What are Complementary and Alternative Methods of Treatment (CAM)?

By Katy Dorendorf, PsyD              

There are a variety of different treatment options available when children are diagnosed with a developmental or behavioral disorder. Many types of behavioral health treatments are supported by strong research which supports their use as effective. These treatments are termed conventional treatments, empirically based practices or EBP’s. However, many treatments commonly used with both children and adults do not yet meet the criteria that to be called  empirically based. These treatments are referred to as Complementary and Alternative Methods or CAM. But was does CAM mean anyway and what treatments qualify?

The definition of complementary and alternative methods of treatment (CAM) varies. The National Center for Complementary and Alternative Medicine (NCCAM, 2011a) at the National Institutes of Health (NIH) defined CAM as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine (Introduction, para. 1).” Specifically, complementary treatments are interventions used jointly with conventional (i.e., scientifically supported treatments), while alternative treatments are methods used instead of conventional treatment (NCCAM, 2011a). Other terms often used to describe CAM include unconventional, nontraditional, nonstandard, not accepted, unproven and controversial (Nickel, 2001). An additional term you will often hear used with CAM is integrative or integrated treatment. This term is used to describe the combination of conventional treatments with CAM treatments that scientific evidence has suggested are safe and effective (NCCAM, 2011a).

The NCCAM divides CAM therapy into the following categories:

• natural products and biologically-based therapies
• whole medical systems and traditional healers
• manipulative and body-based therapies
• mind-body therapies
• movement therapies
• energy medicine.

The category of natural products and biologically based therapies is the most commonly used CAM for children and adults in the United States (NCCAM, 2011b). This category is quite broad, and includes interventions ranging from the use of vitamins and herbal supplements (e.g., magnesium and vitamin B6, melatonin, etc.) to the development of specialized diets (e.g., the Gluten Free, Casein Free diet, etc.) as well as non-traditional uses of medical procedures (e.g., secretin injections, etc.).

Alternative medical systems and traditional healers utilize cultural methods of treatment based on native theories, beliefs, and practices (NCCAM, 2011a). Traditional whole medical systems include Ayurvedic medicine and traditional Chinese medicine (NCCAM, 2011a). Over the last decade, whole medical systems including homeopathy and naturopathy were developed and became more popular (NCCAM, 2011a).

Manipulative and body-based treatments focus on the overall structure and systems of the human body, and includes treatments such as massage therapy and spinal manipulation. Points of focus for these treatments generally include impacting the soft tissues, bones and joints, and circulatory and lymphatic systems (NCCAM, 2011a).

Treatments included in the mind-body therapies category focus on the interaction between the mind, body, and behavior, and its effect on overall health (NCCAM, 2011a; Wong & Smith, 2006). Commonly used mind-body treatments include music therapy, animal assisted therapy, hypnotherapy and yoga (NCCAM, 2011a). Movement therapies, such as the Fiedenkrias Method, Alexander Technique, and Pilates, are also considered CAM as they promote physical, mental, emotional and spiritual well-being.

Finally, the category of energy medicine is based on the theories that different forms of energy can be manipulated, and by manipulating these energy fields, changes in biological health and behavior can occur. Energy medicine includes, but is not limited to, magnet therapy, light therapy, qi gong, Reiki, and healing touch (NCCAM, 2011a).

Currently in the United States, it is estimated that approximately 38% of all adults and 12% of all children are using some form of CAM, meaning there is probably someone in your life currently using a CAM treatment (NCCAM, 2011b). Overall, evidence for the effectiveness of CAM treatments has not yet reached the standards needed for them to be considered conventional or empirically based. Despite the lack of scientific evidence, some CAM treatments appear to provide children and their families with benefits. Additionally, since treatments are at times limited and difficult to obtain, CAM therapies offer families more options (Hanson et al., 2007). These therapies can often empower families in the face of a chronic disorder with no known cure and limited effective treatment options (AAP, 2001; Smith, 2008;).

However, at the same time it is important to recognize that many CAM therapies may not be effective and some are potentially hazardous even if they seem harmless. As a result, the safety and costs of any treatment must be investigated prior to beginning. This can be easily accomplished by reading current research available on the treatment (see below for resources) or by speaking with a trained behavioral health provider who can help you sort through the research on the method in which you are interested. Often steps can be taken to neutralize potential risks associated with CAM treatments such as the proper care and treatment of animals in Animal Assisted Therapy, close medical monitoring during the use of natural products treatments, and close nutritional monitoring during dietary interventions. Yet unproven treatments with significant risks such as Auditory Integration Training (AIT), which can harm the child’s hearing, or the use of high dose supplement and vitamin therapies that may have potentially life altering health risks and medicinal interactions, should not be utilized outside of research protocols (AAP, 1998; Nye & Brice, 2005). Sifting through the buildup of information available on CAM can make distinguishing between potentially harmful CAM and potentially beneficial CAM a stressful task, but with proper resources and guidance from you child’s team members it is a task which can be easily conquered.

Trusted Resources on CAM:

• Effective Child Therapy, Division 53: effectivechildtherapy.com
• National Institutes of Health: nih.com
• National Center for Complementary and Alternative Medicine: nih.gov
• American Psychological Association: apa.org

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