative medicine:
interventions for work-related stress. Am J Public Health 2001;91:270–6.
problems and potential. Br Med J 2001;322:161–4.
6. Dunn RL, Donoghue JM, Ozminski RJ, Stephenson D, Hylan TR.
32. Gagne D, Toye RC. The effects of therapeutic touch and relaxation
Longitudinal patterns of antidepressant prescribing in primary care in
therapy in reducing anxiety. Arch Psychiatr Nurs 1994;8:184–9.
the UK: comparison with treatment guidelines. J Psychopharmacol
33. Turner JG. The effect of therapeutic touch on pain and anxiety in burn
patients. J Adv Nurs 1998;28:10–20.
7. Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention
34. Engle VF, Graney MJ. Biobehavioural effects of therapeutic touch. J Nurs
in the management of depression: systematic review and meta-regression
analysis of randomised controlled trials. Br Med J 2001;322:763.
35. Wardell DW, Engebretson J. Biological correlates of Reiki Touchsm
8. Pampallona S, Bollini P, Tibaldi G, Kupelnick B, Munizza C. Patient
healing. J Adv Nurs 2001;33:439–45.
adherence in the treatment of depression. Br J Psychiatry 2002;180:104–9.
36. Russinova Z, Wewiorski NJ. Use of alternative health care practices by
9. Pathare SR, Paton C. ABC of mental health: psychotropic drug treatment.
persons with serious mental illness: perceived Benefits. Am J Public
10. Martin RM, Hilton SR, Kerry SM, Richards NM. General practitioners’
37. Luff D, Thomas KJ. Models of complementary therapy provision in
perceptions of the tolerability of antidepressant drugs: a comparison of
primary care. Final report to the Department of Health. Medical Care
selective serotonin reuptake inhibitors and tricyclic antidepressants.
Research Unit, ScHARR, University of Sheffield, 1999, 4, 10, 79–83.
38. Weze C. Evaluation of healing by gentle touch for the treatment
11. Beck AT. Cognitive therapy: A 30-year retrospective. Am Psychol
of musculoskeletal disorders at the Centre for Complementary Care.
MSc Research Dissertation, St Martin’s College, Lancaster University.
12. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for
39. Dixon M. Does ‘healing’ benefit patients with chronic symptoms? A
noncompliance with medical treatment: meta-analysis of the effects of
quasi-randomized trial in general practice. J R Soc Med 1998;91:183–8.
anxiety and depression on patient adherence. Arch Intern Med 2000;160:
40. Weze C, Leathard HL, Stevens G. Healing by gentle touch in
musculoskeletal disorders. Spirituality Health Int 2005;6:200–211.
41. Tiplady P. Healing assessed by NHS. Chrism 1996;33:9–11.
Hirschfeld RMA, et al. Time to recovery, chronicity, and levels of
42. Dorman PJ, Slattery J, Farrell B, Dennis MS, Sandercock PA. A
psychopathology in major depression: A 5-year prospective follow-up of
randomised comparison of the EuroQoL and Short Form-36 after stroke.
431 subjects. Arch Gen Psychiatry 1992;49:809–16.
43. Hurst NP, Jobanputra P, Hunter M, Lambert M, Lochhead A, Brown H.
52. Reid IC, Stewart CA. How antidepressants work: new perspectives on
Validity of EuroQoL a generic health status instrument in patients with
the pathophysiology of depressive disorder. Br J Psychiatry 2001;178:
rheumatoid arthritis. Br J Rheumatol 1994;33:655–62.
44. Van Agt H, Essink-Bot M-L, Krabbe P, Bonsel G. Test-retest reliability
53. Kim JJ, Yoon KS. Stress: metaplastic effects in the hippocampus. Trends
of health state valuations collected with the EuroQoL questionnaire. Soc
54. Mackay N, Hansen S, McFarlane O. Autonomic nervous system changes
45. Hale AS. ABC of mental health: depression. Br Med J 1997;315:43–6.
during Reiki treatment: a preliminary study. J Altern Complement Med
46. Hollon SD, Thase ME, Markowitz JC. Treatment and prevention of
depression. Psychol Sci Public Interest 2002;3:39–77.
55. Irwin M, Pike J, Oxman M. Shingles immunity and health functioning in
47. Scott J. Treatment of chronic depression. N Engl J Med 2000;342:
the elderly: Tai Chi Chih as a behavioural treatment. Evid Based
Complement Alternat Med 2004;1:223–32.
48. Koesis JH, Frances AJ, Voss C, Mann JJ, Mason BJ, Sweeney J.
56. Zollman C, Vickers A. ABC of complementary medicine. Users
Imipramine treatment for chronic depression. Arch Gen Psychiatry
and practitioners of complementary medicine. Br Med J 1999;
49. Benson H. The relaxation response: its subjective and objective historical
57. Bondareff W, Alpert M, Friedhoff AJ, Richter EM, Clary CM, Batzar E.
precedents and physiology. Trends Neurosci 1983;6:281–4.
Comparison of sertraline and nortriptyline in the treatment of major
50. O’Brien JT. The ‘glucocorticoid cascade’ hypothesis in man: prolonged
depressive disorder in late life. Am J Psychiatry 2000;157:729–36.
stress may cause permanent brain damage. Br J Psychiatry 1997;170:
58. Richardson P. ABC of mental health: psychological treatments. Br Med J
51. O’Keane V. Evolving model of depression as an expression of multiple
interacting risk factors. Br J Psychiatry 2000;177:482–3.
Received February 19, 2006; accepted June 28, 2006
PATHOZYME PROGESTERONE Ref OD487 Enzyme Immunoassay for the quantitative determination of Progesterone in human serum or plasma. Store at 2oC to 8oC. DO NOT FREEZE. For in-vitro use only. INTRODUCTION MATERIAL REQUIRED BUT NOT PROVIDED Progesterone is a C21 steroid which is synthesised from both Micropipettes: 100l, 200l, 1000l and 5000l tissue and circulating cho
J. Astron. Space Sci. 23(3), 167–176 (2006) THE PEAK ENERGY–DURATION CORRELATION AND POSSIBLE IMPLICATIONS ON GAMMA RAY BURST PROGENITOR Heon-Young Chang Department of Astronomy and Atmospheric Sciences, Kyungpook National University1370 Sankyuk-dong, Buk-gu, Daegu 702-701, Korea (Received June 26, 2006; Accepted July 19, 2006) ABSTRACT We investigate the correlation between the