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Predictors of positive opinion about Bach Flower Remedies in adults from three Latin-American countries: An exploratory study

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The current study aimed to determine if positive opinions about BFR interacts with spirituality in adults from three Latin-American countries using a CHAID algorithm. Participants were 703 adults from Cuba (n = 319), Costa Rica (n = 252) and Chile (n = 132). Predictors: demographic data, received information, received treatment, spirituality, dispositional optimism and willingness to use a placebo intervention were measured and analyzed. A supervised classification which included a training phase (n = 423) and a test phase (n = 280) was employed. Received information about BFR, spirituality and education were selected as significant predictors of the positive opinion about BFR (>90% of correct classifications).
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... In fact, it has been suggested that spirituality could be the main dispositional predictor of the effect of BFR (24)(25)(26)(27). Furthermore, it has also been suggested that spirituality predicts self-opinion about BFR whenever individuals receive enough information about this therapy, regardless of their dispositional optimism, or whether they have or not already received treatment (28). ...
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Background: We present two studies (hereafter Study 1 and Study 2), aimed to evaluate Bach Flower Remedies (BFR) effectiveness in controlling food cravings (FC), with assessment at three different stages: baseline, 1 month after baseline and 3 months after baseline. Methods: Study 1 consisted in a double-blind placebo-controlled trial aimed to assess the specific effects of a BFR-formula and the overall effectiveness of the placebo-control on FC (n=173). Participants were assigned to BFR (n=65), Placebo (n=55) and Control group (n=53). On the other hand, Study 2 did not involve deception, and combined an implementation intention instruction with the BFR-formula, all aimed to reduce FC in overweight and obese adults while at home (n=74). Every participant received an implementation intention instruction to sip a glass of water whenever experiencing FC at home. BFR group (n=37) was instructed to sip water with BFR solution diluted in it, whereas Water group just sipped plain water (n=37). Results: Study 1 did not support specific effects for BFR; placebo seemed to be effective in controlling FC. Moreover, findings from Study 2 suggest that BFR, used at least once a day, in conjunction with implementation intention intervention, may be helpful in reducing FC in overweight and obese adults while at home. Conclusions: Results of both Studies helped us evaluate the ‘power of the placebo’ in helping individuals overcome FC in their everyday life.
... Some clinical evidence has been provided in the case of attention deficit hyperactivity, 144 several psychological problems and pain, 145 and external use in the treatment of carpal tunnel syndrome, 146 with relative good acceptance in Latin American countries. 147 Musicotherapy. Music is usually recognized as a healing therapy for emotional diseases, providing comfort beyond entertainment as suggesting usefulness in psychiatric disorders and mental health. ...
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Introdução: A terapia floral faz parte de um campo emergente de terapias complementares, caracterizado pelo uso de meios menos onerosos, fundado numa visão integral da saúde e, principalmente, por métodos não invasivos e não tóxicos. No Brasil, esta terapia vem ganhando espaço, principalmente a partir da aprovação da Política Nacional de Práticas Integrativas Complementares (PNPIC), que possibilita a articulação entre os sistemas médicos complexos e a medicina tradicional e complementar, visando à prevenção de doenças, recuperação, promoção e racionalização das ações em saúde. Objetivo: avaliar a quantidade de cirurgiões-dentistas habilitados em terapia floral e número de cursos já oferecidos dessa habilitação por estados e regiões do Brasil. Material e Método: Os dados referentes aos números de cirurgiões-dentistas habilitados e a quantidade de cursos de habilitação em terapia floral foram coletados diretamente do site do Conselho Federal de Odontologia (CFO), assim como a distribuição geográfica desses no Brasil. Todos os dados utilizados nesta pesquisa são de acesso público. Resultados: São Paulo detém o maior número de cirurgiões-dentistas habilitados em terapia floral (n=16) e é o estado brasileiro, onde o único curso de habilitação foi ministrado. Por regiões, o Sudeste apresentou o maior número de profissionais habilitados no país (56,8%). No Sul, para cada habilitado existem 5.586,6 cirurgiões-dentistas, enquanto que no Nordeste este número cresce para 16.425. Conclusão: Há poucos cirurgiões-dentistas habilitados e cursos de habilitação em terapia floral em todo o país, tendo maior concentração na região Sudeste, principalmente no estado de São Paulo. Descritores: Essências Florais; Terapias Complementares; Odontologia; Odontólogos. Introduction: Floral therapy is part of an emerging field of complementary therapies, characterized by the use of less expensive means, based on an integral view of health and, mainly, non-invasive and non-toxic methods. In Brazil, this therapy has been gaining ground, especially since the adoption of the National Policy on Complementary Integrative Practices (PNPIC), which allows the articulation between complex medical systems and traditional and complementary medicine, aiming at disease prevention, recovery, promotion and rationalization of health actions. Objective: to evaluate the number of dentists qualified in floral therapy and the number of courses already offered by this qualification by states and regions of Brazil. Material and methods: The data referring to the numbers of qualified dental surgeons and the number of qualification courses in floral therapy were collected directly from the website of the Federal Council of Dentistry (CFO), as well as the geographical distribution of these in Brazil. All data used in this survey are publicly accessible. Results: São Paulo has the largest number of dentists qualified in floral therapy (n = 16) and is the Brazilian state, where the only qualification course was given. By region, the Southeast has the highest number of qualified professionals in the country (56.8%). In the South, there are 5,586.6 dental surgeons for each qualified, while in the Northeast this number grows to 16,425. Conclusion: There are few qualified dental surgeons and habilitation courses in flower therapy throughout the country, with a higher concentration in the Southeast region, mainly in the state of São Paulo. Descriptors: Flower Essences; Complementary Therapies; Dentistry; Dentists. Resumen Introducción: La terapia floral forma parte de un campo emergente de terapias complementarias, caracterizado por el uso de medios menos onerosos, fundado en una visión integral de la salud y, principalmente, por métodos no invasivos y no tóxicos. En Brasil, esta terapia viene ganando espacio, principalmente a partir de la aprobación de la Política Nacional de Prácticas Integrativas Complementarias (PNPIC), que posibilita la articulación entre los sistemas médicos complejos y la medicina tradicional y complementaria, buscando la prevención de enfermedades, recuperación, promoción y racionalización de las acciones en salud. Objetivo: evaluar la cantidad de dentistas habilitados en terapia floral y número de cursos ya ofrecidos de esa habilitación por estados y regiones de Brasil. Material y Método: Los datos referentes a los números de dentistas habilitados y la cantidad de cursos de habilitación en terapia floral fueron recolectados directamente del sitio del Consejo Federal de Odontología (CFO), así como la distribución geográfica de esos en Brasil. Todos los datos utilizados en esta investigación son de acceso público. Resultados: São Paulo posee el mayor número de dentistas habilitados en terapia floral (n = 16) y es el estado brasileño, donde el único curso de habilitación fue dictado. Por regiones, el Sudeste presentó el mayor número de profesionales habilitados en el país (56,8%). En el Sur, para cada habilitado existen 5.586,6 dentistas, mientras que en el Nordeste esta cifra crece a 16.425. Conclusión: Hay pocos dentistas habilitados y cursos de habilitación en terapia floral en todo el país, teniendo mayor concentración en la región Sudeste, principalmente en el estado de São Paulo. Descriptores: Esencias Florales; Terapias Complementarias; Odontología; Odontólogos.
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Background: A randomized, pilot, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on Bach flower remedies (BFR) on symptoms and signs of carpal tunnel syndrome. Methods: Forty-three patients with mild to moderate carpal tunnel syndrome during their "waiting" time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and nonblinded BFR (n = 13). These groups were treated during 21 days with topical placebo or a cream based on BFR. Results: Significant improvements were observed on self-reported symptom severity and pain intensity favorable to BFR groups with large effect sizes (η(2) partial > 0.40). In addition, all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain, night pain, and tingling, also with large effect sizes (φ > 0.5). Finally, there were significant differences between the blinded and nonblinded BFR groups for signs and pain registered in clinical exam but not in self-reports. Conclusion: The proposed BFR cream could be an effective intervention in the management of mild and moderate carpal tunnel syndrome, reducing the severity symptoms and providing pain relief.
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We tested the contribution of two mechanisms, response expectancy and motivational concordance, to reported psychological benefit from a popular, biologically inactive, self-help, complementary therapy (a placebo). Flower essences were taken by 251 people for self-selected symptoms and were randomized to receive three different kinds of information. When the flower essence was presented as a spiritual therapy, then baseline spirituality (beta=.35, P=.01) and expectancy (beta=.25, P=.03) independently predicted outcome. When flower essences were presented as an affirmation (i.e., nonspiritual) therapy, then spirituality negatively (beta=-.27, P=.03) and expectancy (beta=.33, P=.01) predicted outcome. For both groups, expectancy predicted outcome after controlling for spirituality and compliance, but did not after controlling for ease of task completion. Expectancy failed to predict outcome in the nonenhanced ritual group. The results suggest that motivational concordance is an important therapeutic mechanism for real-life placebos.
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The aim of this study was to determine whether absorption and spirituality predict the placebo response independently of expectancy. This was an open study of self-treatment with self-selected Bach flower essences. Participants' expectancy of the effect of flower essences, attitudes to complementary medicine, holistic health beliefs, absorption, and spirituality were measured prior to treatment. One month after the start of treatment, participants responded to an e-mail enquiry about symptom change using a single seven-point change scale. One hundred sixteen participants (97 university undergraduates and 19 staff) completed all assessments. Spirituality and absorption together predicted additional variance compared with a cluster of expectancy measures comprising expectancy, attitude to complementary medicine, and holistic beliefs (increment in R(2)=.042, P=.032), and spirituality alone (but not absorption alone) predicted more additional variance than did the expectancy cluster (increment in R(2)=.043, P=.014). Our data are inconsistent with conventional explanations for the placebo effect. The mechanism underlying the placebo response is not fully understood.
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Introduction: No term has probably been as misused and has caused so much confusion as the term 'placebo'. Its effects have strengthened medical treatments throughout history without receiving due recognition. Understood as events attributable to the significance acquired by an intervention in a given therapeutic context, it takes on a new dimension, detaching from the prevailing tautological definitions. Objective: Analyze the challenges posed by this theoretical stand, as well as its potential for research and clinical practice. Method: An analysis is conducted of the limitations of its use in randomized clinical trials, among them the efficacyparadox paradox. A contrast is made of evidence of its effectiveness generated in various contexts. A description is provided of placebos available in clinical practice and situations of use, as well as doctors' and patients' opinions. Its effect is presented from a biopsychosocial perspective, within the framework of Lifestyle Medicine. An outline is provided of the factors preventing alternative medicines from being «better than a placebo». Finally, its place in clinical practice is identified and exemplified. Conclusions: The placebo effect should be understood as an effect from the context, structured on the basis of the individual significance assigned to the intervention by a specific culture and historical development, which is significant for a large number of diseases, through the activation and modification of psychological and physiological variables. Conceived of as an Optimal Healing Environment, it acquires the «active principle» required to act by itself (when the alternative is doing nothing), or strengthen the effect of conventional treatments.
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We examined the hypothesis that a tendency to experience the world in terms of a sense of `special' connection is responsible for the self-transcendent value dimension identified by multi-dimensional scaling and constitutes a common factor for different religious and non-religious interpretations of spirituality. Eight different groups were studied including: (a) six different types of faith leaders in India and the UK, (b) people who self-rated as spiritual but not religious, and (c) those self-rating as neither spiritual nor religious. They completed a questionnaire that assessed (a) the strength of their spirituality irrespective of type (self-perceived spirituality) and (b) the experience of special connection to the following categories: people, nature, places and the universe, with and without using the term spiritual. For all eight samples the different types of connection were highly inter-correlated, and self-perceived spirituality correlated with the sum of connection items irrespective of whether items included the term spiritual or not. Variation between groups in the size of the latter correlation was consistent with different interpretations of spirituality in those groups. Although the meaning of spirituality is socially constructed, variability within faith leader groups suggests that its interpretation is also affected by personality.
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A placebo by proxy effect occurs when a patient's response to therapy, assessed either objectively or subjectively, is affected by the behavior of other people who know that the patient is undergoing therapy. We recruited 58 children aged 2-5 years who reported frequent tantrums and examined the effect of a pharmacologically inert substance (flower essence) that is purported by the manufacturers to reduce temper tantrums. Tantrum frequency, tantrum severity, and parental mood were measured on 5 occasions over 8 days before treatment and on a further 5 occasions over 10 days after the start of treatment. Compared to the period before treatment, there was a continuing reduction in tantrum frequency (p = .002) and severity (p = .003) over the 8 days of placebo treatment. There were significant day-to-day correlations between parents' mood and tantrum frequency (r = .23) and severity (r = .19). Children's response to treatment for tantrums is associated with the beliefs and mood of the adult carer. We cannot say whether tantrum reduction was due to objective changes in child behavior, changes in parental perception, or both, but both are clinically important changes.
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To determine whether spiritual and religious identities predict complementary and alternative medicine (CAM) use above and beyond other known influences such as gender, region of residence, social status, personality, health, and access to conventional medicine. Analyzing data from the 1995-1996 National Survey of Midlife Development in the United States (n=3032), this study examines the correlations between four aspects of spirituality/religiousness-i.e., spiritual only, religious only, both spiritual and religious, and neither spiritual nor religious-and six measures of CAM. Compared with spiritual only persons, the odds of using energy therapies are 86% lower for spiritual and religious persons, 65% lower for religious only persons, and 52% lower for neither spiritual nor religious persons. Compared to spiritual only persons, spiritual and religious individuals are 43% more likely to use body-mind therapies in general; however, when this category does not contain prayer, meditation, or spiritual healing, they are 44% less likely. Religious only individuals are disinclined toward CAM use. After controlling for established predictors including educational attainment, personality, social support, and access to conventional medicine, the present study demonstrates that spirituality and religiousness are associated, in unique ways, with CAM use. Additional research on this topic is clearly warranted.
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The field of placebo research has made considerable progress in the last years and it has become a major focus of interest. We know now that the placebo effect is a real neurobiological phenomenon and that the brain's 'inner pharmacy' is a critical determinant for the occurrence of psychobiological and behavioural changes relevant to healing processes and well-being. However, harnessing the advantages of placebo effects in healthcare is still a challenge. The first part of the theme issue summarizes and discusses the various kinds of placebo mechanisms across medical fields, thereby not only focusing on two main explanatory models-expectation and conditioning theory-but also taking into account empathy and social learning, emotion and motivation, spirituality and the healing ritual. The second part of the issue focuses on questions related to transferring knowledge from placebo research into clinical practice and discusses implications for the design and interpretation of clinical trials, for the therapeutic settings in daily patient care, and for future translational placebo research.
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Bach flower remedies continue to be popular and its proponents make a range of medicinal claims for them. The aim of this systematic review was to critically evaluate the evidence for these claims. Five electronic databases were searched without restrictions on time or language. All randomised clinical trials of flower remedies were included. Seven such studies were located. All but one were placebo-controlled. All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos.
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Homeopathy and Bach Flower Remedies (BFRs), historically-related complementary healing modalities classified as prescription/nonprescription drugs and over-the-counter homeopathic nutritional supplements, respectively, are compared with respect to indications, dosage philosophies, associated procedures, reported outcomes, safety profiles, and the possible operation of the placebo effect. Original data and published research reports, including case studies, retrospective meta-analyses, and double-blind clinical trials are compiled and evaluated for both healing systems. Homeopathy and BFR therapy both feature highly diluted natural medicinal substances, flexible dosage schedules tailored to individual patients, and energy-based healing action. They differ with respect to practitioner training and certification, number and types of medicinal source materials, remedy combinations and applications, and potential toxicity or other side-effects. Extensive testing has produced mixed or equivocal results regarding the efficacy of both of these health care systems. While a variety of positive outcomes have been frequently recorded with Homoeopathy and BFR treatments, it is likely that the placebo effect operates to a significant extent in both approaches.
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Pharmacists need to know about complementary therapies so they can advise patients on their suitability, and also their compatibility with conventional drugs. This article discusses, from a pharmaceutical perspective, the types of therapies available, their applications and indications, and issues surrounding the placebo effect.
Article
A common sense view in psychotherapy holds that there are individual differences in response to different treatments. However, despite considerable effort, no clear rationale exists to guide the selection of therapy for individual patients. Rather than focusing on specific components of therapy as a basis to predict interactions between patients and treatments, we draw on motivational concordance theory and a contextual model of psychotherapy to test whether, in an analogue study, perceived effectiveness of different therapy vignettes is related to human values. Two samples (undergraduates and members of the public) read short vignettes, informed by six therapies for depression (cognitive behaviour therapy, client-centred therapy, antidepressant medication, existential psychotherapy, psychodynamic psychotherapy, and a complementary medicine: Bach flower essences), provided ratings of perceived effectiveness, and completed questionnaire measures of dispositional motivations (Schwartz Values Scale and the Spiritual Connection Questionnaire-14). Responses were analysed using multidimensional scaling (MDS). In both samples, expectancy for the cognitive behavioural-informed vignette was related to Self-direction and Stimulation, and was opposed to Tradition, Conformity and Security. Expectancies for the Drug vignette were associated with Power and Security. People perceive therapies as more effective if the therapy is congruent with their values. These preliminary data suggest motivational concordance is a useful framework for predicting client-treatment interactions.
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The motivations of cancer patients in seeking complementary therapies are, fundamentally, self-healing motivations which, when engaged appropriately, can contribute to the patient's psychological and physical well being. In this paper, we apply a theoretical model, the Risk Adaptation Model, to furthering the clinical understanding of the motivations of cancer patients in seeking complementary therapies. The model identifies six discrete cognitive processes which, in combination, are hypothesized to play a central role in therapy seeking. Emphasis in this model is placed on the patient's need to maintain positive expectancies (optimism) when faced with the risk and uncertainty of cancer. This understanding of complementary-therapy seeking is grounded in the perspective that clinicians must respect the autonomy of cancer patients in their quest for appropriate therapies, and assist rather than direct their process of therapy-seeking.
Article
This paper explores the potentiality of Bach flower remedies as a means of pain relief through a retrospective case-study analysis to establish how clients suffering with painful conditions responded to the therapy. Of 384 subjects, 41 suffered pain. Of these, 46% felt treatment had relieved their pain; in 49% the physical outcome was unknown. About 88% of all subjects reported an improvement in their emotional outlook. The role of placebo and its influence on the study's key features: focus shift from physical pain to emotional outlook, and the importance of the client-practitioner relationship and belief in the therapy. The use of Bach flower remedies has brought about positive emotional changes in the majority of clients in this study. Whilst it is difficult to draw a definitive conclusion as to significance of the therapeutic value of these remedies in relation to pain above that of a placebo, the results are encouraging. In particular, relief of negative emotions and promotion of positive thought including how clients opened up about, and dealt with, emotional issues. The indication is that potential for Bach flower remedies as a therapeutic agent in the relief of pain does exist and is worthy of further qualitative and quantitative investigation through robust, purpose-designed studies to replicate and progress the results shown here.
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The Rational-Experiential Inventory (REI) and Tellegen Absorption questionnaire were completed by 131 undergraduate students who also completed a scale measuring complementary medicine use (with separate entries for practitioner and self-delivered use) and vitamin/mineral use. Less rationality and greater absorption predicted greater use of practitioner-delivered and self-delivered complementary medicine, and vitamin/mineral use. Logistic regression showed that rationality and absorption were independent predictors of these behaviours. In addition to confirming previous research, this is the first demonstration that complementary medicine and vitamin/mineral use are predicted by the same variables, including less rationality.
  • M Linderman
M. Linderman, Biases in intuitive reasoning and belief in complementary and alternative medicine, Psychol. Health 26 (3) (2011) 371e382.
Bach Flower Remedies: Form and Function
  • J Barnard
J. Barnard, Bach Flower Remedies: Form and Function, Lindisfarne Books, Great Barringtong, MA, 2004.