Research: HERMAN and co-authors,

Listed in Issue 128


HERMAN and co-authors, Department of Psychology, University of Arizona, Tucson, AZ, USA, present a method for describing and evaluating holistic Naturopathic practice.


: Even though complementary and alternative medicine is generally practised as distinct systems of medicine, almost all CAM research has focused on single therapies. In order to more adequately evaluate the effectiveness of these medical systems, studies that evaluate the outcome of intact whole systems are needed. One challenge lies in defining the whole medical system in a way that ensures treatment fidelity. This paper presents a proposed method to measure treatment fidelity (treatment criteria) in studies of the naturopathic medical system.


In this illustrative example of the theory-based development and post-oc "testing" of treatment criteria against an existing database of actual treatments prescribed by a random sample of naturopathic physicians, treatment criteria for 3 conditions —-menopausal symptoms, bowel dysfunction, and fibromyalgia — and their comparison to actual treatments were measured.


A set of meaningful, measurable treatment criteria based on the naturopathic practice principles were defined that could have generated the majority (82%-93%) of treatment prescriptions given at visits for these conditions. Several of the treatment criteria components are common across the 3 conditions studied, and might be appropriate for all visits to doctors of naturopathy. Others are specific to each condition.


The criteria presented here ensure model validity, help identify critical components of care, enable study replication, and provide a measure of quality of care.


Herman PM, Sherman KJ, Erro JH, Cherkin DC, Milliman B, Adams LA. A method for describing and evaluating naturopathic whole practice. Alternative Therapies in Health & Medicine 12 (4): 20-88, Jul-Aug 2006.

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