When people actually take time to look at alternative therapies like CranioSacral Therapy (CST), the first thing that is questioned is usually the evidence to support the many wide and varied claims that alt-med therapists make. Whilst evidence for the efficacy of a treatment is a hugely important factor, it is not the only thing that should be taken into account.
One often overlooked, but I feel important area, is the actual training of the therapists. This is particularly important when the therapist is claiming to be able to treat serious medical conditions.
People involved in the diagnosis and treatment of healthcare issues are in a position where a patient may come to them feeling ‘unwell’, this could be due to a minor, self limiting condition that if untreated will clear after a few days, but there is also the distinct possibility that somebody could have an undiagnosed, potentially serious medical condition.
This is simply my opinion, but I firmly believe that what is required is somebody who, after undergoing sufficient training is capable of recognising these conditions, or at very least identifying that something is wrong and the patient is in need of further, specialist care for diagnosis and subsequent treatment.
The NHS have a special name for these people, you may have heard of them …… they’re called Doctors! When you visit your local GP or hospital consultant you are getting the services of somebody who has undergone a serious amount of training.
http://www.nhscareers.nhs.uk/details/Default.aspx?Id=550
“ It can take a minimum of nine years to train as a general practitioner (GP) and 12 years before a doctor is suitably qualified to apply for a post as a hospital consultant”
Simply completing a medical degree course will typically take at least 5 or 6 years
http://www.nhscareers.nhs.uk/details/Default.aspx?Id=641
“The “standard” five-year degree course” or if you’ve got the required background (perhaps 3 years of study for a biology degree) then “Accelerated courses for graduates (four years)” are an option.
Those who practice CranioSacral Therapy (CST) often claim that they can treat a wide range of
medical conditions. For now let us put aside the need for good quality, scientific evidence and leave that for another day. Lets have a brief look at the training requirements for a CranioSacral Therapist,.
How well trained are these therapists ?
How capable are they of identifying potential complications associated with these conditions?
The best place to get a feel for the training is the establishments in the UK who offer the training courses. These are by no means all of the organisations offering CST training, but they certainly seem to be a representative selection:
Upledger Institute:
http://www.upledger.co.uk/core-training-cms-21.html
Arranged in five principal stages, the Upledger CranioSacral Training programme is built around a series of 4-5 day intensive workshops.
College of Cranio-Sacral Therapy (CCST):
http://www.signifier.co.uk/CCST/training1.htm
Two Year Diploma Course:
Eighteen weekends (6 groups of 3 weekends) spread over two years.
Or take the ‘fast track’ on a One Year Diploma Course.
Six 6-day stages spread over a year in London
Institute of Craniosacral studies:
http://www.craniosacralstudies.co.uk/
The Two-Year Professional Training in Process-based Craniosacral Therapy consists of 16 modules totalling 47 days.
Karuna Institute:
http://www.karuna-institute.co.uk/cranio/twoyear.html
The professional training in Craniosacral Biodynamics is taught at the Institute over ten five-day seminars during two years;
Or to make things even clearer;
| Organisation | Duration of Training | Qualification | Recognised By |
| UK University | 5-6 Years | Medical Degree | GMC/NHS |
| Upledger Inst | 20-25 Days spread over 2 years | Diploma | CranioSacral Therapy Assoc |
|
College of CranioSacral Therapy |
36 Days spread over 1 or 2 years | Diploma | CranioSacral Therapy Assoc |
|
Institute of CranioSacral Studies |
47 Days spread over 2 years | Diploma | CranioSacral Therapy Assoc |
|
Karuna Institute |
50 Days spread over 2 years | Diploma | CranioSacral Therapy Assoc |
Well it quickly becomes clear that there is a huge difference in the level of training.
All the CST training establishments say that the course consists of ‘intensive’ training and that there is work to do in between the formal training stages. As described by the upledger institute, there is a need to
“absorb and apply the practical work, further develop your fine palpatory skills, review the course notes and cover required reading.”
So there is an element of home study & revision required, the same sort of thing required for any professional training course!
We can easily see that there is no comparison between obtaining a medical degree and a CranioSacral diploma. But somehow CST therapists claim to be able to effectively diagnose and treat many of the same medical conditions. Within the NHS treatment of these conditions can require the attention of doctors who have undergone specialist training to allow them to deal effectively with what are often complex medical conditions. You simply cannot spend a few days a year, learning unproven therapy techniques and claim to have the knowledge required to offer these treatments.
All alt-med practitioners of all persuasions will eventually use the argument that it is down to patient choice and this is very true, but patient choice should be based on solid facts, reliable evidence and good quality training. Of course CST is not alone in this level of professional training and other therapies have equally unrealistic levels of training before becoming ‘qualified‘
So when it comes to patient choice, your choice should include, Medical Doctor or therapist, Medical Degree or diploma , recognised & tested treatments with built in safety measures or an unproven, unregulated therapy!
Earlier I asked 2 questions:
How well trained are these therapists ?
How capable are they of identifying potential complications associated with these conditions?
Anybody care to answer…
Maybe it’s time to have a closer look at that evidence we put aside earlier …..
Blue Wode
August 29, 2010
A very interesting post. I’m already looking forward to your examination of the evidence!
Incidentally, another area that is evidently important, but that’s often overlooked, is the therapists’ CPD programme. That includes seminars, symposiums, and workshops. A particularly impressive event was presented by John Upledger himself, not so long ago:
For more outrageous observations made at that symposium, read on…
http://www.massagetoday.com/archives/2002/11/15.html
Zeno
August 29, 2010
There is a very good reason why we take the brightest of our school pupils and put them through 5 tough years of University and even more years of hell until they are ready to be let loose on the public – medicine is difficult.
Except there are those who think it’s easy. But they are fooling themselves – and others.
It would be interesting to also give the entrance qualifications required for many quack courses. Given Blue Wode’s quote, I suspect that not even one GCSE is required for those ‘therapists’.
skepticbarista
August 29, 2010
Blue Wode & Zeno,
I think the whole question of a therapists training needs to be looked at alongside the questions about evidence. Even medical treatments that are supported by good quality evidence need suitably qualified experts to implement that treatment.
The levels of training for CST is a joke when you consider the types of disease & ailments they claim they can help with. These people don’t have sufficient training to recognise these conditions let alone treat them. For example, the conditions listed above include Cerebral Palsy, stroke or stress related conditions add this to the fact that CST therapists often (almost always) offer to treat illness in babies and young children. You have to ask, what are the consequenses of a CST therapist not recognising signs of complications or the presence of serious conditions in the very young ?
It is not even the validity of the treatment that is worrying, these people will be dealing with ‘patients’ (customers) who may have undiagnosed conditions that need proper medical attention. Thankfully the ASA do take into consideration whether an advert could discourage people from seeking the correct medical treatment.
I think we would find this is the same with many alt-med therapies. I doubt homeopathy, reflexology and reiki etc are any better. They make much of the fact that they treat the whole body, not just ‘symptoms’. I have a feeling they wouldn’t recognise the symptoms in the first place!
It just seems to me that it is an area of quackery that often gets overlooked.
andrew Gilbey
August 30, 2010
Interesting post, SB.
Like so many altmed ideas, this is another that makes no sense whatsoever.
Zeno
August 30, 2010
Blue Wode
That is just beyond parody! You couldn’t make it up. Well, CS therapists obviously do.
harry-h
September 6, 2010
Why have a comments section if you just edit out the ones you don’t agree with.
Obviously no point in anyone with an OPEN mind looking at this blog, I know I wont bother again.
Keep on preaching to the converted, so you can all agree with each other and avoid any real confrontation or argument.
Zeno
September 6, 2010
harry-h
What on earth are you talking about? Have you posted this in the wrong page?
skepticbarista
September 6, 2010
Harry,
No comments have been edited out, nor has any user been blocked.
The point of the comments section is to comment on the subject of the blog post.
If you have posted anything and it has not shown up then let me know, I’ve checked the spam bin and it’s empty.
alison
September 7, 2010
Other therapies are worse than this, at least for veterinary CAM:
In order to embark on training for an alternative therapy for horses, all you generally need is a willingness to pay the fees (the main exception is acupuncture, for which you have to be a qualified vet). Courses in alternative therapies for horses range from a weekend (reiki), one to three days (homeopathy), five weekends (applied kinesiology), a fortnight (Bowen Technique) to 1-3 years of part-time study (aromatherapy, shiatsu, McTimoney chiropractic) – this sounds better but may be as little as eighteen weekends in total. At the end of such a course you get a certificate of some sort and are entitled to purchase insurance and to treat other people’s horses, for money. I fnd the reiki particularly breathtaking, particularly as that course also includes some time spent on the safe way to handle a horse for those with no prior experience.
You are taught by people who are more interested in passing on and reinforcing their beliefs than in exploring the facts. There is nothing academically rigorous at all – how could there be?
I was once told by someone who taught a CAM-for-horses course that she deliberately refrained from teaching much about anatomy, physiology and pathology so as not to discourage those students who were not particularly, well, intellectual. She felt that the therapy she taught worked perfectly well without such knowledge and that it could be regarded as an optional extra for those who happened to be interested enough to do the work themselves.
Part of the problem is that many of these people think they do more good than vets do, because they believe that their own intuition and desire to be a healer count for more than veterinary knowledge.
It’s heartbreaking because, unlike adult humans, animals have no choice in the care they get when they are ill or injured.
Debra
April 14, 2011
I think several of you are missing the point here. Doctors (MDs) only know how to listen to their patients complaints, send them for blood tests, MRIs, ultrasounds, which are then read by radiologists trained to read the results and then report back to the doctors. With lesser problems that are easily recognized by GPs, their answer is to prescribe pharmaceuticals, and then some of them have to look up in their medical books the correct medicine to prescribe before they write the prescriptions; thus bombarding the human body with chemicals. Enter, the choice; the choice to not bombard your body with chemicals and the choice to find another way to manage pain primarily, and if by osmosis, alternative therapies alleviate other symptoms, then that is a good thing. Upledger’s teachings are all over the world. Most quackery does not get that far, so something that CST does must be helping.
Speaking of quacks, I was diagnosed with MS in 2009; went to about five different neurologists who just read the reports and said, “Yep that’s what you have.” Except one, who said, but you don’t present with any of the typical symptoms of someone who has or has had MS for the past 30 years. Go figure! A chiropractor did diagnose me with fibromyalgia. Another famous naturopathic doctor has written books about blood type and diet. Once I took my ills into my own hands, and investigated these diagnoses, I became my own doctor. Once I changed my diet to follow the BTD, a lot of my inflammation, arthritis, and bodily allergy has subsided; and the last time I had an MRI to determine or prove or disprove the diagnosis of MS, any lesions that were in my brain from probably childhood infections, were diminishing. So all of those doctors out there who are diagnosing MS for example should be shot. Curiously, they are tied to pharmaceutical companies and will get you set up and ready to inject yourself with poisons at warp speed. It is just unconscionable that these “doctors” are allowed to practice.
Don’t get me wrong, there are some great doctors out there, who are really closet alternative doctors. You can tell, because they study and have the knowledge of alternative therapies; they just don’t publicize their knowledge that much. Geography plays another big role in the quality of doctors; wherever the money is, is where you will find the better doctors. Compare Morris County, NJ to Ocean County, NJ and you would think you were on another planet. The high level of competency in Morris County doctors compared to the incompetency of Ocean County doctors paints a very glum picture for people who go to doctors in Ocean County, NJ. I know, because I have experienced both scenarios. And that is just comparing two counties in NJ; I believe there are 21 counties in NJ.
Bottom line is that if there is a previously existing problem anyone who treats a person needs to know what is going on. Additionally, there are always in my estimation going to be co-morbidities existing in people. The problems range from the simple (like diet) to the very complex (like physical and mental) disorders. But, in all disorders be they of the mind, body, or spirit, all respond to gentle touch; all respond to a physical connection, because all suffer from stress that manifests in physical behaviors. How does someone with Tourette’s Syndrome focus on something highly detailed in nature; displaying no tics; yet TS is a medical neurological disorder. So, is it the will; is it the mind that controls the ticcing; what is it. Clearly, the body can control and heal itself with the right modalities and therapies that do not necessarily include pharmaceuticals. Everyone responds to touch. Cancer patients respond to touch, which uplifts their spirits, which can possibly give them the will to fight. How do you explain that? MDs are taught to give a pill; Alterntive therapies and Naturopathic doctors are trained to find the help from within the body. So, in closing, I believe the CST is a valid therapy; maybe not the only therapy but certainly valid, and if more training is available or required then that is also a good thing.
MadPT
July 26, 2011
I would like to add just one caveat to the comments on therapist vs. MD training. While CST has been debunked and is not supported by any logical healthcare practitioner (of which I am one) you cannot compare a Diploma program to a medical degree. There are several specialist programs in the world of PT that are validated and add pieces to a foundation already in place by many years of medical education. In order to enter a diploma program a PT first also goes through 5-6 years of rigorous medical and diagnostic training. Orthopedic physical therapists, nine times out of ten, are much more qualified to identify and/or diagnose musculoskeletal and sometimes neurological disorders than a GP. Keep that in mind the next time you go into your GP with pain down your leg and he/she writes a script ot PT for “hip pain, evaluate and treat”.