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Mind-Body Therapies

Mind-body medicine focuses on the interactions among the brain, mind, body, and behavior, and on the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health .1 Examples of mind-body medicine therapies include meditation, focused imagery, hypnosis, biofeedback, yoga, qigong, and spirituality.  A number of these therapies and their use in pediatrics will be discussed below.

Meditation

Meditation is a skill that can be helpful in stress reduction and pain control.  It can also be beneficial if it is used during a long and/or painful medical procedure. During meditation, the person focuses on a silently repeated word or mantra, sound, visual image, object, or their breathing. This promotes the development of stability, inner calmness, and helps the person face pain, anxiety, or fear.  The side effects of meditation include the improved ability to deal with stress, reduced pain and anxiety, and enhanced immune function. 2

Using developmentally appropriate teaching styles, meditation can be taught to children.  Even children as young as preschool age can benefit from a quiet time spent sitting in the lap of a meditating adult. 3

Examples of Use

Although well supported in adults, studies supporting the use of meditation in pediatrics are limited.  However, anecdotal reports claim that children using meditation show reduced stress and pain perception .3  Wall (2005)4 showed that a 5 week clinical project combing Tai Chi and meditation for middle school aged boys and girls resulted in the children being calmer, relaxed, less reactive and more self-aware.  Barnes, et al., (2004)5 showed that a twice daily, three month meditation program for middle school aged teens resulted in a lowering of their resting heart rate and blood pressure.   

Biofeedback

Biofeedback involves the use of electronic devices to help people control body functions that are normally unconscious (such as breathing, heart rate, muscle tension, skin temperature). 1  By watching their electronic device measurements, patients can learn to become more relaxed and learn how to control and alter their unconscious body  functions. 

Examples of Use

Biofeedback is currently being used in pediatrics.  It has been shown to be helpful in treating children with recurrent headaches/migraines 6, dysfunctional voiding 7, intractable constipation 8 and chronic pain.9 

Yoga

Yoga is the practice from Ayurvedic or traditional Indian medicine that combines breathing exercises, physical postures, and meditation.  Its’ goal is to calm the nervous system and balance the body, mind, and spirit. 10

Examples of Use

Yoga can be useful for pediatric patients.  A randomized trial looking at daily yoga practice for four weeks for adolescents with irritable bowel syndrome reported that the subjects doing yoga had lower levels of functional disability.11 Yoga has also been tried as an adjunct to medication for children with ADHD.  In a small study of nineteen boys ages 8 to 13 years with ADHD, yoga was found to be most beneficial if it was used during the evening when medication effects were absent.12    

Spirituality

Spirituality is defined as an individual’s sense of purpose and meaning of life beyond their material values.  This can be practiced in many ways, such as through religion.10  Spirituality can be an on-going dynamic process that reflects the human spirit.  Personal spirituality comes from experiences unique to each person and it is often difficult to express. Spirituality is not just related to religion; spirituality concepts are important to both religious and non-religious persons.13  

Examples of Use

In the pediatric healthcare literature, spirituality is most often mentioned as part of palliative care and the care of life-threatening illnesses such as cancer. 14, 15   For example, very ill children may be able to use art as a technique to express their spirituality.  With a small amount of direction, very sick and/or dying children maybe able to use crayons or markers to express their spiritual state.  In the early 70s, Elizabeth Kubler-Ross identified that many dying children drew butterflies as a symbol to express their spiritual states. 13    

 

References

  1. http://nccam.nih.gov/health/backgrounds/mindbody.htm, accessed 3/25/08
    2. .
  2. Kemper, K. & Shannon, S.  (2007). Complementary and alternative medicine therapies to promote healthy moods.  Pediatric Clinics of North America, 54, 901-926.
  3. Ott, M. J. (2002).  Mindfulness meditation in pediatric clinical practice.  http://medscape.com/viewarticle/444209.
  4. Wall, R. (2005).  Tai Chi and mindfulness-based stress reduction in a Boston public middle school.  Journal of Pediatric Health Care, 19(4), 230-237.
  5. Barnes, V. Davis, H., Murzynowski, J. & Treiber, F. (2004).  Impact of meditation on resting and ambulatory blood pressure and heart rate in youth.  Psychosomatic Medicine, 66, 909-914.
  6. Balottin, U. & Termine, C. (2007).  Recommendations for the management of migraine in paediatric patients.  Expert Opinion in Pharmacotherapeutics, 8(6), 731-744.
  7. Kibar, Y., Ors, O., Demir, E., Kalman, S., Sakalliouglu, O., & Dayanc, M. (2007).  Results of biofeedback treatment on reflux resolution rates in children with dysfunctional voiding and vesicoureteral reflux.  Urology, 70(3), 566-567.
  8. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. (2006). Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.  Journal of Pediatric Gastroenterology and Nutrition, 43(3), e1-13. 
  9. Hermann, C. & Blanchard, E. (2002).  Biofeedback in the treatment of headache and other childhood pain. Applied Psychophysiology and Biofeedback, 27(2), 143-162.
    10.
  10. http://nccam.nih.gov/health/backgrounds/mindbody.htm, accessed 4/1/08
    11. .
  11. Kuttner, L. Chambers, C, Hardial, J., Israel, D., Jacobson, K., & Evans, K. (2006).  A randomized trial of yoga for adolescents with irritable bowel syndrome.  Pain Research & Management, 11(4), 217-223.
  12. Jensen, P. & Kenny, D. (2004).  The effects of yoga on the attention and behavior of boys with Attention-Deficit/hyperactivity Disorder.  Journal of Attention Disorders, 7(4), 205-214.
  13. Davies, B., Brenner, P., Orloff, S., & Worden, W. (2002).  Addressing spirituality in pediatric hospice and palliative care.  Journal of Palliative Care, 18(1), 59-67.
  14. Calabrese, C. (2007).  ACT – for pediatric palliative care.  Pediatric Nursing, 33(6), 532-534.
  15. Walco, G. (2007).  Religion, spirituality, and the practice of pediatric oncology.  Journal of Pediatric Hematology and Oncology, 29(11), 733-735.

 

Author's Note: This website does not intend to provide specific CAM practice guidelines, but will provide information on how CAM could be used in pediatrics.  In addition, links will be provided to more specific practice information when they are available.