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Placebo Effect & CAM

The biggest obstacle to the acceptance of Complementary and Alternative Health (CAM) in our scientifically-oriented culture is perhaps the established use of double-blind, randomised controlled trials (RCTs). CAM is currently difficult to 'prove' with clinical trials. In conventional medicine, RCTs are the way the efficacy of any new treatment is assessed. Orthodox medicine is heavily invested in a health care system where the specific effects of drug X cures condition Y (Lee-Treweek and Stone, 2005). However, in CAM it is the specific and non-specific effects of a healing method that helps a condition.

So, the problem for CAM is that RCTs disallow many non-specific factors that are thought to be highly influential in the efficacy of CAM, such as the continuity, congruence, intimacy and empowerment of the CAM therapeutic relationship (Lee-Treweek and Stone, 2005 and Lee-Treweek, 2005).

Allopathy can criticise CAM for being merely a placebo effect (Lynoe, 1990 cited in Di Blasi, 2005), where CAM is compared to research which shows that dummy pills will help about 30% of people get better (Lee-Treweek and Stone, 2005; Heller et al., 2005). However, perhaps CAM has a gift to give to offer the world here, as more enthusiastic CAM practitioners produce a stronger placebo effect (Uhlenhuth et al., 1966 cited in Heller et al., 2005).

The placebo effect is removed in RCTs for clearer research results as it is negatively marked, being associated with quackery (Di Blasi, 2005). But this comes at the cost of ecological validity (how generalisable the findings are to real-life settings). Despite all attempts at removing the placebo effect it remains potent, which mystifies and frustrates scientists and physicians and cracks the biomedical theoretical box (Di Blasi, 2005).

So, in both CAM and orthodoxy, the placebo effect deserves research so that its potency can be harnessed for the benefit of public health (Heller et al., 2005).  If biomedicine integrates the power of the placebo effect, the acceptability of CAM is likely to skyrocket. As it stands, the 'clash of systems and values' over research methodology and political power (Lee-Treweek and Stone, 2005) is a major sticking point in CAM's growth, acceptability and professionalisation.

References
  • Di Blasi, Z. (2005) 'The crack in the biomedical box: the placebo effect' in Lee-Treweek, G., Heller, T., Spurr, S., MacQueen, H. and Katz, J. (eds.) (2005) Perspectives on Complementary and Alternative Medicine: A Reader, Abingdon, Routledge.
  • Heller, T., Heller, D. and Yamey, G. (2005) 'A critical look at orthodox medical approaches' in Lee-Treweek, G., Heller, T., MacQueen, H., Stone, J. and Spurr, S. (eds.) Complementary and Alternative Medicine: Structures and Safeguards, Abingdon, Routledge.
  • Lee-Treweek, G. (2005) ‘I'm not ill, it's just this back: osteopathic treatment, responsibility and back problems’ in Lee-Treweek, G., Heller, T., Spurr, S., MacQueen, H. and Katz, J. (eds.) Perspectives on Complementary and Alternative Medicine: A Reader, Abingdon, Routledge.
  • Lee-Treweek, G. and Stone, J. (2005) ‘Critical issues in the therapeutic relationship’ in Heller, T., Lee-Treweek, G., Katz, J., Stone, J. and Spurr, S. (eds.) Perspectives on Complementary and Alternative Medicine, Abingdon, Routledge, Taylor and Francis.

Also see:-

Placebo Effect


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