1. Dr Rachel Harrison Rose Garden Medical Centre Leith, Edinburgh
CranioSacral Therapy
Dr Rachel Harrison
Rose Garden Medical Centre
Leith, Edinburgh
GP 20 yrs, Homeopathy, CST
Still GP
Invited because of study
Integrative medicine
Proud ofNHS
Not just pharmacology

2. who you are? NHS? Education? Parents?
who had heard of CST before today
Who has experience of CAM?
What kinds?
Anyone had CST?
Kids had CST?

3. Complementary Therapy on NHS (CAM)
General Practice
Physiotherapy
Mental Health Services
Hospices
Hospitals
RoseGarden: autogenic, acupuncture, cst, homeopathy
Physio / pain clinic acupuncture
Thistle – CST (Alex)
Mental health W Lothian Physio – Karen CST – paid for training
Hospices
Public demand
France: CST considered routine post delivery – osteopaths Michel Odent, Leboyer)
USA use of CAM for children stands at 70% in 2006 cf 10% 10 yrs previously

4. Glasgow Homeopathic Hospital
Open to Homeopathy since inception
Continues in spite of increasingly aggressive attacks
Used to be 4 homeopathic hospitals with beds, now only 2, but lots of outpatient, treat ‘heartsink patients’ homeopathy, massage, reflexology, CST (while I worked there)
Anyone had any form CAM on NHS in Belfast?
What / How?

5. Effective Safe Practice
Cost of Patient’ Condition to
NHS Family Society
Safety and cost of treatment
Outcome - demonstrate effectiveness
New service weigh up
How much support do these people/patients/kids need
Impact on family of living with ADHD – you know more than me
Impact on School, society, the distress of child

6. Why Complementary Medicine?
Condition merits treatment.
Orthodox treatment effective?
Side effects?
Cost?
Other treatment?
Is orthodox treatment adequate?
side effects
cost of Strattera in Belfast? – Anyone know? - £240,000 from Gen Practice edinburgh last year
What else do we currently offer the kids?
Integrative medicine, what is available, use everything that works, together if appropriate, reduce more aggressive treatments?
Do we have effective Alternative or Complementary?

7. Why CranioSacral Therapy?
Safe
Gentle
Addresses Structural Changes
Parents can participate
Evidence Based Medicine
Anne’s chat
Get to keep clothes on!
Children like it - Jo climbs onto table
Safe – no high velocity, less risk
Kids can treat family
What evidence?
Why have any of you chosen some form of therapy? (word of mouth)
Why do GPs recommend treatment? Trials? Drug companies? Patients feedback
Evidence based medicine:
The Gold standard RCT - Ethics, funding, Energy - medication particularly suitable What motivates? Who promotes results? folic acid in ISD, Depression, sugar in prison
CAM research, whole person treatments less easy to randomise, rarely poss to placebo but always possible to do outcome studies

8. My Grumpy teenager – no make up - hand over face or looking away
‘I think you should pay your patients!’ – so sore
but sullen before then relaxes / chats/ less rude / more likely to return to revision!
Jo 11 yrs old ,++ support at school, often off school, falling off stool, frustrated, constant attention, siblings suffer. – climbs on table, shows me where to put hands. Talks about anger
More relaxed and attentive, weaning off strattera

9. Two consecutive studies
Multi Practitioner Study
Ten CranioSacral Therapists
Up to ten consecutive patients each
NHS patients (Single Practitioner)
Before and After Questionnaires
Evidence base:
CST on NHS - started study to allow transparency
Colleagues can decide if appropriate to continue funding
Look at your handouts
Single Practitioner – that’s me. All NHS patients
Referred within Rose Garden Medical Centre
Talk through pre only

10. Conditions Treated With CST
Number
Headaches and Migraine 23
Neck Pain 22
Depression/Anxiety/Stress 18
Back Pain 15
Other Musculoskeletal Problems 13
Unsettled Babies 12
Sleep Problems 4
Gastrointestinal Problems
Jaw Tension/Dysfunction 3
Neuralgia
Dizziness/Tinnitus
Shoulder Pain 2
Other conditions 8
Relate to their handout, 2 columns,
Anyone who has had CST want to add a condition/outcome?
130 patients in all (both studies)

11. Glasgow Homeopathic Hospital Outcome Score
+4 Cure
+3 Major Improvement
+2 Improvement of value in Daily Living
+1 Minor Improvement
0 No change
-1 Minor Deterioration
-2 Deterioration impacting on daily living
-3 Major Deterioration
-4 Death
Post questionnaire
after 6 sessions or 6 weeks post treatment - GHHOS
Validated tool. Modified - a weakness of study
Score for main problem, secondary problem if appropriate, wellbeing
GP vists in 6/12 pre and post

12. Some weird stuff, adults can do this too but little harder to hold them – swimming pool
Birth trauma revisited - babe or adult,

14. 46 patients with outcome data
34 (74%) valuable or better improvement in main problem
31 (67%) valuable or better improvement in a secondary problem
30 (65%) also valuable or more improvement in general well-being.
15 (70%) of patients on medication for problem decreased or stopped it.
Of 73 multi practitioner patients we have follow up data for 46
This is from the multipractitioner group,
Single Practitioner 67 patients results slightly better but self selected
Follow up data on almost all but captive audience
2 out of 130 patients reported deterioration – short lived – do get aggravations but often only once and rarely last >1 /52
Note improvement in secondary condition and well being in many patients
Not many medications can boast that – iatrogenic disease cause of up to 60% admissions to hospital
GPs pleased – drop in drugs bill
But best of all….

15. Single practitioner patients
60% reduction in GP consultation rate
AS GPs this is what we love to see
Because I had access to notes
Interestingly even the patient who said worse after treatment and stopped after 3 sessions
(v complex lady/problems) attended 19x in 6/12 before and 8x in subsequent 6/12

16. Patient Feedback Comments
Our experience of CST was very positive and the approach is very encouraging for a new mum. (Mother of unsettled colicky baby)
The treatment helped Max (2months old) relax and become calmer in himself. It has helped his breathing and ability to turn his head.
So nice to treat them tiny - certainly help settle, colic, feeding, poss long term effects.

17. Patients Feedback Comments
Migraine has been a longstanding problem and I am very happy with my improvement.
I feel my improvement is totally due to CST, I feel better after a few sessions than after six months of GP and medicines. (Headaches)
I felt better when the treatment started but now it has reverted to what it was before. (Migraine )
Doesn’t work for everyone, other comments on sheet – Verity (not on sheet)’feel more connected to self’
35 yrs Migraine in 73 yr old stopped after 5 treatments – still get christmas card
Back pain – taken off list for surgery

18. So many have really tights necks and chest, many kids love to get on table

19. Adolescents with ADHD 28 Adolescents 2 weeks Massage therapy
Self rated ‘happier’
Better concentration
Less fidgeting
Lower Hyperactivity rating
Body work of different kinds,
Massage compared with Relaxation exercises
not so easy to relax – hands on better
Importance touch - not just relaxaton

20. Use of CST in Physically Impaired Population in Southern Ireland
46 service users
0 – 18 years old
20 item survey
100% feedback
Symptom control
Decrease stress in siblings, parent and patients
All parents wanted more treatment
Other studies, see reference sheet at end of handout
Glicksen – happy to give her address, published in JACM

21. Parent Feedback Comments
The sessions have markedly improved his coordination and concentration. This allows his siblings to have a normal relationship with him.
My Child is always so calm and relaxed after sessions. When the treatment stopped in the holidays the anxiety would start to rise again.
Siblings’ health, kids sometimes come with siblings, patient can treat them
Munichin Cambridge – 2 sisters diabetic, one totally out of control, free fatty acid levels fluctuate wildly during family therapy, still not normalised 2 hrs later

22. Why CST? Structural tension Anxiety/sleep Co-ordination Concentration
Wellbeing
Relaxation
Results
Some Anne has mentioned, cases mary will discuss
Results from Studies – well being and secondary
Upledger allows for dialogue –good for emotional
Decrease stress and anxiety – self esteem
Family benefit
Immune System:
Salivary IgA shown to increase after hands on work,

23. References
The Use of CST in a physically impaired population in a disability service in Southern Ireland: Glikson M, JACM, November 07
Adolescents with ADHD benefit from Massage Therapy, Adolescene, 1998
Relationship of CranioSacral Findings in School Children with Developmental Problems: Upledger, Journal of American Osteopathic Association, 1978
See sheets

24. This Service Integrated support Use CST Ensure safety Monitor outcome
Demonstrate Effectiveness
Proud of British!
Pragmatic, use what works – (GP influenced by patients)
French trial and theories, years on ethics, CAM illegal unless Doctors No lay Homeopaths but spend far more on homeopathy than uk. Call selves hairdressers, yoga teachers, actually CAM but even further behind than us with regulation/research)
Tried to start pilot study into treatment headaches – told I had already demonstrated this should go straight for full trial.
British lead the way. Try it, demonstrate outcome while providing service

25. Dr Rachel Harrison Rose Garden Medical Centre Edinburgh