The Relationship between Marriage and Family Therapists and Complementary and Alternative Medicine Approaches: A National Survey
Caldwell, Karen L., Winek, Jon L., Becvar, Dorothy S., Journal of Marital and Family Therapy
Respondents to a mail survey of a random sample (N = 424) of Clinical Members of the American Association for Marriage and Family Therapy provided information about their contexts of practice, use of complementary and alternative medicine (CAM), and relationships with CAM providers. Consistent with both national trends and the experience of psychologists as reported in a similar survey, the results of this survey suggest that marriage and family therapists have been affected significantly by and have a growing awareness of CAM practices. Limitations of the study and implications for the field are discussed.
It has been more than 10 years since marriage and family therapists (MFTs) were urged to overcome their ambivalence about the notion of illness and to "conceptualize and differentiate the varieties of illness/ distress from one another in order to clarify, strengthen, and broaden the scope of family therapy, theory, and clinical practice" (Wynne, Shields, & Sirkin, 1992, p. 16). Since then, the overlap between family therapy and family medicine (Doherty & Baird, 1983) has been acknowledged, and collaborative family health care has emerged as a distinct paradigm (Nichols & Schwartz, 2004). Given an approach to health that is based on both a systemic perspective and an awareness of the fundamental connection between mind and body, one that is shared by family medicine practitioners, it is not surprising that many MFTs accepted the challenge to create models for collaborative practice (e.g., Cohen & Milberg, 1992; Larivaara, Vaisanen, & Kiuttu, 1994; Leff & Walizer, 1992; McDaniel, Hepworth, & Doherty, 1992; Miller, 1992; Rolland, 1994; Seaburn, Lorenz, Gunn, Gawinski, & Mauksch, 1996; Stein, 1992; Wright, Watson, & Bell, 1996). And over time, family therapists have become essential members of many medical contexts.
Today, both within and outside of medical settings, there also is increasing acknowledgment of the mind/body connection. An important manifestation of this shift is represented by expanding awareness and greater utilization of complementary alternative medicine (CAM). It thus seems appropriate to consider the extent to which MFTs have been affected by and/or are having an impact on this shift, including the degree to which they once again may be expanding their scope of interest and practice. We begin this consideration with a review of the literature related to CAM practices and their use in general. We then describe a survey of a random sample of Clinical Members of The American Association for Marriage and Family Therapy (AAMFT) regarding their relationship with CAM practices. This is followed by a discussion of the results of a mail survey and subsequent data analysis. We conclude with some thoughts about implications and ramifications for the profession and the future.
The National Center for Complementary and Alternative Medicine (NCCAM; 2002), established in 1998 as a component of the National Institutes of Health, defines CAM as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine" (p. 1). Complementary and Alternative Medicine therapies, which are subject to frequent change as various approaches are adopted into conventional health care, currently are classified into five categories: (1) Alternative Medical Systems, (e.g., Ayurveda, traditional Chinese medicine); (2) Mind-Body Interventions, (e.g., meditation, prayer); (3) Biologically Based Therapies (e.g., herbs, vitamins); (4) Manipulative and Body-Based methods (e.g., chiropractic, massage); and (5) Energy Therapies, either biofield therapies (e.g., qi gong, therapeutic touch), or bioelectromagnetic-based therapies (e.g., blue light treatment, electroacupuncture).
The results of several surveys indicated significant increases in the use of CAM in the United States during the decade of the nineties (cf, Astin, 1998; Eisenberg et al. …