holistic therapy case study

Holistic Therapy: Healing Mind, Body, and Spirit

In the 1970s, practitioners in the health care field began to see the benefits of this and that treating only one symptom at a time did not succeed in improving overall quality of life (Relman, 1979). It was this realization that opened the door to alternative forms of care in medicine and mental health treatment.

Holistic therapy helps clients with physical, mental, existential, and relational issues and can lead to widespread health and healing. In this article, let’s first jump into an understanding of holistic healing, with a discussion of suitable techniques, research, and recommended books.

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This Article Contains

What is holistic psychology, holistic therapy: how it can promote mental wellbeing, different types of holistic therapy, holistic treatment techniques for specific conditions, 5 benefits of holistic healing, what research says about the effectiveness of holistic therapy, 4 books on holistic health, a take-home message.

Holistic psychology views individuals as more than just the sum of their parts. It focuses on how different aspects of an individual work together. This approach in psychology examines behavioral, social, emotional, environmental, physical, and psychological factors when evaluating and treating individuals (Ventegodt et al., 2007).

Holistic psychology uses an integrative approach to synthesize the relationship between mind, body, and spirit to address how issues in one area of a person’s life can lead to problems in other areas (Ventegodt et al., 2007). Clinicians of holistic psychology believe in using a collaborative approach to help clients gain awareness of these connections.

For this reason, self-reflection and awareness are foundational components of holistic psychology. With deepened awareness, clients find connections between emotions, thoughts, physical experiences, spiritual beliefs, and how they work together in daily life. Holism in psychology is complex, and the challenge is often creating interventions that address the scope of an entire client (Ventegodt et al., 2007).

This approach provides unique solutions that other procedures often miss. It shares commonalities with gestalt psychology , which views human behavior as a whole, and humanistic psychology, which accounts for environmental, social, emotional, and group dynamics.

With a deeper understanding of how emotions, thoughts, physical experiences, and spiritual beliefs work together to support behavior, clients can find self-acceptance and healing (Latorre, 2000).

Holistic therapies use techniques that target various aspects of the human, such as body, emotions, and soul, which benefit mental health and wellbeing. These three aspects are ideally addressed throughout three different stages of therapy.

The initial stages of treatment allow the therapist to gain trust with the client and focus on bringing awareness to the physical body. The awareness and release of physical tension through massage, body work, or body scans opens the client to being more receptive to emotional states.

Once a client develops trust with the therapist and awareness of physical sensations, verbal forms of therapy allow them to process and understand the emotions that arise from the release of body tension. The client and therapist can explore these emotions and the role they play in the individual’s life.

The third level of therapy involves the mind and soul and is the most difficult to reach. Exercises focused on an existential approach aim to connect the client with deeper meaning in the world. It may involve aspects of philosophy, values, beliefs, and meditation.

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Holistic therapy generally includes complementary therapies that are tailored to a client’s specific needs and goals. After an initial assessment, a holistic therapist will create a treatment plan in collaboration with the client. This treatment plan might use a variety of holistic approaches to enhance the mind–body–spirit connection and improve wellbeing.

Every client is different, and the modalities might look different from person to person. Where one might find forest bathing to be their ideal medicine, others might find expressive arts therapy most helpful.

Consequently, there are plenty of psychotherapy modalities out there, many of which you will find on our blog. Some types of holistic therapies include the following:

Breathwork can help regulate the nervous system , increase lung capacity, decrease anxiety, and improve sleep (Brooks et al., 2021). There are a multitude of breathing techniques that can be implemented in holistic therapy. A few of these include box breathing, alternate nostril breathing, pursed lip breathing, diaphragmatic breathing, and holotropic breathwork.

Somatic Experiencing (SE®)

Somatic experiences are “bottom-up” approaches to treat issues like anxiety, depression, and trauma (Brooks et al., 2021). They use body awareness, physical sensations, and movement to tap into deeper emotions and release them.

Hypnosis is also known as hypnotherapy and involves an altered state of awareness and an increase in relaxation and focus. According to Mayo Clinic (2022), it can help with anxiety, behavior change, and managing chronic pain.

Body work (acupuncture and massage)

Acupuncture and massage are forms of “body work” that can promote mental, emotional, and physical health. Acupuncture involves inserting tiny needles into specific trigger points of the body, which can help with pain, anxiety, and depression (Vickers et al., 2018).

Massage uses a mixture of light and heavy pressure to release physical pain, tightness, and discomfort. Research has shown that massage also has the ability to decrease depression and anxiety (Vickers et al., 2018).

Reiki is a form of energy healing rooted in Japanese tradition. The client lies on a table or grounding mat, and the practitioner may place their hands gently on, above, or around their body in order to release energy that can get “stuck” during stressful times or traumatic events. Research has demonstrated that reiki can reduce depression and anxiety and improve quality of life (Billot et al., 2019).

Expressive therapies

Expressive therapies use creative activities to help clients share and process emotions that can be difficult to put into words (Stuckey & Nobel, 2010).

Expressive arts therapy may use a mix of different techniques or select one form depending on the client’s needs and goals. Forms of expressive therapy include music therapy, dance therapy, art therapy, and drama therapy .

Research has demonstrated positive neural effects when experiencing and participating in forms of art and expressive therapies (Stuckey & Nobel, 2010).

Yoga therapy

While the practice of yoga dates back over 3,000 years in Eastern cultures, it has more recently been used as a therapeutic treatment in the West to improve physical, mental, emotional, and spiritual wellbeing.

Research has consistently demonstrated that yoga and yoga therapy can decrease stress, improve sleep, alleviate depressive symptoms, improve physical health, and assist in the treatment of trauma (Woodyard, 2011).

Recreational therapy

Recreational and leisure activities have consistently been found to promote positive emotions, provide a buffer against stress, and promote general mental and emotional wellbeing (Takiguchi et al., 2022).

Recreational therapy , also known as therapeutic recreation, uses creative activities such as crafts, sports, dance, music, and community outings to treat a variety of illnesses and disabilities. Certifications can be obtained specifically for recreational therapy to help individuals reach optimal mental, emotional, and physical wellbeing

Stress and anxiety

Anxiety is one of the most common mental health disorders in Western cultures, with over 18% of American adults struggling with some form of anxiety (Anxiety & Depression Association of America, n.d.).

Some of the most effective techniques used to treat anxiety holistically include mindfulness, yoga, breathing techniques, hypnosis, and physical exercise.

Chronic pain

Alternative medicines are common forms of treatment for musculoskeletal and other pain disorders. Between 59% and 90% of clients using holistic alternative treatments for chronic pain reported that they were helpful and could provide an adjunctive treatment to pain (Urits et al., 2021).

Much of the research on holistic treatment for chronic pain has centered around acupuncture, tai chi, meditation, and yoga. These techniques provide a physical release and help to connect the mind and body in a way that minimizes the experience of pain.

Post-traumatic stress disorder (PTSD) is a disorder that creates psychological pain, impairs social function, and poses a threat to general health and life (Song et al., 2020).

Some effective holistic techniques to treat PTSD include herbal medicine, meditation, yoga, deep-breathing exercises, and other mind–body therapies.

A meta-analysis comparing these holistic alternatives found they were at least as effective as medication in decreasing negative symptoms and moderating problematic behaviors (Song et al., 2020). As with treatment of other conditions, holistic approaches have positive effects with limited risks and side effects.

Holistic therapy is often used to help treat addiction issues and is part of many addiction treatment facilities (in- and outpatient treatment centers). Research has demonstrated that holistic techniques of dance/movement therapy, yoga, art therapy , recreation therapy, and spiritual growth and development help clients struggling with addiction to develop self-esteem, confidence, and a renewed identity (Breslin et al., 2003).

There are many benefits to holistic treatments for healing and improving wellbeing. There are beneficial effects of holistic treatment for depression, anxiety, stress, cognitive function, family communication, chronic pain, PTSD, and addiction (Ventegodt et al., 2006).

1. Mind–body connection healing

Mental health issues can manifest physically with symptoms of phantom pain, digestive issues, lack of focus/clarity, and poor sleep (Ventegodt et al., 2006).

Holistic healing works with the body to regulate the nervous system and improve both mental and physical health. When the mind, body, and spirit are connected and aligned, the body naturally heals itself.

2. Autonomy and empowerment

Holistic healing practices emphasize choice and a practitioner–client relationship. Holistic therapy allows clients to take responsibility and make autonomous decisions regarding their own health and healing journey.

Clients can learn about the various options and lifestyle choices that will lead to better mental, emotional, and spiritual wellbeing and take ownership of behavior change.

3. Emphasis on prevention

The goal of holistic medicine is to improve health, educate clients, and create sustainable wellness over a lifetime. Holistic therapies encourage positive choices that improve mind, body, and spirit to actually prevent, rather than just treat, illness and disease and increase vitality and longevity.

4. Limited side effects

Since most holistic therapies focus on natural options, there are few risks and side effects. Unlike many conventional treatments, such as surgery and prescription medications, holistic healing has minimal risk for complications, discomfort, or long-term side effects.

5. Cost effective

Many holistic techniques can be practiced with minimal or no financial cost. While a trained holistic therapist may be beneficial in evaluating and designing a treatment program for specific goals, things like mindfulness, meditation, dance , a home yoga practice, spiritual practices, and physical exercise in nature cost nothing and can easily be integrated into daily life.

There are many benefits to using a holistic approach and adopting holistic therapy. This video provides more information on the topic.

Research consistently supports the effectiveness of holistic therapy. A review of alternative holistic therapy found that acupuncture, tai chi, osteopathic medicine, and chiropractic care effectively diminished physical pain, fatigue, and depression in chronic pain patients (Urits et al., 2021).

Research examining the use of holistic therapy to specifically treat mental health disorders is also promising. Holistic treatment techniques such as yoga, massage, guided imagery , meditation, and spiritual practices have been found to be beneficial for individuals with serious mental health issues (Russinova et al., 2002).

The study found that holistic practices promote recovery in multiple areas by helping to manage emotions, reduce cognitive impairments, and enhance social, spiritual, and physical function.

While many holistic mental health treatment programs focus on common issues like anxiety and depression, holistic therapy can also be beneficial for more severe psychiatric disorders, including bipolar disorder and schizophrenia (Russinova et al., 2002).

Holistic therapy is particularly effective at decreasing stress, depression, anxiety, and improving general wellbeing. A one-month, (eight-session) mind–body–spirit holistic treatment program helped a group of students decrease stress and anxiety. The program improved health-related behaviors and levels of depression when compared to a control group of participants (Rentaia et al., 2019).

Students that participated in the holistic treatment program were able to handle stressful situations better, take responsibility for their wellbeing, and felt they were able to take charge of their health.

As a holistic treatment therapy, yoga has been specifically studied in areas of mental health. A consistent yoga practice has been found to reduce stress, depression, PTSD symptoms, and chronic pain (Brooks et al., 2021). Yoga is often incorporated into mental health treatment programs and addiction recovery programs.

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With the growing popularity of alternative and holistic health treatment options, there are many informative books to help both practitioners and clients learn about and improve wellbeing.

1. The Holistic Therapy Bible: Over 80 Effective Treatments to Heal the Mind, Body & Spirit – Jane Alexander

This comprehensive book takes the mystery out of “holistic treatment.”

It reviews a multitude of different therapy modalities that are commonly used in holistic therapy and explains them in a way that both practitioners and clients can understand.

It may be a particularly helpful guide for clients to determine which treatment options are best for them, what they are most comfortable with, and what the risks/benefits of each might be.

Find the book on Amazon .

2. Eastern Body, Western Mind: Psychology and the Chakra System As a Path to the Self – Anodea Judith

This book combines the Eastern philosophy of yoga with Western psychological practices.

It applies both sets of principles in combination to address issues of family dynamics, addiction, mental health issues, and personal empowerment.

It can provide wonderful ideas and serve as a guide for coaches, therapists, counselors, and educators working with clients.

3. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma – Bessel van der Kolk

The Body Keeps the Score is a must-read for anyone interested in mental health and the mind–body connection.

It is a foundational read for yoga practitioners, therapists, mental health clinicians, or anyone who has experience working with trauma.

Discussing both the biological and scientific basis of trauma and mental health issues, it provides ideas on how to integrate somatic experiences into the healing process.

4. Holistic Health: Healing Therapies for Optimal Wellness – Larry Trivieri and The American Holistic Medical Association

This comprehensive book reviews an extensive list of potential methods of healing from a natural and holistic perspective.

Some of them focus on the physical aspects of healing but support mental and emotional wellness in the process.

This guide can provide ideas and supplemental forms of treatment for any clinician to use.

Holistic health therapy has ancient roots but is relevant, popular, and effective today. In many ways, it has become a buzzword in the field of mental health.

While bringing the mind and spirituality into the healing process was once deemed “barbaric” by colonized societies, it is now recognized as a necessary integration for health and wellbeing (Relman, 1979).

As outlined in this article, there is a wealth of evidence to support holistic treatment options and therapeutic techniques. Given the many benefits holistic therapy offers, mental health practitioners can easily adopt them as part of a comprehensive treatment plan.

Collaborating with clients, a renewed sense of empowerment and self-awareness between the mind–body–spirit connection can lead to a long life of health and wellbeing.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

Anxiety & Depression Association of America. (n.d.). Anxiety disorders: Facts & statistics . Retrieved February 20, 2024, from https://adaa.org/understanding-anxiety/facts-statistics
Billot, M., Daycard, M., Wood, C., & Tchalla, A. (2019). Reiki therapy for pain, anxiety and quality of life. BMJ Supportive & Palliative Care , 4 , 434–438.
Breslin, K., Reed, M., & Malone, S. (2003). A holistic approach to substance abuse treatment. Journal of Psychoactive Drugs , 35 (2), 247–251.
Brooks, J., Lawlor, S., Turetzkin, S., Goodnight, C., & Galantino, M. (2021). Yoga for substance use disorder in women: A systematic review. International Journal of Yoga Therapy , 31 (1), 219–230.
Latorre, M. A. (2000). A holistic view of psychotherapy: Connecting mind, body and spirit. Perspectives in Psychiatric Care , 36 (2), 65–68.
Mayo Clinic. (2022). Hypnosis . Retrieved February 20, 2024, from https://www.mayoclinic.org/tests-procedures/hypnosis/about/pac-20394405
Relman, A. S. (1979). Holistic medicine. New England Journal of Medicine , 300 (6), 312–320.
Rentaia, S., Thimmajja, S., Tilekar, S., Nayak, B., & Aladakatti, R. (2019). Impact of holistic stress management program on academic stress and wellbeing of Indian adolescent girls: A randomized controlled trial. Journal of Educational Health Promotion , 8 , 253–259.
Russinova, Z., Wewiorski, N., & Cash, D. (2002). Use of alternative health care practices by persons with serious mental illness: Perceived benefits. American Journal of Public Health , 92 (10), 1600–1603.
Song, K., Xiong, F., Ding, N., Huang, A., & Zhang, H. (2020). Complementary and alternative therapies for post-traumatic stress disorder. Medicine , 99 (28), 211–224.
Stuckey, H., & Nobel, J. (2010). The connection between art, healing and public health: A review of current literature. American Journal of Public Health , 100 (2), 254–263.
Takiguchi, Y., Matsue, M., Kikutani, M., & Ebina, K. (2022). The relationship between leisure activities and mental health: The impact of resilience and COVID-19. Applied Psychological Health and Wellbeing , 10 , 359–384.
Urits, I., Schwartz, R., Orhurhu, V., Maganty, N., Reilly, B., Patel, P., Wie, C., Kaye, A., Mancuso, K., Kaye, A., & Viswanath, O. (2021). A comprehensive review of alternative therapies for the management of chronic pain patients: Acupuncture, tai chi, osteopathic manipulative medicine and chiropractic care. Advanced Therapy , 38 (1), 76–89.
Ventegodt, S., Clausen, B., Nielsen, L., & Merrick, J. (2006). Clinical holistic health: Advanced tools for holistic medicine. Scientific World Journal , 6 , 1242–1255.
Ventegodt, S., Kandel, I., & Merrick, J. (2007). A short history of clinical holistic medicine. Scientific World Journal , 7 , 1622–1630.
Vickers, A., Vertosick, E., Lewith, G., MacPherson, H., Foster, N., Sherman, K., Irnich, D., Witt, C., & Linde, K. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. Journal of Pain , 19 (5), 455–474.
Woodyard, C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International Journal of Yoga , 4 (2), 49–54.

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Person-Centered Therapy Case Study: Examples and Analysis

Introduction

Welcome to The Knowledge Nest's in-depth exploration of person-centered therapy case study examples and analysis. We aim to provide you with comprehensive insights into the therapeutic approach, techniques, and outcomes associated with person-centered counseling. Through real-life case scenarios, we demonstrate the effectiveness of this humanistic and client-centered approach in fostering personal growth and facilitating positive change.

Understanding Person-Centered Therapy

Person-centered therapy, also known as client-centered therapy or Rogerian therapy, is a compassionate and empathetic therapeutic approach developed by the influential psychologist Carl Rogers. This person-centered approach recognizes the profound significance of the therapeutic relationship, placing the individual at the center of the therapeutic process.

Unlike traditional approaches that impose solutions or interpretations on clients, person-centered therapy emphasizes the innate human capacity to move towards growth and self-actualization. By providing a supportive and non-judgmental environment, therapists aim to enhance clients' self-awareness, self-acceptance, and self-discovery. This holistic approach has proven to be particularly effective in addressing a wide range of mental health concerns, empowering individuals to overcome challenges and achieve personal well-being.

Case Study Examples

Case study 1: overcoming social anxiety.

In this case study, we explore how person-centered therapy helped Sarah, a young woman struggling with severe social anxiety, regain her confidence and navigate social interactions. Through the establishment of a strong therapeutic alliance, her therapist cultivated a safe space for Sarah to explore her fears, challenge negative self-perceptions, and develop effective coping strategies. Through the person-centered approach, Sarah experienced significant improvements, enabling her to participate more actively in social situations and regain a sense of belonging.

Case Study 2: Healing from Trauma

John, a military veteran suffering from PTSD, found solace and healing through person-centered therapy. This case study delves into the profound transformation John experienced as he worked collaboratively with his therapist to process unresolved trauma. By providing unconditional positive regard, empathetic listening, and genuine empathy, the therapist created an environment where John felt safe to explore his traumatic experiences. With time, he was able to develop healthier coping mechanisms, embrace self-compassion, and rebuild a sense of purpose.

Case Study 3: Enhancing Self-Esteem

In this case study, we examine Lisa's journey towards building self-esteem and self-worth. Through person-centered therapy, her therapist empowered Lisa to identify and challenge deeply ingrained negative self-beliefs that inhibited her personal growth. By offering non-directive support, active listening, and reflective feedback, the therapist enabled Lisa to develop a more positive self-concept, fostering increased self-esteem, and self-empowerment.

Analysis of Person-Centered Therapy

The therapeutic relationship.

Person-centered therapy places profound importance on the therapeutic relationship as the foundation for positive change. The therapist cultivates an atmosphere of trust, respect, and authenticity, enabling the individual to feel heard and valued. By providing unconditional positive regard, therapists create a non-judgmental space where clients can freely explore their thoughts, emotions, and experiences.

Client-Centered Approach

The client-centered approach encourages individuals to take an active role in their therapeutic journey. The therapist acts as a facilitator, guiding clients towards self-discovery and personal growth. By allowing clients to set the agenda and directing the focus of sessions, the person-centered approach acknowledges the unique needs and perspectives of each individual.

Empowering Self-Awareness and Growth

Person-centered therapy seeks to unlock individuals' innate capacity for self-awareness and personal growth. Through empathic understanding, therapists support clients in gaining insight into their emotions, thoughts, and needs. This heightened self-awareness helps individuals develop healthier coping mechanisms, make meaningful choices, and move towards a more fulfilling life.

Person-centered therapy, as exemplified through the case studies presented, offers a powerful and transformative path towards holistic well-being and personal growth. The Knowledge Nest is committed to providing a platform for sharing knowledge, experiences, and resources related to person-centered counseling. Together, we strive to facilitate positive change, empower individuals, and create a more compassionate and understanding society.

Explore more case studies and resources on person-centered therapy at The Knowledge Nest to discover the profound impact of this therapeutic approach.

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Is Holistic Therapy Right for You?

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change.

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Types of Holistic Therapy

What holistic therapy can help with, effectiveness, things to consider, how to get started.

Holistic therapy, also sometimes referred to as holistic psychotherapy or body-centered psychotherapy, is an integrative type of therapy that incorporates both traditional and non-traditional treatments to help the individual as a whole.

Rather than focusing on a narrow problem, it considers mental, physical, and spiritual factors that influence a person's well-being and seeks to help people heal and thrive on a deeper level.

Holistic therapy combines aspects of traditional talk therapy and non-traditional approaches, including hypnosis, breath therapy, and meditation.

Holistic psychotherapy is an umbrella term that can encompass a number of different types of treatments. Professionals who offer this type of treatment may refer to themselves as holistic therapists, but they may also refer to their practice as:

Eclectic or integrative therapy : An approach that draws on multiple traditions and techniques in order to best address a person’s needs.
Mind-body therapy : This refers to groups of techniques that focus on improving body functioning and inducing relaxations as a way to improve health.
Somatic therapy : A body-centric approach that utilizes strategies such as breathwork, dance, and meditation to heal trauma, stress, and other mental health issues.
Spiritual therapy : An approach that incorporates belief systems and spiritual faith to explore problems that a person faces in their life.

Holistic therapy utilizes a range of techniques to help individuals understand their symptoms. In addition, such strategies are designed to foster a greater sense of self-awareness to better understand the connections between their body, mind, and relationships and how these elements play a role in mental health.

Such techniques are often rooted in mindfulness and bodywork practices. These techniques may include techniques commonly used in complementary and alternative medicine (CAM) that are designed to promote relaxation and help individuals better understand the connection between the body, mind, and spirit. Some of these practices include:

Acupuncture
Biofeedback
Guided imagery
Mindfulness

In addition to these elements, therapists incorporate psychotherapy approaches including cognitive-behavioral therapy (CBT), psychoanalysis , and person-centered therapy .

Holistic therapy may be helpful in the treatment of a number of different psychological conditions. Some of these include:

Emotional difficulties
Family problems
Work-related problems

Since this type of therapy seeks to heal the whole person, it may be helpful for problems that do not have a single, definable cause or those that affect multiple areas of a person's life.

Benefits of Holistic Therapy

The wellness practices that are frequently utilized in holistic therapy are often used more generally to help people deal with tension and stress and to promote overall well-being.

One benefit of holistic therapy is that it is a whole-body approach that addresses mental, physical, and spiritual health. It often allows individuals to better see the connections between these different aspects of their lives and better understand how this affects their health and wellness.

Many holistic techniques are also strategies that people can practice and perform on their own outside of therapeutic sessions. This can be particularly helpful in daily life when people are facing situations that can trigger stress, anxiety, or changes in mood.

By implementing tactics such as deep breathing , mindfulness, or meditation, people can better manage the situations that are contributing to distress.

Holistic approaches are also often centered on prevention in addition to treatment. Rather than waiting until a problem emerges, learning to utilize holistic treatments may be helpful for preventing problems that can harm a person's emotional, physical, social, or spiritual well-being.

Because of the wide variety of techniques and approaches utilized in holistic therapy, it can be difficult to evaluate its efficacy. However, it often incorporates other empirically validated therapies such as CBT and brief dynamic psychotherapy.

Techniques such as acupuncture, yoga, and deep breathing have also been effective for many purposes.

Some research does suggest that integrated, holistic care can have many benefits.

One 2017 article suggested that holistic approaches offer physical and mental benefits that are also cost-effective.
Research has found that mindfulness and meditation are useful for reducing anxiety and stress and can be adapted for various purposes and situations.
Guided imagery, often used in holistic practices, may help improve sleep, improve mood, decrease stress, and improve relaxation.
Research has shown that deep breathing techniques can reduce stress levels and promote relaxation, which can benefit both physical and mental health.

As with other types of therapy, it is essential to be willing to work with your therapist to deal with the emotional and mental conflicts you are facing. Holistic approaches require participation and are often very hands-on.

The non-profit academic medical center Cleveland Clinic notes that holistic therapy should not take the place of traditional medicine but can be used in conjunction with other treatments to help improve the healing process and overall well-being.

In some cases, your therapist may begin with more traditional, psychotherapeutic techniques before moving to other alternative therapies.

It is often helpful to approach treatment with an open mind in order to enjoy the full benefits of the process.

If you are interested in trying holistic therapy, there are a few things you should do before you get started.

Find a Therapist

The first step is to find a professional in your area who practices holistic therapy. Online therapy may be an option in some cases, but many of the more hands-on practices (massage and Reiki, for example) require in-person appointments.

You might start your search by talking to your primary care physician to see if they can refer you to a local holistic therapist. Another idea is to do a general online search or look through a therapist directory.

People who incorporate holistic techniques into their practices may go by other titles including clinical psychologist or marriage and family therapist, so you may need to ask about the techniques that they practice if there is a specific experience you are interested in trying.

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What to Expect

During your first session, your therapist will evaluate your current state of functioning and work with you to develop goals for your treatment. Because holistic therapy is flexible, your needs can be evaluated, and your plan adapted as you progress through therapy based on your needs.

You should also find out about insurance and payment options before you begin your treatment. Because many holistic approaches are not covered by insurance, your therapist may not accept insurance as a form of payment. Check with your insurance provider to find out what services are covered before you begin treatment.

Brom D, Stokar Y, Lawi C, et al. Somatic experiencing for posttraumatic stress disorder: a randomized controlled outcome study . J Trauma Stress . 2017;30(3):304-312. doi:10.1002/jts.22189

Cleveland Clinic. Holistic psychotherapy .

Shafran R, Bennett SD, McKenzie Smith M. Interventions to support integrated psychological care and holistic health outcomes in paediatrics . Healthcare (Basel) . 2017;5(3):44. Published 2017 Aug 16. doi:10.3390/healthcare5030044

Behan C. The benefits of meditation and mindfulness practices during times of crisis such as COVID-19 . Ir J Psychol Med . 2020 Dec;37(4):256-258. doi:10.1017/ipm.2020.38

Cleveland Clinic. Guided imagery .

Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults . Front Psychol . 2017;8:874. Published 2017 Jun 6. doi:10.3389/fpsyg.2017.00874

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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Clinical holistic medicine: the case story of Anna. III. Rehabilitation of philosophy of life during holistic existential therapy for childhood sexual abuse

Affiliation.

1 Nordic School of Holistic Medicine, Copenhagen K, Denmark. [email protected]
PMID: 17370004
PMCID: PMC5917133
DOI: 10.1100/tsw.2006.338

When we experience life events with overwhelming emotional pain, we can escape this pain by making decisions (in our mind) that transfer responsibility from our existence to the surrounding world. By doing this, we slowly destroy the essence of our being, health, quality of life, and ability to function. The case of Anna is an excellent example of such a systematic destruction of self, done to survive the extreme pressure from childhood abuse and sexual abuse. The case study shows that the damage done to us by traumatic events is not on our body or soul, but rather our philosophy of life. The important consequence is that we can heal our existence by letting go of the negative decisions taken in the past painful and traumatic situations. By letting go of the life-denying sentences, we come back to life and take responsibility for our own life and existence. The healing of Anna's existence was done by existential holistic therapy. Although the processing did not always run smoothly, as she projected very charged material on the therapists on several occasions, the process resulted in full health and a good quality of life due to her own will to recover and heal completely. The case illustrates the inner logic and complexity of intensive holistic therapy at the most difficult moment, where only a combination of intensive medical, psychiatric, and sexological treatment could set her free. In the paper, we also present a meta-perspective on intensive holistic therapy and its most characteristic phases.

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A holistic approach means to provide support that looks at the whole person, not just their mental health needs. The support should also consider their physical, emotional, social and spiritual wellbeing.

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It is important not to assume that how you interpret situations will be the same as the person you are supporting. Listening, asking and checking are key skills to be able to provide a holistic service. A holistic approach focusses on a person’s wellness and not just their illness or condition.

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A case study of depression: A holistic exploration through the lens of biopsychosocial dynamics

Sarkar, Bubul; Ali, Arif 1 ; Paul, Fayaz Ahmad 2

Tele-MANAS, National Health Mission, Christian Bosti, Guwahati, Assam, Under Ministry of Health and Family Welfare, New Delhi, India

1 Department of Psychiatric Social Work, Institute of Human Behaviour and Allied Sciences, New Delhi, India

2 Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, Tezpur, Assam, India

Address for correspondence: Dr. Arif Ali, Associate Professor, Department of Psychiatric Social Work, Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Depression is a complex mental health condition influenced by biological, psychological, and social factors. Psychiatric social workers play a crucial role in conducting comprehensive assessments and implementing interventions to address the multi-dimensional nature of depression. This case study seeks to evaluate the psychosocial factors associated with a case of depression and to implement an intervention based on the biopsychosocial approach. This single subject case study explores the effectiveness of the bio-psycho-social model in comprehending depression and its treatment through psychiatric social work intervention. The study employs a pre- and post intervention baseline assessment, utilizing tools such as social history Performa, family assessment device, Beck depression inventory, Self-esteem Scale, Social Adaptive Functioning Evaluation, Multi-dimensional Perceived Social Support Scale, and a family questionnaire. The case referred from the Outdoor Department at Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, for psychiatric social work assessment and intervention. The results exhibit a significant improvement in pre- and post intervention scores, indicating enhanced daily functioning, reduced depression, increased insight, heightened awareness regarding illness, and improved self-esteem. This study underscores the importance of a biopsychosocial approach in understanding and treating depression comprehensively. The findings emphasize the efficacy of psychiatric social work interventions within this framework, contributing to improved clinical outcomes and facilitating the client’s understanding of their illness. The integration of biological and psychosocial aspects in treatment is essential, necessitating a holistic theoretical paradigm.

Introduction

Depression is a pervasive issue with significant implications for both work and social performance. Understanding the complexity of this disorder requires a comprehensive approach, and the biopsychosocial model stands out as the most effective framework. [ 1 ] Recognizing the uniqueness of each patient in terms of diagnosis, formulation, and treatment is crucial. [ 2 ] As outlined by the biopsychosocial model, the intricate interplay between genetic makeup, mental health, personality, and sociocultural environment shapes individuals’ experiences of health or illness. [ 3 ] This model proposes, and empirical evidence supports, that biological, psychological, and social factors are interdependent and mutually influential. Depression, being a condition with multifaceted origins, necessitates a holistic understanding that considers the entirety of contributing factors. Hence, a comprehensive explanation of depression should encompass all the relevant elements. For effective treatment, a biopsychosocial depression model, integrating biological, social, and psychosocial aspects, is imperative. [ 1 , 3 ] The primary goal of this study is to evaluate a range of psychosocial factors linked to the client’s condition. Our aim is to offer a comprehensive biopsychosocial intervention geared toward improving the client’s overall well-being and psychosocial functioning. By addressing the diverse facets of depression, we aspire to enhance the understanding and effectiveness of interventions, ultimately fostering improved mental health outcomes for the client.

Methodology

A single-subject case study design was employed to investigate the efficacy of psychiatric social work intervention based on a biopsychosocial model in addressing depression. The case was referred from the Outdoor Patient Department at Lokpriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam. A comprehensive examination of pre- and post-test was done to see the effectiveness of the intervention. The Social History Performa was utilized for assessing personal and family history, guiding the formulation of tailored interventions. The psychiatric social work intervention was intricately designed to align with the bio-psycho-social approach, targeting both the individual client and their family members. In the course of the intervention sessions, various scales were administered to comprehensively assess the diverse dimensions of the client’s condition. These scales were strategically chosen to measure and quantify the key aspects related to the biological, psychological, and social components of the client’s mental health. Informed consent was obtained from the patient, and consent was also secured from their family members.

Instruments used for the study

Beck depression inventory.

Beck depression inventory is a comprehensive tool designed to evaluate the various aspects of depression. It includes items for assessing sadness, punishment, pessimism, self-criticality, past failure, loss of pleasure, suicidal thoughts or wishes, guilty feelings, crying, agitation, loss of interest, indecisiveness, worthlessness, and loss of energy. In addition, it explores the changes in sleeping patterns, irritability, appetite, concentration difficulty, tiredness or fatigue, and loss of interest in sex. [ 4 ]

Family assessment device

Family assessment device (FAD) is a tool designed to assess family dynamics across seven domains. It measures problem-solving, communication, role, effective responsiveness, effective involvement, behavioral control, and general functioning within the family context. This tool provides a comprehensive understanding of the family’s interaction patterns and functioning. [ 5 ]

Social adaptive functioning evaluation

This assessment tool focuses on evaluating the social skills by measuring social-interpersonal, instrumental, and life skills functioning. It provides insights into an individual’s ability to navigate various social contexts and adapt to different life situations. [ 6 ]

Self-Esteem scale

The Self-Esteem Scale by Rosenberg is utilized to measure an individual’s global self-worth. It assesses both positive and negative feelings about the self, providing valuable insights into self-perception and emotional well-being. [ 7 ]

Family questionnaire

The family questionnaire is employed to assess expressed emotional status within the family context. Developed by Wiedemann et al. , it specifically measures criticism and emotional over-involvement (EOI) of family members toward patients with mental illness. The questionnaire comprises two subscales: Critical comments and EOI, offering a nuanced understanding of family dynamics and their impact on mental health. [ 8 ]

Background of the case presentation

The client of this case is a 24-year-old male educated up to the primary level residing in Assam, marked by significant socioeconomic challenges. He was married and employed as a daily wage worker. According to the information, the patient could not pursue further education due to financial constraints within the family, compelling him to start working at the age of 19 years. The patient’s work trajectory involved initial employment as a daily wage worker, followed by a stint as a security guard in a private company in Bangalore at the age of 22 years. After a year, he returned to his hometown and continued working as a helper in a local construction company. However, his employment has currently ceased due to ongoing health issues. At the age of 20 years, during his stay in Bangalore, the patient initiated alcohol consumption in social settings with friends. This pattern evolved, leading to solitary alcohol consumption. Postmarriage, he abstained from alcohol for 7 months. The patient also engaged in cannabis use from the age of 19 years, starting with friends and eventually smoking alone. At present, he has refrained from cannabis use for the past 2 months. The client’s marriage to an underage girl of his choice triggered a cascade of challenges. Friends’ comments regarding potential legal consequences, given the underage nature of his wife, led to the patient’s distress. This distress manifested in a low mood, fear of police intervention, and an aversion to work.

Reports indicate that the patient spent significant time in bed, avoiding any productive activities. Despite sharing his concerns with friends, the patient did not receive meaningful assistance. Ongoing unemployment, exacerbated by fear of legal consequences, led to critical comments from family members, especially the wife and parents. The patient’s distress escalated to the point of suicidal attempts, including the consumption of phenyl, necessitating treatment at a civil hospital. The supportive role of the patient’s mother was pivotal, leading to his subsequent referral to a psychiatric hospital. The patient reported feelings of worthlessness, hopelessness, diminished interest in enjoyable activities, decreased social interaction, suicidal thoughts, and disturbances in sleep and appetite. In the mental status examination, the patient appeared well-groomed, maintained eye contact, rapport was established, and cooperated with the examiner. Speech exhibited normal prosody, intensity, and speed. However, thought content revealed ideas of hopelessness, worthlessness, helplessness, and suicidal ideation. The patient demonstrated grade 3 insights. The diagnosis of F32.2 (severe depression without psychotic symptoms) according to International Classification of Disease-10 criteria underscores the complex interplay of socioeconomic challenges, substance use, marital concerns, and mental health issues in this case.

Outcome of the case

Table 1 provides an overview of the family dynamics of the client’s family based on the McMaster FAD. It reveals that the family’s problem-solving (3.0) and general functioning (3.16) were unhealthy, whereas other domains communication (2.1), roles (2.2), affective responsiveness (2.1), affective involvement (1.90), and behavioral control (1.5) were healthy.

The assessment indicated that affective involvement was deemed healthy according to the FAD Scale administered to the mother. However, during the session, over-involvement was observed qualitatively in the patient and family member interviews during the session. This led to the addressing of expressed emotions in the context of the findings.

Table 2 indicates an improvement in the social functioning of the client after the intervention. Various domains, such as bathing and grooming, clothing and dressing, and eating, feeding, and diet, show positive changes postintervention.

Biopsychosocial formulation

The biopsychosocial assessment revealed depressive symptoms in the patient, coupled with a history of harmful substance use (alcohol, cannabis, and tobacco). The patient’s marriage to an underage girl triggered severe distress, leading to exacerbated depressive symptoms and impaired social and occupational functioning. Notably, the patient exhibited low self-esteem, and his illness resulted in a cessation of work, contributing to a financial crisis in the family. The family, belonging to a lower socioeconomic status, experienced heightened stress due to the patient’s illness.

Biopsychosocial intervention

Biopsychosocial intervention sessions involve a holistic approach to addressing mental health concerns by considering the interplay of biological, psychological, and social factors. In the biopsychosocial approach, a thorough assessment is done to understand the biological, psychological, and social aspects of the client’s condition. In biological intervention sessions, emphasis on incorporating medical and pharmacological interventions as needed, such as medication management for psychiatric symptoms. Addressing any physical health issues that may contribute to or be influenced by the mental health condition. In psychological interventions, the session mainly focused on providing psychological therapy focusing on enhancing coping skills, emotional regulation, and cognitive restructuring. In social interventions, the sessions mainly focused on addressing social determinants of mental health, including family dynamics, relationships, and support systems. Strategies were implemented to improve social functioning and interpersonal relationships. Biopsychosocial intervention sessions strive to create a comprehensive and individualized approach that addresses the complexity of mental health issues, aiming for sustained improvement in the client’s overall well-being.

A comprehensive intervention plan was implemented, comprising a total of 14 sessions conducted at both the individual and family levels. The intervention was tailored to address the psychosocial factors identified during the assessment sessions. Each session had a duration of 45–60 min, allowing for in-depth exploration and targeted therapeutic interventions. The patient was prescribed antidepressant (tablet sertraline 50 mg) and sleeping tablet (clonazepam 0.5 mg) to address the biological aspects of depression.

Given the patient’s limited insight at a grade 3 level and a lack of sufficient knowledge about their illness, the therapist employed a combination of insight orientation therapy and psycho education to address these issues. Insight orientation therapy was utilized to help the patient gain a deeper understanding of the symptoms and underlying reasons for their illness, aiming to foster increased insight into their condition. Simultaneously, motivational intervention therapy was implemented to boost the patient’s motivation for change and further develop their insight regarding his illness. The session predominantly concentrated on cultivating and reinforcing the client’s motivation, contributing to a more informed and motivated approach to managing their mental health. Psycho education was delivered to educate the patient about the biopsychosocial factors contributing to their illness, emphasizing the importance of regular medication and follow-up. Supportive counseling was provided to the client, wherein the therapist offered reassurance, encouragement, rationalization, clarification, and behavior goal-setting to provide emotional support, considering the patient’s limited social support network. Activity scheduling was structured for the client, aiming to engage them in daily activities and emphasizing values, pleasure, mastery, and goal achievement. Due to the family’s economic challenges, information about government welfare benefits and vocational training opportunities was provided. The therapist assisted the family in applying for a disability card at the district disability rehabilitation center to access government welfare benefits.

At the family level, psycho-education for family members was provided. The session addressed misunderstandings about mental illness and informed family members about signs, symptoms, and the biopsychosocial nature of the patient’s condition. Early warning signs of relapse were discussed, stressing the importance of regular medication and follow-up. The therapist explained the role of the family in supporting the patient’s treatment journey. Family intervention was conducted to focus on addressing EOI. The therapist worked with the family to manage EOI and critical comments. Supportive counseling for the mother was also provided. The therapist offered emotional support to the patient’s mother, acknowledging her supportive role. This biopsychosocial intervention targeted the patient’s biological, psychological, and social needs, incorporating a tailored approach to address the multifaceted aspects of depression. The combination of medication, insight-oriented therapy, psycho-education, and support at both individual and family levels demonstrates a comprehensive strategy aimed at improving the patient’s overall well-being and functional capacity.

Figure 1 illustrates the changes in the domains of depression, self-esteem, and expressed emotion after the intervention. Postscores indicate significant improvements in depression levels and self-esteem, as well as notable changes in the family’s expressed emotions.

The presented case study adopts a comprehensive biopsychosocial approach to understanding and treating depression. The integration of biological, psychological, and social interventions allowed for a holistic understanding of the client’s condition and provided a foundation for tailored therapeutic strategies. The therapist’s engagement with the patient and family was crucial in establishing rapport and facilitating effective hospital follow-up. Both pharmacotherapy and nonpharmacological interventions were employed, aligning with contemporary research suggesting the efficacy of combined approaches in addressing depression. [ 9 ] The outcomes of the intervention were promising, with notable improvements observed in the patient’s understanding of his illness and increased knowledge within the family regarding depression. Postintervention, significant enhancements were evident in the patient’s daily functioning, leading to reintegration into the workforce. Securing employment as a salesman reflects the positive impact on the client’s overall well-being. Furthermore, the intervention contributed to a noteworthy improvement in self-esteem, emphasizing the importance of addressing psychological aspects in depression management. The efficacy of nonpharmacological therapies in treating mild-to-severe depression aligns with current literature. [ 9 ] This underscores the importance of considering a range of therapeutic options, including psychotherapeutic interventions, alongside pharmacological approaches. The inter-disconnectedness of biological, psychological, and social factors in depression is acknowledged, emphasizing the need for a multifaceted treatment approach.

The biopsychosocial model’s emphasis on integrating biological and psychological interventions resonates with the existing literature. The combinations of psychosocial and pharmacological interventions have demonstrated improved outcomes in severe depression, aiding in recovery and reducing the risk of relapse. [ 10-15 ] The bio-psycho-social approach proved effective in addressing the complex interplay of factors contributing to depression. Integrating biological interventions such as pharmacotherapy with psychological interventions such as insight orientation and motivational therapy, along with social interventions targeting financial difficulties, demonstrated positive outcomes. This aligns with existing literature emphasizing the benefits of combined approaches in treating depression. [ 10 , 12 ]

Following the comprehensive biopsychosocial interventions implemented during the inpatient stay and the subsequent follow-up session, the patient exhibited positive outcomes across multiple domains. Biologically, there was a noticeable improvement in the management of the patient’s symptoms, with any necessary medical and pharmacological interventions contributing to stabilization. Psychologically, the patient demonstrated enhanced insight into their condition, a more robust coping repertoire, and improved emotional regulation. Socially, interventions aimed at addressing the patient’s socioeconomic context resulted in strengthened support systems and improved interpersonal relationships. The holistic approach, incorporating elements of insight orientation therapy, psychoeducation, and motivational intervention therapy, contributed to a more nuanced understanding of the patient’s mental health. The 1-month inpatient treatment, coupled with the postdischarge follow-up, facilitated a smoother transition to the community setting. Overall, the biopsychosocial interventions led to a positive outcome, fostering the patient’s overall well-being and psychosocial functioning.

Strength and limitation

The implementation of a biopsychosocial approach, including various therapeutic modalities such as insight orientation therapy, psychoeducation, and motivational intervention therapy, is a strength. This multifaceted approach addresses the patient’s needs across biological, psychological, and social domains. The positive outcomes observed in the patient across multiple domains (biological, psychological, and social) suggest the effectiveness of the interventions during the inpatient stay and follow-up sessions. The holistic interventions contributed to a more nuanced understanding of the patient’s mental health, fostering overall well-being and psychosocial functioning.

The absence of subsequent follow-up sessions postdischarge is a notable limitation. A single follow-up assessment might not capture the long-term impact of the interventions, and ongoing monitoring could provide a more comprehensive understanding of the patient’s progress. The case study’s findings may be specific to this individual and may not be fully generalizable to a broader population. Factors unique to the patient’s circumstances could limit the applicability of the interventions to other cases.

In conclusion, the biopsychosocial approach is pivotal in enhancing the client’s understanding of depression and improving clinical outcomes. The presented case study exemplifies the effectiveness of psychiatric social work interventions rooted in the bio-psycho-social framework in addressing depression comprehensively. The integration of biological and psychosocial elements proves beneficial in the recovery process, highlighting the importance of a holistic treatment paradigm. This case underscores the notion that a nuanced understanding of depression, considering its multifaceted nature, is crucial for tailoring effective interventions. The combined use of pharmacological and psychosocial strategies, aligned with the principles of the biopsychosocial model, offers a promising avenue for managing depression and reducing the risk of relapse. Supportive literature consistently reinforces the need for an integrated approach, emphasizing that addressing the interconnected factors influencing depression leads to more comprehensive and sustainable therapeutic outcomes. As mental health interventions continue to evolve, the biopsychosocial model stands as a valuable guide in navigating the complexities of depressive disorders.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

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Biopsychosocial model; depression; insight; psychiatric social work; self-esteem

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A Case Using an Integrative Approach to Relationship Counselling

Author: Jan McIntyre

Mark is 28 and has been married to Sarah for six years. He works for his uncle and they regularly stay back after work to chat. Sarah has threatened to leave him if he does not spend more time with her, but when they are together, they spend most of the time arguing, so he avoids her even more. He loves her, but is finding it hard to put up with her moods. The last few weeks, he has been getting really stressed out and is having trouble sleeping. He’s made a few mistakes at work and his uncle has warned him to pick up his act.

This study deals with the first two of five sessions. The professional counsellor will be using an integrative approach, incorporating Person Centred and Behavioural Therapy techniques in the first session, moving to a Solution Focused approach in the second session. For ease of writing the Professional Counsellor is abbreviated to “C”.

After leaving school at 17, Mark completed a mechanic apprenticeship at a service station owned by his uncle and has worked there ever since. His father died from a heart attack when Mark was six years old and his uncle, who never married, has been a significant influence in his life. He is the youngest of three children, and the only boy in the family. One sister (Anne) is happily married with two children and the other (Erin) is single and works overseas. Mark and his mother have a close relationship, and he was living at home until his marriage.

Some of Mark’s friends are not married and say he was a fool for ‘getting tied down’ so young. Mark used to think that they were just jealous because Sarah is such a ‘knockout’, but lately he has started to wonder if they were right. In the last couple of months, Sarah has been less concerned about her appearance and Mark has commented on this to her. Sarah had been looking for work, but doesn’t seem to do much of anything now.

Three months ago, Sarah found out she can’t have children. According to Mark, she hadn’t spoken about wanting kids so he guessed it wasn’t a big deal to her. When she told him, Mark had joked that at least they wouldn’t have to go into debt to educate them. He thought humour was the best way to go, because he had never been very good at heavy stuff. Sarah had just looked at him and didn’t respond. He asked if she wanted to go out to a movie that night, and she had started to shout at him that he didn’t care about anyone but himself. At that point, he walked out and went to see his brother-in-law, Joe and sister, Anne.

Since then, he and Sarah hardly spoke and when they did it often turned into an argument that ended with Sarah going into the bedroom, slamming the door and crying. Mark usually walked out and drove over to Joe’s place. When Anne tried to talk to Sarah about it, Sarah got angry and told Anne to keep out of it, after all what would she know about it. She had her kids. Joe and Anne had kept their distance since then. Mark talked to his mother, but she said that this was something he and Anne had to work out together. It was she who suggested that Mark come to see C.

Session One

When Mark arrived for the first session, he seemed agitated. C spent some time developing rapport, and eventually Mark seemed to relax a bit. C described the structure of the counselling session, checked if that was ok with Mark, then asked how C could help him.

Mark: “I really wanted Sarah to come; my wife, but she said that I need to sort myself out. I have to tell you, I don’t think counselling is really for men. Women are the ones that like to talk for hours about their problems. I only came here because she insisted and I don’t want her to walk out on me.”

C: “Your marriage is important to you.”

Mark: “Yeah, sure. We’ve had fights before, but they weren’t anything major. And we always made up pretty quickly. But this is different. It seems like whatever I say is wrong, you know? Lately, I haven’t been able to concentrate properly at work and I wake up a lot through the night. I’m feeling really tired and I wish Sarah would get off my case.”

C used encouragers while Mark described what had been happening over the past few months. When he had finished ventilating his immediate concerns, C, moving into Behavioural techniques, summarized and asked Mark to decide what issue he wanted to deal with first. “Mark, you have discussed a number of issues: you are concerned that communication between you and Sarah has been reduced to mostly arguments; you’re unsure how to deal with the fact that Sarah cannot have children; you want to improve your relationship with Sarah; you are worried that Sarah might leave you, and you are feeling very stressed out. What area would you like to work on first?”

Mark: “I just want her to talk to me without arguing. All this is making it really hard for me to concentrate at work, you know.”

C: “Sounds like two goals there, to reduce your stress and to improve communication between Sarah and yourself.”

M: “Yeah, I guess so. If she would just talk to me instead of crying.”

C used open questions and reflections to encourage Mark to look at his feelings. “How do you feel when she goes into the bedroom and starts crying?” Mark: “Well, she’s never been a crier, and I don’t know what to say to her. If I mention not having children, she will probably cry even more.”

C: “So you feel confused about what to do, and anxious that you may upset her even more.”

Mark: “Yes, I just can’t seem to think straight sometimes. Like, I want things to be the way they were, but it’s just getting worse.”

C informed Mark about the use of relaxation techniques to reduce his stress and checked out if he would like to give it a try. “Mark, you appear to be having difficulty coping because you are feeling very stressed. I believe that learning relaxation techniques would decrease the level of stress and help you think more clearly. How does this sound to you?”

Mark: “I’m not into that chanting stuff if that’s what you mean.”

C explained that there are many forms of relaxation and described the deep breathing and muscle tensing method; Mark agreed to do this for 10 minutes twice a day.

As the first session drew to a close, C reviewed the relaxation technique and asked Mark to practise it as often as possible. A second appointment was arranged for the following week.

At the next session, C asked Mark how the relaxation exercise had helped. “I forget to do it some mornings, so I did it for twenty minutes at night instead. I told Sarah what I’m doing and she just leaves me to it. Not sure if it’s making any difference but I’ll keep doing it. It’s nice to have twenty minutes of peace and quiet.” At this point, C moved into a Solution Focused approach.

C congratulated Mark on commencing the relaxation practice, then checked out if it was okay to ask him some different types of questions. Mark agreed and C asked a miracle question. “Imagine that you wake up tomorrow and a miracle has happened. Your problem has been solved. What would other people notice about you that would indicate things are different?”

Mark looked at C, who waited in silence. Eventually Mark responded. “Ok, they would see me and Sarah talking a lot more, without arguing.”

C: “What else would they notice about you?”

Mark: “I would probably be spending more time at home. You know, not staying back so late at work.”

C: “What would they notice that was different about Sarah?”

Mark: “That’s easy. She wouldn’t be crying and yelling all the time.”

C: “So what would she be doing instead?”

Mark: “I guess she would be talking to me, and smiling.”

After spending some time exploring what would be different if the miracle happened, C asked Mark what he had tried in the past to improve communication. Mark revealed that he bought Sarah some flowers and a box of chocolates (his uncle’s suggestion) but it hadn’t really made any difference. C complimented Mark on his efforts and continued with an exception question.

“Can you think of a recent occasion, when you would have expected a quarrel to start and it didn’t?”

Mark furrowed his brow and appeared to be thinking deeply for some time. C waited in silence. Finally, Mark answered. “Actually, about a week ago, I was a bit late home from work and I was expecting another tongue-lashing, but it never came.”

C asked Mark what was different about that night.

Mark: “Well, Sarah was happier.”

C: “How did you know she was happier?”

Mark: “She talked to me, you know, just talked about something she had seen on the telly or something like that.”

C: “And how was that for you, Mark?”

Mark: “Not bad. Actually, it wasn’t too shabby. We did get to chat, and we haven’t done that for ages.”

C: “Can you explain, “Wasn’t too shabby”; I haven’t heard that term before?”

Mark: “Oh, it means it was all good, you know, it was okay.”

C: “So you came home and chatted with Sarah over a cuppa and you found that wasn’t too shabby?” Both smiled

Mark: “I really liked it. I remember thinking I would have come home earlier if I had known it was going to be like that.”

C: “If I was to ask Sarah what was different about that night, what do you think she would say?”

Mark: “Boy, this is getting weird.”

Mark: “Let’s see. She would probably say, “He actually sat and had a cup of coffee with me, instead of just flopping in front of the telly. She’s always griping about that.”

At the appropriate time, C called for a break. “I’d like to take a break and give us both time to consider all the things we’ve talked about. After that, I will give you some feedback.” After the break C summarized what had been discussed and complimented Mark on the work he had put into exploring his problems. He seemed less stressed and had shown that he was committed to improving his relationship with Sarah.

Counselling continued for another three sessions, by which time Mark’s stress had reduced considerably, he was coming home from work earlier and making an effort to talk more to Sarah. The arguments were less frequent and not so heated.

Session Summary

The Person Centred approach allows the client to take the lead and discuss issues as they see them. This encourages the client to talk openly, which was especially useful in this instance since the client showed a reluctance to do so at first.

The Behavioural technique of goal setting is used to clarify what the client wants to achieve out of the sessions.
Solution Focused Therapy , this approach acknowledges that the client has the ability to solve his own problem.
Miracle questions assist the client to examine how they and others would be behaving if the problem were already dealt with. This helps the client to look at their current behaviour and see what they can do to bring about the required change.
Exploring what the client has tried in the past highlights that the client is committed to solving the problem. Exception questions help the client to see that there are times when the problem does not occur, and that they have contributed to that situation. This shows the client that they have control over the problem.
Clarifying client’s words, eg. “Not too shabby” shows respect for the client’s language and emphasises that the client is the expert.

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Stephan van Heerden

Gestalt Therapy Practice

[email protected]

+27822654044

Jun 9, 2020
10 min read

Gestalt Process Therapy - short case studies

1. After Dino therapy, Douw stopped strangling himself

The 8-year-old Douw's behavioural problems have ruined his relationship with his mother: He strangled himself as soon as his mother tried to communicate with him. In the car on his way to the consulting room, he again strangled himself next to his mother with his school tie, so that his face and eyes turned red. The mother was despondent about her son's aggression and rejection.

During the single Dino therapy session with Douw, the breakthrough came and his problem was solved.

As Douw described the narrow spot in his Dinosaur's neck, and how difficult it was for the Dinosaur to swallow, because of meat stuck in his throat, he lay down on the couch. He was in the fetus position and with tears in his eyes told the story of a speedboat. His family had a speedboat when he was still very young. He was very scared of the boat's noise and feared the propeller would hurt him. His parents then sold the speedboat. Douw said his mother was angry with him about the boat.

After the session with Douw, his parents were surprised that he remembered the boat because he wasn't even three years old at the time. The parents admitted Douw did not like the boat, but their reason for selling it was only financial.

When Douw could talk about this and realize that his mother was not angry with him about the boat, his compulsion to strangle himself in his mother's presence, immediately cleared up. The mother-son relationship was restored.

The obstruction in the Dinosaur's throat disappeared.

There are cases where clients, during Gestalt Dino therapy, sort out their psychosomatic symptoms, discover their true identity, begin to lose weight, deal with their loss, and improve their self-esteem.

2. After the farm murder, Dean's memory loss was sorted out with Gestalt Colour Therapy:

The 10 year old Dean was brought for therapy because of his memory loss and aggression. He disrupted the classroom daily with his fights and in addition, he suffered from severe short-term memory loss. As soon as he switched to action to perform an assignment, he immediately forgot what he was busy doing. In the middle of his conversations he forgot what he was talking about. He was a candidate for psychiatric treatment, medication and long-term therapy. However, Dean's problem was resolved in only 80 minutes in Gestalt Colour Therapy.

Gestalt Colour Therapy has reached the following places in Dean's subconscious and enhanced his awareness and integration:

Pink 1 and Pink 2 were frustrated because they continually painted each other pink, and hated to be pink. Red 1 had the role of marking answers correct or wrong, like a teacher with her red pen. Pink I and 2 told Red 1 how unfortunate they were, and Red 1 brought it to the attention of Pink that it was their own fault and that they could stop their trouble fighting if they just wanted. Pink wanted to know why Red 1 did not explain it to them earlier.

As integration took place, Dean discovered that he was the one who caused trouble in the classroom and only he could stop it.

While Dean experimented with Brown, he repeatedly forgot with what colour he was busy. He lost concentration and asked each time, "What was I busy talking about?" When Dean's actions were brought to his attention, he discovered that it was Brown's job to help him to forget.

Another facet of Red, Red 2, also came under Dean's awareness. While Dean was experimenting with Red 2, he became very aggressive and made fists. He discovered Red 2's function was to be angry. "When should Red 2 get angry?" the facilitator asked. "When Brown cannot manage to forget. Red 2 helps Brown to forget by getting angry and provoking a fight."

Blue's work was to remind Dean of family who were happy, but Purple had to remind him of unhappy family, family members like Grandmother. Dean told the facilitator how he and his father found Grandpa in a puddle of blood in the farmhouse where Grandpa was killed.

Dean tried to forget about his grandfather's death and other traumatic events in the family, such as his brother who died of an asthma attack and Mother's sadness about her newborn baby's death. But in his family it was taboo to talk about these incidents.

When Dean could not manage to forget about these traumatic experiences, he used fighting and disruption of the classroom to forget.

Because awareness and integration took place, Dean's memory loss and aggression were summarily a thing of the past.

3. Gestalt Colour Therapy freed Thabiso from his revenge

A touching case where Gestalt Colour Therapy radically influenced a person’s life is the case of Thabiso, a matric learner. Thabiso lived with seven other relatives in a two bedroom house. He was thrown out of his parents’ house after he reported his brother, who raped his 12 year old sister, to the police. The relatives believed that the matter should have been addressed amongst them. Thabiso was at a very hopeless place in his life. He considered taking revenge on his family as they rejected him.

With the help of Gestalt Colour therapy, Thabiso relinquished his revenge and thoughts on murder and began to focus positively on his own life.

Experimenting with the colour purple, Thabiso made contact with an unprocessed experience in his heart, where his uncle mistreated him as a boy in the past. With the help of blue, he drew new energy from a source deep in his heart, from memories of a school choir in which he sang. With the help of pink, he once again experienced his unfinished childhood dream of owning a pink suit, but of which he only owns a pink T-shirt today. Yellow helped him discover a part of his personality, which managed to calm him down. Thabiso realized that revenge would only bring more trouble, and with the help of colour he could now focus on something he could really benefit from - a decision to focus on his true needs and buy himself a set of cooking pots for his new room. Experimenting with pink-purple contact helped Thabiso eliminate the conflict between his dream and his sense of inferiority.

Colour empowered him with awareness and self-knowledge to discover a new existence message deep in his heart:

“I should believe in myself, change can be possible for me. If I don’t stay the person I am, I will become an unknown person – I will live but no one will know. I have to state the facts and be heard, shout it out! I have anger but it’s not worth it. There are so many better things to do than thinking about revenge and being angry. All I need to do is to stand up and start believing in myself then I’ll succeed in life.”

There are cases where Gestalt Colour Therapy calms the anger of children and adults, changing an attitude towards school or work, improving problem behaviour and concerning symptoms such as forgetfulness, depression, self esteem problems, obsessions or self injuring.

4. Zahir discovered the root of her pain through Gestalt Dino Therapy

Zahir was a gifted and versatile student, who could make a success of many fields of study. However, since the age of 14, she began to suffer from chronic abdominal pain, of which the cause could never be accurately diagnosed and treated medically successfully. After school she went to study for a chartered accountant and excelled as the top student. During her final year of study, her abdominal pain, anxiety and depression forced her to report for therapy. During Gestalt Dino therapy, the root of her problem was discovered and she was cured of her chronic abdominal pain.

During Gestalt Dino therapy, a Dinosaur projection and metaphor are used, during which the facilitator integrates palaeontology and Gestalt therapy to enhance the client's awareness. The facilitator investigates the interaction between the client's psycho / socio / biological micro-cosmos and geological macro-cosmos. In the metaphor the Dinosaur is freed from the sediment of history in which it is trapped. The client is freed from his or her historical pain, such as trauma and loss.

An examination of the Dinosaur's neck, jaw, chest and abdomen revealed the following: Zahir's biggest, subconscious motive is to try to see far into the future - when one day, as a wealthy woman, she can financially care for her mother. Her single-parent mother, with hardship and sacrifice, took care of her alone all these years. That is why Zahir chose Accountant as a field of study (so that one day she could make good money), and not sports science, which was her true love and interest. Rather, she sacrificed her true identity, corrupted her choice, and inhibited her emotional metabolism, rather than ignoring her mother's needs.

Examining the Dinosaur's tail and legs revealed how heavy the loss was for Zahir not to live up to her true interests, such as her love of adrenaline driven activities. The characteristics of the Dinosaur's tail and the condition of the Dinosaur's rectum revealed that there is a deep-rooted traumatic experience that generally makes Zahir feel anxious and restrained. This unfinished experience came to Zahir's awareness during a Gestalt Astro therapy session. Gestalt Astro therapy work on aspects that came to the client's awareness during Dino therapy, but which were not completed.

The cause of the Dinosaur's constipation and clogged rectum are images that Zahir saw as a 3-year-old girl when her mother brought her into her father's studyroom, images that little Zahir couldn't understand or process: Her father's body after he committed suicide.

There are cases where Gestalt Dino therapy explains and solves problems, such as a champion javelin thrower, who suddenly becomes too anxious for her spear; A first-team rugby player who suddenly suffers from epilepsy; A teenage tennis star who overcame her anorexia and hit the ball better than ever before; an 8-year-old boy who gets a solution to his intense chronic back pain; a ten-year-old boy whose aggression and memory loss are sorted out.

5. Martin discovered why he was regularly involved in car collisions

During therapy, Martin discovered why he was regularly involved in car collisions, why he ended his relationship with his girlfriend suddenly, without reason, why he cut himself and was so deeply dissatisfied with life.

During his elementary school days, he constantly heard his parents arguing - about money. At that time, his wealthy uncle impressed him greatly, because this uncle drove a red Ferrari, was wealthy, had his own law firm, and in addition, this uncle's marriage seemed so happy. "My dream for my future was to be like my uncle one day."

"I decided that one day I would do just like my uncle: I would also become a lawyer and get very rich. Then I would buy my red Ferrari and only then would I seek my wife, because then my wife and I would never fight about money like my parents."

Martin made his decision the rules for his life, his unwritten philosophy. When his studies in law were almost complete and the final exam was underway, the first car crash occurred on the way to the exam room and he couldn't write his test. And a few weeks later another collision and once again his studies stopped dead. After a while he was able to focus on his studies again, but he was hospitalized with a broken leg after a third collision.

Was there something magical that kept Martin from completing his studies?

Meanwhile, Martin rejected one cute girl after another, each time only when their relationship was very satisfying. Not to mention his dark depression and self-mutilation. His life was a mess.

The reason for the car collisions, love problems and depression was because Martin did not really want to be a lawyer. He just wanted to become a wealthy lawyer not to be like his parents one day. Each time, as soon as his studies were almost completed, the unfinished puzzle who he really wanted to be and what he, as a 10-year-old, swore to himself, would come to the fore and cause collisions to prevent Martin from becoming something which he doesn't really want to be. He rejected his girls because his unwritten, subconscious philosophy dictated that he must first become a lawyer, then become rich and buy his red Ferrari, and only then seek his wife.

During therapy, Martin discovered who and what he really wanted to be in life. After completing his therapy, he discontinued his studies in law, again appreciated his old car and bought a caravan and moved to the seaside village of his dreams where he enrolled for a trade as a plumber. During the therapy, he could meet his wealthy uncle again in his subconscious, thank him for being there when he needed him, and ask him to release his hand now, because he is big and knows who and what he want to be. He also took up his love-life wholeheartedly, started to face life again and never went back for the electric shock treatment his psychiatrist urgently advised him.

6. Krila's broken wings were healed

The case of 15 year old Krila’s broken wings is an example of the impact of Gestalt Process Therapy. Krila came for therapy because she lost her enthusiasm for her sports and school work and friends. She was depressed and suffered from body aches.

Gestalt Colour Therapy helped her discover the source of the pain in her joints and shoulder blades:

During Gestalt experimentation with the colour pink, the pain in her joints and shoulder blades became overwhelming. She became aware of the day in grade 1 when her friends decided she may not be part of their "fairy tale" group, because she was not as beautiful as they were. She could sit outside their circle and watch, but were not allowed to have wings or stretch out her arms and flutter her hands.

Hence the origin of her aching shoulder blades and wrists at age 15. Broken wings.

During the third therapy appointment, Gestalt Dino therapy deepened her self-knowledge and awareness even further.

Krila's Dinosaur drawing revealed that the Dinosaur has a cavity on her back, exactly where the Dinosaur's wings were in an earlier period of evolution. (Also a place on the body where the physical pain bothered Krila.)

A pencil mark, that accidentally became part of the drawing (but was motivated by the subconscious), right above the cavity on the Dinosaur's back, was part of the Dinosaur's story: A seed that fell from a tree and came to lie in the cavity on the back. One of the same tree's seeds also got stuck under a foot of the Dinosaur and caused an infection - hence the swelling on the Dinosaur's foot. (In Dino therapy, the Dinosaur's feet relate, among other things, to the individual's first contact with her reality and what her first attempts look like when she makes contact or tries to avoid it.)

Krila has a problem at this point in making contact with her friends and feels that they are bullying her.

During the fourth appointment, a Gestalt Astro therapy appointment, Krila discovered what this seed, which caused the Dinosaur's foot to swell, means and where the seed came from.

(During Gestalt Astro therapy, the individual bridges the distance to earlier stages in her life where unfinished experiences and unprocessed feelings lie hidden.) Here, Krila discovered that she, as a three-year-old girl, was the little seed. The tree that cast the seed was her father. She became aware of the fact that, as a three-year-old girl, she was unable to make contact with her father because he was an alcoholic.

It was this unprocessed experience that inflamed the Dinosaur's foot. It was the same unprocessed experience that caused Krila's inability to make contact with her peer.

Deeper healing occurred during the second Astro therapy session:

Krila was able to make contact with the tree that threw the seed (her father's true heart). A small seed on the ground, falling from the tree, told the tree how lonely and lost she was. The tree has empathy for the seed and told the seed:

"You didn't fall far from the tree. Germinate and now become your own tree.”

ITEC Holistic Massage Case Studies!

Ok folks, as promised here are my case studies i did last year for the Itec Holistic massage course. There are five in total and the names have been removed. There are no consoltation sheets or follow up sheets cos they would have to be scanned in and would take up far too much space on the board.

Ok,so here are the rules. Do not present these as your own work, as this spoils it for everyone and besides you really should do the case studies as it is the only way that you will learn. These are to be posted here only, don't put them on your site or anyone else site without my permission. You can keep them on your hard drive and ditribute them to fellow students once the same conditions are applied to them.

Sorry for the conditions, but i think they are fair enough. I hope other people follow my example and give up whatever information/case studies/sample papers they have.

Hope they are of value. These all passed by ITEC but are by no meansd presented as definitive case studies, many forms i assume are acceptable. This is the format i choose.

Case Studies 1

CASE STUDY #1

* is a thirty-four year old man who lives with his fiancée in the town centre of . He is the bar manager of a local venue and is a singer in a rock band. He is a very busy man and seldom has time for himself. He decided to come to massage to get some time to relax and get away from the worries of the world. His job is very stressful as his boss puts him under a lot of pressure. He also finds dealing with drunken customers very stressful and often ends the night with a headache. He doesn’t get much sleep ( about six hours a night at the most) because he finds it hard to switch his brain off when he is trying to sleep and doesn’t have a day off. He is a non-smoker but feels that the smokey working atmosphere is having a toll on his lungs.

On average he does at least one gig a week with his own band. They play all over the country so he spends a lot of time travelling at the weekend. Although he puts a lot of time into the band, organising bookings etc he finds this very enjoyable. He does find however that things can get on top of him and he gets a bit overwhelmed.

Because of the amount of time he spends at work he gets little time to exercise. He was once very fit, he use to work on a building site, but would see himself as been very unfit now. He has put on a bit of weight over the last couple of years and is finding it hard to lose it as he lose his sweet stuff and eats a lot of microwave meals.

TREATMENT PLAN

Because * has no serious health problems, and I found no areas of tension or stiffness, I intend to make * ’s sessions as relaxing as possible. I will put more emphasis on effleurage and petrissage movements and stray away from frictions and percussion. This will also help him with his sleeping problems. I will try to make the session as relaxing as possible to help him get some time away from his stresses.

I will encourage him to try to eat more healthily and try to take some exercise. I will suggest that he cuts down on his caffeine intake and try to relax a bit more.

SESSION ONE

* seemed to be a bit nervous at the beginning of the session so I asked him what his concerns where. He told me that he had never gone for a massage session before and wasn’t really sure what was going to happen. I explained that he would be covered with towels at all times apart from the area that I was working on. I explained that I would start on his legs, go to his abdomen, followed by his head shoulders and arms. I would then ask him to turn over and I would work on the back of his body. I told him that if at any time he was feeling uncomfortable, tender or in pain to let me know. He seemed a bit calmer and relaxed after this and so we proceeded with the session.

Judging by the amount of stress that * is under form work I was expected to find areas of tension in his body. However over the entire message I found no area of significant stiffness or tension. All his muscles seemed quite relaxed.

For homecare advice I suggested that he cut down on his caffeine intake as this may be a factor in his sleeping patterns. I also encouraged him to drink plenty of water as he drinks very little to none at the moment. I also suggested that he cut down on his sweet and biscuit intake and try to eat a more b *ced diet.

SESSION TWO

I asked * how he had gotten on after his last session and he told me that he had a great and long sleep that night after the session but was back into his normal sleep pattern after that. He was still feeling very stressed about work as a lot was going on. There was work been done in the venue and it was behind schedule and his boss was putting a lot of pressure on him.

During the massage when * turned over onto his abdomen he feel asleep nearly straight away. Again during the session I didn’t notice any areas of significant tension.

After the session * told me that he felt really tired and a bit worn out. For home care advice I suggested that he should cut down on his caffeine especially before he goes to bed or late in the evening. I also suggested that he try not to think about work related stuff before he goes to sleep. He should try to put all thoughts of work out of his head until he is in work. Perhaps he should take a walk in the evenings to clear his head.

SESSION THREE

* told me that he once again had a great nights sleep on the night of the previous session, but was still finding it hard to get a long night’s sleep after that. He also told me that he had headaches all week, they where mild and dull but nearly constant.

The whole way during the session * was restless, and was constantly twitching, scratching and re-arranging himself on the couch. I asked him if he was uncomfortable or if the room was too hot or too cold but he told me he was fine. When I pointed out that he was moving about so much he told me that he couldn’t really relax as he had stuff on his mind. He had had an argument with his girlfriend earlier in the day and was finding it hard to put it out of his mind

I performed a lot of effleurage and petrissage movements on him and spent a lot of time on his back as he had told me that he enjoyed this area been worked on.

For homecare advice I suggested that he spend an hour or even half hour each day relaxing with no television, stereo or other distractions. During this time he should not think about work or his worries but just let his mind relax. He was still drinking a lot of coffee and told me he was finding it hard to cut down. He blamed the lack of coffee during the week for his headaches. He knew that it was withdrawal symptoms but felt that he just didn’t have the energy to go through them at the moment.

SESSION FOUR

* told me that he had felt more relaxed this week. He had been taking time out each day to relax and not thinking about all his stresses. The pressure was calming at work and he was now walking to work each day to get exercise. He also told me that he had started listening to his favourite radio programme (The Goon Show) just before he went to sleep and this was putting him in good form and keeping his mind of things. He was sleeping better now.

He also informed me that he had bumped his left leg at work and now had a bruise that covered his left rectus femoris and Vastus Lateralis. I didn’t work on or around this area as he sore and tender.

I noticed that when I got to his left gastrocnemus muscle that there was a good deal of tension in it. I put this down to the fact that his upper leg was sore and that he was probably walking slightly irregularly because of this.

For homecare advise I suggested the same things as before. Cut down on his caffeine intake, cut down on his sweet/biscuit intake and try to drink more water.

CONCLUSION.

I was very surprised that * didn’t have more areas of muscle tension in his body due to the amount of stress that he is under. He finds it very hard to get to sleep at night because he starts thinking about stuff when he gets into bed. His new idea of listening to a comedy show before he goes to sleep seems to be taken his mind off things and helping him to get to sleep. He is also spending some time each day to relax and take his mind of things.

He has also started to walk into work to get more exercise. He tried to cut down On his caffeine intake but started getting headaches from the withdrawal. This made his a bit agitated and in bad form so he went back to his normal daily amount.

I believe that if * continues with his massage sessions and spend some time each day relaxing that his stress levels will be greatly reduced and his sleeping patterns will improve.

Case Studies 2

CASE STUDY 2

* * is a twenty-seven year old women who lives with her boyfriend and her dog. Her parents are separated but she sees both of them regularly and has a good relationship with them both. She has one brother who she sees less regularly but she enjoys his company when she does. She has an up and down relationship with her boyfriend as he has suffered from a drinking problem for a number of years and has a tendency to go on drinking binges. This, obviously cause a lot of stress for her at home. In the last couple of months he has however gone for professional help and has been sober.

* is also doing her final year at college. She is studying to be a teacher and say that the work load is just “unbelievable”. This is causing her a lot of stress also.

* would not be too fit and would be overweight. She has started the Atkins Diet recently and has gotten some success. She tries to go for a walk everyday but has found that since she has started this exercise programme that she has had one problem after another. First of all she broke her one of the phalanges in her right foot big toe and then she developed planter fibrositis in the same foot. fibrositis is a build-up of lactic acid inside muscles, it’s causes inflammation of soft tissues and stiffness and pain. Her doctor believes that she developed this condition because of her new exercise programme.

She is currently not taking any medication

For her right foot I intend to perform a lot of effleurage to help feel out the areas of tension. I will then perform some petrissage on her heel to break down tension and stiffness and to manipulate the muscles. This will help to release the build up of the toxins present there. It will also help with increasing the circulation. I will perform some friction movements on her heal to also help with the tension and to loosen tightness. * suffers from cold hands and feet and this would suggest that her circulatory system is could do with some encouragement. However in all these movements I will be very careful of her recent bone injury.

For her over all circulation I intend to do a good deal of petrissage, percussion and effleurage all over her body. I will encourage her to perhaps take up some exercise that will cause less impact on her feet such as swimming.

* would also like some help with her cellulite which she has around her buttocks and upper legs. I will perform some pounding movements to help breakdown the fatty deposits. This will also help with her circulation and improve her muscle tone.

I spent a lot of time on * ’s legs and feet as this was where she was having the most problems. Starting with some gentle effleurage to help her relax into the message I worked my way into some petrissage movements such as wringing and lifting of her rectus femoris and outer vastus muscles. I did some kneading and lifting on her lower leg which worked on the sides of her gastrocnemius and soleus muscles. When I got to her feet I did a leg stretch and ankle rocking. I noticed that her left foot was slightly longer than her right foot. I performed a lot of effleurage on her foot before going into lateral stretches, thumb rotations and frictions around her heel. All the time I was performing these movements I was checking in constantly with her about tension, pressure and pain. She found that these movements were not uncomfortable.

Over the rest of her body I performed a lot of effleurage and petrissage to help with circulation. I did some hacking and cupping on her thighs, gluteal muscles, trapezius, lattissimus dorsi and hamstrings to also help with circulation and to improve muscle tone. I did some pounding movements on her gluteal muscles and hamstrings.

After the massage I suggested that she took up an exercise like swimming that would have less impact on her feet. She felt that this would be a good idea. For her stress levels to do with college I suggested that she took ample breaks and not to over strain herself too much. She should perhaps spend half an hour each day meditating and taking her mind off all her worries.

Before the message I asked * how she had gotten on since the last session. She told me that she had been in great form all week, the best she had felt in years. She was putting this down to a combination of the message session and a Reiki session that she had had. She said that it felt great to be looking after herself and treating herself well. She told me that she had started swimming the night before and was intending to go at least once a week.

I asked her how her foot was doing and she said that although it did feel better it was still giving her a bit of trouble every now and again.

I began to talk to her about her diet and suggested that the Atkins diet was really a healthy diet to be following. She told me that she finds it very hard to eat healthy and would rather eat unhealthy and lose weight than try to stick to a diet that she won’t follow. Either way she says she is going to eat unhealthy, the only difference is that with the Atkins you will loose weight.

As with the first session I spent a lot of time on her legs trying to improve circulation, and improve muscle tone. I paid particular attention to her feet yet again by doing some kneading, frictions and effleurage. Along the posterior of her upper legs I performed some lymphatic drainage towards the inguinal nodes to help to encourage the lymphatic system to remove the toxins that the body was now letting go off. I also did some drainage to the submandibluar nodes, the axillary nodes and the cervical nodes.

After the session I encouraged her to drink plenty of water to help flush out of the toxins in her body. I asked her to think again about her diet and to continue her swimming.

Before the massage I asked * how she had gotten on since her last session. Again she told me that she had been in great form. She was continuing with her swimming and had now added an underwater aerobic class to it. She told me she was also at another Reiki session and believed that this was helping her a lot. She had also lost nearly a stone since she had started on her Atkins diet and was very pleased with this. I asked her had she thought about my suggestion about her diet and she said that she had but was still going to stay on it as it was working for her. She told me however that she had been slightly constipated over the last couple of days.

Her foot was feeling much better and she believed that this was a lot to do with the message and also to do with her new exercise programme.

Again I worked on her legs breaking down the tensions and stiffness. I tried to improve her circulation with some petrissage and effleurage and then did some lymphatic drainage towards her inguinal nodes to help release these toxins that were being released.

I performed some pounding movements on her gluteal muscles and her hamstrings to help with her cellulite.

I also spend some time doing some large intestine creeping to encourage peristalsis and help with her constipation. She found this slightly uncomfortable along her transverse colon.

I encouraged her once again to drink plenty of water after the session. I asked her about her stress levels and home and she told me that it was considerable less these days that her boyfriend was coping well with being sober and was doing fine. She has put her college work in perspective and although still stressful it no longer causing as much. She told me that she was taking half an hour each day sitting in her spare room with a oil burner and some relaxing music and meditating. She was finding this to be a great help and described it as getting away from the world for awhile.

Since the last session * had been to the doctor to get a check up on her foot. The doctor was very pleased with her recovery, he too believed that the swimming was a good idea. * had also been to another Reiki session and was feeling a lot calmer and happier. I asked her how she felt that the messages where affecting her and she told me that she definitely felt a lot more relaxed and was sleeping easier at night. She also told me that she now found it easier for her to relax her body almost as if her body had gotten use to it. She told me that she doesn’t really have cold hands or feet anymore and believed that her circulation was a lot better. Her overriding feeling was that it felt great to be looking after herself physically after years of letting herself go. It was improving her confidence level and her self esteem.

I asked her about her constipation since her last session and she said that she was back to normal and having no more difficulties.

During the message I didn’t pay as much attention as I had done in previous sessions to her legs and feet as the problem had depleted more or less. However I did spend some time doing some basic effleurage and petrissage movements along with some percussion and lymphatic drainage. The rest of the massage I performed as more of a relaxing massage than an invigorating one to help with her relaxation and stress relief. I spent a good bit of time on her back doing plenty of effleurage, circle of eight over her trapezius and fanning all over her back.

For homecare advice I suggested she drink plenty of water, continue with her swimming and under water aerobics and to continue with her half hour daily of “getting away from the world”.

Since our first session together * has come along way. At the beginning she was a bit down on herself and felt that maybe it was too late for her to start doing stuff to improve physically. By the end of her fourth session she was almost a different person. It was at this point that I noticed just how down she had been. She is enjoying her new lifestyle and I believe that she will continue as she now has the momentum behind her.

The problem with her foot seems to be under control. I believe that the swimming rather than walking is a better form of exercise for * at the moment. Because she is overweight her feet would be under considerable impact when she walks which would is not the case when she is swimming or doing her under water aerobics.

I would still be concerned about her diet. The Atkins plan does not seem like a healthy diet to me. I have researched it and the jury seems to be out on it at the moment. There are as many people for it as there is against it. However I believe that a more balanced diet would be more satisfactory and healthy. But for * it seems to be getting her where she wants to be weight-wise. I would suggest that when she gets down to her target weight that she visits a dietician and discuss a more balanced diet to keep the weight off and to make sure that she is getting the right vitamins and minerals.

Case Studies3

* * is a twenty-two year old single man who lives at home with his parents and two sisters. He would put his stress levels at home between 5 and 8 out of ten. Recently his grandmother died and this obviously has had an effect on his stress levels.

* works as a mechanic and he would put his stress levels at work at 6. He enjoys his work even though he works long hours.

When * was a child he was very sick and often spent time in hospital. He has however had no serious health problems for the last number of years.

His diet is fairly well balanced, although he has a high in-take of sweets and biscuits. He is a non-smoker and doesn’t drink alcohol. He drinks about 4 to 5 pints of water a day.

All in all, * would see himself as fit, healthy and happy.

I intend to use a lot of effleurage on * as his skin comes under a lot of stress from his work. He is often covered in oil and grease. This will help in desquamation and will help improve his circulation.

I also intend to use a lot of Petrissage all over his body but particularly on his legs, as I felt that he had a lot of tension in his hamstrings and gastrocnemus muscles. This will help to break down any tension or stiffness that he has from his job. He is fairly active and drinks plenty of water each day so this will also help in the release of any lactic acid that has built up on his muscles.

I will also perform some percussion to stimulate the cardiovascular system and help improve his circulation.

Session One

I spent a lot of time of doing effleurage all over * ’s body as he comes into contact with a lot of grease and dirt because of his job as a mechanic. This will help with desquamation. I followed this with some petrissage to encourage circulation and to help break down any tension in his muscles. I noticed that he had a good deal of tension in the back of his legs along his ham-strings, more so in his left leg than his right. However this did not continue up through his body as I found that most areas of *’s body were more or less tension free.

I noticed that in places, such as his hands and face, that * ’s skin is very dry and a bit flaky in patches, I put this down to his work.

As home care advice, I suggested that even though he comes home from work very tired he should really try to have a shower ever night to wash the grease off his skin. He said that he tries to most nights but sometimes he is just too tired and just goes to sleep and has his shower in the morning. I also suggested that perhaps he should use some sort of moisturiser on his skin to help with it’s dryness.

I asked * how he had gotten on after the last session. He told me that he felt very tired for the rest of the night after the massage and that it was very hard for him to get out of bed the next morning. He also told me that his stomach felt like he had been doing crunches and that he had urinated frequently the night and day after the massage.

He also told me that he had tried to use moisturiser but was feeling a bit stupid putting it on thinking about what the boys at work would think of him if they found out. He said that he used the moisture mostly on his hands and had started to use moisturising soap.

I went easy and gently over his transverse abdominis, going easy on the large intestine creeping. I did this because he found that his stomach was sore after the last session.

I noticed that the tension in his hamstrings was not as pronounced and was moving more freely when I performed some wringing movements.

I asked him how he was getting on with his showering at night. He told me that he was able to shower most nights but that one or two nights he was just too tired.

I also advised him to cut down on his sweet and biscuit intake as this might be a reason for his tiredness. Sugar and caffeine giving him a quick fix but leaving him more tired in the long term. He said that he would give it ago.

Since the last session * ’s grandmother died and he had been off work. Her funeral was the following day but he decided that he would still attend the session as he needed a break from all the mourning and ritual that surrounds a funeral. He was close to his grandmother and was taking the death very badly. He was also worried about his Mum as it was the second relation of hers that had died recently and she was really taking it bad. He was very worried for her.

I decided that for this session that I would do more of a relaxing session than an invigorating one to help * reduce his stress levels. I did plenty of effleurage and some gentle petrissage . I spent a lot of time on his back, predominately on his trapezius as I found a lot of tension and stiffness there. It was not surprising considering the amount of stress he was under. I performed some wringing, circle of eight and some hacking and cupping on his trapezius to help breakdown the stiffness.

For homecare advice, I suggested that he look after himself and make sure that he got to talk about his feelings with someone. I suggested that maybe he should go talk to a counsellor if he felt really bad. I suggested that he spend some time to relax and get away form the whole stress of the funeral, perhaps going for a walk on his own or listening to some relaxing music.

It was two weeks since the last session I asked * how he was getting on. He told me that he was getting back into the swing of things and that life had more or less returned to normal. He was back at work and back into his routine. He said that his stress levels where getting back to normal and that he was feeling a bit better about his grandmothers death.

I asked him if he had continued using the moistureiser on his skin and he told me that he was using it everyday and was noticing that his skin wasn’t as dry.

He also said that his stomach had not been as sore as it was after the first session. He had also cut down slightly on his sweet intake but was still eating a lot of junk.

I performed a good deal of effleurage over his entire body to try and find the places of tension and stiffness. A lot of his body was tense and I had to perform a lot of petrissage and percussion to try and sort this out. I noticed a lot of tension again around his trapezius. When I was performing some wringing movements I checked in with * and asked about pressure and he said that it was a bit tender. This was the same around his deltoids.

* has been under a lot of stress recently with the death of his grandmother and his worries about his mum. He is also in a job that is very tireing and he feels exhausted a lot of the time. The oil and grease from his job was having a negative impoact on his skin but with the help of the massage (which helped with desquamation) and the use of skin moistueresers he should be able to get this under control.

Although he has a well balanced diet and drinks plenty of water I suggested that he cut down on his sweet and biscuit intake. This could be having an impact on him with regard to his tiredness and also such a high intake of sugar isn’t good for his digestion.

* told me that he enjoyed the sessions and that he would continuing having massages done as he felt that they were very beneficial.

Case Studies4

CASE STUDY #4

* * is a twenty-one year old woman who lives with her Fiancée and two cats. She has a sister and a brother who are both older than her. Her parents have recently separated and this has been causing her a lot of anxiety and stress. She works as a body Piercer in a tattoo shop in * .

She had her tonsils removed when she was sixteen and had her appendix removed when she was eleven. She suffered from anorexia when she was seventeen/eighteen and was so ill she nearly died twice. Once when her stomach suffered serious injury and again when she had kidney trouble. She has recovered and is in good health now. However she still takes medication for depression. She does on occasion suffer from panic attacks but not near as often as previous.

Since recovering from anorexia she has been working with a Dietician and now has a very well balanced diet. She is now normal weight, but told me that she has a tendency to eat unhealthy every now and again, indulging in sweets and fast food.

She doesn’t take much exercise and would not be fit.

I intend to use a lot of effleurage on *’s hamstrings, quads, gastrocnemus and Tibialis anterior as she has poor circulation in this area. I will perform some kneading and Hacking and cupping movements on her quadriceps and hamstrings to also promote circulation.

I believe that * will benefit from the feelings of well-being that come from a holistic massage so I will to make her sessions as relaxing as possible. I will do this by using very vigorous movements sparingly and concentrate more on petrissage and effleurage than the more rigours percussion and friction movements.

I intend to do some large Intestine creeping to encourage Peristalsis as * would only have a bowel movement about twice a week.

I will encourage * to take more exercise and to try to keep her diet more consistent. I believe she will benefit from drinking more water as she suffers from frequent urinary tracts infections and the water will help to flush out the toxins from her body. I will also perform some lymphatic drainage along with the petrissage to encourage this toxin release.

I notice from the outset of this session that the circulation in *’s legs was poor as she had areas of white blotches on her legs. I performed a lot of effleurage and followed this by some petrissage on her upper and lower legs. She told me that she doesn’t like anyone touching her feet as she finds this very uncomfortable. I tried some basic effleurage but even this was too much for her so I discontinued.

I moved onto her abdomen area and spent some time doing some large Intestine creeping. I did this to encourage peristalsis as * would not have frequent bowel movements. After a few movements she started to find this slightly uncomfortable so I moved on to some wringing on her Internal and external obliques.

I next moved to her head, where I performed some basic effleurage followed by some scalp kneading. This was followed by some effleurage on her face and some lymph drainage to her submandibluar nodes. I use some tapotment on her cheeks and again some drainage.

I moved to her upper torso doing some effleurage. I followed this with a series of sliding neck movements starting on the left side and continuing on the right. After this I did some deltoid frictions, a movement she found a bit tender and sore but I didn’t notice any tension in them.

I continued to her arms with some effleurage, tricep and bicep kneading and some gentle hacking and cupping on her triceps. I did some work on her lower arm and moved to the hand doing some lateral stretches and metacarpal frictions and palmar kneading.

I got her to move on to her front so that I could begin to work on the back of her body. I noticed that her legs seemed to bend inwards in this position with her feet angled medially. I asked if she was comfortable and would she like a cushion or pillow under her feet to support her. She declined saying that she was comfortable as she was.

I performed some effleurage, wringing and hacking and cupping on her left and right hamstrings followed by some Lymphatic drainage towards her inguinal nodes. I tried to encourage circulation.

On her lower legs I kneaded and divided her gastrocnemus

I moved on to her back starting with some effleurage, back stretches and kneading from her buttocks to shoulders. When I started performing wringing and circling on her trapezius she told me that her nipple ring was sore because of the pressure. She informed me that she had been at a music concert recently and in the course of dancing had torn part of her nipple with her nipple ring. I eased on the pressure and moved down towards her lower back. I suggest that she use Savlon spray on her nipple to clean it.

I did some lymphatic drainage first to her cervical nodes, then her axillary nodes and finished with some thenar effleurage across her lower lumbar area.

I finished the session with some fanning over her kidneys and full back, followed by some more effleurage and some hacking and cupping over her entire back area.

I suggested that she take some time each day for exercise, to help with her circulation and for her sense of well-being, perhaps going for a walk in the evenings after work. This would also help to increase her level of fitness.

I asked her how she felt after her last massage. She told me that she had felt very relaxed and tired after it. She also had gone to the toilet nearly straight away after the session. Her nipple piercing had healed more or less completely and was not causing any problems.

I began the session with some effleurage on her legs and followed with some wringing, rolling and some percussion movements. This was to increase circulation and to release any lactic acid that had accumulated from *’s new exercise regime. I stayed away from her feet as I knew she found this uncomfortable.

I moved onto her abdomen area and spent some time doing some large Intestine creeping. I did this to encourage peristalsis. I moved on to some wringing on her Internal and external obliques.

I next moved to her head and face, where I performed some basic effleurage followed by some scalp kneading, some effleurage on her face, lymph drainage to her submandibluar nodes and tapotment on her cheeks.

Moving to her upper torso I did a series of sliding neck movements starting on the left side and continuing on the right. After this I did some deltoid frictions. * had found this area a bit tender in the last session so I was careful to ask her how my pressure was and how the movement felt. She told me that it was fine.

I moved unto her arms performing effleurage, tricep and bicep kneading and some gentle hacking and cupping on her triceps. After doing some work on her lower arm I moved to the hand doing some lateral stretches and metacarpal frictions and palmar kneading.

After performing some effleurage, wringing and hacking and cupping on her left and right hamstrings I followed with some Lymphatic drainage towards her inguinal nodes. On her lower legs I kneaded and divided her gastrocnemus

I moved on to her back starting with some effleurage, back stretches and kneading from her buttocks to shoulders. I did some wringing of the trapezius and lymphatic drainage to both her cervical nodes and her axillary nodes. I did some fanning over her kidneys and full back before I moved onto wringing of her gluteal muscles. I finished the session with some gentle effleurage and some spinal vibrations.

I noticed that *’s circulation had not really improved much even though she was now taking more exercise. I asked her what type of shoes did she wear on a regular basis and she told me that she usually wore boots that went up as far as her knee and had thick soles. She also told me that she had been wearing these boots for a number of years (as they where her favourite) and at this stage where starting to fall apart. I suggested that she stop wearing these boots for a couple of weeks and see if there is any improvement in her circulation. I also suggested that she keep up her daily exercise.

Since the last session * had hurt her neck. She told me that she woke up one morning with a stiffness in her right side sternocleidomastoid muscle area that was limiting her movement somewhat. She put it down to the way she had slept as she could think of no incident where she could have suffered the injury. I asked her if she had been wearing her boots, she told me that she hadn’t worn them since I suggested that she didn’t. I put forward the idea that maybe there was some kind of re-alignment was happening in her back because of her change of foot wear. This hypothesis was backed up when I noticed that the muscles in her right leg (particularly her gastrocnemus muscle) also seemed to be more tense than usual.

I asked her about her bowel habits and had there been any change. She told me that she finds it easier to go to the toilet now especially after she has a massage. I did some work on her large intestine to further encourage bowel movement and suggested that she talks to her dietician about her bowel habits.

I performed some effleurage on her legs and followed with some wringing, rolling and some percussion movements. I concentrated on her right leg as there was more tension in it than her left. I did a lot of kneading on her right gastrocnemus and some lymphatic drainage on both legs.

On head and face I performed some basic effleurage followed by some scalp kneading, some effleurage on her face, lymph drainage to her submandibluar nodes and tapotment on her cheeks.

I moved unto her arms performing effleurage, tricep and bicep kneading and some gentle hacking and cupping on her triceps. I some lateral stretches and metacarpal frictions and palmar kneading.

I moved on to her back starting with some effleurage, back stretches and kneading from her buttocks to shoulders. I did some wringing of the trapezius and worked on her sternocliedomastoids and deltoids to try to work out some of the tension. I did lymphatic drainage to both her cervical nodes and her axillary nodes. I did some fanning over her kidneys and full back before I moved onto wringing of her gluteal muscles. I finished the session with some gentle effleurage.

I noticed straight away that *’s circulation had improved greatly. She hadn’t worn her boots for a few weeks at this stage and had been taking more exercise and this has seemed to make all the difference. She still had the tension in her sternocleidomastoid muscle but she told me that it was no-where near as severe. I performed some wringing movements followed by some frictions to try to work out the stiffness and tension. The tension that I had notice in her right leg was now more or less gone and seemed to be back to normal. But I still did some wringing on the area to break down any residual stiffness.

* had gotten her belly-button pierced since the last session so I avoided doing too much effleurage on the area. I simply did some large intestine creeping and some lifting and wringing of her obliques. I took into account her piercing when she turned over onto her stomach by offering a pillow to lie on so that her piercing wouldn’t get damaged.

On her head and face I performed some basic effleurage followed by some scalp kneading, some effleurage on her face, lymph drainage to her submandibluar nodes and tapotment on her cheeks. I also did some eyes and nose stroking.

I moved unto her arms performing effleurage, tricep and bicep kneading. I some lateral stretches and metacarpal frictions, palmar kneading and some wrist and elbow frictions..

When working on her back I kept in mind her new piercing and so was very careful with my pressure and check in with * frequently to ask her how the movements felt. I performed some kneading on her gluteal muscles and did lymphatic drainage to both her cervical nodes and her axillary nodes. I did some fanning over her kidneys and full back before I moved onto wringing of her gluteal muscles. I finished the session with some gentle effleurage.

Since the first session * ’s circulation has greatly improved. I believe this id due not only to the massages but also due to her change of footwear. I also have encouraged her to take more exercise. Her diet is very balanced and healthy although I believe she would benefit from taking more water each day.

Because of her piercing I was unable to work over certain areas at times, but I believe that the massages would have helped in the healing process.

The pain in her sternocleidomastoid had more or less disappeared by the last session and I believe that this pain was do to with a realignment that was happening from her change of footwear.

* enjoyed her sessions and she believes that she would benefit from more sessions. She intends to have massages regularly.

Case Studies5

CASE STUDY # 5

* * is a forty-nine year old woman. She lives alone in her house in #####. She has two grown up children called ############. She has been separated from her husband for nearly eight years. She is currently unemployed.

* would say that she has currently no health problems but goes on to state that she has an ulcer which flares up every now and again. She has had no major operations in her life but has always suffered from painful periods and has had very bad headaches. She also suffers from constipation.

She smokes about twenty cigarettes but claims that she doesn’t really think that they are doing her too much harm (if any). She bases this on the fact that when she was off them for nearly a year she didn’t feel any different from when she was smoking other than she was having panic attacks. She says that smoking is good for her.

She would put her stress levels at 4 out of ten and is finding the time away from working very relaxing. She does however wish that she was a bit more financially better of.

* exercises regular. She goes for a walk every day and often goes hill walking at the weekend.

Because of her problem with constipation I intend to do some work along her intestine to encourage peristalsis. I will do some large intestine creeping and some circling movements over her abdomen.

Her left side Trapezius is very tense so I will do some wringing and friction movements on this area to try to break down the tension and stiffness. I will follow this with some lymphatic drainage to clear any lactic acid or toxins. This seems to be a localised tension area as the rest of the left side of her body is not overly tense.

I will encourage * to cut down on her smoking habits and to increase her intake of protein.

* felt very relaxed during and after the session and told me that she felt great. I noticed that she had some tension in her left side of her trapezius muscle so I performed some wringing and friction movements on the area trying to work out the tension. * told me that the area was a bit tender as I was working on it.

I followed this with some lymphatic drainage all along her back top help with the absorption of the toxins into the lymphatic nodes.

I performed some large intestine creeping to encourage peristalsis as * has a problem with constipation. There was a number of areas along the intestine that where hard, so I performed the movement a number of times. * did not find this movement uncomfortable or painful.

For home care advice I suggested that * drink some extra water to help flush out the toxins that were removed during the session. I also suggested that she continue with her walking and exercise programme.

* told me that she had really enjoyed the last session and was looking forward to the massage. I asked her about her constipation and she told me that she was still having trouble going to the toilet.

I spent some time doing large intestine creeping and notice a lot of hardness in a couple of areas. * found these movements to be slightly painful so I lessened the pressure.

The left side of her trapezius was less tense than the previous session and seemed to be going back to it’s normal relaxed tension.

For homecare I suggested that she continue with her exercise programme, drink plenty of water, try to cut down on cigarettes and try to include some more protein in her diet.

* told me that her bowel movements where a lot better and that she no longer was feeling constipated. She told me that she was really enjoying having the massage done and felt that that it was really helping her to relax. She also told me that she was having her menstrual period and asked me not to work on her abdomen as she was tender and sore in this area. She told me that she always had painful periods and that they took a lot out of her physically and emotionally. * looked a bit pale and a bit tired looking.

Overall * seemed to relax into the massage and had no areas of significant tension or stiffness. Because I was leaving out her abdomen I spent more time on her upper back , doing some petrissage movements (wringing, circle of eight) on her trapezius which she found very enjoyable.

For homecare advise I suggested that she take it easy during her period and not worry too much about going for her walks if she didn’t feel up to it.

* has had a very bad tooth ache all week and had been using clove oil on it to ease the pain. I asked her why she hadn’t gone to the dentist and she told me that she was very nervous about going to the dentists and was putting it off hoping that the pain would go away.

I stayed away from doing any movements on her face as the whole left side of her face was in pain.

The rest of her body was more tense than usual, particularly her upper arms and shoulders. I performed some petrissage movements on her trapezius, some frictions on her deltoids and some wringing/hacking and cupping on her triceps.

For home care advise I suggested that she should try to over come her nervousness of going to the dentists and make an appointment to have her tooth looked at. It was quite obvious that her tooth was causing her a lot of pain.

* * told me that she was really enjoying having the massage done and that she would continue to have sessions. She believed that the massage was helping her relax more and was giving her a greater sense of well-being.

She had no areas of significant tension in her body until the last session when she had some tension in her shoulders and upper arms. I believe that this was due to her toothache as she hunched her shoulders every time the toothache became severe. I suggested that she go see a dentist to have it looked at but she said that she is nervous of dentist.

**** believes that the massage has helped her with her constipation. I performed a lot of intestine creeping to encourage peristalsis and I believe that this had a positive impact on her.

Case Studies

So there they are, if i have missed a name or some other personal detail let me know and i will edit them out. If you recognise anyone from the case studies keep the privacy. And good luck all of you with your holistic massage!!!

When i am finished my Aromatherapy and Reflexology i will put up my case studies for that as well.

If anyone is interested i have some assignments for fetac Anatomy and phis, work health and safety, human growth and development, care provision and practice etc. Let me know if these would help!!:D

RE: Case Studies

Frater you are absolutely amazing, and really generous of you to spend all that time making these case studies available for others. The case studies are really well written, you've obviously put a lot of thought into them.

I hope that this will encourage others to share their knowledge so they can repay the favour to you someday in your next set of training.

*huge hugs*

RE: ITEC Holistic Massage Case Studies!

Good news people, i was talking to some of the other people in my class and some of them have agreed to post up their case studies as well. Hopefully they get them uploaded soon.

Frater I have just skimmed your case studies and have to say thank you for doing this, it was time consuming and extremely generous of you. Thank you.

My own tutor is very accommodating and has given us examples of studies, but i was a bit anxious about putting in very similar copies, this way i can use a combination of yours and hers for ideas to make mine more individual whilst being informative. I particulaly like the way that you hve used their life background to inform your treatment and advice as I feel it gives more scope to be seen to be offering differentiated aftercare lifestyle advice.

Have you any advice for revision for the A&P as the exams are in July and this is currently terrifying me at the moment, I have really struggled to learn the muscle names and actions but is is not sinking and I keep revising them so dread what it is like in July. I am hoping that as I progress with the case studies that it will cease to be less of a problem. any advice re revising will be gratefully received!

Take care and good luck with your studies. Regards

With regard to learning the muscles, just do your best but remember that there is only five questions on muscles in the final written exam so don't kill yourself over it.

In my exam all we got where actions of muscles...

Frater - I only joined HP today and came across your case study posting. These are a fantastic help - you must have spent ages typing them up. I have done all of my case studies, but have yet to hand them in to my tutor, so looking through yours is a real help to make sure I have covered everything. Of course, will strictly observe your conditions, but it is really useful to get someone else's take on these. Our tutor has not given us examples, and I have not found anything near as helpful as yours. If mine pass, I will gladly do the same for other members.

Again, many thanks.

Sunset [sm=sandrine.gif]

Hi, I just joined today but have used this site for about six months. Have been so grateful for all the time people have given up to help others. I got all exams next week on Tues and Fri. All my case studies have been passed. Thank you so much for your help. x

Thanks a million for this.... I'm doing the intensive A, P & M course so this will be a great help as a guide.

Generosity really does make the world go round!

Just to say thanks for your help. I am beginning Holistic Massage in October and these will be of immense help to me as guidance notes. Anything I feel that's important to help others will be posted in this forum.

Frater, Thank you! I'm about to study ITEC Holistic Massage, and found your case histories fascinating; thank you for taking the time and effort to put them on here, I'll be re reading them. They are so good, I can learn a lot from them. Thanks to you again, and have a good week!

PS) Frater, And what do you think about 2012??

RE: Case Studies 1

Thank you soooo much for your cases. There are an extraordinary guidance for me. I have pleanty time to work on them but I am struggling since my tutor isn´t to .... hmmm.... well, not as good as wished.

Lots of love and good energy

Hi Barbara,

That problem got sorted, it's all good now.

Even more reason to have fun.

The party will begin soon.

In Love and Joy

my god frater, i realise u posted your case studies a while ago but taking a break from doing my last one a few days ago due to an extreme mental block i decided to have a look on hp and found yours which really inspired me and i had to thank u thank you love jayne;)

hi frater! i have recently finished my aromatherapy training courses and is about to start my case studies which i had no idea where to start 😮 until i saw ur case studies!! i was amazed/suprised/impressed !!! and its now like a candle in the dark side which leads me a direction:)! have you finished your aromatherapy case studies? i would like to learn more from you!! thank you so much!!!:)

Hi Everyone

I am new to the forum and I am studying foran HND inaromatherapy, swedish massage, reflexology, psychology etc and to say im struggling is the truth!! I never realised how hard this was going to be.Due to one of our tutors being a nightmarein teachingwe have from now until the 23rd May to do all our12 clients 6 times each and as for the aromatherapy case studies we have no advice from our tutor on them at allitsan impossible task. I am quite distressed to be honest.

I am not even sure ifwhat I am writing is correct for case studies can anyonehelp please?

I did find some notes on case studies that frater put onbut would appreciate any advice on the format of them and how we end the conclusion??

I would be one very grateful Angel

Cheers - love and light to everyone

[sm=angel-smiley-027.gif]

Many thanks...

Hello everybody studying massage!!

Great Case Studies btw.

I am looking into different courses, mainly into the field of massage and/or beauty therapy. I am looking at Itec & Cibtac part time courses, as Cidesco is way too expensive and full time as well. Can anybody tell me about their experience at certain schools/institutions that teach in these fields? It would have to be a course that offers an international certificate, as at the moment I have a Scottish and Spanish diploma in massage, but can´t get started. I am looking for courses in the UK or Ireland.

Thanks all in advance! Claudia

hi your case studies are great do you have any case studies for aromo? i could look at doing my aromo course at the moment

:)thanks Frazer - much appreciated as I am about to embark on my massage course and wanted to see how the case studies were constructed.

Have just finished A& P/Reflexology/Business Awareness - have passed all but very concerned and disappointed with our tutor and education authority as we learnt reflexology from the wrong book - can you image our surprise on the day of the exam we noticed other students from a different class had Louis Tucket's book - we didn't! - foot mapping was completely different to what we had been taught and various other bits and pieces. It was borne out as we all as a class under achieved with our marks in the theory reflexology and as for the practical I'm not sure how this is marked as we also seemed to have under achieved here as well.

Ah well, a pass is a pass

I started ITEC HOLISTIC MASSAGE 2year course in september 2006. am relly enjoying it. I have a few of my case studies done. I had a quick read through your they look good, but our tutor is very strick on putting plenty of info in and she incourages us to use more A&P in our summarys and the benefits of each movement ie wat effleurage does ect.

I am also doing health and saftey and A&P. I have done one assignment in A&P it was different exercise to work on different muscles ect and have another one to complete its about the lungs and heart. Next year i will be doing aromotheraphy and Reflexogy. Also doing indian head this year and reiki.

Looking forward to seeing further more of ur work thanks

I'm just starting my case studies and this is a real help! I'm living in london but go to Dublin often to see sisters.

Are you still in Dundalk? Are you practicising this year?

Just handed my case studies in a few weeks ago and these were a massive help to me and really put my mind at rest about what I was handing in as I usually fret that nothings ever 'good enough'. So, thanks. 🙂

Hi, Thank you for you case studies. I am shocked at how short they are actually. Only your fourth case study was as long as mine are. My tutor is making us write a page on Conclusion and another page on Reflective Practice. He is making us write a page and a half for each massage! I am so annoyed cause it takes me over two hours to do one massage write up. ARGH!!! I have 6 left and have run out of words and my mind is blank! I am so glad that you passed successfully with what you have written. I only wish my tutor would be as cool as yours.

Thanks again. Lea

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Occup Ther Int
v.2023; 2023
PMC10599905

“Being Holistic Is a Lot to Ask”: A Qualitative, Cross-National Exploration of Occupational Therapists' Perceptions and Experiences of Holistic Practice

Mona asbjørnslett.

1 Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Norway

Lisebet S. Skarpaas

Linda stigen.

2 Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway

Associated Data

Data is available on reasonable request.

Being holistic is often used by occupational therapists to describe their practice and philosophy worldwide. This study explores the perspectives of 33 occupational therapists, working in 13 different countries, on their understanding of holistic epistemology and practice and how they seek to incorporate holism in their work. On the basis of a qualitative study design, individual interviews were conducted with the participants by 18 Norwegian undergraduate occupational therapy students, supported by their supervisors. The authors subsequently analyzed the transcribed data, using a thematic analysis approach. Three principal themes emerged: (1) holism as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. When talking about holism and holistic practice, participants described their holistic practices in various ways, and their accounts reflected different understandings and cultural contexts. Participants characterized a holistic approach as one emphasizing the importance of occupations and activities and helping patients regain independence in their everyday lives. However, they also highlighted the specific challenges they faced, including cultural factors and inadequate resources. Significantly, participants from both Western and non-Western contexts emphasized the importance of holistic practice, suggesting that a dichotomous understanding of Eastern versus Western philosophical approaches does not necessarily make sense in occupational therapy interventions. Therapists' degree of commitment to client-centered practice appears of greater relevance. With its international perspective, our study sheds light on important areas of contemporary occupational therapy practice, including the difficulties occupational therapists face when seeking to cover “everything” in an effort to be more holistic.

1. Introduction

Holistic approaches and epistemology are featured in the practice of occupational therapy in different parts of the world. In this study, we define epistemology as a specific way of knowing the world and how knowledge is constructed [ 1 ]. As such, clinical practice in occupational therapy is constructed around a core value of being holistic, which is widely present in the occupational therapy literature. For example, in a USA-based national survey, more than 80 percent of occupational therapists using the Model of Human Occupation (MOHO) in their practice reported that this model supported holistic, occupation-focused, client-centered, and evidence-based practice [ 2 ]. Research involving Swedish occupational therapists suggests that these practitioners distinguish between a holistic, socially oriented approach on health and a biomedical one [ 3 ]. A study from the UK [ 4 ] explored how occupational therapists aspired to be holistic and claimed a holistic perspective as a part of their identity and self-definition. However, these therapists often struggled to define the meaning of holism. As they negotiated the tension between theory, beliefs, and practice, they found that holism could at times appear “an illusion” [ 4 ].

Historically, holism is an idea that occupational therapists often use to describe and characterize their practice: one where the individual is viewed as an integrated being [ 5 ]. In the late 1980s, groundbreaking research by Cheryl Mattingly, an occupational therapist, and Maureen Hayes Fleming, an anthropologist, explored the thought processes of occupational therapists when treating patients and what they thought about their practice, language, and values [ 6 ]. As the researchers noted, “occupational therapists have always presented themselves as concerned with the patient's relationship with the disease, as well as with the ‘whole person'” ([ 6 ], p.74.). On the basis of our own experience of the relationship between disability and meaningful occupations, we share the view that occupational therapists seek to treat the whole person [ 6 ].

For Hasselkus and Dickie, a holistic view of disability differs sharply from a medical understanding. With reference to McColl, she emphasizes that, from a holistic view, disability can be seen as normal experiences of life and with opportunities for personal growth, development, and a unique way of being in the world. From this, it follows that the task becomes one of achieving a balance and living one's life within the constraints of the disability [ 5 , 7 ].

Holistic ideas and approaches are also evident in recent occupational therapy literature, including that relating to occupation-focused medical rehabilitation [ 7 , 8 ]. In the book edited by Huri [ 8 ], holistic influences are evident in studies that argue for the unique quality of occupational therapy and suggest that a holistic approach enhances patients' life skills to enable participation in everyday life activities [ 9 ]. For instance, in her study on psychomotor therapy, Probst employs a holistic view of a unified body and mind, with a focus on movements, in her exploration of the treatment of patients with severe mental health disorders [ 10 ].

Akyruek and Bumin [ 11 ], whose research focuses on community participation for people with disabilities, refer to Hussey et al. [ 12 ] and argue that a holistic approach in occupational therapy involves the following:

The handling of occupational therapy in all directions of humankind is called holistic approach. Holistic approach emphasizes the organic and functional relationships between whole and parts. This approach assumes the person as a whole as biological, psychological, sociocultural and spiritual . ([ 11 ], p. 83)

Recent literature also emphasizes the central role played by meaningful activity and occupations within the profession. Fisher and Martella argue that a person-, environment-, and activity-centered approach lies at the root of occupational therapy. They stress the importance of understanding occupation as a transactional whole in which occupational and situational elements are always intertwined [ 13 ].

The value of holistic approaches has been highlighted by research in other fields, where dichotomous understanding of body and mind is addressed. For example, a study of cancer survivors suggests that mindful engagement in everyday occupations can help such individuals unlock their core self and enjoy enhanced quality of life [ 14 ]. It has also been found that to achieve holistic mind-body connection and well-being for women who have suffered childhood abuse, mindful engagement in daily activity can promote a “journey to wholeness” [ 15 ].

A persistent claim made in the literature is that there is a gap between Western approaches to healthcare (often characterized as “reductionist”) and Eastern perspectives judged to be more holistic. Tsipris seeks to narrow this perceived gap by advocating the introduction of yoga to an occupational therapy program [ 16 ]. Twinley questions the adequacy and holistic depth of the terminology used by therapists, notwithstanding our tendency to view activity and occupations as health-promoting and positive [ 17 ].

In general, holistic approaches are sensitive to cultural differences and human diversity; they take into account how people think and feel about health and illness and how they use available health services [ 18 , 19 ]. Morrison argues for the adoption of a pragmatic epistemology by occupational therapists, one which enables us to see new connections and understand occupations as social phenomena, integral to the way society constructs and reconstructs itself [ 20 ].

As a profession characterized by theoretical, ethical, and cultural diversity, occupational therapy can only be enriched by critical perspectives [ 21 ]. As Hammell notes, building on our diversity may well enable our work to have a global impact [ 22 ]. Despite the presence of holism in occupational therapy literature for several decades, the authors of this study were unable to identify research with an international perspective: that is, research that attempts to explore the ways in which holism is understood and applied by occupational therapists in different parts of the world.

1.1. Holistic Philosophy

The premise of our study (project) is that occupational therapy is embedded in an occupation-based and holistic epistemology [ 23 ]. For Di Stefano, the holistic philosophy is the basis of complementary and alternative medicine in the West, where being holistic is directed towards understanding a whole system rather than selected events or phenomena. For Di Stefano, being holistic is complementary to biomedical approaches and traditions. Holistic philosophy sees life as influenced by many factors, including those beyond the purview of scientific notions of rationality, materiality, and mechanism [ 24 ]. For Di Stefano (citing Jan Christian Smuts), holism has come to signify a philosophical position that acknowledges the central unity of creation. Holistic is a powerful term and carries the synergetic understanding that “wholes are greater than the sum of their parts” ([ 24 ], p. XVIII).

With this background, it is evident that the idea of holism has been present in occupational therapy for many years and that it remains a relevant philosophical foundation for our practice. However, we have been unable to locate any previous studies exploring how occupational therapists apply the concept of holism in practice. The research question addressed in the study that forms the basis of this paper is therefore “How do occupational therapists in different practice contexts around the world understand and use the term ‘holistic' in relation to their practice?”

2. Design and Methods

The initial stages of this qualitative project were carried out by a team of bachelor students, employing a qualitative descriptive research design [ 25 ]. In qualitative descriptive studies, researchers stay close to their data and to the surface of words and events; this is the method of choice when straight descriptions of phenomena are desired [ 26 ]. The initial aim of this project was to explore the experiences, reflections, and taken-for-granted ideas of occupational therapists representing different countries and cultures where the meaning of context is particularly relevant [ 27 ]. Open, semistructured interviews were conducted with a total of 33 participants, located in a range of different countries.

2.1. Participants and Recruitment

The participants comprised 27 female and 6 male occupational therapists, working in Chile, Canada, Australia, Iran, Abu Dhabi, Palestine, Israel, Tanzania, Romania, Germany, the Netherlands, the United Kingdom, and Norway (see Table 1 for participants' demographic characteristics). Three researchers (the authors of this study), together with the undergraduate students involved in this project, used their international networks to recruit participants. The recruitment criteria was that the participants were performing occupational therapy in their present country.

Participants' demographic characteristics.

#	Country of practice	Sex	Age group	Current workplace/type of praxis	Work experience
1	Australia	Female	37	Teaching hospital, neurology section	16 years
2	Australia	Female	30-40	Private practice, mixed range of clients	13 years
3	Australia	Female	30-40	Hospital setting, neurology	12 years
4	Canada	Female	20-30	Inpatient geriatric unit	1 year
5	Canada	Female	20-30	Community-based setting	1 year
6	Chile	Female	20-30	Four rural health centers in the municipality	4 years
7	Chile	Female	20-30	Home-based occupational therapy	1.5 years
8	Chile	Female	20-30	School-based and private sessions in homes	1 year
9	United Kingdom	Female	47	Adult social care, council	24 years
10	United Kingdom	Female	43	Adult social care, council	17 years
11	Iran	Female	29	Rehabilitation clinic	4 years
12	Iran	Female	27	Rehabilitation center, private	3 years
13	Iran	Female	30	Private clinic	5 years
14	Netherlands	Male	20-25	Neurological rehabilitation center	1 year
15	Netherlands	Male	20-30	Hospital setting	1 year
16	Norway	Female	50	Neurological rehabilitation in hospital	27 years
17	Norway	Female	38	Rehabilitation in hospital	15 years
18	Norway	Female	35	Municipality health services	9 years
19	Norway	Female	38	Work-related rehabilitation	12 years
20	Romania	Female	30	Pediatric outpatient, hospital	7 years
21	Romania	Female	36	Day center	7 years
22	Tanzania	Female	30-40	Hospital setting and outpatient	7 years
23	Tanzania	Male	40-50	Hospital setting, community health setting and university	15 years
24	Tanzania	Male	30-40	Hospital setting	4 years
25	Palestine	Male	43	University	9 years
26	Palestine	Female	37	OT center, pediatrics	15 years
27	Israel	Female	41	Early development center,	19 years
28	Palestine (Gaza)	Male	54	Rehab hospital	27 years
29	Palestine	Female	39	Physical disability, pediatrics center	17 years
30	Abu Dhabi	Male	38	Outpatient clinic	14 years
31	Germany 1	Female	30-40	Private clinic	15 years
32	Germany 2	Female	30-40	Private clinic	12 years
33	Germany 3	Female	30-40	Polyclinic rehabilitation	2.5 years

2.2. Interviews

Interviews were conducted between 2019 and 2021. Occupational therapy undergraduate students from Norway conducted all 33 interviews as part of their bachelor thesis in occupational therapy. The interviews lasted from 35 to 97 minutes. While some students were able to interview their informants in person, most of them used digital platforms such as WhatsApp, Zoom, and Skype to conduct the interviews. All interviews took the form of life world explorations, described by Brinkmann and Kvale as semistructured interviews. The aim was to illuminate themes of everyday life in an attempt to understand the perspectives of the informants [ 28 ]. During the interviews, the students followed an interview guide structured around an open, narrative approach with a focus on events and happenings. They started the interviews with a sequence of open questions, as in the following:

“Can you tell me what happened yesterday at work (a regular weekday)? Let us start with when you came to work. Describe what first happened when you came to work – tell me about your morning routine? Who did you meet? Is that usual?” The students were asked to continue the interviews along these lines, exploring at greater depth activities, situations and/or events, and relationships with other people (positive or negative) that informants saw as central to their occupational therapy practice.

2.3. Data Analysis

Initial analysis of the interviews was carried out by a total of 18 undergraduate occupational therapy students for their bachelor degree theses. Seven pairs of students focused on single countries, while a further two pairs analyzed material from two countries. During this primary phase, the focus was on occupational therapists working within specific national contexts.

In order for a subsequent meta-analysis to be carried out, anonymized copies of all transcribed interviews were kept by the principal researchers (the authors of this paper). We then engaged in an inductive, explorative approach to gain an overall view of the topics of concern and taken-for-granted ideas in a thematic analysis, as recommended by Stanley [ 25 ].

In the next phase of the analysis, all interviews were uploaded into the NVivo software and coded inductively by adding open codes to participants' words or phrases [ 25 , 27 ]. During this process, it became clear that holistic ideas and holistic practice were topics which appeared in most of the interviews. Regarding this as a “taken-for-granted idea,” we then returned to the raw material and read it afresh through the lens of holism. During this phase, we also had several discussions on the dimensions of holism and being holistic. On this basis, we highlighted passages which described or offered reflections on this concept.

Text condensation and line-by-line coding were then applied to these passages, so that we could build codes inductively and evaluate in detail participants' statements related to the holistic approach.

In the third phase of the analysis, similar codes were brought together to form categories [ 25 ]. The categories were divided into holistic epistemology and holistic practice. We further discussed the coding and categories and agreed on three main themes: (1) being holistic as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. Through further analyses and abstraction of the results, the authors of this paper were inspired to develop a conceptual model illustrating the idea of holism as employed and described by the participants. The aim of this visualization was to facilitate the conceptualization of how occupational therapists apply holistic ideas in practice.

2.4. Trustworthiness and Validation Strategies

Several methodological concerns about trustworthiness and processes of validation can be raised regarding this study. Firstly, all the interviews were conducted by undergraduate students. It is a strength of the research that the data collection is done by different interviewers, thereby potentially enabling a more broad-based exploration of occupational therapy worldwide than one limited to a single researcher's perspectives. Several of the students involved in the project themselves had a foreign background, enriching the multicultural dimension of the research.

However, according to Brinkmann and Kvale, validation is related to craftsmanship [ 28 ]. The undergraduate students lacked research experience, which raises questions about the quality and depth of the data gathered. While some students performed their interviews in English, others interviewed in their native language, subsequently translating the transcription into Norwegian or English. This, too, raises questions regarding the degree to which the results represent an accurate interpretation of participants' meanings [ 29 ].

We would argue that our study is strengthened by the richness and diversity of the data collected, enabled by our decision to reach out to occupational therapists across the world: professionals with different educational, cultural, and practical backgrounds and experience. On the other hand, the validity of interview data gathered across countries, cultures, and languages may suffer through loss of accuracy and nuance in cultural or linguistic translation. Given that the students handled both the transcription and translation of the interviews they conducted, linguistic inaccuracies and misunderstandings may have crept in.

To strengthen trustworthiness for the student projects, member checking via supervision, methodological decisions, discussions, and presentations to other students was introduced at the start [ 25 ]. To minimize the risk of misunderstanding the content of participants' responses, most students worked in pairs, discussing the process with costudents and also their supervisors. Another criterion of validation is authenticity: the degree to which researchers capture the multiple perspectives and values of their participants [ 29 ]. Given the international scope of our study, we would argue that this criterion is met to some extent.

Questions about reliability arise from the fact that the authors of this study conducted only the secondary analysis of the data; they did not carry out interviews and transcribe or interpret the primary data themselves [ 29 ]. However, all three authors supervised the students during the research and were very familiar with the research process, thereby strengthening their credibility as researchers [ 28 ]. The authors also engaged in a long process of reading the material, coding its content, and discussing and interpreting emerging themes, all of which strengthen the validity of the results [ 30 ].

2.5. Ethics and Ethical Considerations

Approval for collecting and storing the data was granted by the Norwegian Center for Research Data (project number 100341). The participants were informed that participation in the interviews was voluntary, their responses would be treated in confidence, and there would be no negative consequences from participating in the study. Written informed consent was provided from all participants. All methods were carried out in accordance with relevant guidelines and regulations.

In the presentation of the results, excerpts from interviews are set in cursive, with the nationality of the participant added, in brackets, at the end of the quote. As they explained their own practice of holistic occupational therapy, their accounts reflected different understandings and cultural contexts.

3.1. Holism as a Broad and Narrow Concept

Holism was described and explained in a variety of ways, taking both a broad occupational perspective, such as in community practices, and a narrow understanding, such as in individual physical training, but despite their quite different practices and cultural contexts, the concept seemed to be a central part of occupational therapists self-understandings worldwide.

When discussing the concept and use of holistic approaches, participants spoke of how theories within occupational therapy, such as in the Model of Human Occupation, were associated with holistic perspectives. As participants explained, such theoretical perspectives helped them take into consideration the environment and not only the personal factors (Palestine), by taking into account factors beyond the purely medical/physical aspects. In this quote, it is evident that considering the environment was always present in a holistic approach.

Even though not all the participants distinguished holism in occupational therapy from forms of medical treatment, other participants sometimes divided between what they saw as holistic and more focused on a specific injury, diagnosis, or impairment. This latter type of focus was seen to represent a pathological and reductionistic view of clients, rather than the broader, activity-based perspective they themselves employed. Turning to one of the broad explanations of being holistic, one of the informants put it like this:

I would explain this holistic because we see a full view of the person. And we take more of an approach to look at all aspects instead of a lot of other professions, focus more on the injury, the diagnosis or the impairment, whereas we see the individual as a whole, which includes their environment and their activities or occupations and everything else about them. (Canada)

Holism also seemed to be included when the therapists explained their skills and expertise when helping people with activity problems. One informant also believed that people outside the profession acknowledge how occupational therapists see and focus on the whole person: the participant put it like this:

And I think we have the lucky position of being able to understand our client holistically and how we can help them be able to do what they want to do and use our expertise and creativity to help enable them to get back to those activities. (Australia)

Explanations of holism does necessarily inherit what a full view of a person or looking at all aspects means, but when therapists add the environment, doing, and occupation, this makes more meaning to our specific professional viewpoints. Thus, taking an overly broad or holistic view of our profession may make it more difficult for occupational therapists to explain what exactly it is that they do—and may reinforce views at large in society to the effect that occupational therapy is vague and nebulous.

3.2. Being Holistic Spans from Treating Body Parts to Teaching Marginalized Children

A holistic approach was generally seen as one stressing the importance of occupations and activities and helping patients regain independence in their everyday lives. At the same time, holistic treatment and therapy was explained in many ways, depending on social and cultural understandings, as well as possibilities within different countries. Since most participants worked in hospitals or other medical facilities (including private clinics), their perspective on holistic practice tended to be influenced by the health systems operating in their particular country. In addition, the context in which rehabilitation treatment unfolded (in many cases clinics and hospitals) had an impact on individual treatment.

Some participants argued that holistic occupational therapy meant treating individual body parts, while others were concerned with the way specific social and cultural understandings of disability and illness influenced their practices. In Norway, as an example, rehabilitation treatment and assistive technology are paid for by the government, where occupation-based intervention towards the goal of enabling clients to live independently in their own homes is an important aim. However, elsewhere in the world, occupational therapy treatment and assistive technology could be less of a priority. In Iran, for instance, rehabilitation treatment did usually not receive government funding, leaving many people unable to afford assistive technology or therapy. With medical doctors presiding over the allocation of occupational therapy, treatment and goals like independent living might be given a lower priority or even described as a waste of resources. One Iranian participant spoke of the emphasis placed on getting patients with cerebral palsy or in stroke rehabilitation to walk again:

It is expected that the family of a patient who is unable to walk will ask: “when will he start walking?” This is disappointing. In our culture, disabled people are not accepted. A person doing his work while sitting in a wheelchair is not acceptable for the society. This means that the opportunities for disabled people are limited. I always ask clients and their families what they mean by getting well, or healing: what does it mean to them? (Iran)

In this example, occupation-based values were not always visible in treatment strategies. Some participants problematized, while wishing to be “more holistic,” and felt limited by their specific work context such as the hospital where they were based, or a country representing a marginalized view on disability as treatable or nontreatable.

In Iran, physical training for patients prioritized for occupational therapy was usually associated with intensive individual training to gain independence:

I always warm up my hands by putting on cream and massaging them. Then we start by moving the joints in all fingers, thumbs included, folding the hand by bending all the fingers. Hand power, such as squeezing a small ball for about five seconds. (Iran)

Participants working in other parts of the world had different perspectives. Two participants, the first from Tanzania and the second from Germany, saw a holistic approach to rehabilitation as involving adapting therapy to meet the patient's own needs, requests, and understandings of OT:

What we do is, we make sure that our therapy is going to focus on helping the client's needs. If the client is having a problem with their hand, then we make sure our therapy is based on that. (Tanzania)

And if the patient has another problem --he can be here because of his shoulder but has a back pain – I will treat his back, I do not care, it is just like that. Or if he says “my hand hurts today”, I will do something with his hand. If he has a problem with his psyche, I will talk to the patient in a therapy session. (Germany)

Another participant, such as one who worked in a community health center, and using a family health model, described how she had adopted to a more holistic practice . For her, this meant addressing more than the individual person; it involved working with the client's whole family and wider environment.

Other, such as in a case from Romania, occupational therapists followed up on everyday occupational needs for marginalized children during the COVID-19 pandemic lockdown, where occupational therapists together with other professionals arranged for online schooling in order to prevent the children from dropping out of school. In this example, the occupational therapists used their creative skills not simply to meet children's educational needs but also to help children acquire what the therapists called life and recreational skills, such as serving food and learning about hygiene, where helping children live independent every day is visible through addressing occupational problems.

As a last point in this part, it is important to stress that occupational therapists not necessarily find it satisfying to work only in the environment, because their expertise is also identified with individual treatment approaches, which is problematized from Chile, from a therapist working with children with autism and sensory integrative problems:

Well, another challenge is that it's difficult to withdraw myself from wanting to do clinical treatment. Wanting to take a child out of the classroom and be able to do a session with him, because sometimes I feel that I have the time. But what is required of me is something else. I don't take a child out of his classroom to do an individual sensory integration session with him, even though I would love to have a ball pool or swings to work with. To be frank, I'm not cut out to work in a purely clinical way. (Chile)

Like in this quote, participants' accounts of holistic practice within occupational therapy included diverse social and cultural understandings, where they also touched on the limitations and possibility characteristic of communities, hospitals, and rehabilitation centers in their abilities to perform holistic occupational therapy, which was explained as both treating the individual person and working in a broader environment.

3.3. Being Holistic Is a Lot to Ask

Some of the participants questioned if our profession is holistic or if the idea of being holistic is too much to ask. Several participants did in fact speak of the difficulty of being holistic in their practices. One informant reflected on the complex foundations of occupational therapy, noting that being holistic, covering a lot, becomes difficult, because occupational therapy needs to adapt to a particular context and then narrows what occupational therapy is about:

We have to include the whole person, as we are used to doing as OTs. But we also have to be good at not treating the whole person, as that is the responsibility of all the community services. (Chile)

For the participants, occupational therapy principally involved thinking and acting from an occupation-based perspective. While being holistic could be “a lot to handle,” informants agreed that ideas about how occupations affect our lives formed the core of occupational therapy.

Being holistic, however, was trying to see what the patient needs and educate the family and the caregiver about the recourses that can help the patient on things and that may make his life better, make his life easier, and improve life, for example. Working with a patient with a spinal cord injury exemplifies this dilemma:

It's really difficult to explain to them that this is things that happen when you have a kind of spinal cord cut. You will not gain your old skills before, right now our goal that the wheelchair will be a part of your body, you need to understand that. You need to have a good skill and maneuvering or manipulate the wheelchair, you need to strength the upper body, right now your skills is good you can climb use only your hands, you need to go transfer yourself from the wheelchair down or up or from the wheelchair to the bed and from the wheelchair to the car. Your life will be continued and ok, but there is an extra part added to your life called the wheelchair, you need to understand this. (Abu Dhabi)

Furthermore, the participant elaborated and continued:

So when I try to explain this to the patient, the whole goal of the family and the patient is shifted from taking medication, trying to find a solution or waiting for a miracle, to another goal, a functional goal that make his life better -- he's moving on, he's trying to think “I will return to work again, I want to continue my life, to have my own home, I will get married soon”. So this is a kind of shifting the goals or trying to broaden the patient's tunnel vision … this kind of feeling I believe in more than other theory. (Abu Dhabi)

Questioning the wide-ranging expectations, including families and patient surrounding their work as occupational therapists, participants observed that attempting to apply a holistic approach could make life even more difficult for them. They suggested that a holistic approach always needed to be limited to a particular context or situation and that the field in which they worked usually limited their opportunity to treat the whole person.

They also described dealing with multiple challenges on a daily basis, constantly aware of the high expectations surrounding them. While their occupational therapy services often adapted to environmental expectations and community and workplace possibilities, this could create more problems for therapists wishing to be more holistic while at the same time meeting the requirements of real world practice.

As highlighted by a Canadian occupational therapist, to remain client-centered and know and use those holistic theories and principles of OT, and then balance that with what the hospital is asking you to do in a hospital setting is difficult (Canada). She further elaborated and problematized being holistic while having to treat patients at a hospital under strict time constraints:

And I think it can become hard to balance that holistic, client-centered model and then the pressure from the hospital and management and administration to get people out as quickly as possible. And you have very limited time with each person because caseloads are so large it can become overwhelming. So I think it's definitely a balancing act…. (Canada)

As in this case, when the main goals of therapy are being able to go to the bathroom by themselves, get dressed, and make a simple meal, where leisure activities are less important in the hospital setting, being holistic is questioned by the therapist. The participant problematized how hospital settings and a medical context could make it difficult to follow patients' own needs, or being holistic and client-centered. An occupational therapist working in Gaza also gave an example of what happened when a client's individual priorities were overlooked during rehabilitation:

The client told me:“You did me lot of good and I learned how to eat, how to dress, how to transfer, how to move with a chair, and it is very good. But I don't even know how to do my prayers, how to go to the mosque, you know, for Friday prayers, how to perform this.” (Palestine).

As suggested above, many participants identified the attitude of being client- or family-centered as part of holistic practice. Being client-centered was seen to involve meeting clients where they were at a particular moment and addressing their priorities, interests, and needs.

As the participants pointed out, individual training may not necessarily conform with holistic practice, particularly where therapists are required to work within many different domains. In such situations, was working holistically too much to ask?

4. Discussion

The aim of this study was to explore the perspectives of occupational therapists in different parts of the world on holism and being holistic in their everyday practice. Three main themes emerged from the analysis of interview data: (i) holism as a broad and narrow concept, (ii) being holistic spans from treating body parts to teaching marginalized children, and (iii) being holistic is a lot to ask.

In Figure 1 , we bring together in the form of a conceptual model the various perspectives provided by our participants on what holism is, how it is practiced, what it takes from the therapist, and the challenges and dilemmas related to holistic occupational therapy.

An external file that holds a picture, illustration, etc.
Object name is OTI2023-2432879.001.jpg

Conceptual model of participants' descriptions of holistic occupational therapy practice.

The participants' strong expressions of the perception of holism as a core concept in occupational therapy place holism at the center of our model. Furthermore, the participants' value of holism extended beyond occupational therapy literature and practice to wider society and culture. When considering holism in relation to their clients, the participants offered a variety of perspectives, whether related to body and mind or to the different arenas in which clients lived their everyday lives. Their ideas, summarized in the client square at the bottom right side of the model, are captured in the theme “holism as a broad and narrow concept.”

Participants' reflections on what holism demands of them as therapists, including the skills required of them, are summarized in the therapist square at the bottom left side of our model and are presented in greater detail in the theme “being holistic is a lot to ask.”

Participants also provided a range of perspectives on how holism related to their practice as occupational therapists. The square labelled “practice” at the top of our model presents some broad areas mentioned by participants in relation to their practice, including challenges to holistic work posed by their specific work context and the complexity of applying a holistic approach when working in different settings. This is described in the theme “being holistic spans from treating body parts to teaching marginalized children.”

Separating the three large squares circling our model's core theme are three smaller elliptical bubbles, shaded green. These represent three dilemmas or conflicting viewpoints that the participants seem to juggle in their practice. Firstly, there is the question of whether to practice in a clinical setting or a more “natural” one, such as the client's home. Secondly, therapists may find themselves having to choose between a strictly medical focus and an approach more geared to activity and occupation. Thirdly, therapists are confronted by the gap between their desire to be more client-centered and the limited resources at their disposal. These dilemmas represent some of the tensions experienced by the participants regarding their holistic practices, as captured in the theme “being holistic is a lot to ask.”

4.1. Findings in relation to the Existing Literature

Our themes illustrate and shed light on the ways in which occupational therapists in different parts of the world understand the term “holism” and the concept of “being holistic.” In general, their perspectives reflect those found in occupational therapy literature [ 6 – 8 ]. Their descriptions also accord with the findings of studies [ 3 – 5 , 31 ] which highlight how holism is frequently used to describe and characterize occupational therapy practice and thereby to inform practice.

When describing what they understand by the meaning of “being holistic,” occupational therapists tend to use broad, even lofty, definitions. They talk about their efforts to be “holistic thinkers” and capable of “seeing and treating the whole person.” This in turn raises questions such as what does it mean to “see the whole person.” One answer suggested by the participants is having the aim of helping people do what they want to do. This is consistent with what is generally understood as client-centered occupational therapy: working closely with clients and having respect for their preferences, values, and choices [ 13 ].

Our themes, particularly the second one, illustrate the diversity of settings in which occupational therapists seek to apply holistic approaches. These attempts unfold in family homes and local communities; they can extend to school-based work with marginalized children requiring help with basic life skills. There are similarities here with an occupation-based understanding of working in tandem with clients who are actively engaged in real occupations [ 13 ]. Here, cultural variations emerge as significant. While some countries and cultures emphasize the importance of independent living, others may not see this as the main goal of occupational therapy interventions. This does not mean that occupational therapists working in such contexts do not have a holistic approach but rather that they must operate within broader social parameters (for example, in relation to disability and illness). While some societies may view disability as an opportunity for growth and development [ 7 ], it can also be understood as a hindrance to independent living and in some cases not worth treating.

The meaning of occupations in everyday life finds emphasis in occupational therapy literature [ 6 – 8 , 13 ]. However, less attention has been paid to what practicing occupational therapy might mean in different contexts: in hospitals versus medical clinics, for example, or in different cultural settings. Perhaps as a result of this, occupational therapists explain holistic therapy in a variety of ways; for our participants, massaging a hand, treating a back pain, and asking a patient to squeeze a ball are all examples of holistic practice. To justify that this can be a holistic approach, we can turn to Di Stefano saying that treatment is judged to be holistic as long as it is connected or complementary to a broader unity [ 24 ]. In this case, holistic practice can be seen as something that leads to further functional opportunities for the patients.

Significantly, occupational therapists working in both Western and non-Western societies spoke of the link between physical training and holistic practice. This suggests that a dichotomous understanding of Eastern versus Western philosophy and practices does not necessarily make sense in occupational therapy interventions. More relevant is the commitment to practice that is essentially client-centered. As Fisher and Martella [ 13 ] note,

Client-centered practice requires that occupational therapists develop therapeutic rapport and a collaborative relationship with their clients, and then work with their clients in a manner that is respectful of their clients' own perspectives, preferences, values and choices. ([ 13 ], p. 64)

Our final theme captures the challenge implicit in attempting to “see the whole person,” which is indeed a lot to ask. In Finlay's [ 4 ] study, some therapists found the challenge so great as to suggest that holism might be an illusory goal [ 4 ]. Across the world, resources available for occupational therapy are limited, suggesting that asking practitioners to cover “everything” in their effort to be more holistic may be unrealistic. Perhaps in some cases, our services would benefit from some degree of narrowing, when working with physical impairment and illness. We end this discussion with a definition, drawn from the literature of medical rehabilitation. For Akyurek and Bumin, a holistic approach involves “the handling of occupational therapy in all directions of humankind” ([ 11 ], p. 83). This definition is consistent with our analysis, which underlines the multidimensional character of holism and the fact that a holistic approach includes adapting to diverse social understandings of disability and illness. At the same time, this understanding is vague and its meaning is not clear. This raises the following questions: how helpful is our holistic epistemology of “covering everything” to an understanding of what occupational therapy is about? Does it act to support the work of therapists in the field or does it make their work even more complicated?

4.2. Conclusion and Looking Ahead to Future Research

In this study, we have investigated the perspectives of occupational therapists located in different parts of the world regarding their understanding of holism as an epistemology and the ways in which they attempt to apply this philosophy in their work. Our analysis leads us to conclude that holism is a many-faceted and broadly understood term which can be interpreted in a variety of ways, according to cultural and social context, political systems, and economic factors such as resource availability. We look forward to further research on the use of theoretical perspectives within our profession, including core ontological and epistemological ideas of what occupational therapy is all about. We recommend that such researches embrace the performance of occupational therapy in different contexts and cultures.

While not covering all cultures and countries, our study indicates that there are significant variations in occupational therapist's understanding and application of holism. We view our research as a contribution to the ongoing debate around the concept of holism and how we, as occupational therapists, might better incorporate holistic approaches in our practice. If we continue to claim that occupational therapy is a holistic profession, we need to clarify our own understanding of holism—and the extent to which it can inform therapeutic practice across a range of different contexts and circumstances.

Acknowledgments

We would like to thank all the bachelor students in occupational therapy, who participated in this project. The study is funded by the Oslo Metropolitan University and Norwegian University of Science and Technology.

Data Availability

Conflicts of interest.

The authors declare no conflicts of interests.

How Physiotherapy Helps with Chronic Pain Management

Chronic pain is a debilitating condition that affects millions globally. Unlike acute pain, which is a temporary response to injury, chronic pain persists for months or even years, severely impacting daily life and well-being. With the complexity of chronic pain, managing it effectively requires a multifaceted approach. Physiotherapy, with its holistic and patient-centric methods, plays a crucial role in alleviating chronic pain and improving the quality of life for sufferers. In this blog, we’ll explore how physiotherapy helps manage chronic pain, the techniques involved, and practical tips for patients and practitioners.

Understanding chronic pain

Chronic pain is pain that lasts longer than three months, beyond the normal healing period. It can stem from an injury, or illness, or have no apparent cause. Conditions like arthritis, fibromyalgia, and neuropathy often lead to chronic pain. This type of pain affects approximately 20% of adults globally, with a higher prevalence among older adults, women, and those with lower socioeconomic status.

The impact of chronic pain extends beyond physical discomfort. It can lead to emotional distress, anxiety, depression, and social isolation, creating a significant burden on individuals and healthcare systems alike.

The role of physiotherapy in chronic pain management

Physiotherapy adopts a comprehensive approach to managing chronic pain, addressing both physical and psychological components. Unlike treatments that focus solely on symptom relief, physiotherapy aims to identify and treat the underlying causes of pain.

Holistic approach

Physiotherapists assess the patient’s overall health, lifestyle, and emotional well-being. They consider factors such as posture, movement patterns, and muscle imbalances that contribute to pain. This holistic approach ensures that treatment is not only about relieving symptoms but also about improving the patient’s overall function and quality of life.

Customised treatment plans

Every patient is unique, and so is their experience of pain. Physiotherapists create individualized treatment plans based on a thorough assessment. This personalized care helps in targeting the specific needs and goals of each patient, making the management of chronic pain more effective.

Key physiotherapy techniques for chronic pain management

Explore key physiotherapy techniques: manual therapy, exercise therapy, electrotherapy, and education for chronic pain management empowerment.

Manual therapy

Manual therapy includes hands-on techniques such as massage, joint mobilization, and manipulation. These methods help to relieve pain, reduce muscle tension, and improve joint mobility. For example, massage can increase blood flow to affected areas, promoting healing and reducing pain.

Exercise therapy

Exercise therapy is fundamental in chronic pain management. Tailored exercises help strengthen weak muscles, improve flexibility, and enhance overall physical fitness. Regular exercise can also stimulate the release of endorphins, the body’s natural painkillers, helping to reduce pain and improve mood.

Example exercise : Stretching exercises for the lower back can alleviate chronic back pain by reducing muscle tightness and improving range of motion.

Electrotherapy

Electrotherapy involves using electrical stimulation to reduce pain. Techniques like Transcutaneous Electrical Nerve Stimulation (TENS) and ultrasound therapy can modulate pain signals and promote tissue healing. TENS, for instance, works by sending small electrical impulses through electrodes placed on the skin, which can block pain signals from reaching the brain.

Education and self-management

Patient education is crucial in empowering individuals to manage their pain. Physiotherapists guide posture, ergonomics, and lifestyle modifications. Teaching patients how to manage their condition, avoid triggers, and use pain-relief techniques helps them take an active role in their recovery.

Case studies and success stories

These case studies highlight how tailored physiotherapy programs can significantly improve chronic pain management outcomes.

Case Study 1: Chronic back pain

Patient profile. A 45-year-old office worker with chronic lower back pain due to prolonged sitting and poor posture.
Treatment plan. The physiotherapist designed a program including core strengthening exercises, ergonomic adjustments to the workplace, and manual therapy for muscle relaxation.
Outcome. After three months, the patient reported significant pain reduction, improved posture, and enhanced mobility.

Case Study 2: Fibromyalgia

Patient profile. A 35-year-old woman diagnosed with fibromyalgia, experiencing widespread pain and fatigue.
Treatment plan. A combination of gentle stretching exercises, relaxation techniques, and patient education on energy conservation and pain management.
Outcome. Over six months, the patient showed improved pain tolerance, better sleep, and increased participation in daily activities.
Lessons learned. These cases illustrate that with the right treatment plan, physiotherapy can provide substantial relief and functional improvements, even in complex chronic pain conditions.

Benefits of physiotherapy in chronic pain management

Physiotherapy enhances life by reducing pain, restoring mobility, and fostering mental well-being in chronic pain management.

Pain reduction. Physiotherapy employs various techniques that target pain at its source, reducing the reliance on pain medications. Techniques like manual therapy and exercise can significantly alleviate pain.
Enhanced mobility. Chronic pain often restricts movement. Physiotherapy helps improve flexibility, strength, and joint function, allowing patients to regain their mobility and perform daily activities with less discomfort.
Improved quality of life. Effective pain management through physiotherapy can lead to better mental health, increased social interaction, and a higher overall quality of life. Patients often experience reduced anxiety and depression, contributing to their overall well-being.

Practical tips for managing chronic pain

Empower yourself through consistency, lifestyle adjustments, and patient education for effective chronic pain management.

Consistency. Consistency in following the prescribed exercise and treatment plan is crucial. Regular practice helps in maintaining progress and preventing relapses.
Lifestyle modifications. Adopting a healthy lifestyle can influence pain levels. Recommendations include maintaining a balanced diet, ensuring adequate sleep, and managing stress through techniques like mindfulness and relaxation exercises.
Patient empowerment. Encouraging patients to take control of their condition through self-management strategies fosters independence and resilience. Educating patients about their condition and involving them in the treatment process enhances their commitment to managing pain effectively.
Collaboration with other healthcare professionals. In chronic pain management, collaboration among physiotherapists, doctors, psychologists, and others ensures comprehensive, holistic care for patients.
Multidisciplinary approach. Chronic pain management often requires collaboration between physiotherapists, doctors, psychologists, and other healthcare providers. A multidisciplinary approach ensures comprehensive care, addressing all aspects of the patient’s condition.
Referral process. Knowing when to refer patients to other specialists is essential. Physiotherapists should collaborate with healthcare professionals to provide a holistic treatment plan that includes medical, psychological, and physical interventions.

Future trends in physiotherapy for chronic pain

Physiotherapy is advancing with technologies like virtual reality and wearables, and new research is continually refining pain management strategies.

Technological advancements

Emerging technologies like virtual reality and wearable devices are revolutionizing chronic pain management. Virtual reality can provide immersive environments for therapeutic exercises, while wearable devices offer real-time feedback on physical activity and pain levels.

Research and innovation

Ongoing research in physiotherapy is continually enhancing our understanding of pain mechanisms and treatment strategies. Staying updated with the latest studies and innovations helps physiotherapists adopt evidence-based practices.

Physiotherapy plays a pivotal role in managing chronic pain, offering a holistic and personalized approach to treatment. By incorporating techniques such as manual therapy, exercise, and patient education, physiotherapists can significantly reduce pain and improve patients’ quality of life. For those suffering from chronic pain, seeking physiotherapy can be a transformative step toward regaining control over their lives.

Julian Carter , a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.

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School-based team sports as catalysts for holistic student wellness: a narrative review.

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Kang, X.; Meng, Q.; Su, C.-H. School-Based Team Sports as Catalysts for Holistic Student Wellness: A Narrative Review. Behav. Sci. 2024 , 14 , 528. https://doi.org/10.3390/bs14070528

Kang X, Meng Q, Su C-H. School-Based Team Sports as Catalysts for Holistic Student Wellness: A Narrative Review. Behavioral Sciences . 2024; 14(7):528. https://doi.org/10.3390/bs14070528

Kang, Xiaolei, Qing Meng, and Chun-Hsien Su. 2024. "School-Based Team Sports as Catalysts for Holistic Student Wellness: A Narrative Review" Behavioral Sciences 14, no. 7: 528. https://doi.org/10.3390/bs14070528

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Holistic Therapy: Healing Mind, Body, and Spirit

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Expressive therapies

Yoga therapy

Recreational therapy

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1. Mind–body connection healing

2. Autonomy and empowerment

3. Emphasis on prevention

4. Limited side effects

5. Cost effective

17 Top-Rated Positive Psychology Exercises for Practitioners

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2. Eastern Body, Western Mind: Psychology and the Chakra System As a Path to the Self – Anodea Judith

3. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma – Bessel van der Kolk

4. Holistic Health: Healing Therapies for Optimal Wellness – Larry Trivieri and The American Holistic Medical Association

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A case study of depression: A holistic exploration through the lens of biopsychosocial dynamics

Introduction

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Family assessment device

Social adaptive functioning evaluation

Self-Esteem scale

Family questionnaire

Background of the case presentation

Outcome of the case