Positive Health Online

Conflicts within Complementary Medicine

Your editorial highlighting the conflicts within complementary medicine expresses the long held concerns of many therapists. This situation has far-reaching and disturbing implications because many of the people involved in this sort of behaviour also lack the expertise and personal attributes to be successful therapists, but are able to obtain positions of power through ruthless endeavour.

They tend to be self-publicists who attract others of a similar disposition to build up large, usually self-regulated organisations that provides the power in numbers and the money to perpetuate their vested interests which are usually very cleverly disguised.

Some manipulate their way into positions that involve setting standards of training for particular disciplines, despite their lack of qualifications and experience for the job. They pay lip service to high standards of training and paint a rosy picture of their activities. Many are fooled. Scant regard is given to anyone who asks questions, or to any member of the public who has the misfortune to be treated by one of the poorly trained therapists from such organisations. Codes of Practice and Ethics appear to be ineffectual. The poorly trained therapist is likely to be taken on as a teacher. It is sad to witness such a mis-use of power.

I would not like to detract from the tremendous amount of good work, that I have witnessed, being carried out by skilled and dedicated therapists, both in the public sector, working with cancer patients and others, and also in private practice. They represent all that is good and meaningful in complementary medicine. They certainly deserve support and proper representation as they swim against the tide of egotism and greed.

Mary Martin, Principal
Mary Martin School of Reflexology

Advertising and the Law

A recent complaint to the Advertising Standards Authority brought against the Bowen Association has brought some considerable consternation and concern to practitioners and publishers alike as to what can and cannot be claimed by therapists in their publicity material. The offending advertisements were run in professional journals and concerned the claim that the therapy was 'safe', that it referred to 'addressing' (not treating) certain serious conditions such as Asthma and that it implied that the conditions listed could be helped by the therapy. Seeing that a large number of therapies are using similar wording and claims in their advertising material, where do complementary therapists stand?

In a survey that the ASA themselves carried out, 'alternative' treatments presented some of the greatest number of problematic claims. Generally, the concerns were that a particular treatment claimed to 'cure' a condition as distinct from relieving its symptoms. Additionally, it was felt that advertisers tended to over-emphasise the likely degree of relief offered by any given product or therapy. Recent rulings upholding complaints have been brought against various therapies and products recently, including the following:

* Ecoflow of Saltash, Cornwall, for health claims in its brochures attributed to magnotherapy;
* Sound Therapy of Street, Somerset, for claims that it could help with conditions such as depression and learning difficulties;
* Allergycare, of Taunton, Somerset, for claims that the Vega machine could identify allergies;
* Allied Health of Cardiff, for claims that the Acupoint machine 'provides rapid, long-lasting pain relief' and 'fast relief from all these ailments Asthma, Hepatitis, Migraines, Multiple Sclerosis,' etc.;
* Allergy Testing Service, Merseyside, for claims that Bio-Resonance Therapy could 'help desensitise the body' to substances such as wheat, milk and yeast and their effects.

In all the above cases, the rulings were upheld on the basis that there was insufficient evidence to support the claims made. The ASA's code states that; (clause 3.1) 'advertisers must hold documentary evidence to prove all claims, whether direct or implied, that are capable of objective substantiation.' Further on, the code states (clause 50.1) 'Medical and scientific claims made about beauty and health-related products should be backed by trials, where appropriate conducted on people. Substantiation will be assessed by the ASA on the basis of established scientific knowledge.' This ruling is a major problem for many complementary therapies, even though these are, in essence, contradictory statements. In the first clause, it talks about claims 'that are capable of objective substantiation.' In the second clause, it states that claims… 'should be backed by trials'. Given the huge lack of any objective evidence to support the beneficial effects of complementary therapies it is difficult to know where we stand especially when many therapists would submit that objective substantiation of complementary therapies is often extremely difficult if not actually impossible.

The second clause violated by the Bowen Technique ruling relates to the use of the word 'safe'.

How many of us use that word in our material? Beware, we are on very shaky ground! Clause 50.5 states that 'Advertisements should not suggest that any product is safe or effective merely because it is 'natural' …' or, (Clause 50.4), '…that their therapies are guaranteed to work, absolutely safe or without side-effects for everyone' Again, these are interesting points. How many advertisements have we seen in the popular press that claim various pharmaceutical drugs are 'safe'? As far as I understand, if one uses the words 'generally considered to be safe' we are OK, but it is far from clear.

One of the major concerns of the ASA is to do with mentioning 'serious' diseases. Their argument is that if one offers stherapies for serious ailments then this might discourage people from having essential (i.e. orthodox medical) treatment. Clause 50.1 states; '…medical advice is needed for serious or prolonged ailments and advertisers should not offer medicines or therapies for them'. This, then, is a blanket no-no for mentioning any serious conditions. 'Serious' presumably means life-threatening, but the wording 'or prolonged' also seems to imply any chronic disease as well, such as osteo-arthritis, or even long-standing back-pain. The ASA specifically mentions conditions such as arthritis, high cholesterol levels and prostate problems.

This ruling, and others like it, raise some very serious questions about what complementary therapists are allowed to say, and needs some considerable clarification. This article has been sent to the ASA for their comments and I have asked for guidance on where we stand. There is no doubt that this ruling has implications far outside the world of Bowen.

John Wilks, Chairman
Craniosacral Therapy Association of the UK and the Bowen Association UK. Tel: 01963 220615.

Reflexology following surgical intervention

I was interested to see your update summary on the study by Kesselring into reflexology following surgical intervention, and your comments regarding its design. While I have not seen the full report it would appear from your comments that a standardised protocol was followed when applying reflexology. My view is that in itself this does not pose a problem; I myself follow a set procedure when treating people with reflexology. What you do not say, but I infer, is that Kesselring's protocol did not allow for any extra time to be spent on certain reflexes as required, a practice which in my experience most reflexologists, including myself, would follow. Therefore this latter point would concern me also.

A second detail that you do not mention is whether Kesselring only 'worked' certain reflexes and omitted others, although the use of foot massage for one of the control groups suggests that this was not the case. However, if it were (and other authors have used this method [Flocco and Oleson 1993]) my concern would be that the intervention is no longer holistic as not all of the physical body is being treated. It also raises the question as to whether only working pre-determined reflexes can really be said to be reflexology. Most books on the subject list specific points to work for certain ailments, but these are usually presented as first aid measures or as 'homework' for the client to perform between full treatments from a therapist.

That said I recognise that it is extremely difficult to conduct randomised control trials for hands on therapies where the choice is either for 'sham' treatment or for a similar but alternative treatment, as in this case. The author is to be congratulated for undertaking a trial into this difficult area.

May I add that I have only recently started subscribing to Positive Health and consider it an interesting journal, with on the whole well-written and properly referenced articles. Keep up the good work.

Sarah Bonthron M.A. (Comp. Health), R.G.N.,
Full Member of the Association of Reflexologists, Member of the Register of Qualified Aromatherapists.

A Response to the Which? Report Published 5th August 1999 by The Health Store

As the single biggest voice within the health food industry and the UK's oldest and most respected buying group for the health and wholefood sector, The Health Store disputes the claim by Which? magazine that customers may receive conflicting and poor advice from health food shops.

The Health Store is wholly owned by its 300 plus members, and remains completely independent of any outside interests. It acts as the mouthpiece of its members – all of whom are shareholders – and works to support and help them in every aspect of their business.

Belén Sánchez-Arias, Marketing Manager for The Health Store commented: "Our members are all independent retailers and we advise anyone turning to homoeo-pathy and natural remedies to consult their local independent health and wholefood retailer for advice. We were naturally concerned by the Which? report and immediately contacted a sample of our members to confirm their level of professional qualifications and experience.

"High street retailers are less likely than independents to supply accurate, relevant and up-to-date information on symptoms and natural remedies as they do not specialise in this area and are less likely to hold relevant experience and qualifications. We were also delighted to see that the two stores mentioned in the report as giving correct advice to indigestion symptoms are both members of The Health Store."

Belén added: "The sample of stores visited by the Which? researchers is not a good representation of the 1,700 and we felt that the research itself could perhaps have been more balanced. However, we also recognise that there is a gap in knowledge that some customers could fall through. There is currently no legislation on the sale of homeopathic remedies – so it is a similar situation to that of OTC medicines. As such, any retailer can choose to sell either homeopathic or OTC remedies or even to recommend a particular brand over another."

Following the publication of the Which? report, The Health Store contacted a random sample of 67 of its members by fax. They were all asked if they had any formal, relevant qualifications and if so, what these were.

Of the 67 questioned:

* three did not reply;
* 60 indicated they had formal qualifications;
* only four indicated they had not (although each of these four all have a significant number of years' experience in the industry).

Of the 60 who have formal qualifications:

* 45 have the National Association of Health Stores' Certificate in Health Food Retailing;
* 38 have the National Association of Health Stores' Diploma in Health Food Retailing;
* 37 are members of the Institute of Health Food Retailing;
* 55 had additional relevant qualifications, being qualified as pharmacists, herbalist, nutritionalists or aromatherapists.

The Health Store recommends that anyone concerned about their symptoms or contra-indications with other medicines should consult their GP, particularly pregnant or breastfeeding women and those recovering from illnesses.

For further information on The Health Stores or to find your nearest retailer please contact The Health Store on tel (0115) 955 52 55 or by e-mail mail@thehealthstore.co.uk

The Health Store is the UK's oldest buying group for health and wholefood retailing and has hundreds of member stores across the UK – and even in Reykjavik, Iceland and Gibraltar. Its aim is to ensure that all members (who are also shareholders) have access to ethical products, all of which are as near to their purest state, with the minimum amount of artificial flavourings, additives and colourings as possible. All The Health Store's own-label brands are free of genetically modified ingredients and the company has taken a strong and vocal stand against GM foods.

For further information please contact either Lynn Redgewell or Kathryn Harrison at Audax Communications on 0115-941 7887.