Running head: ALTERNATIVE MENTAL HEALTH TREATMENT
The Importance of Alternative Methods in Mental Health Treatment
Olivia Berglund
Western Washington University
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Mental health patients can be one of the most vulnerable and unpredictable populations to
serve in the human services field. Some of the most prevalent disorders amongst mental health
patients are anxiety and stress. Even if these symptoms are undiagnosed, feelings of stress can
affect mental health patients drastically in day-to-day functioning. In the world of western
medicine, structured systems of treatment for mental health patients have been implemented and
continue to be carried out through a majority of mental health care providers in western medical
institutions. The main way that the western medical system treats people with mental health
problems is through the use of pharmaceutical medications. These medications oftentimes have
adverse effects on the patients that can sometimes be as worse as death. Because of the growing
popularity of antidepressants, anti-anxiety medications, and other pharmaceuticals, alternative
methods of treatments are oftentimes forgotten about and not even considered by health care
professionals during the treatment process. On top of this, many private insurance companies
will not even cover medical charges that are not considered traditional western medicine
practices.
To begin, there are many alternative methods to mental health care treatment that are
currently gaining popularity among health care professionals and mental health patients in the
western world that are not considered traditional. A few examples include art therapy, kava,
exercise, relaxation training, bibliotherapy, phototherapy, herbal remedies, transcranial magnetic
stimulation, and acupuncture. These methods are some of the non-pharmaceutical options that
have started to be utilized for depression, anxiety, schizophrenia, various phobias, panic,
substance abuse, and posttraumatic stress disorder. (Jorm et al., 2004)
Different treatment methods work for different people, thus some of these nonpharmaceutical options work better for specific populations. For example, populations that have
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been involuntarily westernized, such as indigenous populations in the United States and Canada,
in addition to populations who have emigrated from the eastern world to the western world, tend
to hold more importance on non-pharmaceutical approaches to mental health care (Berthold et
al., 2007; Maar & Shawande, 2010). Refugees from Cambodia suffering from alcohol abuse
problems, post-traumatic stress disorder, and depression tend to seek out alternative methods of
treatment just as frequently as western methods (Berthold et al., 2007). This is an example of
how eastern traditions and western traditions are both being sought out and are not inhibitive of
each other.
Limiting factors to popular western treatment methods, such as physical state of the
patient or lack of monetary resources, must also be taken into consideration. Many pregnant
women do not want to be on medications during pregnancy due to possible adverse effects on the
fetus. Although the Food and Drug Administration has not yet approved many of the alternative
treatment methods such as phototherapy or transcranial magnetic stimulation, many pregnant
women continue to use these alternative methods (Tjoa & Pare, 2010). Additionally, research by
Pardini et al. (2013) focused on depression in prisoners, an at-risk population with few resources
for treatment. The use of bibliotherapy through providing prisoners with depression with selfhelp books was proven to decline symptoms of depression at a low cost and without the use of
antidepressants.
There is a large amount of people in the western world who do not want to be dependent
on taking a medication for the rest of their lives in order to combat against his or her mental
illness or disorder. Many antidepressant and anti-anxiety medications are prescribed to mental
health patients for extremely long periods of time and, in many instances, for life. One woman
who was diagnosed with schizophrenia began to get fed up with the traditional western methods
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of treatment. She was put on medication believing that she would be a diagnosed schizophrenic
for the rest of her life, but this specific patient was not content with this option. She decided to
take matters into her own hands and work closely with a therapist on a regular basis who then
suggested art as a creative outlet for treatment. The patient began illustrating her personal
depictions of her dreams, eventually created a book out of her art, and successfully withdrew
from the anti-psychotic medications that had been prescribed to her. (Barnes & Schellenberg,
2004)
Research by Price (2013) suggests that behavioral activation is another useful alternative
to pharmaceutical treatment options in mental health patients dealing with depression and
anxiety. The case that was studied focused on a patient who had tried many different
antidepressants and several different forms of psychotherapy, but had not been able to
successfully deal with the issue at hand. Finally, the patient began working with a therapist who
suggested behavioral activation, which is a technique in which the therapist acts as a coach to the
patient to help them attain short term goals, such as being more physically active on a routine
basis, in order to reach long term goals, such as dealing with depression and anxiety in order to
re-enter the workforce. Working with a depressed population with a relatively low level of
motivation can be one of the greatest challenges in this method, but the key is for the patient to
be willing to be patient with the slow process of changing avoidant behaviors by maintaining a
focus on activation in all realms of the patient’s life.
As alternative medicine options and treatment methods are gaining popularity,
psychologists and other medical professionals are forming their own opinions around the subject
matter. One clinical psychologist in particular, who worked with the patient that utilized art
therapy to treat her own schizophrenia, believes that mental health treatment should come from
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the holistic perspective. When treating a mental health patient, one must take into consideration
that some people do not see life-long dependence on an anti-psychotic medication as successful
medical treatment. According to research by Barnes & Schellenberg (2004), a holistic approach
to mental health treatment includes wellbeing in each individual sphere of the patient, nurturing
important relationships in the patient’s life, and instilling confidence in the patient’s ability to
heal. This psychologist explores her past training in the institutional medical system and her
level of discontentment with the medical system that she was being trained under. This article
states that medical care should be more humanized and done on a case-by-case basis, rather than
using the same pharmaceutical treatment methods for patients with similar mental health
disorders. (Barnes & Schellenberg, 2004)
As people become more and more aware of the successful stories that have come from
mental health patients using alternative treatment methods, more and more people are beginning
to question the western methods. On the contrary, research by Berthold et al. (2007) states that
the Surgeon General theorized that methods of mental health treatment that are used in eastern
countries, such as Cambodia, would interfere and inhibit the western medicine process. This was
disproved through the survey that was done amongst Cambodian refugees (Berthold et al., 2007).
The study performed face-to-face interviews with Cambodian refugees with post-traumatic stress
disorder, depression, or alcohol use disorder living in the United States. Results found that only a
minority of the population relied on complementary and alternative treatment methods, which
was strongly associated with the seeking of western medical services. This demonstrates the
importance of providing alternative options for culturally responsive treatment methods,
especially when treating mental health disorders, instead of providing fewer options in order to
keep western medicine progressive. Similarly, the survey done by Angermeyer, Breier, Dietrich,
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Kenzine and Matschinger (2005) focused on mental health patients from Germany, Slovakia, and
Russia. Each group of patients was asked about what mental health issue they were seeking
treatment for and what method of treatment that they wanted to use. Keeping the patient’s culture
and personal beliefs in consideration while suggesting treatment for something such as
schizophrenia or major depressive disorder was very important in the patient’s decision making.
It was found that when patients believed that their disorder was due to the expression of God,
and not due to personal circumstances, natural remedies were more likely to be suggested.
Additionally, if personal stress of the patient was considered to be the cause of the disorder,
meditation and/or yoga were suggested in half of the instances. This shows the importance of
taking the values of the patient into strong consideration when contemplating different treatment
methods. Even the way that a patient perceives their mental health issue can make a great impact
on the treatment process.
Research by Maar and Shawande (2010) supports the process of merging aspects of
traditional Aboriginal treatment methods with the western medical system. Officials decided to
slowly implement more traditional practices in the treatment of the Aboriginal people because it
was found that their health would not improve through providing more western medicine
services. The ties that the Aboriginal people have to their traditions are a very important aspect
of their lives and many people try to keep these ties strong, especially when it comes to medical
treatment. The use of traditional healers has been implemented in Aboriginal health care centers
in an effort to combine western practices with Aboriginal traditions. The effort to combine
traditional practices with western practices has not been an entirely smooth process. One issue
has been surrounding the regulation policy for traditional healers. Aboriginal people, in general,
do not want to be regulated by the system. In the past, Aboriginal communities chose their
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traditional healers and trusted them to provide quality services. Trying to blend this idea into the
mainstream medical field has been challenging due to the fact that in this example, it is very
difficult to regulate the practice of the healers and try to help prevent malpractice and any
possible health risks to patients. This article demonstrates the importance of implementing
alternative healing methods for specific populations, which in this case is the Aboriginal people
of Canada, and being extremely thorough in creating a successful collaboration of traditional and
mainstream practices. (Maar & Shawande, 2010)
The use of alternative medicine has been increasing over the past years, according to
research by Roy-Byrne et al. (2005) that focused on patients seeking treatment for anxiety and
depression-related disorders. The use of alternative medicine in treatment of mental health
patients with anxiety-related symptoms is an important method within this population because
many of these patients have anxiety about the side effects of different medicines and, thus, will
be more likely to want to use other forms of treatment. For example, Siev and Chambless (2007)
concluded through an experiment comparing the results of cognitive therapy with relaxation
therapy that both of these methods have the potential to be equally successful in treating patients
with anxiety and/or panic-related mental health disorders.
Alternative treatment methods for mental health patients are gaining popularity as the
importance of such methods is investigated, with some of the most effective treatment options
being art therapy or self-help methods such as bibliotherapy. The non-use of pharmaceutical
treatment options, although not necessarily recognized as important by western medicine, is
important in minority populations, such as pregnant women and immigrants living in the United
States. How can the current western medical industry implement more alternative treatment
methods into the mainstream medical system? Further research on the effectiveness of specific
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treatments in comparison to pharmaceutical options could be of great influence when it comes to
demonstrating the importance of providing alternative options to all patients when making
systemic changes in western medicine.
Hypothesis
In order to examine and compare the effectiveness of alternative mental health treatment
in the reduction of stress, I will conduct a longitudinal study over the course of fifty years, as
long as subjects are alive and willing to participate. I will be looking to find how effective the
use of two different alternative methods in a specific population: art therapy and relaxation
training. I predict that over the twenty years of the longitudinal study, both relaxation training
and art therapy will show a substantially lesser amount of stress in the patients. I think that if the
participant uses alternative therapy more often, his or her level of stress will decrease.
Procedure
Sample
The sample for this study will include one person from each state in the United States,
who is currently hospitalized for some kind of psychiatric treatment. If possible, I would like to
include a variety of mental health issues such as schizophrenia, major depressive disorder, and
posttraumatic stress disorder. In order to not limit the sample, I will select participants from a
variety of socioeconomic backgrounds, ethnic identities, genders, and ages in order to make the
sample more easily generalized to the American public. Out of the fifty participants, half will be
regularly participating in art therapy and half will be using relaxation training.
Method
In this longitudinal study, I will annually assess the stress level of participants through a
one-on-one interview with each participant each year in the month of March, in order to keep
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results from being skewed. The participants will be asked record the amount of time throughout
the year that he or she participated in either art therapy or relaxation training, the independent
variable. Then, I will have the participant assess his or her own level of stress, the dependent
variable, on a 1-10 scale, with 1 being the lowest stress level and 10 being the highest possible
level of stress. The research study will not be harmful to patients because they will be permitted
to use more institutionalized treatment methods as well as the designated alternative method.
Results
After each interview, I will chart the results in a table recording the results for each
individual every year. At the end of the fifty years, I will use the table to make a line graph to see
the trend of stress level in relation to hours spent on art therapy or relaxation training over time. I
will make a graph for each individual participant. The y-axis will represent the total number of
hours and the x-axis will represent the level of stress. I will then calculate the average results for
each group, art therapy and relaxation training, and make a line graph similar to the individual’s
graphs for the two groups to show how they compare to each other.
Analysis
I will be analyzing the graphs to see if an increase in the total hours spent practicing the
designated alternative therapy method correlates with a decrease in the level of stress and relate
it back to either support or disprove my hypothesis that more hours spent using alternative
therapy will decrease stress level. If the results support my hypothesis, this could lead to more
use of alternative therapy methods in mental health treatment.
Limitations
This study is limited because the participants are not required to exclusively use either art
therapy or relaxation training. Participants will be allowed to take part in more popularized and
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institutionalized treatment methods such as prescription medications. This can potentially skew
the results because the effects of treatment methods can potentially vary on a case-by-case basis.
In addition, due to the long amount of time that the study will take place over, there is a
possibility that subjects will no longer wish to participate in the study, other health issues will
prevent them from being able to participate, or the unfortunate event that a participant passes
away before the end of the study.
Conclusion
With the acknowledgement of possible limitations to the proposed study, the results will
benefit the public by raising awareness within the medical community about the effectiveness, or
lack of effectiveness, of art therapy and relaxation training. With unlimited resources and no
limitations, future research could be done in which participants solely use one method of
treatment and are compared to each other over a long period of time. If more people know about
the effectiveness of these low-risk alternative treatments, more people could potentially use
alternative treatment as the main method of treatment rather than a supplemental treatment
method.
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References
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