While complementary therapies is the term preferred by the authors for therapies that are not a part of conventional Western biomedicine, numerous other terms are also used: alternative medicine/therapies, integrative medicine or health care, holistic care, non-allopathic treatments, and non-traditional care. The title selected by the National Institutes of Health for its department on non-biomedical therapies is the National Center for Complementary/Alternative Medicine (NCCAM) www.nccam.nih.gov.

The term complementary has been preferred as it conveys that these therapies are used in conjunction with, rather than as replacement for, a biomedical treatment. The designator alternative conveys that a therapy is used in place of a biomedical treatment.

The term complementary has been preferred as it conveys that these therapies are used in conjunction with, rather than as replacement for, a biomedical treatment. The designator alternative conveys that a therapy is used in place of a biomedical treatment.

For example, progressive muscle relaxation would be added to the treatment of persons with epilepsy rather than used as a replacement for antiepileptic medications. (Studies have shown that use of progressive muscle relaxation improves control of seizures [Whitman, Dell, Legion, Eibhlyn, & Staatsinger, 1990.]) However, complementary therapies are also used alone and not in conjunction with biomedical therapies. This is particularly true when these therapies are used to promote health. For example, persons

may obtain massage on a routine basis to prevent the build up of stress.

Integrative care conveys that the system of care incorporates both biomedical and complementary therapies and that the two types of therapies are both considered when planning the care of patients. This term is also used to denote to consumers that both types of therapies are available in a facility. Integrative care more readily applies to medicine than to care provided by other health professionals as some complementary therapies have been an integral part of care provided by these professions over the years.

Holistic therapies is another term that is used to designate non-biomedical therapies. Cartesian philosophy has dominated Western medicine for several centuries. According to this philosophy, the mind and body are separated and do not affect each other; little attention is given to spiritual or social aspects of patients. Eastern health practices and the increasing body of research on psychoneuroimmunology reveal the interactive processes in humans with the mind, body, and spirt influencing the well-being of the entire person. The NCCAM has designated a category of therapies as mind-body therapies; however, a holistic philosophy underpins the majority of complementary therapies. While many biomedical treatments affect the entire person, attention has largely focused on the impact that the therapy has on the eradication or management of a physical problem. When an antihypertensive medication is prescribed, only the blood pressure is evaluated to determine the impact of the medication; minimal attention is given to how the medication affects the spiritual and psychological realms. In contrast to the Cartesian philosophy of medicine, nursing has espoused a holistic approach to persons and health care.

Finding a definition that encompasses the vast domain of therapies and systems of care has proven to be a challenge. A number of definitions for complementary/alternative therapies have been proposed. An interdisciplinary panel established by the Center for Complementary/Alternative Medicine in the National Institutes of Health proposed the following definition:

Complementary/alternative therapy is a broad domain of healing resource that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and the domain of the dominant health system are not always sharp and fixed (Panel on Definition and Description, 1997 ).

The definition uses the term complementary medicine, but the word "medicine" can arguably be changed to "therapies".

Efforts have been made to classify the more than 1800 identified complementary therapies. Similar to the development of a definition for complementary therapies, classifying these therapies is a daunting task since entire systems of care, therapies that are quite widely known and used, variations of these therapies, and practices of indigenous cultures that are largely unknown in the western world are encompassed within the domain of complementary therapies. The underlying mechanism of action for many therapies is unknown, thus providing additional challenges to the development of a classification schema.

The NCCAM has proposed the following categories for complementary therapies: mind-body therapies, alternative health care systems, biological-based therapies, manipulative and body-based therapies, and energy therapies that encompass therapies originally included in the biofield and bioelectromagnetic categories. Table 1 provides a description and examples of therapies in each category. NCCAM has noted that once a complementary therapy has become an accepted treatment for a specific condition it should no longer be classified as being a complementary therapy. This reference, however, is in terms of Western biomedicine. Many of these therapies are an integral part of other systems of health care and of other professions, such as nursing. NCCAM also notes that the boundaries between CAM and the dominant health care system are constantly changing and what may be deemed complementary at one point in time may subsequently be recognized as part of mainstream health care at a later date. This designation usually occurs when research has established that the therapy has proven to be efficacious through the use of randomized clinical trials.

The philosophical base underlying the use of many complementary therapies differs from the conventional Western biomedical model. While biomedicine seeks to

The philosophical base underlying the use of many complementary therapies differs from the conventional Western biomedical model. While biomedicine seeks to eliminate or correct the underlying problem, the purpose for using therapies in other systems of health care system is to achieve harmony and balance in the person.

eliminate or correct the underlying problem, the purpose for using therapies in other systems of health care system is to achieve harmony and balance in the person. Zollman and Vickers (1999) state: According to most complementary practitioners, the purpose of therapeutic intervention is to: restore balance and facilitate the body’s own healing responses rather than to target individual disease processes or stop troublesome symptoms. They may therefore prescribe a package of care, which would include modification of lifestyle, dietary change, and exercise as well as a specific treatment. Thus, a medical herbalist may give counseling and an exercise regimen, guidance on breathing and relaxation, dietary advice, and a herbal prescription (p. 694).

It is the philosophy that underlies the use of complementary therapies that appears to be of equal importance as the therapies themselves.

Merely adding additional therapies to a system of care without implementing a holistic, caring approach to the care of patients will do little to improve health care.

Merely adding additional therapies to a system of care without implementing a holistic, caring approach to the care of patients will do little to improve health care.