Introduction to complementary and alternative medicine, herbal medicines and medical marijuana, and animal-assisted therapy — highest-yield facts only.
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| Conventional healthcare | Professionals treat symptoms and disease using DRUGS, RADIATION, or SURGERY. Also called allopathic, biomedicine, mainstream, orthodox, and Western medicine. |
| Complementary medicine | A non-conventional approach used TOGETHER WITH conventional medicine. The therapy itself does not decide this — whether conventional care continues does. |
| Alternative medicine | A non-conventional approach used IN PLACE OF conventional medicine. This is the higher-risk pattern the counseling checklist screens for. |
| Integrative medicine | Patient-centered, whole-person care combining conventional medicine with evidence-based complementary therapies. Emphasizes wellness, prevention, and the therapeutic relationship. |
| Functional medicine | Whole-person approach focused on underlying CONTRIBUTORS to disease: lifestyle, nutrition, environment, genetics, psychosocial factors. An approach to practice, usable by physicians, physician assistants, and nurse practitioners. |
| Functional vs naturopathic | Functional medicine is a WAY CLINICIANS PRACTICE. Naturopathic medicine is a PROFESSION with its own philosophy and training, practiced by naturopathic doctors. |
| Hippocrates | “Father of Medicine.” Credited with “Let food be thy medicine.” |
| National center (NCCIH / formerly NCCAM) | Federal lead agency for scientific research on complementary and integrative health. Sits within the NIH, under Health and Human Services. Researches safety, effectiveness, and mechanisms; provides evidence-based information. Does NOT license, approve products, or accredit. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| 6 reasons for popularity | Perceived natural/safe; desire for control; dissatisfaction with conventional outcomes; interest in holistic care; easy access; value on practitioner time and relationship. |
| The disclosure gap | Many patients do not disclose unless asked. Some think providers will disapprove; others DO NOT CONSIDER SUPPLEMENTS OR HERBS TO BE “MEDICATIONS.” Ask specifically, nonjudgmentally. |
| Clinician role | Open nonjudgmental dialogue; routinely ask; evaluate with best available evidence; direct to reliable sources (the national center, NIH, CDC, peer-reviewed literature); monitor herb-drug and supplement-drug interactions. |
| Counseling checklist | Is there research? Does it require stopping conventional treatment? Substantial side effects? Unfounded claims (e.g. curing cancer)? Travel to another country? State-licensed for that therapy? Offered by an established institution? How expensive / out-of-pocket? |
| Most-used approaches (2012 survey) | Natural products 17.7% > deep breathing 10.9% > yoga/tai chi/qi gong 10.1% > chiropractic or osteopathic manipulation 8.4% > meditation 8.0%. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| The five domains | (1) Whole medical systems (2) Mind-body medicine (3) Biologically based practices (4) Manipulative and body-based practices (5) Energy therapies. |
| The stated caveat | Commonly used for teaching, but MANY THERAPIES OVERLAP CATEGORIES. Current efforts emphasize evaluating evidence, safety, and effectiveness of specific practices over classification. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| Definition | Complete systems with their own philosophy and explanation of disease, diagnosis, and therapy, evolved SEPARATELY from conventional medicine. Examples: Ayurveda, homeopathy, naturopathy, traditional Chinese medicine. |
| Ayurveda | Traditional system of India. Sanskrit ayur (life) + veda (knowledge/science). Health = balance of the doshas; illness = imbalance. Treats with diet, herbs, massage, meditation, yoga, internal cleansing. |
| The 3 doshas | VATA = space/ether + air → movement, circulation, communication. PITTA = fire + water → digestion, metabolism, temperature. KAPHA = water + earth → structure, stability, lubrication. |
| Ayurveda safety | Some preparations contain metals, minerals, or gems. 1 IN 4 supplements tested had high LEAD; ALMOST HALF had high MERCURY. FDA warns some products may be harmful. |
| Homeopathy origin | Germany, late 1700s. Greek homeo (like) + pathos (disease). |
| Law of similars | “Like cures like” — a substance producing symptoms in the healthy treats those symptoms in illness. Example: cutting onions → burning teary eyes, runny nose → Allium cepa for colds/hay fever. |
| Law of minimum dose | The LOWER the dose, the GREATER the effect. Repeated dilution and shaking = SUCCUSSION. Sources: plants (red onion, poison ivy, belladonna), minerals (arsenic), animals (crushed whole bees). |
| Homeopathy evidence | Theories not consistent with established chemistry, pharmacology, biology. Little convincing evidence for most conditions. CAUTION: some products labeled homeopathic are NOT highly diluted and may contain substantial active ingredient. |
| Naturopathy | Founded on the healing power of nature; body's inherent capacity to heal. Finds the CAUSE rather than treating symptoms. Uses hydrotherapy, dietary counseling, supplements, herbs, acupuncture, physical and mind-body therapies, exercise. |
| Traditional Chinese medicine | Qi (“chee”) = vital force flowing along MERIDIANS. Disease = disrupted/imbalanced Qi. Health = balance of YIN and YANG. Five elements: EARTH, FIRE, WATER, WOOD, METAL. Practices: acupuncture, herbal medicine, dietary therapy, massage, tai chi, qigong. |
| TCM safety | Some Chinese herbal products contain HEAVY METALS, PESTICIDES, and MICROORGANISMS. Evidence varies by product and condition. Consider herb-drug interactions. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| Definition & uses | Interactions between BRAIN, MIND, BODY, and BEHAVIOR and their influence on health. Used for chronic pain, anxiety and stress disorders, insomnia, headache, cancer-related symptoms. |
| Biofeedback | Principle: “ANYTHING THAT CAN BE MEASURED CAN BE CHANGED.” Electronic monitoring of heart rate, blood pressure, muscle activity, skin temperature, breathing, brain activity. GOAL = self-regulation WITHOUT the equipment. |
| Biofeedback types | ELECTROMYOGRAPHIC: skin sensors detect muscle-tension electrical activity → tension headache, migraine, rehabilitation, pelvic floor dysfunction. BREATHING: chest/abdomen sensors → anxiety, stress; develops diaphragmatic breathing. |
| Guided imagery vs visualization | VISUALIZATION = “seeing” images in the mind's eye. GUIDED IMAGERY = uses ONE OR MORE SENSES to create a detailed mental experience. May reduce stress, anxiety, pain. |
| Hypnosis | Focused attention + reduced peripheral awareness + enhanced response to suggestion. NOT SLEEP. Mechanism poorly understood; responsiveness varies. |
| Hypnosis indications | Acute/chronic pain, anxiety, stress, phobias, irritable bowel syndrome, nausea and vomiting, procedure-related distress, habit disorders, insomnia, childbirth support. |
| Hypnosis myths | NOT only entertainment; people do NOT lose consciousness or memory; the therapist does NOT control the patient; it is NOT sleep. |
| Meditation | Intentionally focusing attention and awareness. TRANSCENDENTAL = silent MANTRA, 20 MINUTES TWICE DAILY. MINDFULNESS = present-moment awareness WITHOUT interpretation or judgment. |
| Relaxation therapy | Promotes the relaxation response, counteracting stress: SLOWER BREATHING, DECREASED HEART RATE, LOWER BLOOD PRESSURE. Techniques: progressive muscle relaxation (tense/relax groups), guided imagery. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| The four practices | Botanical medicine, natural products and supplements, chelation therapy, diet therapies. |
| Botanical medicine | Plants or plant extracts used medicinally — plant materials, algae, macroscopic fungi. Forms: tea, powder, tablet, capsule, elixir, topical, injection. (Opiates from poppy, digoxin from foxglove, vincristine from periwinkle.) |
| Dietary supplements | Among the MOST COMMONLY USED complementary approaches; available without prescription. Vitamins, minerals, probiotics, botanicals, specialty products. Often used without telling clinicians — consider adverse effects and drug-supplement interactions. |
| Chelation mechanism & uses | Chelating drugs BIND METALS and ENHANCE THEIR EXCRETION. Established: lead poisoning, iron overload, other heavy metal toxicity. Exposures: LEAD (old paint, plumbing), ARSENIC (well water, rice), MERCURY (fish). |
| Chelation controversy | EDTA infusions marketed for cardiovascular disease: evidence LIMITED and CONTROVERSIAL; NOT a substitute for evidence-based treatment. Risks: kidney injury, hypocalcemia, infusion-related complications. |
| Diet therapies | Mediterranean, plant-based, intermittent fasting. May support prevention/management of chronic disease. Evidence varies by pattern and condition; weigh nutritional adequacy and patient-specific factors. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| Definition | Focus on the MUSCULOSKELETAL SYSTEM AND SOFT TISSUES — bones, joints, muscles, connective tissue — using hands-on technique to improve function and reduce pain. |
| Chiropractic | Diagnosis and management of musculoskeletal conditions, PARTICULARLY THE SPINE. Spinal manipulation plus exercise therapy, rehabilitation, heat/cold, massage, lifestyle counseling. |
| Doctor of osteopathic medicine | A FULLY LICENSED PHYSICIAN — prescribes, performs procedures, practices any specialty. Four years of medical school plus residency, with extra musculoskeletal and osteopathic training. OMT commonly for low back and neck pain. |
| Cupping | Vacuum created inside a cup on the skin; suction ELEVATES skin and underlying tissue. Thought to increase local blood flow. Evidence limited; benefits primarily SHORT TERM. |
| Massage | Manipulation of the body's soft tissues; practiced in most cultures throughout history. Types: Swedish, deep tissue, hot stone. |
| Reflexology | Pressure to specific areas of the FEET, HANDS, or EARS believed to correspond to organs or body systems. Evidence limited and inconsistent. |
| Gua sha | Also SCRAPING, COINING, SPOONING. Repeated strokes with a smooth-edged instrument. May increase local blood flow and reduce muscle tension. Used for neck and back pain; evidence limited. |
| Term | What you need to know |
|---|---|
| Term | What you need to know |
| Basis | Belief that BIOFIELDS (energy fields) influence health and healing; traditions describe a vital life force such as Qi. The EXISTENCE AND CLINICAL SIGNIFICANCE OF SUBTLE BIOFIELDS HAVE NOT BEEN CONCLUSIVELY DEMONSTRATED scientifically. |
| Acupuncture | Thin needles inserted at specific points. In TCM, stimulation influences the flow of Qi along meridians. Modern research suggests it may influence PAIN-PROCESSING PATHWAYS; benefits selected pain and symptom-management uses. |
| Reiki | Biofield therapy; practitioners believe energy is directed THROUGH THE HANDS, placed lightly on or just above the body. Used for relaxation, stress reduction, well-being. Evidence limited and inconclusive. |
| Tai chi | Slow controlled movements + breathing + focused attention, based on balancing Qi. “MEDITATION IN MOTION.” May improve BALANCE, physical function, and well-being. |
| Term | What you need to know |
|---|---|
| DSHEA 1994 | Defined dietary supplement and dietary ingredient. Regulates herbs as dietary supplements, NOT as drugs, and only after they are on the market. Required ingredient and nutrition labeling; gave FDA authority for good manufacturing practice rules, which are not rigorously adhered to. |
| What DSHEA does not do | No standardized purity or bioavailability guarantees. No requirement to report adverse effects. Supplements are not “drugs”, so FDA oversight is far less than for over-the-counter drugs. |
| Efficacy claims | Cannot make drug efficacy claims — label must state claims have “not been evaluated or approved by the Food and Drug Administration.” |
| Advertising complaints | False or misleading advertising and adverse events go to the Federal Trade Commission (FTC), not the FDA. |
| Market size | Supplement sales exceed $150B worldwide and over $50B in the US (2021). Most common alternative therapy in use today. |
| Counterfeits and sourcing | FDA estimates 2 of every 3 supplements sold online is counterfeit. After the first office purchase, 1 in 3 patients refills from Amazon or another online retailer. |
| Why potency varies | Climate, soil, where grown/harvested/stored, and batch differences. Products may contain heavy metals, unlabeled prescription drugs, or toxic plants. |
| Evidence quality | Most studies low quality — small samples, flawed statistics, possibly exaggerated findings, and tested products may not match what patients buy. Always ask who funded it. |
| WHO usage estimate | WHO (2006) estimates 80% of the world's population relies on herbal medicine. US herb use quadrupled from 3% to 12% by 1998. |
| Term | What you need to know |
|---|---|
| Vocabulary | Botanical = substance from part of a plant (bark, roots, leaves). Herbalism = study/practice of using plant material. Phytotherapy = the European term. Teas and tinctures are rapidly absorbed; tinctures contain alcohol. |
| Most common products | Fish oil is the most common natural product (2012 NCCIH). Multivitamins and minerals are the most widely used supplements overall — one per day, not with milk or antacids. |
| Drugs from plants | Morphine (opium poppy), digitalis/digoxin (foxglove), reserpine (rauwolfia), aspirin (willow bark), quinidine (cinchona), vinca alkaloids (periwinkle). |
| Fish oil / omega-3 | DHA more for blood pressure, cognition, fetal brain and eye development; EPA more for inflammation and vasodilation. Both reduce platelet aggregation. Mercury purity is the concern. |
| Joint supplements | Glucosamine from proteins and shellfish — avoid in shellfish allergy. Chondroitin from animal cartilage. MSM mainly for osteoarthritis, no identified contraindications, caution in sulfa allergy. |
| Liver herbs | Milk thistle (silymarin) for toxic/inflammatory liver disease, cirrhosis, hepatitis C — antioxidant, anti-inflammatory, antifibrotic. Burdock, chicory and dandelion stimulate bile flow; dandelion is a source of iron, potassium and zinc. |
| Antioxidant / detox cluster | Alpha lipoic acid recycles CoQ10, vitamins C and E, chelates mercury/lead/arsenic, 600–1,200 mg daily in diabetes and neuropathy studies. N-acetylcysteine = glutathione precursor, antioxidant, mucolytic, used for acetaminophen toxicity. Glutathione = cysteine + glycine + glutamine; power is in the sulfur. |
| Coenzyme Q10 | Essential to mitochondrial function, densest in cardiac tissue, declines with age. Ubiquinol (reduced) absorbs up to 8× better than ubiquinone (oxidized). |
| Adaptogens | Natural substances that help the body adapt to stress, restore endocrine balance, modulate immunity and maintain homeostasis. Brekhman & Dardymov 1968: a “normalizing influence on physiology, irrespective of the direction of change.” |
| Symptom-targeted herbs | St. John's Wort (depression, anxiety, sleep); echinacea (colds — may reduce chance of illness, not its length); chamomile/lavender/lemon balm (sleep, anxiety); peppermint (digestive, IBS); saw palmetto (BPH, a 5-alpha-reductase inhibitor; NIH found no benefit); capsaicin (topical pain via reduced substance P); arnica (musculoskeletal pain, bruising). |
| Term | What you need to know |
|---|---|
| St. John's Wort | CYP3A4 INDUCER — increases metabolism and reduces effect of antidepressants, birth control pills, cyclosporine, digoxin, indinavir, irinotecan, phenytoin, phenobarbital, warfarin. May increase photosensitivity. |
| Bleeding risk | Vitamin K, fish oil and “blood moving” herbs increase warfarin's anticoagulant effect → bleeding. Garlic thins blood like aspirin. Evening primrose oil may increase bleeding on warfarin. |
| Green tea (opposite direction) | Contains small amounts of vitamin K, making warfarin LESS effective. Also contains EGCG. |
| Chemotherapy | Antioxidants such as vitamins C and E may reduce the effectiveness of some chemotherapy. |
| Absorption effects | Flaxseed can slow absorption of ALL medications. Multiminerals: no salt substitutes (elevated potassium). |
| Blood glucose | Milk thistle may lower blood sugar — caution in diabetes/hypoglycemia or on glucose-altering drugs. Glucosamine interacts with diabetic agents including insulin. |
| Do-not-use lists | Echinacea: avoid in autoimmune disorder, anxiety/depression, asthma, cancer, migraines, seizures (interaction risk itself is low). Black cohosh: stop for liver disorder or abdominal pain, dark urine, jaundice. |
| Pediatric warning | Peppermint oil must not be applied to the face of infants or young children — inhaled menthol can cause serious effects. |
| Statins ↔ CoQ10 | Statins and diabetic medications lower CoQ10; one study showed a nearly 40% fall in plasma CoQ10. |
| Taking the history | Patients may not disclose: they assume “natural” is harmless and fear the provider will be skeptical. Prescriber ignorance is usually reluctance/disapproval, not absent data. Extra caution in pregnancy/lactation, children (weight-based dosing) and elderly polypharmacy. |
| Counseling stance | Do not discount supplements from personal bias — patients will use them. Facilitate communication, warn about interactions, recommend high-quality products over the cheapest, and use high-quality evidence (“googling can lead you astray”). |
| Term | What you need to know |
|---|---|
| Endocannabinoid system | Two G-protein coupled receptors, CB1 and CB2, plus regulatory enzymes. Modulates pain, seizure threshold, appetite, digestion, mood; may affect intraocular pressure. |
| Receptor locations | CB1: central nervous system and throughout the brain (psychoactive effects), also immune, GI, reproductive, adrenal, heart, lung, bladder. CB2: mainly the immune system. |
| Δ9-THC | Partial agonist at both CB1 and CB2 but HIGHER AFFINITY FOR CB1. First-pass metabolism produces 11-hydroxy-THC — longer lasting and MORE psychoactive. |
| CBD | Major non-psychotropic cannabinoid. Anti-anxiety, anti-nausea, anti-arthritic, anti-epileptic, anti-psychotic. CB2 agonist. Reduces THC psychoactivity by ALTERING CB1 SHAPE. |
| CBD other sites | 5-HT1A (anxiolytic/antidepressant), desensitizes TRPV1, increases adenosine signaling, GPR55 antagonist, GABA-A. |
| Phytocannabinoids | More than 100 discovered in the cannabis flower; only a few characterized in depth, mainly Δ9-THC and CBD. Terpenes give smell and may have an effect. |
| Dosing | No set dosing — principle is LOW AND SLOW; some recommend 4 mg three times daily and titrate. Over 10 mg THC at once can produce euphoria. |
| Interactions | Few data; predictions rest on cytochrome P-450. Caution with narrow therapeutic windows. Expect interaction with sympathomimetics, CNS depressants and anticholinergics — alcohol, benzodiazepines, SSRIs, zolpidem. |
| Term | What you need to know |
|---|---|
| Legal nature (Florida) | Law passed November 2016. State-approved but still ILLEGAL FEDERALLY. It is a physician RECOMMENDATION, not a prescription, and is for HOME USE ONLY. |
| Qualifying conditions | Cancer, epilepsy, glaucoma, HIV/AIDS, PTSD, ALS, Crohn disease, Parkinson disease, multiple sclerosis; comparable conditions; terminal condition diagnosed by a physician OTHER than the certifying one; chronic nonmalignant pain from a qualifying condition. |
| Supply limits (2023) | Certified for three 70-day supplies, or six 35-day supplies for smoking only. Aggregate THC cannot exceed 350 mg/day or 24,500 mg per 70-day supply for non-smoking routes. |
| Daily route limits | Edibles 60 mg · Inhalation 350 mg · Oral 200 mg · Sublingual 190 mg · Suppository 195 mg · Topical 150 mg · Smokable flower 2.025 g (2.5 oz per 35 days). |
| Oral vs inhalation | Oral: onset 10–30 min, lasts 6–8 h, good for chronic effect, poor in malabsorption. Inhalation: onset 60–90 sec, lasts ~2 h, good for breakthrough, poor in COPD or inhalant-triggered asthma. |
| Strain types | High CBD = universal (AC/DC, Remedy, Pennywise). Sativa = uplifting, daytime. Indica = relaxing, sleep. Hybrid = mixture. |
| Adverse effects | Relatively positive profile: headache, dry eyes, dry mouth, dizziness, lightheadedness, numbness, cough. Serious effects rare, low-to-moderate dependence, active dose far below lethal dose. High CBD → somnolence, decreased appetite, diarrhea, fatigue. High THC → anxiety, cholinergic deficits, immunosuppression. |
| Contraindications | ABSOLUTE: acute psychosis, unstable psychiatric conditions, hypersensitivity to cannabis/safflower oil. RELATIVE: severe cardiovascular, immune, liver or kidney disease. Can exacerbate arrhythmia, worsen bronchitis/pneumonia; possible link to MI, stroke, PVD. |
| Rimonabant | CB1 BLOCKER approved in Europe 2006 as an anti-obesity drug, withdrawn 2009 for depression, anxiety and suicidal ideation. Never approved in the US. |
| Evidence and candidacy | 2015 meta-analysis: RCTs for chemotherapy nausea/vomiting, appetite in HIV/AIDS, chronic pain, MS spasticity, depression, anxiety, sleep, glaucoma — mostly MODEST improvement. JAMA 2015 candidate: debilitating condition with RCT support, multiple failed 1st/2nd-line agents, failed FDA-approved cannabinoid (dronabinol, nabilone), no active substance abuse or unstable psychiatric disorder. Not first line. |
| Cannabinoid hyperemesis | Major: cyclical nausea/vomiting, COMPULSION TO BATHE IN HOT WATER, daily use >3 years, mild abdominal pain. Minor: age <50, morning predominance, normal bowel habits, negative workup. Refractory to antiemetics — needs haloperidol or droperidol; stopping takes weeks due to FAT DEPOSITS. |
| Term | What you need to know |
|---|---|
| Definition | A GOAL-DIRECTED intervention in which the animal is used during the treatment process to aid achievement of therapeutic goals. |
| History | 600 BC ancient Greeks, horse-assisted therapy for the incurably ill · 1860 Florence Nightingale, small companion animals (birds) for the chronically ill · 1867 Germany, birds/cats/dogs/horses in a disability community · late 1800s horse research on PHYSICAL recovery · 1919 first US use, dogs for soldiers with PTSD · 1944 Pawling Convalescent Hospital, NY veterans with farm animals and dogs. |
| Companion animal | A pet. NO special training to help cope with a disability. For company, amusement, psychological support, extrovert display. |
| Emotional support animal | Usually cat or dog, may be turtle, horse or rabbit. Provides emotional comfort, companionship, friendship, affection. TRAINING NOT REQUIRED BY LAW. A licensed healthcare or mental health professional may recommend one. |
| ESA letter | Written by a physician or licensed mental health professional, documenting need as part of MENTAL HEALTH TREATMENT. Required for Fair Housing Act protection. Landlord may not charge a pet fee, enforce breed restrictions, deny housing, or evict. |
| Florida Statute 817.265 | Falsifying ESA documentation or misrepresenting a disability-related need = MISDEMEANOR OF THE SECOND DEGREE, plus 30 hours community service within 6 months of conviction. |
| Service animal (ADA) | A DOG individually trained to do work or perform tasks for a person with a disability (physical, sensory, psychiatric, intellectual or other mental). Trained MINIATURE HORSES must be allowed as a reasonable modification. |
| ESA vs service animal | Emotional support and comfort animals are NOT service animals under Titles II and III of the ADA. December 2020 Department of Transportation rule: a service animal is a dog individually trained for a person with a disability, and an ESA is no longer a service animal for air travel. |
| The two permitted questions | Is the dog a service animal required because of a disability? What work is the dog trained to perform? Professional training is NOT required — handlers may train the dog themselves. ANY breed may serve. A hospital must generally allow the animal wherever patients and the public may go. |
| Term | What you need to know |
|---|---|
| Guide / Seeing Eye dog | Navigation and environmental awareness for people who are blind or visually impaired. |
| Hearing or signal dog | Alerts a person with significant hearing loss or deafness when a sound occurs, e.g. a knock at the door. |
| Psychiatric service dog | Detects onset of psychiatric episodes (panic, anxiety). Cues: pacing, tremors, changed breathing, repetitive behaviors. Responses: nudging, retrieving medication, guiding to safety. Tasks: medication reminders, safety checks/room searches, interrupting self-injury, assisting the disoriented. |
| Sensory signal dog (SSigDOG) | For autism spectrum disorder — distracts repetitive movements such as hand flapping with an unobtrusive signal like a discreet nudge. |
| Seizure response dog | Barks to alert a caregiver, presses alarm buttons or pre-programmed devices, stays beside the person to prevent injury, stands next to them to break a fall. |
| Why horses | Sentient beings; PREY animals, highly aware of surroundings; social herd animals that MIRROR emotions (calm = calm); establish boundaries; seek a leader they trust. Exquisitely sensitive to how we present ourselves and to nonverbal cues. |
| Hippotherapy | Greek hippos = horse. American Hippotherapy Association: a physical, occupational or SPEECH therapy treatment strategy using equine movement. Gives BILATERAL RHYTHMIC STIMULATION mimicking the human gait; benefits neural and motor pathways. For neuromotor and sensory dysfunction — autism, neuromuscular disorders, cerebral palsy. |
| Hippotherapy certification | OT, PT and speech-language pathology professionals via the American Hippotherapy Association: 3 years (6,000 hours) in practice, ≥100 hours of hippotherapy in the previous 3 years, and a passed multiple-choice examination. |
| Equine-assisted psychotherapy | MENTAL HEALTH TREATMENT — mental-health therapist PLUS an equine specialist. For anxiety, PTSD, antisocial disorders, grief and loss, ADHD. May improve trust and secure attachment in traumatized youth. Horse provides feedback and mirroring; non-judgmental, unbiased. |
| Horsemanship as therapy | Feeding, watering, exercising and grooming establish routine and structure; caring for and nurturing something else builds empathy. |
| Equine-facilitated learning | EXPERIENTIAL LEARNING for educational, professional and personal goals. Builds trust, honesty, connection, self-regulation, self-confidence, leadership, self-awareness. Used for groups and corporate team building. |
| EAP vs EFL (the key table) | Mental health treatment vs educational/skill development · therapist vs instructor/facilitator · psychological disorders vs leadership and life skills · CLINICAL goals vs LEARNING goals · patient/client vs participant/learner. |
| Certifying bodies | PATH International (Professional Association of Therapeutic Horsemanship International) and Eagala. Medical education: Dr. Allan Hamilton's “From Barnyard to Bedside”, University of Arizona College of Medicine, for nonverbal communication and bedside manner. |
| Term | What you need to know |
|---|---|
| Origin | ~4,000 years, part of Traditional Chinese Medicine. Yellow Emperor's book of internal medicine ~200 BC. ~350 points by 300 AD. |
| James Reston, 1971 | New York Times journalist; acute appendicitis in China; acupuncture + moxibustion for post-op pain, needles in LEFT arm and LEFT leg. Brought acupuncture to US attention. |
| US scale | >6.5% of adults have used it · >10 million treatments/yr · >103 countries · >38,000 licensed acupuncturists · 47 of 50 states license. |
| Five branches of TCM | Acupuncture · herbalism · massage/tuina · diet/nutrition · movement (Tai Chi Chuan, Qigong). |
| Yin / Yang | INTERDEPENDENT, INTERCONSUMING, INTERTRANSFORMING. Tao gives rise, through their polarity, to the flow of Qi. Yin = hypoactive, quiet, pale, moon, winter. Yang = hyperactive, loud, bright, sun, summer. |
| Illness | A disturbance of Qi and disharmony between yin and yang. Treatment REBALANCES them; prevention is paramount. |
| Five constituents | Qi (energy) · Xue (blood) · Jin Ye (body fluids) · Jing (life essence) · Shen (spirit). |
| Meridians | Paths Qi travels. SIX PAIRS + 2 unpaired (Du, Ren). 361 points + extras. Names/numbers standardized by the WORLD HEALTH ORGANIZATION. |
| Zang (yin, solid) | Lung, heart, spleen, kidney, liver, (pericardium). |
| Fu (yang, hollow) | Large intestine, small intestine, stomach, bladder, gallbladder, (Sanjiao). |
| Five elements | Wood = GB, LV · Fire = SI, HT, PC, SJ · Metal = LU, LI · Earth = ST, SP · Water = UB, KD. |
| Yin syndrome | Depressed, tired, lassitude → STIMULATE yang points: LI4, LI11, ST36, GV14. |
| Yang syndrome | Anxious, insomnia, agitated → SEDATE with yin points: HT7, PC6, LV3, KI6, SP6. |
| Six exogenous factors | Wind (tremors, tics, headaches) · Cold (GI, colds) · Summer heat (heat stroke) · Damp (GI, skin, edema) · Dryness (lungs, GI, skin) · Fire heat (mania, anxiety, skin). |
| Myofascial trigger point | 3–5 mm area IN a muscle, abnormal after injury. Consistent referred pain patterns. ~70% correspondence with classical points. |
| Mechanism | Local · segmental/gate control · descending inhibition · central. Releases endorphins, serotonin, enkephalins, GABA, norepinephrine, dopamine. Prolonged serotonin elevation. |
| Cautions | Needle phobia · warfarin/bleeding disorders · heart valve disease · epilepsy during seizure · diabetes (NEUROPATHY) · pregnancy (certain points). |
| CONTRAINDICATION | Local infection. Safety: SINGLE-USE needles, full history, accurate diagnosis, care with risky points (pneumothorax). |
| World literature split | Organic lesions 40% · pain 25% · surgical anaesthesia 10% · neurological 10% · substance abuse / psychiatric / misc 5% each. |
| Pain studies split | Musculoskeletal 67% · headache 12% · arthritis 9% · neuralgia 7% · dental 4% · malignant 1%. |
| Moxibustion | Dried mugwort burned on/near skin or needle for HEAT; used since 500 BCE; moves Qi and blood. Pain, tendonitis, digestive, menstrual. |
| Cupping | Glass cups + flame = vacuum. Records to 28 AD. STATIONARY 5–10 min · walking/sliding along a meridian · FLYING = rapidly removed and replaced. Darker marks = more build-up. |
| Ear acupuncture | Needles + ear seeds/tacks. NADA protocol (National Acupuncture Detoxification Association) = anxiety/depression, substance abuse. Used by US military and some emergency departments. |
| Tai Chi | Slow internal martial art, deep breathing, constant motion. Styles Yang, Chen, Wu, Sun, Fu. REDUCES FALL RISK in older adults; lowers stress, anxiety, blood pressure. |
| Term | What you need to know |
|---|---|
| NOT TESTED | Osteopathic medicine slides are marked “not in course objectives so will not be tested on.” |
| Chiropractic | Diagnosis, treatment, prevention of NEURO-MUSCULOSKELETAL disorders. Structure (spinal movement) ↔ function (nervous system). |
| Founding | Daniel Palmer, IOWA, 1895. 39 states by 1931. Today >70,000 chiropractors, 19 accredited programmes, all states regulated. |
| Education | Bachelor's first → 6 didactic + 4 clinical semesters → national boards I–IV. Doctor of Chiropractic, 3.5–4 years. |
| PRIMARY LESION | Intersegmental dysfunction = discrete areas of HYPOMOBILITY within spinal articulations. |
| Adjustment | HIGH-VELOCITY, LOW-AMPLITUDE thrust, usually by hand. Purpose: restore normal motion, normalise the nervous system. |
| Techniques | DIVERSIFIED = manual, multiple modalities, MOST COMMON · Flexion/distraction = segmental table · Thompson = drop table · Activator = handheld instrument · Logan = gentle soft tissue · Gonstead = side lying · Sacro Occipital = cranial sacral. |
| Cauda equina syndrome | After LUMBAR manipulation. ~1 per 100 MILLION manipulations. |
| Cerebrovascular accident | After UPPER CERVICAL manipulation. ~1 in 5.85 MILLION. 400× LESS than deaths from GI bleeding on non-steroidal anti-inflammatories. |
| 1994 guideline | Agency for Health Care Policy and Research put spinal manipulation at the TOP of options for certain back pain; of 23 low back pain options, manipulation + anti-inflammatories most beneficial. |
| Massage etymology | Arabic massa = to touch; Greek massein = to knead. |
| Massage history | China 3000 BCE Tui Na · India 3000 BCE Ayurvedic · Egypt 2500 BCE tomb paintings · Japan 1000 BCE Shiatsu · medieval Europe: DISCOURAGED by the Church of Rome · Per Ling (Sweden, early 1800s) founded Swedish massage. |
| Massage licensure | 500–1,000 hours by state + Federation of State Massage Therapy Boards examination + continuing education. |
| Effleurage | Smooth GLIDING, usually with oil. Opens and closes every session. PALM → deep tissue; FINGERTIPS → sensory nerves. |
| Petrissage | LIFTING and KNEADING skin, subcutaneous tissue, muscle. Often WITHOUT lotion. Frees adhesions, assists venous return. |
| Tapotement | Beating/tapping with side of hand, cupped hand, fingertips. Swedish massage. |
| Friction | Deep CIRCULAR or CROSSWISE with thumbs, fingertips, palms, elbows. Only technique that may be painful. |
| Massage rules | Swelling → start PROXIMALLY (“uncorking the bottle”) · pressure in line with VENOUS flow · along muscle fibres · never painful, no bruising · avoid bony prominences. |
| Massage effects | LIGHT+SLOW = systemic relaxation. FAST+DEEP = local blood flow. Research FAILED to support cardiac output/BP/arterial flow increases. Petrissage lowers neuromuscular excitability only DURING massage, only in that muscle. |
| Reflexology | Reflex points on HANDS, FEET, HEAD affecting the nervous system, connected to every body part. |
| Rolfing | = Structural integration. Balance the body in a GRAVITATIONAL field via soft tissue. TEN hour-long sessions, each on an aspect of posture. |
| Homeopathy founding | ~1814, German physician. >200 years. Sources: PLANTS >60%, animal, minerals, tissues, bacteria/viruses. |
| 1st law of homeopathy | Choose a medicine that itself produces a SIMILAR suffering (homoios pathos) to the one it should cure. |
| 2nd law of homeopathy | Curative power increases in DIRECT RATIO to dilution with SUCCUSSION (shaking), per the Law of Similars. |
| Simillimum | Close match between the patient's full physical/mental/emotional picture and a known drug picture. |
| Homeopathy limits | LEAST helpful: anatomical abnormalities needing surgery, end-stage disease, obstacles to cure (excessive drugs, abusive lifestyle). Kleijen: 107 trials, 77% positive. |
| Aromatherapy | Essential oils for therapeutic purposes — massage, inhalation, oral, compresses, baths. LESS IS BETTER; dilute on skin; protect from sun/heat; quality matters. |
| Reiki | JAPANESE, early 1900s. “Laying on hands.” Unseen life force energy: LOW → more illness/stress; HIGH → happier and healthier. |