Advances in medical research, the consumer empowerment, and rising cost of health care have demonstrated the need to treatment models that are holistic and client driven. Complementary and alternative medicine (CAM) offers consumers choices. It includes traditional healing practices, medical systems that are thousands of years old and new or innovative treatments that may be consider unconventional. Well known examples of CAM include herbal remedies, mindfulness, meditation, manipulative/movement therapies, and Chinese Medicine. Knowledge of CAM offers social workers in all settings the opportunity to provide education and advocacy in seeking client centered and culturally competent treatment options.







Tuesday, May 3, 2011

Use of CAM by African Americans

Reports from the National Center for Complementary and Alternative Medicine (NCCAM) indicate although individuals from different ethnic groups use CAM, the highest consumers include women, and individuals with higher educational achievement and income.  Barner, Bohman, Brown & Richards (2010) conducted a review of the use of CAM by African Americans. The researchers conducted a cross-sectional analysis utilizing data obtained from the National Health Interview Survey of 2002. The sample size consisted of 16,113,651 participants ages 18 and over who had used CAM in the last 12 months.  The researchers reviewed the following independent variables: predisposing (age, gender, and education), enabling (income, employment, and access to care), need (health status, physician visits, and prescription medication use) and disease-state factors (most prevalent conditions among African-Americans) that affects the type and choice of interventions.  Their results indicated that at least 20% of the participants had used CAM in the last 12 months.  CAM interventions of choice included alternative medical systems, manipulative and body-based therapies, biofeedback, and energy therapies.  Prayer and folk remedies were amongst the most widely used.  Folk remedies include traditional cures and herbs used to treat medical conditions.  African Americans with higher socio-economic status tended to use CAM interventions for prevention as well as treatment.  The results of this study are important for multiple reasons.  The researchers found that African American used CAM to treat a specific medical condition and do not often disclose their use of CAM with their medical providers for lack of trust.  It is important for medical practitioners to inquire about the use of all therapeutic interventions and their efficacy from the patient’s perspective.  Researchers noted that African American women are more likely to use prayer.  According to Freeman (2009) prayer is difficult to conceptualize and research.  Theologians and researchers conceptualize prayer into distinct types.  Prophetic, verbal, prayer can be used to either request a desired outcome or improve one’s relationship with God. The exact role of prayer was difficult to determine.  Prayer can be used for treatment, as prevention, in conjunction with other treatments.  These research findings are especially important for social worker to take into consideration.  On an individual level, how do social workers incorporate discussions and the use of prayer in their practice with clients?  How does the importance of prayer, as CAM intervention, affect the use or choice of faith-based practitioners in the field of mental health and substance abuse?     
References
Barner, J. C., Bohman, T. M., Brown, C. M., & Richards, K. M. (2010). Use of complementary and alternative medicine for treatment among African-Americans: A multivariate analysis. Research in Social and Administrative Pharmacy, 6(3), 196-208. doi: 10.1016/j.sapharm.2009.08.001
Freeman, L.W. (2009) Mosby's complementary & alternative medicine: A research-based approach (3rd ed.). Mosby
National Center for Complementary and Alternative Medicine (2009).  What is complementary and alternative Medicine? http://nccam.nih.gov/health/whatiscam/ (March 12, 2011)

5 comments:

  1. I was raised in Georgia until I was twelve years old, and we moved to California. I brought with me a lot of traditional alternative treatments for certain medical conditions. I learned these remedies,along with prayers from my three grandmothers, my mother and aunts. In turn I used many of the same herbs,and repeated some of the same prayers when I cared for by now twenty-four year old son. Thank God he never suffered any serious allergic reactions to these home remedies,because I didn't always disclose my treatment to the medical profession. I can remember using warm juice from a baked onion to treat my son's ear infection.

    As a Social Worker I understand the importance of asking my client if they are using any types of herbs to treat any medical conditions,because the herbs may cause some reactions to their physical and mental behavior.

    Posted by Deirdre Coleman,MSW/Intern

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  2. I was not at all suprised about the fact that african american women used prayer more than any other form of alternative medicine. The power of prayer in deeply imbedded in the african american culture and many in this culture (as well as other cultures) believe that only God has the power to change things such as circumstances and serious health conditions. I was also not surprised that african americans take other alternative medicines without consulting thier physicians. Many african americans do not have confidence in the medical profession. This would especially be true for the elders in the african american community who very seldom believe in any western medicine practices.

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  3. As social workers, we know the importance of having the client as the expert of themselves, and us as practitioners help connect the dots. If someone is convinced that prayer is the answer to their problems, it is important to support them in that in order to build a good relationship with the client. It would be helpful for the client to have a relationship with a faith-based practitioner as they would be better able to cater to that client's specific needs. They could also be more knowledgeable in broaching the subject of medicine and therapy with those people who believe prayer is the only answer. It is definitely important to have faith-based practitioners in mental health and substance abuse fields, because as we can see, different people require different interventions.

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  4. This study looks at the use of CAM by African-Americans. The majority of people using CAM are women and individuals with higher income levels. Prayer is one of the most widely used CAM interventions. African-Americans that have higher socio-economic status are more likely to use CAM for treatment. The fact that African-Americans tend to use prayer more for CAM interventions is not surprising. I know that religion and church tend to be central in many African-American families. Historically African-Americans tend to look up to God to help them out of difficult situations such as poverty or poor health. Faith is an important part of African-American life. I do wonder if the study was done among young African-Americans who are not as religious as their parents. I wonder what the results of the study would be like if they were not religious.

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  5. Despite new research on the effectiveness of incorporating CAM interventions and practices into evidence based practice, the area of spirituality and religion seems to be an inherently dangerous area for practitioners. To suggests and use as a basis for treatment spirituality and religion, especially in public settings, seems to contradict secular ideals about medicine and treatment as science based.

    This can be seen in the treatment of substance abuse, and the use of the twelve step program. The AA 12 step program has effectively been used to help many who are struggling to break substance dependence find a sense of purpose through a program that relies upon steps such as relying on a higher power, prayer and meditation, and carrying the message forward after a spiritual awakening. Yet, often this program is modified when used in clinic and treatment facilities to leave out any aspects that might suggest religiosity.

    This might be more beneficial to those seeking treatment who are more opposed to the concept of spirituality and religion. But, it also creates a missed opportunity for those who might greatly benefit from the sense of purpose, faith, or inspiration to change that can be gained through the use of meditation and spirituality.

    It is a precarious at best for professionals in the field of social work to suggest religion or spirituality, or often even methods that involve aspects of these concepts, to those seeking help unless they appear already receptive to these ideas. On the one hand, we must appreciate the need for interventions and methods that are a fit with the client. On the other hand, it is a bit of a shame that the nature of the topic often completely removes the option from the table for those who might benefit.

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