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Massage Today
November, 2012, Vol. 12, Issue 11

Another Look at Massage and Substance Abuse Treatment

By Massage Therapy Foundation Contributor

Contributed By April Neufeld, BS, LMT, NCTMB and Derek R. Austin, MS, CMT, LMT

As readers will recall from reading the previous research review article, "A Mind-Body Intervention that Includes Massage Helps in Treatment of Substance Abuse," (Massage Today, October 2012) Sandy Anderson described the details in Cynthia Price and colleagues' research study on the use of Mindful Awareness in Body-oriented Therapy (MABT) in treatment of women's substance use disorders (SUD).

"MABT combines massage and mind-body approaches to develop introception.and self-emotional care tools," wrote Anderson. In this second publication of the study, Cynthia Price and colleagues reported in the Journal of Alternative and Complementary Medicine (2012) the issues around acceptability and implementation of MABT within a women's substance use disorder clinic.

The article "highlights a number of issues, including negotiating perceived conflicts between the most internally valid study design and patient treatment needs, the importance of clinical staff perspectives and buy-in, changes in program structure or organization that are necessitated by a particular research design, and the importance of participant satisfaction with treatment," wrote Price and colleagues in the introduction. But what may be of greatest interest to Massage Today readers, the study authors emphasize that "massage is one of the primary MABT elements and is thought to be clinically useful for increasing awareness of tension, cueing individuals to physical symptoms of stress and habitual patterns of responding to stress that may be important for relapse prevention." To gauge the individual effectiveness of the MABT treatment, the study participants filled out a written questionnaire that specifically asked about the helpfulness of MABT components (including check-in, massage body awareness exercises, mindful practice, session review, and homework).

I had the pleasure of interviewing Dr. Price and she said, "[This article] highlights how [the participants] felt about their experience, and in their own words were able to describe how the intervention was helpful for them." She went on in great detail about her experience with the women's clinic where the study took place. (This clinic was independent from the University of Washington, which sponsored the researchers). Although future studies should include men, the women's only clinic was chosen because it had been involved with previous research studies and, therefore, the staff was very comfortable accommodating the researchers, could help with setup, and could facilitate the study.

The clinic studied already offered alternative medicine options for the inpatients including yoga and massage therapy. Dr. Price emphasized that it was important for a clinic to already have a holistic focus integrated into the treatment protocol. "The success of a holistic study has more to do with the staff values and willingness to work with outsiders," Dr. Price said, "and [touch based therapies are] less common among community substance abuse clinics." Substance abuse clinics that include alternative medicine options typically are only available at high-end clinics, but Dr. Price indicated that directors of low-income clinics are aware and interested in including these types of treatments. However, funding is limited for all treatment options, so the cost-effectiveness of MABT should be included in future studies.

Dr. Price's article outlines the treatment satisfaction of the participants. A general satisfaction survey was part of the research methods. "Participants were asked to indicate level of satisfaction with the number of sessions received; 21 (84%) of the respondents were satisfied with the total number of sessions. The four participants who were dissatisfied (16% of respondents) indicated that this was due to wanting more sessions (three ended early due to early discharge from outpatient treatment and one due to time conflicts)," wrote Price and colleagues. Participants also indicated how helpful they found the primary MABT elements (check-in, massage with body literacy, inner body awareness exercises, Mindful Body Awareness Practice, session review, and homework), and the majority (84%) indicated that all components were very helpful. The participants were also able to leave comments. When asked about the most important MABT experience, one participant said, "Connecting emotions with sensations – It is difficult for me to identify emotions sometimes but I can now look to my body for cues." Dr. Price told me that the participants' responses gave a clear picture about why paying attention and body therapy were so important in preventing relapse and how it changed the lives of the women involved.

When looking at the implementation feasibility, the researchers wrote, "it was possible to effectively deliver MABT as an adjunct to SUD treatment in the community-based treatment program." The clinic staff gave positive reviews for the study inclusion, which was indicated in their "willingness to suggest alternatives to help accommodate the implementation of MABT and its participants."

LMTs sometimes ask how they can get involved in working with special populations such as people with substance use or addiction issues. When I asked Dr. Price about the massage therapists who participated in her study, she said that the LMTs involved had a background in mental health disorder training or had practices that involved addiction and bodywork.

For additional education, Dr. Price recommended, "LMTs interested in further training specific to body awareness to promote emotional well-being might consider training in the Hakomi method: www.hakomiinstitute.com. MABT protocol training is available for individual therapists, and for treatment facilities interested in implementing MABT as part of their patient's recovery (substance use, eating disorders and trauma) program: www.mindfulbodyawareness.org."

Reference:

  • Cynthia J. Price PhD, Elizabeth A. Wells, PhD, Dennis M. Donovan, PhD, and Marissa Brooks, MPH. "Implementation and Acceptability of Mindful Awareness in Body-Oriented Therapy in Women's Substance Use Disorder Treatment," the Journal of Alternative and Complementary Medicine, 2012, Vol. 18(5): 1-9.

Editor's Note: If you are interested in learning more about the evidence supporting the use and integration of massage therapy in clinical and medical practice with different patient populations, visit The Massage Therapy Foundation at: www.massagetherapyfoundation.org/ and tap into the Foundation's Research Resources.


Click here for more information about Massage Therapy Foundation Contributor.

 

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