I am in the interesting position of looking at RCCM from two perspectives, both as a trustee and also as a corporate member, I am the Chair of BAThH and as such, I could see the benefits available to us, so we joined in the vision that RCCM has for the future of complementary medicine in general healthcare.
At BAThH we represent the interests of professional hypnotherapists around the UK, and we felt that an important way to do this was to get involved with RCCM as a corporate member. We now have rigorous training, a strong code of ethics, with ongoing CPD management and we are involved with organisations that are both collating and leading research in hypnotherapy, so we feel it is time to raise awareness and take that to a higher level. Hypnotherapy can often fall between talking therapies and complementary therapies and so drop off the main agenda, it is time that we change this.
Research is the way to have complementary therapy recognised and integrated into the NHS, providing greater patient choice and maybe even sometimes cutting costs. We want to make sure the voice of hypnotherapy is heard and plays its part in this move towards greater integration, we know the best way to present our case both preparing research and presenting it to NICE is by working with RCCM. I am really looking forward to the free training we can attend on how to develop research strategy and support research among members, this is just the kind of guidance that we need right now. As well as this kind of guidance and support, we get to work with an organisation that can provide us with an interface with NICE, the ASA and lobbying in parliament through the IHC parliamentary group.
Both BAThH and RCCM are supporters of the European Congress for Integrated Medicine conference to be held in London later this year, the fact that we did this independently shows the harmony of our intent. This is a forum to facilitate the advancement of the integration of conventional and complementary healthcare to improve overall healthcare. This conference will bring together medical professionals, researchers, scientists, therapists and health politicians to help navigate the changes that will be necessary, we are delighted to be joining together in this venture. At BAThH we want hypnotherapy to be a part of this dialogue and I want to present our case in the most professional way. We are a much stronger voice for complementary medicine and its integration into mainstream healthcare if we work together and it increases both our visibility and credibility to join with RCCM to this end. We are delighted to be on board, and I am actively encouraging other hypnotherapy organisations to join us too: https://www.rccm.org.uk/register/corporate-member/
We are sadly saying farewell to our trustee Simon Brasch this month, who is moving on to another charity. We are very grateful to Simon for all his support of RCCM over the years and wish him all the best.
RCCM is therefore now looking for a new trustee with IT/website expertise to assist with our online activities. This is a supportive role, working with and advising our administrator.
Applicants will ideally have the following qualities:
- Experience of Website Management
- Experience of Social Media Strategy and understanding how we use it effectively – Create KPI’s and outcomes
- Information Management skills – organise and store all files on secure cloud based platforms
- Knowledge of WordPress platform
- Ability to analyse website analytics / Google Analytics and share insights and suggestions on future developments
- Good understanding of GDPR
- Good project management skills and experience
- Track record of working with external consultants and organisations, including or web hosting company
- Eligible to act as a trustee according to Charity Commission criteria
If you are interested, please get in touch for more information or an informal chat: firstname.lastname@example.org or on twitter @TheRCCM
RCCM member Richard Clark talks about his interest in acupuncture and heel pain:
“When I first set out to look up the evidence base for using acupuncture for plantar heel pain (PHP) I thought it would be simple and quick. Little did I know!
One SR and one CIS later, I realised the extent, complexity and contradictory nature of this topic. Frustrated by wordcount limitations, I set out to explore the ideas further and have just published my reflections. I considered all the evidence I could find, set against relevant theoretical contributions. I analysed problems and synthesised a set of over 20 research recommendations, which are presented in chapter 8. These are at three levels:
- General pointers – e.g. Context bias should be explicitly recognised as a limitation of formal studies, which should aim for ‘ecological validity’
- Broad questions – e.g. How do practitioners think? How is this influenced by different contexts? How can we use the Patchwork model to elucidate this?
- Specific questions – e.g. How does use of the single ashi point compare with the ‘circle the dragon’ technique … in terms of analgesia and long-term healing?
As a lone wolf, prowling the shoreline between the mainland of orthodoxy and the ocean of alternatives, I tow no party line. I questioned assumptions, revealing challenges to any clinicians or researchers who might be set in their ways. For example, some see heel pain as a Kidney problem, because heel pain was thought due to bony heel spurs and ‘Kidney rules bone’ but now we know most patients don’t have spurs, so is it time to challenge the hegemony of KI3 as first choice for treatment? There are so many alternatives!
Similarly, some dry-needlers look no further than the calf for trigger points; they may be surprised to find other myofascial therapists treating PHP from the neck.
But the issues are much larger than which point to use. I have articulated an integrative, exploratory approach which I call ‘Refractive practice’ that offers a framework within which to construct radically different approaches to practice and research, not just for heel pain but for acupuncture in general. And there is more – the Patchwork model (from our CIS) combined with a feminist analysis, led me to a radically new perspective on the field of research as a whole, seeing it as a membrane whose convolutions distort the very nature of the truths we co-create.
I am hoping this model will contribute new approaches to the challenges we face. This is where you come in – I have set up a discussion forum and I look forward to seeing you there”
- Clark R and Tighe M. The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupunct Med 2012; 30: 298-306. DOI: 10.1136/acupmed-2012-010183.
- Clark MT, Clark RJ, Toohey S, et al. Rationales and treatment approaches underpinning the use of acupuncture and related techniques for plantar heel pain: a critical interpretive synthesis. Acupunct Med 2017; 35: 9-16. DOI: 10.1136/acupmed-2015-011042.
- Clark RJ. Advances in acupuncture for heel pain: towards integrative practice and research. Birmingham, UK: Independent, 2020.
RCCM member John Sharkey provides a comment concerning the paper entitled “Fascia Focused Manual Therapy Interventions-Proposed Treatment for Post-COVID Syndrome”.
Clinical anatomists are trained in the management of human tissues as they are involved in cadaveric tissue donation. The role of the anatomist involves screening donations for communicable or transmissible infection both bacterial and/or viral. Taking tissues from cadavers for histological investigations includes fluids, organs, tissue samples and human tissue for research and the training of students and pathology residents (tissues, organs) so all human tissue must be virus and bacteria free. As a Clinical Anatomist and manual therapist I was keenly aware of the serious nature of the so-called ‘novel virus’ identified as Severe Acute Respiratory Syndrome Coronavirus [SARS-CoV-2] and the implication of possible long-term effects, post recovery. At this time researchers are more informed regarding COVID-19 as the story concerning this virus unfolds with new facts emerging fortnightly. When I completed and published my research there were 57 million confirmed cases worldwide. Today that number exceeds 100 million people with 55.2 million people who have recovered. It is the people that have recovered that my research focused on as a significant number of those people are reporting long-term effects including, but not limited to, extreme fatigue, joint soreness, muscle stiffness and painful movement, all issues that can be effectively dealt with by a complementary medical professional with the appropriate fascia focused training. This will reduce the stress and intensity on the National Health Service generally and accident and emergency departments specifically as Long-COVID or Post-COVID-19 patients are destined to increase in number within all communities creating the real potential of overrunning the current medical healthcare system.
John Sharkey MSc
Faculty of Medicine, Dentistry and Clinical Sciences,
University of Chester/NTC,
15-16aSt Joseph’s Parade
The world was turned upside down this year. For many, that has also included how we do our jobs. Academics with teaching responsibilities have had to adapt to new challenges and workload distributions. Additionally, active researchers have been forced to reflect on how the COVID-19 pandemic will affect their research portfolios in the short- and medium-term.
In this blog post, I will discuss my experience of being a co-investigator on a funded study of mindfulness for stroke survivors (https://www.stroke.org.uk/research/helping-people-affected-stroke-self-manage-symptoms-anxiety-and-depression). This includes the steps taken by the research team to account for pandemic public health protocols. My reflections on the implications of the pandemic for CAM researchers in planning future projects and research themes will also be explored.
HEADS: UP (Helping Ease Anxiety and Depression for Stroke Survivors) is a project funded by The Stroke Association, consisting of a stage 1 single-group feasibility study and a stage 2 randomised controlled pilot trial; both stages aim to assess the feasibility and potential effectiveness of an adapted mindfulness course for improving mood disorder in stroke survivors.
At the beginning of the UK lockdown in March, stage 1 feasibility analysis was underway, having already successfully recruited participants, delivered the intervention, and collected their data. Whilst the lockdown did not have a significant impact on this phase, the team needed to reconsider the study as a whole. The first question that needed to be answered was “is the pandemic going to affect study methods and timelines?” Stage 2 was due to commence in late 2020 and so the answer was yes. That necessitated communication with the funder and identification of what COVID-19 adaptations would be required. Three crucial adaptations were identified: recruitment; intervention delivery; and data collection methods.
It was clear that the group format of the intervention would be problematic with respect to social distancing, reduced capacity, and the risk-benefit ratio for participants. The team concluded that online delivery of the course was the optimal solution. As a result of online delivery, geographical restrictions became irrelevant so recruitment could be conducted nationally. Finally, given preferable limitations to close contact, data collection was moved to an online interface.
Given these changes to fundamental aspects of study design, stage 1 feasibility results became effectively meaningless. Those relating to recruitment processes, intervention delivery, and data collection were simply not transferable to the new study design. This necessitated an additional feasibility stage to assess the new design elements, before moving on to the larger-scale pilot trial. Although our plans were accepted by the funder, there was an impact on timescales and costs.
Having reflected on this experience and the impact of COVID-19 on my wider research portfolio, I have identified several areas that other CAM researchers may find valuable to consider:
- Intervention format: some CAMs are group interventions that face similar issues to the HEADS: UP study – social distancing requires reduced capacity and participants still face additional risk. Reduced capacity will influence cost effectiveness, intervention delivery timetable, and staffing. Online delivery may be feasible for some interventions (e.g. mindfulness courses, herbalist consultations) but not for all – despite amazing technological advances, it is not yet possible to receive a massage, for example, over the internet. Thus researchers planning CAM studies based on interventions that require close physical contact (e.g. massage, acupuncture, shiatsu) need to mitigate the additional risks or consider postponing that strand of research. It could be argued that, even when several interventions could be potentially feasible for online delivery, some lend themselves more naturally to online delivery than others (e.g. mindfulness vs yoga or tai chi).
- Recruitment: online delivery potentially opens up recruitment, which may have been based on geographical centres, to a national level. Given that recruitment is a perennial problem in clinical research, this is a net benefit. Recruiting to studies of close proximity CAMS will need to present the additional risks whilst still attempting to appear to be attractive to potential participants. A higher reliance on social media and other virtual networking options may be required.
- Data collection: reducing risk by limiting face to face contact is preferable, which highlights the need to prioritise online data collection where possible. Although raising questions of IT literacy and access, it is relatively easy to administer questionnaires on electronic systems. The pros and cons of online interviews or focus groups should be weighed up on an individual basis – the reduced risk of online interviews needs to be balanced against the limitations in rapport building and personal dynamics.
It is with a heavy heart that we announce the untimely passing of Professor Hugh MacPherson. Hugh will be well known to many RCCM members. Hugh co-founded the Northern College of Acupuncture, and became the UK’s first Professor of Acupuncture at the University of York. He was a frequent attender of the RCCM’s CAMSTRAND conference and a friend to many members. Hugh sadly passed away from pancreatic cancer aged 72. His funeral was held in York on 8th September and was remotely attended by RCCM Trustees. His gravestone is engraved with the words ‘surfer of many kinds of waves’ a reflection of his many skills and interests. The RCCM’s thoughts are with his wife, Sara and his children Angus and Shona.