Rob Wood MIFR;RMN;Dip.Couns.
Rob Wood is a qualified nurse, counsellor and reflexologist/VRT practitoner
Since March 2004, reflexology has been available at The Elms* as a treatment option for clients with a primary diagnosis of anxiety. Any member of the clinical team based at The Elms can make referrals in writing. (*The Elms is a community-based Mental Health Unit in Thornbury, near Bristol, UK. It provides a multi-disciplinary assessment and treatment service for the adult population in the South Gloucester catchment area).
At the initial consultation a brief history is taken and the treatment goals are agreed with the client. They then have their first treatment with a further 5 follow-up sessions, usually at weekly intervals. VRT is usually introduced in session 2, and involves giving an ‘endocrine flush’, paying particular attention to the adrenal glands. This is followed with a conventional treatment, with emphasis on diaphragm rocking and the harmonising/consolidating techniques. I also do extra work on boosting and strengthening the immune system, which has often become weak from the effects of chronic stress.
It was agreed when setting up this service that some form of evaluative data should be collected to measure the effectiveness of reflexology in the treatment of anxiety. Prior to starting treatment clients are asked to sign a consent form stating they have had reflexology satisfactorily explained to them, and are willing to complete questionnaires before, during, and after treatment finishes. In addition clients are invited to make comments on the effect reflexology has had on them.
The treatment process
While anxiety has a range of common symptoms, each person’s experience is unique to them. Therefore although a standard treatment regime is followed, this is inevitably adapted to suit the particular needs of the client. It is emphasised to each client that although they are likely to experience an immediate sense of relaxation after each treatment, it is the cumulative effect on their anxiety symptoms that is the main purpose of the treatment. This is why they are offered 6 sessions, and asked to state treatment goals that can be reviewed on completion.
Each client is shown VRT self-help techniques that they can use in situations where they feel stressed or anxious. Clients value this, as one of the reasons anxiety escalates is the feeling of not being in control. These techniques give a degree of control, (as well as actually having an effect!). The one that clients find most useful is ‘nail-on-nail’ on the pituitary. This can be applied ‘anytime/anywhere’, and done inconspicuously.
One of the main principles of the holistic approach to health-care, is that the healing process works from within, outwards, as the body adjusts to its own innate level of optimum health. Each client’s response to their 6 reflexology sessions has certain common factors, e.g. a beneficial shift in their subjective feeling of anxiety after each treatment; a direct physical experience of relaxation through release of muscle tension.
However it is important to realise the healing process that reflexology can initiate is unique to each client, i.e. while there are some immediate common reactions to a treatment, the cumulative effects can vary considerably. My impressions as to the factors that determine how a client is likely to respond are as follows:
– The causes of anxiety are many and varied but are essentially either a reflection of someone’s psychological make-up, and/or stressful life events.
– Anxiety is often tied up with other psychological conditions such as low self-esteem, depression, obsessional traits, etc.
– Clients whose anxiety levels are largely a direct response to stressful life events will inevitably feel better or worse to some extent dependent upon these trigger factors.
– Other treatments a client may be receiving will play an important role in anxiety levels, such as medication, individual and/or group therapy.
The evaluation of the effect reflexology is having as an effective treatment option for anxiety is influenced by a number of variables as outlined. While the attached information from completed questionnaires and clients comments, certainly gives a positive picture of its value, it is not possible to state that it is reflexology per se that is making the distinct improvement most clients report on completion of their treatment sessions. Obviously the way to test its effectiveness thoroughly is to undertake more detailed research such as a randomized control trial.
However there is sufficient feedback information using current methods to state:
a) The clients feel it makes a positive difference to their experience of stress and anxiety,
b) Having reflexology available at The Elms gives both staff and clients a treatment option as an alternative to, or to complement conventional treatments for anxiety, i.e. it provides increased patient choice, one of the government’s aims for the NHS.
c) A full course of 6 reflexology sessions costs £155. Given the positive client feedback so far, (whilst acknowledging the other variables affecting anxiety levels), this seems to be a cost-efficient treatment option.
d) While the feedback shows some clients did not complete their course of treatment, and a small proportion reported minimal change, there are no reports of any negative treatment consequences.
I have some mixed feelings on using VRT in the treatment of anxiety. I think its main value is the client being taught self-help techniques, because it gives them something that works when needed and a degree of control over their anxiety. When used during a session, the client’s reactions can be unpredictable. For most it is beneficial and aids the healing process. However some clients can find it too much, too soon. One of the things I have learned from this work is that generally the more severe the anxiety, the harder it is for the client to, physically and mentally, let-go. Therefore because a reflexology session will induce relaxation of the muscles, paradoxically this sensation can temporarily make the client feel uncomfortable. So VRT in the treatment of anxiety will certainly bring positive results, but from my experience should not be used in the first treatment, and in subsequent treatments be cautious of the client s reaction.
Complementary therapies such as reflexology are so called because they are seen to ‘complement’ conventional medicine. Surveys indicate a growing preference amongst the population in general to use complementary therapies with a high level of satisfaction of its effects. The service available to clients at The Elms has proved to meet a demand and the feedback via questionnaires and comments is positive.
Of the 28 initial BAI questionnaires, 14 post-treatment questionnaires have so far been returned, enabling the following results to be noted.
On the 1st questionnaire, 7 clients scored in the severe category; 4 in the moderate; 2 in the mild; 1 in the minimum.
client 1: moved from severe (49) to moderate (21) -28
client 3: severe (33) to moderate (25) -08
client 5: severe (41) to mild (8) -33
client 9:severe (27) to mild (12) -15
client 11:severe (51) to moderate (17) -34
client 12: severe (48) to moderate (22) -26
client 13: severe (31) to mild (13) -18
client 2: moved from moderate (23) to minimum (6) -17
client 6: moderate (21) to mild (11) -10
client 8: moderate (16) to minimum (3) -13
client 14: moderate (25) to moderate (19) -06
client 4: moved from mild (8) to minimum (3) -05
client 7: mild (9) to mild (11) +02
client 10: moved from minimum (2) to minimum (0) -02