Issues in complementary and alternative medicine
Issues in complementary and alternative medicine

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Issues in complementary and alternative medicine

2.2 Users' experiences of the therapeutic relationship

CAM users may seek a very different type of therapeutic relationship from those they experience with orthodox practitioners. Some people may want to spend more time with a CAM practitioner than they do with their GP, to have more say in determining the frequency of access to practitioners, to have more control over what happens in the consultation room, and to have more choice about the treatments they are given.

In any therapeutic encounter, people want to be treated with respect, to be listened to, and to have a sense of importance in relation to knowing about their own health. This seems to apply whatever the therapy, setting or level of formality.

Many people can have good and bad therapeutic relationships within the same CAM modality; that is, they may have had a range of experiences within, say, osteopathy or shiatsu. This suggests that some practitioners are better than others at developing healing therapeutic relationships. It could also suggest that some therapeutic styles suit some users more than others and that these users are attracted to particular styles. For example, some users may want the practitioner to take control of the interaction, asking direct questions and seeking answers. Other users might prefer to talk at length about their health problems as they understand them while the practitioner listens.

Patterns of interaction change within the therapeutic encounter according to the stage of illness being treated, which means that relationships between user and practitioner can be fluid. Some users choose a therapy almost at random, without having a clear idea, or realistic expectations, of what it can offer them. Lack of communication about what the therapy is and does leads to dissatisfaction and the person is unlikely to return for further treatment. The same applies when a person feels they have been cheated, either because the practitioner did not seem sufficiently skilled, or because the treatment had no obvious effect.

A practitioner and a client may simply not get on with one another. People who pay for therapy are likely to shop around until they find a practitioner with whom they can have a rapport. A decision not to pursue therapy with a practitioner does not necessarily indicate that the therapeutic relationship has failed, nor does it necessarily cast aspersions on the practitioner.

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