Knowledge, attitudes, and usage of complementary-alternative medicine (CAM): A national survey of clinical psychologists in Indonesia

Health Professionals' Attitudes Towards Traditional Healing for Mental Illness: A Systematic Review

Combining modern treatments with traditional healing approaches has been proposed as one way to address mental health problems, especially in low-income countries where the costs of pharmaceuticals often prevent or reduce their use. Despite health professionals' involvement being crucial for the integration of this approach, their involvement has been limited to date. This systematic review is designed to explore the attitudes of health professionals towards traditional healing practices for mental illness. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines were followed. The studies were identified from Scopus, EMBASE, PubMed, PsycINFO, and the Web of Sciences. The qualities of the included articles were assessed using the Mixed Method Appraisal Tool (MMAT) Version 2018, and mixed-method synthesis was used to narrate the results. Of the 2115 identified articles, 36 were included in the data synthesis. From the extracted data, health professionals had negative, mixed, and positive views towards traditional healing approaches for mental illness. Their negative attitude towards traditional healing approaches were due to their concerns that traditional healing may cause harm to service users, and they have no trust in the scientific basis, education, or practices of healers. Despite the fact that it is crucial for healthcare professionals to comprehend the cultural backgrounds of those receiving mental health services in order to offer care appropriately, health professionals' negative and mixed attitudinal expressions towards traditional healing approaches limit their involvement. This might be improved by identifying barriers from the perspective of practitioners and creating culturally appropriate guidelines for communication and referral between traditional healing approaches and biomedical care.

Evaluation of Knowledge, Attitude, and Practice of Iranian Medical Students Toward Complementary and Alternative Medicine: A Cross-Sectional Survey

Background and Aims

Complementary and alternative medicine (CAM) encompasses a wide variety of health practices and products that are generally not included in conventional medicine. This study evaluates knowledge, attitude, and practice (KAP) among medical students toward CAM in Iran.

Methods

In this cross-sectional study, we developed and used a questionnaire to evaluate the KAP of medical students regarding CAM. The sampling method was convenience sampling. Two hundred and twenty medical students who were in their first to three (junior) and the last 2 years of education (senior) participated in this study. The data was collected from January to May 2017. Data analysis employed descriptive statistics, chi-square test, and independent t-test. Statistical significance was set at p-values less than 0.05.

Results

Of 220 medical students, 125 respondents were CAM users (56.81%). The score of attitude about CAM was 60.13 ± 10.48 in junior students and 60.81 ± 7.32 among senior students. The score of knowledge about CAM was significantly (p = 0.02) higher in senior students (9.05 ± 4.12) than in juniors (7.74 ± 5.23). Traditional Persian medicine (TPM) was found to be the most commonly practiced CAM by both groups of students and their families. Leeching in students and chiropractic in their families had the lowest CAM use rates.

Conclusion

Although CAM knowledge was relatively low in medical students, they have a positive attitude toward it. TPM was the most common practice among CAM approaches. It is necessary to incorporate CAM modalities especially TPM education into the curriculum of medical students and other healthcare disciplines to enhance students' knowledge and attitude toward CAM and its role in healthcare.

Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists

BACKGROUND

Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in some form, as part of their broader mental health care. The aim of this research was to determine the number of types of CM products, practices, and practitioners are recommended and/or referred by Australian psychologists as part of their clinical practice, as well as explore the relationship between psychologists' perspectives on the risk and relevance of engaging with CM in psychology.

METHODS

Survey data was collected from psychologists in clinical practice who self-selected to participate in the study via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice.

RESULTS

Amongst the 201 psychologists, 5% reported not recommending any type of CM, with 63% recommending four or more types of CM. Further, 25% had not referred to a CM practitioner, while 33% had referred to four or more types of CM practitioner. Psychologists are recommending and referring to CM even when they perceive their knowledge of CM to be poor, and that engaging with CM was a risk.

CONCLUSION

This study provides insights into psychologist perceptions of CM within psychology practice and how these perceptions are associated with rates of recommending and referring to CM as part of their clinical practice. These findings may inform the development of CM relevant education and guidelines for psychologists.

Use and perception of complementary and alternative medicine among Iranian psychologists

OBJECTIVES

The seeking and use of Complementary and Alternative Medicine (CAM) modalities by people to treat mental disorders has increased and it is necessary for psychologists to have the necessary information in this field. This study aims to evaluate the use and perception of CAM by Iranian psychologists.

METHODS

This cross-sectional study was conducted on 100 psychologists selected by the census in 2019. Data collection tools consisted of four sections of the demographic section, the CAM questionnaire for psychologists, awareness of CAM, and use of CAM. The validity and reliability of this questionnaire were confirmed.

RESULTS

The mean (standard deviation) scores of attitude and educational needs were 40.45 (11.36) and 33.93 (5.96), respectively. Only 19.25% of psychologists had sufficient knowledge of CAM, and most of them (56.34%) reported that there is an educational need for CAM. In this study, 64% of psychologists used CAM for themselves. There was a significant relationship between the attitude toward CAM modalities and the suggestion of CAM to the clients (p=0.025). There was also a significant relationship between the use of CAM by psychologists and the suggestion of these modalities to their clients (p<0.001).

CONCLUSIONS

Psychologists had not sufficient awareness about CAM and had a moderate attitude. Most of the psychologists reported that there is educational need for CAM. Therefore, it is necessary to design and implement appropriate training courses for psychologists toward CAM modalities.

"Doing My Profession is also Part of Worship": How Clinical Psychologists Address Aspects of Spirituality and Religion in Indonesia

This study aimed to explore how Indonesian clinical psychologists (CPs) address aspects of spirituality and religion (SR), particularly their attitudes towards and experience of it, on the mental health context. Semi-structured interviews were conducted with 43 CPs in public health centres in Yogyakarta Province, Indonesia. Data were analysed using deductive thematic analysis and they generated ten sub-themes which were merged into three central themes. The first theme was experiences related to SR, particularly in Indonesian sociocultural context. The second theme concentrated on participants' clinical experience related to SR integration into clinical practice. The last theme highlighted the effort made by participants to create holistic mental health services. The originality of this study was represented by the interview quote in the title, "Doing my profession is also part of worship". It was found that SR is part of culture and belief among Indonesian people, including CPs and mental health treatment clients. In summary, participants genuinely acknowledged that they were not able to completely detach SR from their professional practice. However, participants also pointed out that they were different with spiritual-religious healers (SRHs) and favourably welcomed future collaboration with credible SRHs. This positive attitude embodied a holistic care approach that recognises the diverse biopsycho-social-spiritual needs of clients. Therefore, professional organisations and psychology faculties should establish regulations and education of SR in psychology curricula and conventional psychotherapy to achieve this holistic mental health services in Indonesia.