Category Archives: Therapetic treatment

PUVA therapy

Description:
PUVA is an acronym. The P stands for psoralen,(Psoralen is a photosensitizing agent found in plants ) the U for ultra, the V for violet, and the A for that portion of the solar spectrum between 320 and 400 nanometers in wavelength. Psoralens are chemicals found in certain plants that have the ability to absorb ultraviolet light in these wavelengths. Once the light energy is absorbed, these chemicals are energized to interact with DNA, ultimately inhibiting cell multiplication, which is their presumed mode of action.

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Certain skin diseases are characterized by cells that are rapidly multiplying. Inhibiting this unrestrained multiplication can be useful in treating these diseases. So PUVA is a combination of an oral drug and subsequent ultraviolet light exposure. The treatment may affect certain blood cells and skin cells so that the skin disease improves.

It is a treatment for eczema, psoriasis, graft-versus-host disease, vitiligo, mycosis fungoides, large-plaque parapsoriasis and cutaneous T-cell lymphoma using the sensitizing effects of the drug psoralen. The psoralen is applied or taken orally to sensitize the skin, then the skin is exposed to UVA.

Photodynamic therapy is the general use of nontoxic light-sensitive compounds that are exposed selectively to light, whereupon they become toxic to targeted malignant and other diseased cells. Still, PUVA therapy is often classified as a separate technique from photodynamic therapy.

Plant sources   from where  we get psoralens:
Ficus carica (fig) is probably the most abundant source of psoralens. They are also found in small quantities in Ammi visnaga (bisnaga), Pastinaca sativa (parsnip), Petroselinum crispum (parsley), Levisticum officinale (lovage), Foeniculum vulgare (fruit, i.e., fennel seeds), Daucus carota (carrot), Psoralea corylifolia (babchi), and Apium graveolens (celery).

Types of PUVA therapy:
The most common form of therapy combines 8-methoxypsoralen taken by mouth followed 45-60 minutes later by exposure of the skin to UVA. Less commonly the drug is applied topically (the medication is occasionally diluted in bathtub water in which the patient is immersed) and then after a few minutes the ultraviolet exposure occurs.

Procedure:
Psoralens are taken systemically or can be applied directly to the skin. The psoralens allow a relatively lower dose of UVA to be used. When they are combined with exposure to UVA in PUVA, they are highly effective at clearing psoriasis and vitiligo. Like UVB light treatments, the reason remains unclear, though investigators speculate there may be similar effects on cell turnover and the skin’s immune response.

Choosing the proper dose for PUVA is similar to the procedure followed with UVB. The physician can choose a dose based on the patient’s skin type. The dose will increase in every treatment until the skin starts to respond.

Some clinics test the skin before the treatments, by exposing a small area of the patient’s skin to UVA, after ingestion of psoralen. The dose of UVA that produces uniform redness 72 hours later, called the minimum phototoxic dose (MPD), becomes the starting dose for treatment.

At the very least for vitiligo, narrowband ultraviolet B (UVB) phototherapy is now used more commonly than PUVA since it does not require the use of the Psoralen. As with PUVA, treatment is carried out twice weekly in a clinic or every day at home, and there is no need to use psoralen.

Narrowband UVB does not cure the legs and hands, compared to the face and neck. To the hands and legs PUVA may be more effective. The reason can be because UVA penetrates deeper in the skin, and the melanocytes in the skin of the hands and legs is deeper in the skin. The Narrowband UVB does not reach the melanocytes.

How maney PUVA  therapy is required:
There ought to be a significant improvement in the patient’s skin disease after about 15 treatments. Treatments are given no sooner than 48 hours apart because the burn induced by PUVA is often delayed for as long as two days (unlike ordinary sunburns). Unless there is a problem, the amount of energy administered to the patient is increased appropriately at each visit depending on the patient’s coloration. After about 30 treatments, a decision is made as to whether to continue treatments. PUVA is not always effective. If there is no improvement after these treatments, it is probably unlikely that continuing this form of treatment is worthwhile. On the other hand, if significant clearing has occurred, it is probably prudent to decrease the frequency of treatments in order to maintain the improvement. Since there is a relationship between the amount of light energy administered and the degree of photo-aging and the induction of skin cancers, it is wise to limit the light exposures as appropriate.

Advantages:
The major advantage to PUVA is that it is an effective therapy that becomes active only at the site of the disease, the skin. It can be used to treat large areas of skin, and the fact that the drug is only activated in the presence of UV light implies that it may be less toxic than other therapies that require systemic administration and whose effects are not localized to just the skin.

PUVA must be administered in a physician’s office under the control of a medical professional so it requires repeated visits to the office. PUVA may not cure psoriasis permanently so treatment can be required indefinitely.

Side effects and complications:
Some patients experience nausea and itching after ingesting the psoralen compound. For these patients PUVA bath therapy may be a good option.

Long term use of PUVA therapy has been associated with higher rates of skin cancer.

The most significant complication of PUVA therapy for psoriasis is squamous cell skin cancer. Two carcinogenic components of the therapy include the nonionizing radiation of UVA light as well as the psoralen intercalation with DNA. Both processes negatively contribute to genome instability.
History  :  Psoralens have been known since ancient Egypt but have only been available in a chemically synthesized form since the 1970s.

Resources:
http://en.wikipedia.org/wiki/PUVA_therapy
http://www.medicinenet.com/puva_therapy_photochemotherapy/article.htm

Chronotherapy

 Definition:   Chronotherapy refers to the use of circadian or other rhythmic cycles in the application of therapy. Examples of this are treatments of psychiatric and somatic diseases that are administered according to a schedule that corresponds to a person’s rhythms in order to maximize effectiveness and minimize side effects of the therapy.

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Chronotherapy is used in different fields, examples of this are the treatment of asthma, cancer, hypertension, and multiple types of depression, among others seasonal affective disorder and bipolar disorder. Apart from the clinical applications, chronotherapy is becoming increasingly popular in non-clinical settings, for example on the work floor, where it is used to increase productivity and performance.

*Methods of pharmaceutical chronotherapy:
*Imitative/Mimetic: Imitating the natural changes in a certain substance in the body.
*Preventive/Precautionary: Taking medicines at the moment that they are most necessary, for example taking hypertension medicine at the time of day that the blood pressure is rising.
*Wake therapy

Chronotherapy is a successful treatment of diseases may depend on the time of day or month that a medicine is taken or surgery performed. Asthma and arthritis pain are examples of conditions now being treated by the clock or calendar.

How our bodies marshal defenses against disease depends on many factors, such as age, gender and genetics. Recently, the role of our bodies’ biological rhythms in fighting disease has come under study by some in the medical community.

Our bodies’ rhythms, also known as our biological clocks, take their cue from the environment and the rhythms of the solar system that change night to day and lead one season into another. Our internal clocks are also dictated by our genetic makeup. These clocks influence how our bodies change throughout the day, affecting blood pressure, blood coagulation, blood flow, and other functions.

Some of the rhythms that affect our bodies include:

*Ultradian, which are cycles shorter than a day (for example, the milliseconds it takes for a neuron to fire, or a 90-minute sleep cycle)
*Circadian, which last about 24 hours (such as sleeping and waking patterns)
*Infradian, referring to cycles longer than 24 hours (for example monthly menstruation)
*Seasonal, such as seasonal affective disorder (SAD), which causes depression in susceptible people during the short days of winter.

Chronotherapy (sleep phase)
In chronotherapy, an attempt is made to move bedtime and rising time later and later each day, around the clock, until the person is sleeping on a normal schedule. This treatment can be used by people with delayed sleep phase disorder who generally cannot reset their circadian rhythm by moving their bedtime and rising time earlier.

Here’s an example of how chronotherapy could work over a week’s course of treatment, with the patient going to sleep 3 hours later every day until the desired sleep and waketime is reached. (Shifting the sleep phase by 3 hours per day may not always be possible; shorter increments of 1–2 hours are needed in such cases.)[citation needed]

Day 1: sleep 04:00 to 12:00
Day 2: sleep 07:00 to 15:00
Day 3: sleep 10:00 to 18:00
Day 4: sleep 13:00 to 21:00
Day 5: sleep 16:00 to 00:00
Day 6: sleep 19:00 to 03:00
Day 7 to 13: sleep 22:00 to 06:00
Day 14 and thereafter: sleep 23:00 to 07:00
While this technique can provide temporary respite from sleep deprivation, patients may find the desired sleep and waketimes slip. The desired pattern can only be maintained by following a strictly disciplined timetable for sleeping and rising.
Other forms of sleep phase chronotherapy:
A modified chronotherapy is called controlled sleep deprivation with phase advance, SDPA. One stays awake one whole night and day, then goes to bed 90 minutes earlier than usual and maintains the new bedtime for a week. This process is repeated weekly until the desired bedtime is reached.

Sometimes, although extremely infrequently, “reverse” chronotherapy – i.e., gradual movements of bedtime and rising time earlier each day – has been used in treatment of patients with abnormally short circadian rhythms, in an attempt to move their bedtimes to later times of the day. Because circadian rhythms substantially shorter than 24 hours are extremely rare, this type of chronotherapy has remained largely experimental.

Chronotherapy is not well recognized in the medical community, but awareness is increasing. The implications are broad in every area of medicine.”

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Side effects:
The safety of chronotherapy is not fully known. While chronotherapy has been successful for some, it is necessary to rigidly maintain the desired sleep/wake cycle thenceforth. Any deviation in schedule tends to allow the body clock to shift later again.

Chronotherapy has been known to cause non-24-hour sleep–wake disorder in at least three recorded cases, as reported in the New England Journal of Medicine in 1992. Animal studies have suggested that such lengthening could “slow the intrinsic rhythm of the body clock to such an extent that the normal 24-hour day no longer lies within its range of entrainment.

Resources:
http://en.wikipedia.org/wiki/Chronotherapy_(treatment_scheduling)
http://www.medicinenet.com/script/main/art.asp?articlekey=551
http://www.medicinenet.com/script/main/art.asp?articlekey=551&page=5
http://en.wikipedia.org/wiki/Chronotherapy_(sleep_phase)

Cognitive Behavioural Therapy (CBT)

Definition:
Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. CBT is commonly used to treat a wide range of disorders including phobias, addictions, depression, and anxiety.

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Cognitive behavioral therapy (CBT) is a short-term psychotherapy originally designed to treat depression, but is now used for a number of mental illnesses. It works to solve current problems and change unhelpful thinking and behavior.  The name refers to behavior therapy, cognitive therapy, and therapy based upon a combination of basic behavioral and cognitive principles.  Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy. This technique acknowledges that there may be behaviors that cannot be controlled through rational thought, but rather emerge based on prior conditioning from the environment and other external and/or internal stimuli. CBT is “problem focused” (undertaken for specific problems) and “action oriented” (therapist tries to assist the client in selecting specific strategies to help address those problems),  or directive in its therapeutic approach.

CBT has been demonstrated to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic, and psychotic disorders. Many CBT treatment programs for specific disorders have been evaluated for efficacy; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.  However, other researchers have questioned the validity of such claims to superiority over other treatments.

Description:
Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in affect and behavior,[8] but recent variants emphasize changes in one’s relationship to maladaptive thinking rather than changes in thinking itself.  Therapists or computer-based programs use CBT techniques to help individuals challenge their patterns and beliefs and replace “errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing” with “more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior.”  These errors in thinking are known as cognitive distortions. Cognitive distortions can be either a pseudo- discrimination belief or an over-generalization of something.  CBT techniques may also be used to help individuals take a more open, mindful, and aware posture toward them so as to diminish their impact. Mainstream CBT helps individuals replace “maladaptive… coping skills, cognitions, emotions and behaviors with more adaptive ones”,  by challenging an individual’s way of thinking and the way that they react to certain habits or behaviors,  but there is still controversy about the degree to which these traditional cognitive elements account for the effects seen with CBT over and above the earlier behavioral elements such as exposure and skills training.

Modern forms of CBT include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy.  Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.

CBT has six phases:
1.Assessment or psychological assessment;
2.Reconceptualization;
3.Skills acquisition;
4.Skills consolidation and application training;
5.Generalization and maintenance;
6.Post-treatment assessment follow-up.

The reconceptualization phase makes up much of the “cognitive” portion of CBT.   A summary of modern CBT approaches is given by Hofmann.

There are different protocols for delivering cognitive behavioral therapy, with important similarities among them.  Use of the term CBT may refer to different interventions, including “self-instructions (e.g. distraction, imagery, motivational self-talk), relaxation and/or biofeedback, development of adaptive coping strategies (e.g. minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain, and goal setting”. Treatment is sometimes manualized, with brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven. CBT is used in both individual and group settings, and the techniques are often adapted for self-help applications. Some clinicians and researchers are cognitively oriented (e.g. cognitive restructuring), while others are more behaviorally oriented (e.g. in vivo exposure therapy). Interventions such as imaginal exposure therapy combine both approaches.

Types of Cognitive Behavior Therapy:
There are a number of different approaches to CBT that are regularly used by mental health professionals. These types include:
•Rational Emotive Behavior Therapy (REBT)
•Cognitive Therapy
•Multimodal Therapy

Medical uses of CBT:
In adults, CBT has been shown to have effectiveness and a role in the treatment plans for anxiety disorders,  depressioneating disorders chronic low back painpersonality disorderspsychosis,  schizophrenia,  substance use disorders,  in the adjustment, depression, and anxiety associated with fibromyalgia,  and with post-spinal cord injuries.  Evidence has shown CBT is effective in helping treat schizophrenia, and it is now offered in most treatment guidelines.

In children or adolescents, CBT is an effective part of treatment plans for anxiety disorders,  body dysmorphic disorder,  depression and suicidality,  eating disorders and obesity,  obsessive–compulsive disorder,  and posttraumatic stress disorder,  as well as tic disorders, trichotillomania, and other repetitive behavior disorders.

Cochrane reviews have found no evidence that CBT is effective for tinnitus, although there appears to be an effect on management of associated depression and quality of life in this condition.   Other recent Cochrane Reviews found no convincing evidence that CBT training helps foster care providers manage difficult behaviors in the youth under their care,  nor was it helpful in treating men who abuse their intimate partners.

According to a 2004 review by INSERM of three methods, cognitive behavioral therapy was either “proven” or “presumed” to be an effective therapy on several specific mental disorders.  According to the study, CBT was effective at treating schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress, anxiety disorders, bulimia, anorexia, personality disorders and alcohol dependency.

Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression.  However, psychodynamic therapy may provide better long-term outcomes.

Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders, including children,  as well as insomnia.  Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls.  CCBT was found to be equally effective as face-to-face CBT in adolescent anxiety  and insomnia.

Criticism of CBT sometimes focuses on implementations (such as the UK IAPT) which may result initially in low quality therapy being offered by poorly trained practitioners.  However evidence supports the effectiveness of CBT for anxiety and depression.

Mounting evidence suggests that the addition of hypnotherapy as an adjunct to CBT improves treatment efficacy for a variety of clinical issues.

CBT has been applied in both clinical and non-clinical environments to treat disorders such as personality conditions and behavioral problems.  A systematic review of CBT in depression and anxiety disorders concluded that “CBT delivered in primary care, especially including computer- or Internet-based self-help programs, is potentially more effective than usual care and could be delivered effectively by primary care therapists.”

Emerging evidence suggests a possible role for CBT in the treatment of attention deficit hyperactivity disorder (ADHD);  hypochondriasis;  coping with the impact of multiple sclerosis;  sleep disturbances related to aging; dysmenorrhea;  and bipolar disorder,  but more study is needed and results should be interpreted with caution. CBT has been studied as an aid in the treatment of anxiety associated with stuttering. Initial studies have shown CBT to be effective in reducing social anxiety in adults who stutter,  but not in reducing stuttering frequency.

Martinez-Devesa et al. (2010) found no evidence that CBT is effective for tinnitus, although there appears to be an effect on management of associated depression and quality of life in this condition. Turner et al. (2007) found no convincing evidence that CBT training helps foster care providers manage difficult behaviors in the youth under their care,[39] and Smedslund et al. (2007) found that it was not helpful in treating men who abuse their intimate partners.

In the case of metastatic breast cancer, Edwards et al. (2008) maintained that the current body of evidence is not sufficient to rule out the possibility that psychological interventions may cause harm to women with this advanced neoplasm.

In adults, CBT has been shown to have a role in the treatment plans for anxiety disorders; depression;  eating disorders;  chronic low back pain;  personality disorders;  psychosis; schizophrenia;  substance use disorders;  in the adjustment, depression, and anxiety associated with fibromyalgia;  and with post-spinal cord injuries.  There is some evidence that CBT is superior in the long-term to benzodiazepines and the nonbenzodiazepines in the treatment and management of insomnia.  CBT has been shown to be moderately effective for treating chronic fatigue syndrome.

In children or adolescents, CBT is an effective part of treatment plans for anxiety disorders;  body dysmorphic disorder;  depression and suicidality;  eating disorders and obesity;  obsessive–compulsive disorder;  and posttraumatic stress disorder;  as well as tic disorders, trichotillomania, and other repetitive behavior disorders. CBT-SP, an adaptation of CBT for suicide prevention (SP), was specifically designed for treating youth who are severely depressed and who have recently attempted suicide within the past 90 days, and was found to be effective, feasible, and acceptable. Sparx is a video game to help young persons, using the CBT method to teach them how to resolve their own issues. That’s a new way of therapy, which is quite effective for child and teenager. CBT has also been shown to be effective for posttraumatic stress disorder in very young children (3 to 6 years of age).  Cognitive Behavior Therapy has also been applied to a variety of childhood disorders,  including depressive disorders and various anxiety disorders.

In the United Kingdom, the National Institute for Health and Care Excellence (NICE) recommends CBT in the treatment plans for a number of mental health difficulties, including posttraumatic stress disorder, obsessive–compulsive disorder (OCD), bulimia nervosa, and clinical depression

Use of CBT  in other different ways:
With older adults:
CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the patient with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences thanks to age.   Some of the challenges to CBT because of age include the following:
The Cohort effect The times that each generation lives through partially shape its thought processes as well as values, so a 70-year-old may react to the therapy very differently from a 30-year-old, because of the different culture in which they were brought up. A tie-in to this effect is that each generation has to interact with one another, and the differing values clashing with one another may make the therapy more difficult.  Established role By the time one reaches old age, the person has a definitive idea of her or his role in life and is invested in that role. This social role can dominate who the person thinks he or she is and may make it difficult to adapt to the changes required in CBT. Mentality toward aging If the older individual sees aging itself as a negative this can exacerbate whatever malady the therapy is trying to help (depression and anxiety for example).  Negative stereotypes and prejudice against the elderly cause depression as the stereotypes become self-relevant.[88]Processing speed decreasesAs we age, we take longer to learn new information, and as a result may take more time to learn and retain the cognitive therapy. Therefore, therapists should slow down the pacing of the therapy and use any tools both written and verbal that will improve the retention of the cognitive behavioral therapy.

Prevention of mental illness:
For anxiety disorders, use of CBT with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes.  In another study, 3% of the group receiving the CBT intervention developed generalized anxiety disorder by 12 months post intervention compared with 14% in the control group.  Subthreshold panic disorder sufferers were found to significantly benefit from use of CBT.  Use of CBT was found to significantly reduce social anxiety prevalence.

For depressive disorders, a stepped-care intervention (watchful waiting, CBT and medication if appropriate) achieved a 50% lower incidence rate in a patient group aged 75 or older.  Another depression study found a neutral effect compared to personal, social, and health education, and usual school provision, and included a comment on potential for increased depression scores from people who have received CBT due to greater self recognition and acknowledgement of existing symptoms of depression and negative thinking styles.[99] A further study also saw a neutral result. A meta-study of the Coping with Depression course, a cognitive behavioural intervention delivered by a psychoeducational method, saw a 38% reduction in risk of major depression.

For schizophrenia, one study of preventative CBT showed a positive effect   and another showed neutral effect.

Criticisms of Cognitive Behavior Therapy:
The research conducted for CBT has been a topic of sustained controversy. While some researchers write that CBT is more effective than other treatments,[148] many other researchers  and practitioners  have questioned the validity of such claims. For example, one study  determined CBT to be superior to other treatments in treating anxiety and depression. However, researchers responding directly to that study conducted a re-analysis and found no evidence of CBT being superior to other bona fide treatments, and conducted an analysis of thirteen other CBT clinical trials and determined that they failed to provide evidence of CBT superiority.

Furthermore, other researchers  write that CBT studies have high drop-out rates compared to other treatments. At times, the CBT drop-out rates can be more than five times higher than other treatments groups. For example, the researchers provided statistics of 28 participants in a group receiving CBT therapy dropping out, compared to 5 participants in a group receiving problem-solving therapy dropping out, or 11 participants in a group receiving psychodynamic therapy dropping out.

Other researchers  conducting an analysis of treatments for youth who self-injure found similar drop-out rates in CBT and DBT groups. In this study, the researchers analyzed several clinical trials that measured the efficacy of CBT administered to youth who self-injure. The researchers concluded that none of them were found to be efficacious. These conclusions  were made using the APA Division 12 Task Force on the Promotion and Dissemination of Psychological Procedures to determine intervention potency.

However, the research methods employed in CBT research have not been the only criticisms identified. Others have called CBT theory and therapy into question. For example, Fancher  writes the CBT has failed to provide a framework for clear and correct thinking. He states that it is strange for CBT theorists to develop a framework for determining distorted thinking without ever developing a framework for “cognitive clarity” or what would count as “healthy, normal thinking.” Additionally, he writes that irrational thinking cannot be a source of mental and emotional distress when there is no evidence of rational thinking causing psychological well-being. Or, that social psychology has proven the normal cognitive processes of the average person to be irrational, even those who are psychologically well. Fancher also says that the theory of CBT is inconsistent with basic principles and research of rationality, and even ignores many rules of logic. He argues that CBT makes something of thinking that is far less exciting and true than thinking probably is. Among his other arguments are the maintaining of the status quo promoted in CBT, the self-deception encouraged within clients and patients engaged in CBT, how poorly the research is conducted, and some of its basic tenets and norms: “The basic norm of cognitive therapy is this: except for how the patient thinks, everything is ok”.

Meanwhile, Slife and Williams  write that one of the hidden assumptions in CBT is that of determinism, or the absence of free will. They argue that CBT invokes a type of cause-and-effect relationship with cognition. They state that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states. Nowhere in CBT theory is agency, or free will, accounted for. At its most basic foundational assumptions, CBT holds that human beings have no free will and are just determined by the cognitive processes invoked by external stimuli.

Another criticism of CBT theory, especially as applied to Major Depressive Disorder (MDD), is that it confounds the symptoms of the disorder with its causes.

A major criticism has been that clinical studies of CBT efficacy (or any psychotherapy) are not double-blind (i.e., neither subjects nor therapists in psychotherapy studies are blind to the type of treatment). They may be single-blinded, i.e. the rater may not know the treatment the patient received, but neither the patients nor the therapists are blinded to the type of therapy given (two out of three of the persons involved in the trial, i.e., all of the persons involved in the treatment, are unblinded). The patient is an active participant in correcting negative distorted thoughts, thus quite aware of the treatment group they are in.

The importance of double-blinding was shown in a meta-analysis that examined the effectiveness of CBT when placebo control and blindedness were factored in.[156] Pooled data from published trials of CBT in schizophrenia, MDD, and bipolar disorder that used controls for non-specific effects of intervention were analyzed. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates, treatment effects are small in treatment studies of MDD, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder. For MDD, the authors note that the pooled effect size was very low. Nevertheless, the methodological processes used to select the studies in the previously mentioned meta-analysis and the worth of its findings have been called into question.

Resources:
http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
http://psychology.about.com/od/psychotherapy/a/cbt.htm

Music Therapy

Definition:
Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

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Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. After assessing the strengths and needs of each client, the qualified music therapist provides the indicated treatment including creating, singing, moving to, and/or listening to music. Through musical involvement in the therapeutic context, clients’ abilities are strengthened and transferred to other areas of their lives. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words. Research in music therapy supports its effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people’s motivation to become engaged in their treatment, providing emotional support for clients and their families, and providing an outlet for expression of feelings.

Music therapy is the use of interventions to accomplish individual goals within a therapeutic relationship by a professional who has completed an approved music therapy program. Music therapy is an allied health profession and one of the expressive therapies, consisting of a process in which a music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients improve their physical and mental health. Music therapists primarily help clients improve their health in several domains, such as cognitive functioning, motor skills, emotional development, social skills, and quality of life, by using music experiences such as free improvisation, singing, and listening to, discussing, and moving to music to achieve treatment goals. It has a wide qualitative and quantitative research literature base and incorporates clinical therapy, psychotherapy, biomusicology, musical acoustics, music theory, psychoacoustics, embodied music cognition, aesthetics of music, sensory integration, and comparative musicology. Referrals to music therapy services may be made by other health care professionals such as physicians, psychologists, physical therapists, and occupational therapists. Clients can also choose to pursue music therapy services without a referral (i.e., self-referral).

Music therapists are found in nearly every area of the helping professions. Some commonly found practices include developmental work (communication, motor skills, etc.) with individuals with special needs, songwriting and listening in reminiscence/orientation work with the elderly, processing and relaxation work, and rhythmic entrainment for physical rehabilitation in stroke victims. Music therapy is also used in some medical hospitals, cancer centers, schools, alcohol and drug recovery programs, psychiatric hospitals, and correctional facilities.
History:
Music has been used as a healing implement for centuries. Apollo is the ancient Greek god of music and of medicine. Aesculapius was said to cure diseases of the mind by using song and music, and music therapy was used in Egyptian temples. Plato said that music affected the emotions and could influence the character of an individual. Aristotle taught that music affects the soul and described music as a force that purified the emotions. Aulus Cornelius Celsus advocated the sound of cymbals and running water for the treatment of mental disorders. Music therapy was practiced in biblical times, when David played the harp to rid King Saul of a bad spirit. As early as 400 B.C., Hippocrates played music for mental patients. In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the patients. In the United States, Native American medicine men often employed chants and dances as a method of healing patients. The Turco-Persian psychologist and music theorist al-Farabi (872–950), known as Alpharabius in Europe, dealt with music therapy in his treatise Meanings of the Intellect, in which he discussed the therapeutic effects of music on the soul. Robert Burton wrote in the 17th century in his classic work, The Anatomy of Melancholy, that music and dance were critical in treating mental illness, especially melancholia. Music therapy as we know it began in the aftermath of World Wars I and II, when, particularly in the United Kingdom, musicians would travel to hospitals and play music for soldiers suffering from war-related emotional and physical trauma.

Approaches:
Approaches used in music therapy that have emerged from the field of education include Orff-Schulwerk (Orff), Dalcroze Eurhythmics, and Kodaly. Models that developed directly out of music therapy are Neurologic Music Therapy (NMT), Nordoff-Robbins and the Bonny Method of Guided Imagery and Music.

Music therapists may work with individuals who have behavioral-emotional disorders. To meet the needs of this population, music therapists have taken current psychological theories and used them as a basis for different types of music therapy. Different models include behavioral therapy, cognitive behavioral therapy, and psychodynamic therapy.

One therapy model based on neuroscience, called “neurological music therapy” (NMT), is “based on a neuroscience model of music perception and production, and the influence of music on functional changes in non-musical brain and behavior functions. In other words, NMT studies how the brain is without music, how the brain is with music, measures the differences, and uses these differences to cause changes in the brain through music that will eventually affect the client non-musically. As one researcher, Dr. Thaut, said: “The brain that engages in music is changed by engaging in music.” NMT trains motor responses (i.e. tapping foot or fingers, head movement, etc.) to better help clients develop motor skills that help “entrain the timing of muscle activation patterns.

Music therapy approaches used with Children:
Paul Nordoff, a Juilliard School graduate and Professor of Music, was a gifted pianist and composer who, upon seeing disabled children respond so positively to music, gave up his academic career to further investigate the possibility of music as a means for therapy. Dr. Clive Robbins, a special educator, partnered with Nordoff for over 17 years in the exploration and research of music’s effects on disabled children- first in the United Kingdom, and then in the USA in the 1950s and 60s. Their pilot projects included placements at care units for autistic children and child psychiatry departments, where they put programs in place for children with mental disorders, emotional disturbances, developmental delays, and other handicaps. Their success at establishing a means of communication and relationship with autistic children at the University of Pennsylvania gave rise to the National Institutes of Health’s first grant given of this nature, and the 5-year study “Music Therapy Project for Psychotic Children Under Seven at the Day Care Unit” involved research, publication, training and treatment. Several publications, including Therapy in Music for Handicapped Children, Creative Music Therapy, Music Therapy in Special Education, as well as instrumental and song books for children, were released during this time. Nordoff and Robbins’s success became known globally in the mental health community, and they were invited to share their findings and offer training on an international tour that lasted several years. Funds were granted to support the founding of the Nordoff Robbins Music Therapy Centre in Great Britain in 1974, where a one-year Graduate program for students was implemented. In the early eighties, a center was opened in Australia, and various programs and institutes for Music Therapy were founded in Germany and other countries. In the United States, the Nordoff-Robbins Center for Music Therapy was established at New York University in 1989.

The Nordoff-Robbins approach, based on the belief that everyone is capable of finding meaning in and benefitting from musical experience, is now practiced by hundreds of therapists internationally. It focuses on treatment through the creation of music by both therapist and client together. Various techniques are used to accommodate all capabilities so that even the most low functioning individuals are able to participate actively.

Assessment and interventions :
As with any type of therapy, the practice of Music Therapy with children must uphold standards of conduct and ethics, agreed upon by national and provincial associations such as the Canadian Association for Music Therapy. In part with this, formal assessment is crucial for understanding the child – their background, limitations and needs, as well as to create appropriate goals for the process and select the means of achieving them. This serves as the starting point from which to measure the client’s progression throughout the therapeutic process and to make adjustments later, if necessary. Similarly to how assessments are conducted with adults, the music therapist obtains extensive data on the client including their full medical history, musical (ability to duplicate a melody or identify changes in rhythm, etc.) and nonmusical functioning (social, physical/motor, emotional, etc.). The assessment process is then carried out in formal, informal, and standardized ways.

The following are the most common methods of assessment:

*Interviews with Clients and/or Family Members
*Structured or Unstructured Observation
*Reviewing of Client Records
*Standardized Assessment Tests

Information gathered at the music therapy assessment is then used to determine if music therapy is indicated for the child. The therapist then formulates a music therapy treatment plan, which includes specific short-term objectives, long-term goals, and an expected timeline for therapy.

Music therapy interventions used with children can fall into two categories. The first, Supportive active therapy, is product- oriented and can included rhythm activities such as body percussion (stomping feet, clapping hands, etc.), singing songs which re-inforce nonmusical skills, awareness and expression, or movement to music (as simple as marching to the beat, as complex as structured dances). The second area is called Insight music therapy which is process-oriented. Activities could include song-writing, active listening and reacting, or auditory discrimination activities for sensory skill development. Music therapy for children is conducted either in a one-on-one session or in a group session. The therapist typically plays either a piano or a guitar, which allows for a wide variety of musical styles to suit the client’s preferences. The child is usually encouraged to play an instrument adapted to his or her unique abilities and needs. These elements are designed to improve the experience and outcome of the therapy.

DIFFERENT BENEFITS OF MUSIC THERAPY:

Prenatal music therapy:
Music Therapy can play an important role during pregnancy. At just 16 weeks, a fetus is able to hear their mother’s speech as well as singing. Through technologies, such as ultrasound, health care professionals are able to observe the movements of the unborn child responding to musical stimuli. Through these fetal observations, we see that the baby is capable of expressing its needs, preferences, and interests through movements in the womb. At the beginning of the second trimester, the ear structure is fully matured. By this time, the fetus will begin to hear not only maternal sounds, but also vibrations of instruments…..CLICK & SEE :

Prenatal music therapy has three main bennefits:

1.Prenatal Stress Relief: Pregnant women may experience high levels of stress which can negatively affect the baby. This will cause the body will release Norepinephrine and Cortisol hormones which will increase blood pressure and weaken the immune system of both mother and child. High levels of cortisol exposure in early development can increase the likelihood of the child later having anxiety, mental retardation, autism, and depression. Music therapists use music to elevate the stress threshold of an expectant mother which helps her to maintain a relaxed state during labour and birthing process. During a music therapy session, the mother is guided to listen to her internal rhythms, as well as listing to the movements and reactions of the fetus in response to her voice and music. This technique is useful in helping reduce the mother’s level of stress, and prepare her for the birth of her child.

2.Maternal-Fetal Bonding: Communication between the mother and fetus is essential during pregnancy. One way of strengthening the bond between the two is through music therapy. Music stimulation helps to develop the fetus’s nervous system, structurally and functionally. The unborn child especially prefers the voice of their mother. The most effective way to enhance communication is through singing. Lullabies are the most popular songs sung by mothers. Singing lullabies is a wonderful way for mothers to express their love and have the baby become familiarized with their mother’s melodies and intonations which will provide them a sense of security when they are born, because it will feel just like how they were in the womb. Electronic voice phenomena studies have shown that the father’s voice engages the fetus from feet to the abdomen – which will lead the baby to start walking at a younger age. The mother’s voice engages the fetus from waist to head which will strengthen the baby’s neck and upper limbs. Not only does prenatal singing benefit the fetus, it also help produce endorphins that automatically reduce the perception of pain and help relax breathing. A fetus can show preference for music; observations have shown the fetus’s movements are gentle when listening to soothing music, and comparatively, where there are dissonances included in the music, their movements are bigger and much more rhythmic, such as rolling. The fetus would be comforted by hearing slow-pace passages of Baroque music (Vivaldi and Handel) and lullabies sung by their mother.

3.Prenatal Language Development: Music is said to be the unborn child’s beginning of language learning. It can be consider as a pre-linguistic language that prepares the Auditory Sensory System to listen, combine, and produce language sounds. The fetus learns through the voice of their mother, not only from speech but songs. The sound is received by the baby through bone conduction when the mother speaks. The singing voice is said to have a wider range of frequencies than speech. Prenatal sounds are important during the prenatal period because it forms the basis of future learning and behaviour.

Music therapy for premature infants:
Music therapy has been shown to be very beneficial in stimulating growth and development in premature infants. Premature infants are those born at 37 weeks or less gestational stage. They are subject to numerous struggles, such as abnormal breathing patterns, decreased body fat and muscle tissue, as well as feeding issues. The coordination for sucking and breathing is often not fully developed, making feeding a challenge. The improved developmental activity and behavioural status of premature infants when they are discharged from the NICU, is directly related to the stimulation programs and interventions they benefited from during hospitalization, such as music therapy.

Music is typically conducted by a musical therapist in Neonatal Intensive Care (NICU), with five main techniques designed to benefit premature infants;

1.Live or Recorded Music: Live or recorded music has been effective in promoting respiratory regularity and oxygen saturation levels, as well as decreasing signs of neonatal distress. Since premature infants have sensitive and immature sensory modalities, music is often performed in a gentle and control environment, either in the form of audio recordings or live vocalization, although live singing has been shown to have a greater affect. Live music also reduces the physiological responses in parents. Studies have shown that by combining live music, such as harp music, with the Kangaroo Care, maternal anxiety is reduced. This allows for parents, especially mothers to spend important time bonding with their premature infants. Female singing voices are also more affective at soothing premature infants. Despite being born premature, infants show a preference for the sound of a female singing voice, making it more beneficial than instrumental music.

2.Promote Healthy Sucking Reflex: By using a Pacifier-Actived Lullaby Device, music therapists can help promote stronger sucking reflexes, while also reducing pain perception for the infant. The Gato Box is a small rectangular instrument that stimulates a prenatal heartbeat sound in a soft and rhythmic manner that has also been effective in aiding sucking behaviours.[41] The music therapist uses their fingers to tap on the drum, rather than using a mallet. The rhythm supports movement when feeding and promotes healthy sucking patterns. By increasing sucking patterns, babies are able to coordinate the important dual mechanisms of breathing, sucking and swallowing needed to feed, thus promoting growth and weight gain. When this treatment proves effective, infants are able to leave the hospital earlier.

3.Multimodal Stimulation and Music: By combining music, such as lullabies, and multimodal stimulation, premature infants were discharged from the NICU sooner, than those infants who did not receive therapy. Multimodal stimulation includes the applications of auditory, tactile, vestibular, and visual stimulation that helps aid in premature infant development. The combination of music and MMS helps premature infants sleep and conserve vital energy required to gain weight more rapidly. Studies have shown that girls respond more positively than boys during multimodal stimulation.[ While the voice is a popular choice for parents looking to bond with their premature infants, other effective instruments include the Remo Ocean Disk and the Gato Box. Both are used to stimulate the sounds of the womb. The Remo Ocean Disk, a round musical instrument that mimics the fluid sounds of the womb, has been shown to benefit decreased heart rate after therapeutic uses, as well as promoting healthy sleep patterns, lower respiratory rates and improve sucking behavior.

4.Infant Stimulation: This type of intervention uses musical stimulation to compensate for the lack of normal environmental sensory stimulation found in the NICU. The sound environment the NICU provides can be disruptive; however, music therapy can mask unwanted auditory stimuli and promote a calm environment that reduces the complications for high-risk or failure-to-thrive infants. Parent-infant bonding can also be affected by the noise of the NICU, which in turn can delay the interactions between parents and their premature infants. But music therapy creates a relaxed and peaceful environment for parents to speak and spend time with their babies while incubated.

5.Parent-Infant Bonding: Therapists work with parents so they may perform infant-directed singing techniques, as well as home care. Singing lullabies therapeutically can promote relaxation and decrease heart rate in premature infants. By calming premature babies, it allows for them to preserve their energy, which creates a stable environment for growth. Lullabies, such as “Twinkle Twinkle Little Star”, or other culturally relevant lullabies, have been shown to greatly soothe babies. These techniques can also improve overall sleep quality, caloric intake and feeding behaviours, which aids in development of the baby while they are still in the NICU. Singing has also shown greater results on oxygen saturation levels for infants while incubated, more than mothers speech alone. This technique promoted high levels of oxygen for longer periods of time.

Music therapy in child rehabilitation:
Music therapy has multiple benefits which contribute to the maintenance of health and the drive toward rehabilitation for children. Advanced technology that can monitor cortical activity offers a look at how music engages and produces changes in the brain during the perception and production of musical stimuli. Music therapy, when used with other rehabilitation methods, has increased the success rate of sensorimotor, cognitive, and communication rehabilitation. Music therapy intervention programs can include an average of 18 sessions of treatment. The achievement of a physical rehabilitation goal relies on the child’s existing motivation and feelings towards music and their commitment to engage in meaningful, rewarding efforts. Regaining full functioning also confides in the prognosis of recovery, the condition of the client, and the environmental resources available. Sessions may consist of either active techniques, where the client creates music, or receptive techniques, where the client listens to, analyze, move and respond to music. Both techniques use systematic processes where the therapists assist the client by using musical experiences and connections that collaborate as a dynamic force of change toward rehabilitation. The music is at times chosen by the client, or by the music therapist based on the clients reciprocation to the music.

Music has many calming and soothing properties that can be used as a sedative in rehabilitation. For example, a patient with chronic pain may decrease the physiological result of stress, and draw attention away from the pain by focusing on music. Music has the ability to associate physiological changes in the body and elicit physiological responses such as pulse rate, respiration rate, blood pressure, and muscle tension. Music may also stimulate a calming effect of the cardiovascular system.

Music therapy used in child rehabilitation has had a substantial emphasis on sensorimotor development including; balance and position, locomotion, agility, mobility, range of motion, strength, laterality and directionality. By using music during senorimotor rehabilitation, it allows clients to express themselves and motivates them to learn the active joint range of motion and motor coordination in which they are aiming to acquire. For example, clients with a brain injury may lack the ability to initiate movement. The intensely captivating and attention enhancing quality of music motivates clients to participate in physical activity or exercise by easing the discomfort and strenuousness of the physical rehabilitation and helps the client persevere without being conscious of the difficulty. Music can be an element of distraction, allowing the client to transcend into a positive, aesthetically-pleasing state that is beneficial to achieving their goals.[48] Research suggests a strong connection between motor activation and the cueing of musical rhythm. Rhythmic stimuli has been found to help balance training for those with a brain injury. Repetition of proficient rhythmic qualities will stimulate participants so that the abrasive beats will synchronize with neural activity during a rhythmic motor task. For example, clients with hemiplegia gain improvement of posture stability, and consistency of symmetrical strides and regularity in step lengths when listening to music with strong rhythmic beats.

Music therapy rehabilitation sessions that incorporate active techniques involve the client producing the music themselves. This may include the client making a musical composition, or performing by singing or chanting, playing instruments, or musically improvising. Singing is a form of rehabilitation for neurological impairments. Neurological impairments following a brain injury can be in the form of apraxia – loss to perform purposeful movements, dysarthria –muscle control disturbances due to damage of the central nervous system), aphasia (defect in expression causing distorted speech), or language comprehension. Singing training has been found to improve lung, speech clarity, and coordination of speech muscles, thus, accelerating rehabilitation of such neurological impairments. For example, melodic intonation therapy is the practice of communicating with others by singing to enhance speech or increase speech production by promoting socialization, and emotional expression.

When having the child actively participate with an instrument, it is especially important for the therapist to provide them with an instrument that they can readily and easily use. Clients with limited physical abilities may express frustration when they are not able to control their environment. The ability to employ and operate a musical instrument provides them a sense of relaxation and accomplishment. Instruments must be selected to provide immediately successful experiences. Certain adaptions of the instruments may be required in order for the people to manipulate them. For example, a drumstick’s handle should be manipulated to be more prominent for those clients that may have a weak grip. Electric music-making devices have been adapted to fit the clients limited but existing movements, strength, and abilities. Electronic devices, such as the Sound Beam and the Wave Rider- read a variety of small movements made by the clients and converts the movements into electronic musical information. The devices are programmed to create easy, yet pleasing notes and sounds in coordination to the participants’ movements. It is also crucial for the client to be aware that music making is simply a modality for rehabilitation and that their wellness is not dependent on their existing musical skills. It provides children with an outlet of expression that they may have lacked in the past or due to present circumstances. By accomplishing the production of musical sounds despite their weaknesses and disabilities, it encourages the client and relieves their anxiety that they may acquire at the thought of playing musical instrument without experience. By using such adaptive music devices, it grants client’s the ability to create sounds that are originally expressive and allows them to experience affirmation –a feeling of capability to control ones own environment- an ability they may not be familiar with.

Music therapy and children with autism:
Music therapy can be a particularly useful when working with children with autism due to the nonverbal, non-threatening nature of the medium.[51] Studies have shown that children with autism have difficulty with joint attention, symbolic communication and sharing of positive affect. Use of music therapy has demonstrated improvements of socially acceptable behaviors. Wan, Demaine, Zipse, Norton, & Schlaug (2010) found singing and music making may engage areas of the brain related to language abilities, and that music facilitated the language, social, and motor skills.   Successful therapy involves long-term individual intervention tailored to each child’s needs. Passing and sharing instruments, music and movement games, learning to listen and singing greetings and improvised stories are just a few ways music therapy can improve a child’s social interaction. For example passing a ball back and forth to percussive music or playing sticks and cymbals with another person might help foster the child’s ability to follow directions when passing the ball and learn to share the cymbals and sticks. In addition to improved social behaviors music therapy has been shown to also increase communication attempts, increase focus and attention, reduce anxiety, and improve body awareness and coordination.

Since up to 30 per cent of children with autism are nonverbal and many have difficulty understanding verbal commands music therapy becomes very useful as it has been found that music can improve the mapping of sounds to actions. So by pairing music with actions, and with many hours of training the neural pathways for speech can be improved. Child-appropriate action songs would be like playing the game “peek-ka-boo” or “eeny meeny miney mo” with a musical accompaniment, usually a piano or guitar.

Children with autism are also prone to more bouts of anxiety than the average child. Short sessions (15 – 20 mins) of listening to percussive music or classical music with a steady rhythm have been shown to alleviate symptoms of anxiety and temporarily decrease anxiety-related behaviour. Music with a steady 4/4 beat is thought to work best due to the predictability of the beat.

Target behaviours such as restlessness, aggression and noisiness can also be affected by the use of music therapy. Weekly sessions ranging for ½ hour to 1 hour during which a therapist plays child-preferred melodies such as Twinkle Twinkle Little Star and engages the child in quiet singing increases socially acceptable behaviour such as using an appropriate volume when speaking. Studies also suggest that playing one of the child’s favorite songs while the child and therapist both play the piano or strum chords on a guitar can increase a child’s ability to hold eye contact and share in an experience due to their enjoyment of the therapy.

Musical improvisation during a one on one session has also been shown to be highly effective with increasing joint attention. Some noted improvisation techniques are using a welcome song that includes the child’s name, which allows the child to get used to their surroundings; an adult-led song followed by a child led song and then conclude with a goodbye song. During such sessions the child would most likely sit across from the therapist on the floor or beside the therapist on the piano bench. Composing original music that incorporates the child’s day-to-day life with actions and words is also a part of improvisation. The shared music making experience allows for spontaneous interpersonal responses from the child and may motivate the child to increase positive social behaviour and initiate further interaction with the therapist.

Some common instruments in music therapy for children are:

Upright piano, Guitar, Xylophone, Small guiro, Paddle drums, Egg shakers, Finger cymbals, Birdcalls, Whistles, & Toy hand bells.
Music therapy has also been recognized as a method for children with autism. Music therapy helps stabilize moods, increase frustration tolerance, identify a range of emotions, and improve self-expression along with much more. The visual and auditory sensory system is responsible for interpreting sounds and images. With autistic children, if a sound or image is unpleasant the child may not have the ability to express itself, which makes it difficult for a therapist, parent, etc. to interpret. Music engages the brain in both sub-coritcal and neo-cortical levels, which means it is not critical to ‘think’ while listening to music when hearing the notes and sounds. Music therapy, in the topic of austism’s sensory interpretation, provides repetitive stimuli which aim to “teach” the brain other possible ways to respond that might be more useful as they grow olde.
Music therapy for Adolescents:

Mood disorders:
According to the Mayo Health Clinic, two to three thousand out of every 100,000 adolescents will have mood disorders, and out of those two to three thousand, eight to ten will commit suicide. Two prevalent mood disorders in the adolescent population are clinical depression and bipolar disorder.

On average, American adolescents listen to approximately 4.5 hours of music per day and are responsible for 70% of pop music sales. Now, with the invention of new technologies such as the iPod and digital downloads, access to music has become easier than ever. As children make the transition into adolescence they become less likely to sit and watch TV, an activity associated with family, and spend more of their leisure time listening to music, an activity associated with friends.

Adolescents obtain many benefits from listening to music, including emotional, social, and daily life benefits, along with help in forming their identity. Music can provide a sense of independence and individuality, which in turn contributes to an adolescent’s self-discovery and sense of identity. Music also offers adolescents relatable messages that allow them to take comfort in knowing that others feel the same way they do. It can also serve as a creative outlet to release or control emotions and find ways of coping with difficult situations. Music can improve an adolescent’s mood by reducing stress and lowering anxiety levels, which can help counteract or prevent depression. Music education programs provide adolescents with a safe place to express themselves and learn life skills such as self-discipline, diligence, and patience. These programs also promote confidence and self-esteem. Ethnomusicologist Alan Merriam (1964) once stated that music is a universal behavior – it is something with which everyone can identify. Among adolescents, music is a unifying force, bringing people of different backgrounds, age groups, and social groups together.

Referrals and assessments;
While many adolescents may listen to music for its therapeutic qualities, it does not mean every adolescent needs music therapy. Many adolescents go through a period of teenage angst characterized by intense feelings of strife that are caused by the development of their brains and bodies. Some adolescents develop more serious mood disorders such as major clinical depression and bipolar disorder. Adolescents diagnosed with a mood disorder may be referred to a music therapist by a physician, therapist, or school counselor/teacher. When a music therapist gets a referral, he or she must first assess the patient and then create goals and objectives before beginning the actual therapy. According to the American Music Therapy Association Standards of Clinical Practice assessments should include the “general categories of psychological, cognitive, communicative, social, and physiological functioning focusing on the client’s needs and strengths…and will also determine the client’s response to music, music skills, and musical preferences” The result of the assessment is used to create an individualized music therapy intervention plan.

Treatment techniques:
There are many different music therapy techniques used with adolescents. The music therapy model is based on various theoretical backgrounds such as psychodynamic, behavioral, and humanistic approaches. Techniques can be classified as active vs. receptive and improvisational vs. structured.  The most common techniques in use with adolescents are musical improvisation, the use of precomposed songs or music, receptive listening to music, verbal discussion about the music, and incorporating creative media outlets into the therapy. Research also showed that improvisation and the use of other media were the two techniques most often used by the music therapists. The overall research showed that adolescents in music therapy “change more when discipline-specific music therapy techniques, such as improvisation and verbal reflection of the music, are used.” The results of this study showed that music therapists should put careful thought into their choice of technique with each individual client. In the end, those choices can affect the outcome of the treatment.

To those unfamiliar with music therapy the idea may seem a little strange, but music therapy has been found to be as effective as traditional forms of therapy. In a meta-analysis of the effects of music therapy for children and adolescents with psychopathology, Gold, Voracek, and Wigram (2004) looked at ten studies conducted between 1970 and 1998 to examine the overall efficacy of music therapy on children and adolescents with behavioral, emotional, and developmental disorders. The results of the meta-analysis found that “music therapy with these clients has a highly significant, medium to large effect on clinically relevant outcomes.” More specifically, music therapy was most effective on subjects with mixed diagnoses. Another important result was that “the effects of music therapy are more enduring when more sessions are provided.”

One example of clinical work is that done by music therapists who work with adolescents to increase their emotional and cognitive stability, identify factors contributing to distress and initiate changes to alleviate that distress. Music therapy may also focus on improving quality of life and building self-esteem, a sense self-worth, and confidence. Improvements in these areas can be measured by a number of tests, including qualitative questionnaires like Beck’s Depression Inventory, State and Trait Anxiety Inventory, and Relationship Change Scale.[65] Effects of music therapy can also be observed in the patient’s demeanor, body language, and changes in awareness of mood.

Two main methods for music therapy are group meetings and one-one sessions. Group music therapy can include group discussions concerning moods and emotions in or toward music, songwriting, and musical improvisation. Groups emphasizing mood recognition and awareness, group cohesion, and improvement in self-esteem can be effective in working with adolescents. Group therapy, however, is not always the best choice for the client. Ongoing one-on-one music therapy has also been shown to be effective. One-on-one music therapy provides a non-invasive, non-judgmental environment, encouraging clients to show capacities that may be hidden in group situations.

Music Therapy in which clients play musical instruments directly, show very promising results. Specifically, playing wind instruments strengthens oral and respiratory muscles, sound vocalization, articulation, and improves breath support.[68] Symbolic Communication Training Through Musicis also an important technique in playing instruments in music therapy, because this makes communication (verbally and non verbally) improved in social situations. Most importantly, is that music provides a time cue for the body to remain regulated. Making music is also important for people of all ages because it causes motivation, increases “psychomotor” activity, causes an individual to identify with a group (in group music), regulates breathing, improves organizational skills, and increases coordination.

Though more research needs to be done to ascertain the effect of music therapy on adolescents with mood disorders, most research has shown positive effects.
Music therapy for Medical disorders:

Heart disease:
According to a 2009 Cochrane review some music may reduce heart rate, respiratory rate, and blood pressure in those with coronary heart disease.   Music does not appear to have much effect on psychological distress. “The quality of the evidence is not strong and the clinical significance unclear”.

Neurological disorders:
The use of music therapy in treating mental and neurological disorders is on the rise. Music therapy has showed effectiveness in treating symptoms of many disorders, including schizophrenia, amnesia, dementia and Alzheimer’s, Parkinson’s disease, mood disorders such as depression, aphasia and similar speech disorders, and Tourette’s syndrome, among others.

While music therapy has been used for many years, up until the mid-1980s little empirical research had been done to support the efficacy of the treatment. Since then, more research has focused on determining both the effectiveness and the underlying physiological mechanisms leading to symptom improvement. For example, one meta-study covering 177 patients (over 9 studies) showed a significant effect on many negative symptoms of psychopathologies, particularly in developmental and behavioral disorders. Music therapy was especially effective in improving focus and attention, and in decreasing negative symptoms like anxiety and isolation.

The following sections will discuss the uses and effectiveness of music therapy in the treatment of specific pathologies.

Stroke:…click & see
Music has been shown to affect portions of the brain. One reason for the effectiveness of music therapy for stroke victims is the capacity of music to affect emotions and social interactions. Research by Nayak et al. showed that music therapy is associated with a decrease in depression, improved mood, and a reduction in state anxiety. Both descriptive and experimental studies have documented effects of music on quality of life, involvement with the environment, expression of feelings, awareness and responsiveness, positive associations, and socialization. Additionally, Nayak et al. found that music therapy had a positive effect on social and behavioral outcomes and showed some encouraging trends with respect to mood.

More recent research suggests that music can increase a patient’s motivation and positive emotions. Current research also suggests that when music therapy is used in conjunction with traditional therapy it improves success rates significantly. Therefore, it is hypothesized that music therapy helps a victim of stroke recover faster and with more success by increasing the patient’s positive emotions and motivation, allowing him or her to be more successful and feel more driven to participate in traditional therapies.

Recent studies have examined the effect of music therapy on stroke patients when combined with traditional therapy. One study found the incorporation of music with therapeutic upper extremity exercises gave patients more positive emotional effects than exercise alone. In another study, Nayak et al. found that rehabilitation staff rated participants in the music therapy group more actively involved and cooperative in therapy than those in the control group. Their findings gave preliminary support to the efficacy of music therapy as a complementary therapy for social functioning and participation in rehabilitation with a trend toward improvement in mood during acute rehabilitation.

Current research shows that when music therapy is used in conjunction with traditional therapy, it improves rates of recovery and emotional and social deficits resulting from stroke. A study by Jeong & Kim examined the impact of music therapy when combined with traditional stroke therapy in a community-based rehabilitation program. Thirty-three stroke survivors were randomized into one of two groups: the experimental group, which combined rhythmic music and specialized rehabilitation movement for eight weeks; and a control group that sought and received traditional therapy. The results of this study showed that participants in the experimental group gained not only more flexibility and wider range of motion, but an increased frequency and quality of social interactions and positive mood.

Music has proven useful in the recovery of motor skills. Rhythmical auditory stimulation in a musical context in combination with traditional gait therapy improved the ability of stroke patients to walk. The study consisted of two treatment conditions, one which received traditional gait therapy and another which received the gait therapy in combination with the rhythmical auditory stimulation. During the rhythmical auditory stimulation, stimulation was played back measure by measure, and was initiated by the patient’s heel-strikes. Each condition received fifteen sessions of therapy. The results revealed that the rhythmical auditory stimulation group showed more improvement in stride length, symmetry deviation, walking speed and rollover path length (all indicators for improved walking gait) than the group that received traditional therapy alone.

Schneider et al. also studied the effects of combining music therapy with standard motor rehabilitation methods.[80] In this experiment, researchers recruited stroke patients without prior musical experience and trained half of them in an intensive step by step training program that occurred fifteen times over three weeks, in addition to traditional treatment. These participants were trained to use both fine and gross motor movements by learning how to use the piano and drums. The other half of the patients received only traditional treatment over the course of the three weeks. Three-dimensional movement analysis and clinical motor tests showed participants who received the additional music therapy had significantly better speed, precision, and smoothness of movement as compared to the control subjects. Participants who received music therapy also showed a significant improvement in every-day motor activities as compared to the control group.[80] Wilson, Parsons, & Reutens looked at the effect of melodic intonation therapy (MIT) on speech production in a male singer with severe Broca’s aphasia.[82] In this study, thirty novel phrases were taught in three conditions: unrehearsed, rehearsed verbal production (repetition), or rehearsed verbal production with melody (MIT). Results showed that phrases taught in the MIT condition had superior production, and that compared to rehearsal, effects of MIT lasted longer.

Another study examined the incorporation of music with therapeutic upper extremity exercises on pain perception in stroke victims. Over the course of eight weeks, stroke victims participated in upper extremity exercises (of the hand, wrist, and shoulder joints) in conjunction with one of the three conditions: song, karaoke accompaniment, and no music. Patients participated in each condition once, according to a randomized order, and rated their perceived pain immediately after the session. Results showed that although there was no significant difference in pain rating across the conditions, video observations revealed more positive affect and verbal responses while performing upper extremity exercises with both music and karaoke accompaniment. Nayak et al. examined the combination of music therapy with traditional stroke rehabilitation and also found that the addition of music therapy improved mood and social interaction. Participants who had suffered traumatic brain injury or stroke were placed in one of two conditions: standard rehabilitation or standard rehabilitation along with music therapy. Participants received three treatments per week for up to ten treatments. Therapists found that participants who received music therapy in conjunction with traditional methods had improved social interaction and mood.

Dementia:...click & see
Alzheimer’s disease and other types of dementia are among the disorders most commonly treated with music therapy. Like many of the other disorders mentioned, some of the most common significant effects are seen in social behaviors, leading to improvements in interaction, conversation, and other such skills. A meta-study of over 330 subjects showed music therapy produces highly significant improvements to social behaviors, overt behaviors like wandering and restlessness, reductions in agitated behaviors, and improvements to cognitive defects, measured with reality orientation and face recognition tests. As with many studies of MT’s effectiveness, these positive effects on Alzheimer’s and other dementias are not homogeneous among all studies. The effectiveness of the treatment seems to be strongly dependent on the patient, the quality and length of treatment, and other similar factors.

Another meta-study examined the proposed neurological mechanisms behind music therapy’s effects on these patients. Many authors suspect that music has a soothing effect on the patient by affecting how noise is perceived: music renders noise familiar, or buffers the patient from overwhelming or extraneous noise in their environment. Others suggest that music serves as a sort of mediator for social interactions, providing a vessel through which to interact with others without requiring much cognitive load.

Amnesia:….click & see
Some symptoms of amnesia have been shown to be alleviated through various interactions with music, including playing and listening. One such case is that of Clive Wearing, whose severe retrograde and anterograde amnesia have been detailed in the documentaries Prisoner of Consciousness and The Man with the 7 Second Memory. Though unable to recall past memories or form new ones, Wearing is still able to play, conduct, and sing along with music learned prior to the onset of his amnesia, and even add improvisations and flourishes.

Wearing’s case reinforces the theory that episodic memory fundamentally differs from procedural or semantic memory. Sacks suggests that while Wearing is completely unable to recall events or episodes, musical performance (and the muscle memory involved) are a form of procedural memory that is not typically hindered in amnesia cases [Sacks]. Indeed, there is evidence that while episodic memory is reliant on the hippocampal formation, amnesiacs with damage to this area can show a loss of episodic memory accompanied by (partially) intact semantic memory.

Aphasia:….click & see
Melodic intonation therapy (MIT) is a commonly used method of treating aphasias, particularly those involving speech deficits (as opposed to reading or writing). MIT is a multi-stage treatment that involves committing words and speech rhythm to memory by incorporating them into song. The musical and rhythmic aspects are then separated from the speech and phased out, until the patient can speak normally. This method has slight variations between adult patients and child patients, but both follow the same basic structure.

While MIT is a commonly used therapy, research supporting its effectiveness is lacking. Some recent research suggests that the therapy’s efficacy may stem more from the rhythmic components of the treatment rather than the melodic aspects.
Music Therapy for Psychiatric disorders:

Schizophrenia:…click & see
Music therapy is used with schizophrenic patients to ameliorate many of the symptoms of the disorder. Individual studies of patients undergoing music therapy showed diminished negative symptoms such as flattened affect, speech issues, and anhedonia and improved social symptoms such as increased conversation ability, reduced social isolation, and increased interest in external events.

Meta-studies have confirmed many of these results, showing that music therapy in conjunction with standard care to be superior to standard care alone. Improvements were seen in negative symptoms, general mental state, depression, anxiety, and even cognitive functioning. These meta-studies have also shown, however, that these results can be inconsistent and that they depend heavily on both the quality and number of therapy sessions.

Depression:...click & see
Music therapy has been found to have numerous significant outcomes for patients with major depressive disorder. A systematic review of five randomized trials found that people with depression generally accepted music therapy and was found to produce improvements in mood when compared to standard therapy. Another study showed that MDD patients were better able to express their emotional states while listening to sad music than while listening to no music or to happy, angry, or scary music. The authors found that this therapy helped patients overcome verbal barriers to expressing emotion, which can assist therapists in successfully guiding treatment.

Other studies have provided insight into the physiological interactions between music therapy and depression. Music has been shown to decrease significantly the levels of the stress hormone cortisol, leading to improved affect, mood and cognitive functioning. A study also found that music led to a shift in frontal lobe activity (as measured by EEG) in depressed adolescents. Music was shown to shift activity from the right frontal lobe to the left, a phenomenon associated with positive affect and mood.
Use of Music Therapy Region wise:

Africa:
Research has shown that in many parts of Africa during male and female circumcision, bone setting, or traditional surgery and bloodletting, lyrical music related to endurance has been used to reduce anticipated pain, therapeutically. In 1999, the first program for music therapy in Africa opened in Pretoria, South Africa. Research has shown that in Tanzania patients can receive palliative care for life-threatening illnesses directly after the diagnosis of these illnesses. This is different from many Western countries, because they reserve palliative care for patients who have an incurable illness. Music is also viewed differently between Africa and Western countries. In Western countries and a majority of other countries throughout the world, music is traditionally seen as entertainment whereas in many African cultures, music is used in recounting stories, celebrating life events, or sending messages

Australia:
In Australia in 1949, music therapy (not clinical music therapy as understood today) was started through concerts organized by the Australian Red Cross along with a Red Cross Music Therapy Committee. The key Australian body, AMTA, the Australian Music Therapy Association, was founded in 1975.

Norway:
Norway is widely recognised as an important country for music therapy research. Its two major research centres are the Center for Music and Health[94] with the Norwegian Academy of Music in Oslo, and the Grieg Academy Centre for Music Therapy (GAMUT),[95] at University of Bergen. The former was mostly developed by professor Even Ruud, while professor Brynjulf Stige is largely responsible for cultivating the latter. The centre in Bergen includes 3 professors and 2 associate professors, as well as lecturers and PhD students. The centre in Bergen has 18 staff, including 2 professors and 4 associate professors, as well as lecturers and PhD students. Two of the field’s major international research journals are based in Bergen: Nordic Journal for Music Therapy and Voices: A World Forum for Music Therapy. Norway’s main contribution to the field is mostly in the area of “community music therapy”, which tends to be as much oriented toward social work as individual psychotherapy, and music therapy research from this country uses a wide variety of methods to examine diverse methods in across an array of social contexts, including community centres, medical clinics, retirement homes, and prisons.
United States:
Music therapy has existed in its current form in the United States since 1944 when the first undergraduate degree program in the world was begun at Michigan State University and the first graduate degree program was established at the University of Kansas. The American Music Therapy Association (AMTA) was founded in 1998 as a merger between the National Association for Music Therapy (NAMT, founded in 1950) and the American Association for Music Therapy (AAMT, founded in 1971). Numerous other national organizations exist, such as the Institute for Music and Neurologic Function, Nordoff-Robbins Center For Music Therapy, and the Association for Music and Imagery. Music therapists use ideas from different disciplines such as speech and language, physical therapy, medicine, nursing, and education.

A music therapy degree candidate can earn an undergraduate, master’s or doctoral degree in music therapy. Many AMTA approved programs offer equivalency and certificate degrees in music therapy for students that have completed a degree in a related field. Some practicing music therapists have held PhDs in fields other than, but usually related to, music therapy. Recently, Temple University established a PhD program in music therapy. A music therapist typically incorporates music therapy techniques with broader clinical practices such as psychotherapy, rehabilitation, and other practices depending on client needs. Music therapy services rendered within the context of a social service, educational, or health care agency are often reimbursable by insurance and sources of funding for individuals with certain needs. Music therapy services have been identified as reimbursable under Medicaid, Medicare, private insurance plans and federal and state government programs.

A degree in music therapy requires proficiency in guitar, piano, voice, music theory, music history, reading music, improvisation, as well as varying levels of skill in assessment, documentation, and other counseling and health care skills depending on the focus of the particular university’s program. A music therapist may hold the designations CMT (Certified Music Therapist), ACMT (Advanced Certified Music Therapist), or RMT (Registered Music Therapist) – credentials previously conferred by the former national organizations AAMT and NAMT ; these credentials remain in force through 2020 and have not been available since 1998. The current credential available is MT-BC. To become board certified, a music therapist must complete a music therapy degree from an accredited AMTA program at a college or university, successfully complete a music therapy internship, and pass the Board Certification Examination in Music Therapy, administered through The Certification Board for Music Therapists. To maintain the credential, either 100 units of continuing education must be completed every five years, or the board exam must be retaken near the end of the five-year cycle. The units claimed for credit fall under the purview of The Certification Board for Music Therapists. North Dakota, Nevada and Georgia have established licenses for music therapists. In the State of New York, the License for Creative Arts Therapies (LCAT) incorporates the music therapy credentials within their licensure.

United Kingdom:
Live music was used in hospitals after both World Wars as part of the treatment program for recovering soldiers. Clinical music therapy in Britain as it is understood today was pioneered in the 1960s and 1970s by French cellist Juliette Alvin whose influence on the current generation of British music therapy lecturers remains strong. Mary Priestley, one of Juliette Alvin’s students, created “analytical music therapy”. The Nordoff-Robbins approach to music therapy developed from the work of Paul Nordoff and Clive Robbins in the 1950/60s.

Practitioners are registered with the Health Professions Council and, starting from 2007, new registrants must normally hold a master’s degree in music therapy. There are master’s level programs in music therapy in Manchester, Bristol, Cambridge, South Wales, Edinburgh and London, and there are therapists throughout the UK. The professional body in the UK is the British Association for Music Therapy[98] In 2002, the World Congress of Music Therapy, coordinated and promoted by the World Federation of Music Therapy, was held in Oxford on the theme of Dialogue and Debate.[99] In November 2006, Dr. Michael J. Crawford and his colleagues again found that music therapy helped the outcomes of schizophrenic patients.

India:
The roots of musical therapy in India, can be traced back to ancient Hindu mythology, Vedic texts, and local folk traditions. It is very possible that music therapy has been used for hundreds of years in the Indian culture.

Suvarna Nalapat has studied music therapy in the Indian context. Her books Nadalayasindhu-Ragachikilsamrutam (2008), Music Therapy in Management Education and Administration (2008) and Ragachikitsa (2008) are accepted textbooks on music therapy and Indian arts.

The “Music Therapy Trust of India” is yet another venture in the country. It was started by Margaret Lobo.
Source: http://en.wikipedia.org/wiki/Music_therapy

Hope Therapy

Hope is an emotion characterized by positive feelings about the immediate or long-term future and often coupled with high motivation, optimism, and a generally elevated mood.Hope is a partially subjective term, and both psychologists and philosophers have struggled to define it. Some argue that hopefulness is a relatively stable personality trait, others believe that hope depends on external circumstances and previous experience, and some people view hope as a choice. Hope is commonly associated with warm feelings about the future, an increased willingness to work toward a goal, and an upbeat mood.

Hope therapy is a fairly recent idea with a fairly basic point. The main way this therapy is practiced is by teaching people in a group class setting to become more oriented toward positive thinking . Positive thinking with positive goals and behavior will help people toachieve their goals. It is separate from the idea of optimism, which is generally having a pervasive belief that good things are likely to happen. Instead, researchers believe that people can be taught to improve their outlook and minor depression in class settings, instead of through traditional talk therapy, which may tend to focus on negative experiences.

CLICK & SEE
It is observed that Hope therapy helps a lot to the people with severe macular degeneration, and people with mild depression, who were not classed as having a mental illness. Most people learn how to create goals, how to determine ways to reach goals and also how to use positive self-talk. Instead of focusing on negative incidents. Hope therapy relied on positive goal-based training. Many people in the groups noted significant elevation of mood, were able to absorb the training and became more goal oriented and were successfully able to use positive self-talk to diminish negative thinking patterns.

Hope therapy is  not just about the “power of positive thinking.” Instead it is based somewhat on the cognitive behavioral model of therapy which works to replace old or negative “hot thoughts” or core beliefs with new ones that are more truthful and positive. However, cognitive behavioral therapy (CBT) does spend at least some time analyzing how negative thoughts or experiences have influenced thoughts and behavior patterns in the here and now. Hope therapy appears to differ from this by focusing more on simply learning to change mindset, without much examination of what caused negative mindset in the past.

People who are facing personal and emotional conflicts, it is not that everything is lost for them. There is HOPE for them, they can also leave beautiful and happy life if some goal is set for them and with proper mental training they start exerting to reach the goal. The Hope Therapy Center (HTC) is a place where disheartened people may find healing and an opportunity to talk with a trained pastoral psychotherapist.

Hopelessness can also affect physical health. People who are not optimistic about their health or about their medical treatment are more likely to remain sick, more likely to report high levels of pain, and less likely to see an improvement in their overall health. Some mental health practitioners, aware of the role hope plays, encourage clients to work on thinking positively about life developments and finding things to be hopeful about. Many mental health professionals believe that hope is an indispensable key to happiness and that people cannot be happy without hope.

Hope therapy will be very much active and successful if this therapy is done along with Yoga exercise with Pranayama & Meditation under the guide line of some expert.

Help taken from:
http://www.wisegeek.com/what-is-hope-therapy.htm
http://www.hopetherapycenter.com/index.html
http://www.goodtherapy.org/blog/psychpedia/what-is-hope

Chemotherapy

Definition:
Chemotherapy is a medical treatment that is needed in order to stop cancer cells from growing and its tracks. Chemotherapy is extremely effective in treating cancer. It is even more effective when it is used with other treatments like radiotherapy. It is also sometimes needed to relief the symptoms, and it is design to give a longer life by causing the disease to go into remission-the stage in which there are no active symptoms.  Chemotherapy works differently than surgery or radiotherapy – two other treatments designed to fight against the cancer as well. Chemotherapy drugs travel throughout the whole body. This is important because it allows the durgs to reach part of the body where the cancer cells may have spread out. In combination with surgery means that fewer surgical procedures need to be done. Follow-up surgery can often be avoided if chemotherapy is used.

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On the other hand, radiation therapy, or radiotherapy, is the use of high energy rays to treat such disease. Is it very important to know that radiation causes damage to cancer cells, so they stop growing. With each treatment, more of the cells die and the tumor shrinks. The dead cells break down and are carried away by the blood, eventually passing out of the body. Normal cells that are also exposed to the radiation process start to repair themselves afterwards, and the process lasts just a few hours. You might be concerned that radiation hurts, but is actually quite painless. Also, in case you are wondering, the radiation gets into your body and then passes out -it does not cause you to become radioactive.

To understand how chemotherapy works, it is helpful to know some basics about the cells of the body. Everything in your body is made up of cells. A group of cells is called tissue and tissues make up all the organs, the major structures of your body. Tissue stays healthy because cells grow and reproduce, new cells replace the ones that are damaged because of injury. This means that a combination of drugs may be used to attack cancer cells so that each drug can attack the cells in a different phase.

Cancer is a disease in which abnormal cells in the body grow and multiply at a very high rate. There are more than 100 specific types of cancer cells. Cancer also may involve the spread of abnormal cells around the body. Normal cells in our body grow, divide, and die in a way that maintains health and does not damage the body. A majority for the cancer cases are due to age issues because of the fact that in adulthood your cells divide only to replace worn-out or dying cells, or in other cases, to repair injuries. Cells make up all living tissue and stronger throughout your childhood. But cancer cells continue to grow and divide, even though they are no serving in any of the vital functions, and can spread to other parts in the body. These cells clump together and form tumors (lumps) that may destroy normal tissue. If cells break off from a tumor, they can travel  throughout the blood stream or the lymphatic system. When they settle in and grow; eventually, forming other tumors. When a tumor spreads out to a new place, it is called metastasis. Even when cancer spreads, it’s called by the name of the body where it originally started and developed. Leukemia, a type of cancer growing, does not usually form a tumor, it is an exception to the rule. The cancer cells get into the blood and the organs that make blood bone narrow, then they circulate through other tissues, where they eventually develop and grow.

Chemotherapy damages cancer cells, but it also can damage normal cells. Damage to these cells is what causes the side effects of chemotherapy treatment. For instance normal cells that divide quickly, such as blood cells and the cells of hair follicles, are more likely to be damaged by chemotherapy medications. In other words, in healthy cells the damage does not last, and many only happen on the days you are actually taking the drugs. Chemotherapy is usually given is several cycles. Depending on the drug and combination, it may last to a few hours, days, or weeks.

How Chemotherapy Is Given
Just as other medicines can be taken in various forms, there are several ways to get chemotherapy. In most cases, it’s given intravenously into a vein, also referred to as an IV. An IV is a tiny tube inserted into a vein through the skin, usually in the arm. The IV is attached to a bag that holds the medicine. The chemo medicine flows from the bag into the vein, which puts the medicine into the bloodstream. Once the medicine is in the blood, it can travel through the body and attack cancer cells.

Sometimes, a permanent IV called a catheter is placed under the skin into a larger blood vessel of the upper chest. That way, a child can get chemotherapy and other medicines through the catheter without having to always use a vein in the arm. The catheter remains under the skin until all the cancer treatment is completed. It can also be used to obtain blood samples and for other treatments, such as blood transfusions, without repeated needle sticks.

Chemo also can be:

•taken as a pill, capsule, or liquid that is swallowed
•given by injection into a muscle or the skin
•injected into spinal fluid through a needle inserted into a fluid-filled space in the lower spine (below the spinal cord)

Chemotherapy is sometimes used along with other cancer treatments, such as radiation therapy, surgery, or biological therapy (the use of substances to boost the body’s immune system while fighting cancer).

Lots of kids and teens receive combination therapy, which is the use of two or more cancer-fighting drugs. In many cases, combination therapy lessens the chance that a child’s cancer will become resistant to one type of drug — and improves the chances that the cancer will be cured.

When and Where Chemotherapy Is Given
Depending on the method used to administer chemotherapy, it may be given at a hospital, cancer treatment center, doctor’s office, or at home. Many kids receive chemotherapy on an outpatient basis at a clinic or hospital. Others may need to be hospitalized to monitor or treat side effects.

Kids may receive chemotherapy every day, every week, or every month. Doctors sometimes use the term “cycles” to describe a child’s chemotherapy because the treatment periods are interspersed with periods of rest so the child can recover and regain strength.

Dosage :
Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side effects, neutropenia) will be intolerable to the patient. This has led to the formation of detailed “dosing schemes” in most hospitals, which give guidance on the correct dose and adjustment in case of toxicity. In immunotherapy, they are in principle used in smaller dosages than in the treatment of malignant diseases.

In most cases, the dose is adjusted for the patient’s body surface area, a measure that correlates with blood volume. The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement.

Side Effects:
Although chemo often effectively damages or eliminates cancer cells, it also can damage normal, healthy cells. And this can lead to some uncomfortable side effects.

The good news is that most side effects are temporary — as the body’s normal cells recover, the side effects gradually go away.

Cancer treatment is multifaceted — that is, patients receive a lot of care (i.e., fluid and nutrition support, transfusion support, physical therapy, and medicines) to help them tolerate the treatments and treat or prevent side effects such as nausea and vomiting.

It’s difficult to pinpoint which side effects a  patient might experience, how long they’ll last, and when they’ll end.

The common side effects are:
1.Fatigue
2.Discomfort and Pain
3.Skin Damage or Changes
4.Hair Loss and Scalp Sensitivity
5.Mouth, Gum, and Throat Sores
6.Gastrointestinal Problems

Other side effects are:
•Anemia
•Blood Clotting
•Increased Risk of Infection

Chemo may cause a reduction in white blood cells, which are part of the immune system and help the body to fight infection. Therefore,  the patient  is more vulnerable to developing infections during and after chemo.

•Long-Term Side Effects
Chemotherapy can cause long-term side effects (sometimes called late effects), depending on the type and dose of chemotherapy and whether it was combined with radiation. These effects may involve any organ, including the heart, lungs, brain, kidneys, liver, thyroid gland, and reproductive organs. Some types of chemotherapy drugs may also increase the risk of cancer later in life. Receiving chemo during childhood also may place some kids at risk for delayed growth and cognitive development, depending on the child’s age, the type of drug used, the dosage, and whether chemotherapy was used in addition to radiation therapy.

Newer anticancer drugs act directly against abnormal proteins in cancer cells; this is termed targeted therapy and is technically not chemotherapy.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://englendd.wordpress.com/2011/06/05/chemotherapy/
http://kidshealth.org/parent/system/ill/chemotherapy.html#
http://en.wikipedia.org/wiki/Chemotherapy

http://medicineworld.org/cancer/lead/11-2008/concurrent-chemotherapy-in-lung-cancer.html

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Radiotherapy

Definition:
Radiotherapy is a way of treating or managing cancer using radiation. It works by damaging cells in the area being treated. Normal cells are able to repair this damage, but cancer cells can’t and are destroyed.
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Radiation therapy is commonly applied to the cancerous tumor because of its ability to control cell growth. Ionizing radiation works by damaging the DNA of exposed tissue, furthermore, it is believed that cancerous cells may be more susceptible to death by this process as many have turned off their DNA repair machinery during the process of becoming cancerous. To spare normal tissues (such as skin or organs which radiation must pass through in order to treat the tumor), shaped radiation beams are aimed from several angles of exposure to intersect at the tumor, providing a much larger absorbed dose there than in the surrounding, healthy tissue. Besides the tumour itself, the radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with tumor, or if there is thought to be a risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumor to allow for uncertainties in daily set-up and internal tumor motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumor position.

Radiation oncology is the medical specialty concerned with prescribing radiation, and is distinct from radiology, the use of radiation in medical imaging and diagnosis). Radiation may be prescribed by a radiation oncologist with intent to cure (“curative”) or for adjuvant therapy. It may also be used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit and it can be curative). It is also common to combine radiation therapy with surgery, chemotherapy, hormone therapy, Immunotherapy or some mixture of the four. Most common cancer types can be treated with radiation therapy in some way. The precise treatment intent (curative, adjuvant, neoadjuvant, therapeutic, or palliative) will depend on the tumor type, location, and stage, as well as the general health of the patient. Total body irradiation (TBI) is a radiation therapy technique used to prepare the body to receive a bone marrow transplant. Brachytherapy, in which a radiation source is placed inside or next to the area requiring treatment, is another form of radiation therapy that minimizes exposure to healthy tissue during procedures to treat cancers of the breast, prostate and other organs.

Radiation therapy has several applications in non-malignant conditions, such as the treatment of trigeminal neuralgia, severe thyroid eye disease, pterygium, pigmented villonodular synovitis, and prevention of keloid scar growth, vascular restenosis , and heterotopic ossification. The use of radiation therapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers.

Method of radiotherapy
Radiotherapy can be given as teletherapy (also known as external beam radiotherapy), when a beam of radiation is aimed at the area to be treated from a machine located away from the patient.

Other forms of radiotherapy are high or low-dose brachytherapy, which involves a radioactive source being placed on or in a tumour.

Dose:
The amount of radiation used in photon radiation therapy is measured in gray (Gy), and varies depending on the type and stage of cancer being treated. For curative cases, the typical dose for a solid epithelial tumor ranges from 60 to 80 Gy, while lymphomas are treated with 20 to 40 Gy.

Preventative (adjuvant) doses are typically around 45 – 60 Gy in 1.8 – 2 Gy fractions (for Breast, Head, and Neck cancers.) Many other factors are considered by radiation oncologists when selecting a dose, including whether the patient is receiving chemotherapy, patient comorbidities, whether radiation therapy is being administered before or after surgery, and the degree of success of surgery.

Delivery parameters of a prescribed dose are determined during treatment planning (part of dosimetry). Treatment planning is generally performed on dedicated computers using specialized treatment planning software. Depending on the radiation delivery method, several angles or sources may be used to sum to the total necessary dose. The planner will try to design a plan that delivers a uniform prescription dose to the tumor and minimizes dose to surrounding healthy tissues.

Treatment planning
All patients who are to have radiotherapy need individually tailored treatment so it is given accurately. A lot of information is needed so the doctor can target the tumour while minimising damage to the healthy tissue. This is called treatment planning and there are a number of ways of doing this.

Simulator planning is done using a specialised x-ray machine that can do the same things as the treatment machines except deliver treatment. The simulator allows the doctor to carefully look at the area that needs treatment and plan it precisely. During the planning, the radiographer will draw some marks on the skin using a pen; when the doctor and radiographer are happy they have an accurate plan, the radiographer may need to make two to three permanent marks called tattoos. These tattoos are the size of a pinhead and are used to ensure the radiotherapy is given to exactly the right place.

ACQSIM planning is done using a scanner. Some patients may need to have an intravenous injection before the scan to show up the area to be treated better. The scan usually takes about 15 minutes and the information from the scan is used to produce a treatment map. Sometimes it’s necessary to take some x-rays and measurements to check the treatment map and this is done on the simulator.

What radiotherapy involves
When radiotherapy treatment is being given by external beam, it’s important the patient is in exactly the same position each time. The radiographers will often use pillows and wedges to make sure the patient is comfortable and in the correct position.

Patients having radiotherapy to the head or neck area may need to have a mould made to keep them in the right position. Moulds are made from clear Perspex after a plaster cast has been made of the head and neck. Once the Perspex mould has been made, the radiotherapy is planned while the patient is wearing the mould and marks are drawn on the mask instead of the skin.

Once the radiographers are happy that the patient is in the correct position they will leave the room to switch the treatment machine on. When the machine is on it makes a buzzing noise. The radiographers watch closely on a television screen. Treatment only lasts a few minutes and does not hurt.

Side effect of radiotherapy
Side effects are different depending on the part of the body being treated. Most side effects are temporary but some may continue for weeks or months after treatment is finished. They include:

•Hair loss (alopecia)
•Cerebral oedema (excess fluid accumulating in the brain) can cause changes in mental state, restlessness, irritability, impaired pupil reactions, headache, increase in blood pressure, decrease in pulse and respiration, and nausea
•Dry or sore mouth or throat, changes in taste sensation, skin thickening
•Inflammation of the gullet, indigestion, nausea, lung inflammation
•Nausea and vomiting, diarrhoea, cystitis
•Sexual dysfunction. In males treatment of the abdomen area can cause impotence, sterility. In females it can cause sterility, loss of sexual desire. Irradiation of the pelvis may cause tightening of the vagina, loss of vaginal lubrication, inflammation or ulceration of the vagina. Some women may find intercourse painful
•Treatment of red bone marrow may cause infection and impaired healing, anaemia, increased tiredness, bruising and bleeding

As well as treating cancer the radiotherapy temporarily damages the outer layers of skin. During treatment the skin cannot repair itself as it normally would and it can become sore. But once treatment has finished the skin generally recovers quite quickly – usually within a month. The level of reaction can depend on your skin type, the type and number of treatments you have, and how you would normally react to the sun.

Skin side effects usually happen later on in the course of radiotherapy treatment or sometimes a few weeks after treatment has finished. Many patients do not have any skin changes at all. Skin care advice will be given to the patients by the staff treating them.

A common side effect of radiotherapy is tiredness and fatigue, which often prevents patients from doing normal everyday activities. Fatigue and tiredness are normal results of having radiotherapy and begin in the first week of treatment, reaching a peak after two weeks of treatment and gradually disappearing a few weeks after treatment has finished.

Radiation therapy accidents:
There are rigorous procedures in place to minimise the risk of accidental overexposure of radiation therapy to patients. However, mistakes do occasionally occur; for example, the radiation therapy machine Therac-25 was responsible for at least six accidents between 1985 and 1987, where patients were given up to one hundred times the intended dose; two people were killed directly by the radiation overdoses. From 2005 to 2010, a hospital in Missouri overexposed 76 patients (most with brain cancer) during a five-year period because new radiation equipment had been set up incorrectly.  Although medical errors are exceptionally rare, radiation oncologists, medical physicists and other members of the radiation therapy treatment team are working to eliminate them. ASTRO has launched a safety initiative called Target Safely  that, among other things, aims to record errors nationwide so that doctors can learn from each and every mistake and prevent them from happening. ASTRO also publishes a list of questions for patients to ask their doctors about radiation safety to ensure every treatment is as safe as possible.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Radiation_therapy
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/cancer/carecancer_radio.shtml
http://www.allvitalpoints.com/2010/how-radiotherapy-is-performed/

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Electro-Convulsive Therapy

Definition:
Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. Electroconvulsive therapy seems to cause changes in brain chemistry that can immediately reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.

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Electroconvulsive therapy (ECT), formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown. Today, ECT is most often recommended for use as a treatment for severe depression which has not responded to other treatment, and is also used in the treatment of mania and catatonia. It was first introduced in the 1938 and gained widespread use as a form of treatment in the 1940s and 1950s.

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Informed consent is a standard of modern electroconvulsive therapy. According to the Surgeon General, involuntary treatment is uncommon in the United States and is typically only used in cases of great extremity, and only when all other treatment options have been exhausted and the use of ECT is believed to be a potentially life saving treatment. However, caution must be exercised in interpreting this assertion as, in an American context, there does not appear to have been any attempt to survey at national level the usage of ECT as either an elective or involuntary procedure in almost twenty years. In one of the few jurisdictions where recent statistics on ECT usage are available, a national audit of ECT by the Scottish ECT Accreditation Network indicated that 77% of patients who received the treatment in 2008 were capable of giving informed consent

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Electroconvulsive therapy can differ in its application in three ways: electrode placement, frequency of treatments, and the electrical waveform of the stimulus. These three forms of application have significant differences in both adverse side effects and positive outcomes. After treatment, drug therapy is usually continued, and some patients receive continuation/maintenance ECT. In the United Kingdom and Ireland, drug therapy is continued during ECT.

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The treatment involves placing electrodes on the temples, on one or both sides of the patient’s head, and delivering a small electrical current across the brain, with the patient sedated or under anaesthetic. The aim is to produce a seizure lasting up to a minute, after which the brain activity should return to normal. Patients may have one or more treatment a week, and perhaps more than a dozen treatments in total.

Although ECT has been used since the 1930s, there is still no generally accepted theory to explain how it works. One of the most popular ideas is that it causes an alteration in how the brain responds to chemical signals or neurotransmitters.

Why & when it is done?
Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of a number of mental health conditions. It may be an effective treatment in someone who is suicidal, for instance, or end an episode of severe mania.

ECT is used to treat:
*Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat.

*Treatment-resistant depression, long-term depression that doesn’t improve with medications or other treatments.

*Schizophrenia, particularly when accompanied by psychosis, a desire to commit suicide or hurt someone else, or refusal to eat.

*Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision making, impulsive or risky behavior, substance abuse and psychosis.

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*Catatonia, characterized by lack of movement, fast or strange movements, lack of speech, and other symptoms. It’s associated with schizophrenia and some other psychiatric disorders. In some cases, catatonia is caused by a medical illness.

Electroconvulsive therapy is sometimes used as a last-resort treatment for:

#Treatment-resistant obsessive compulsive disorder, severe obsessive compulsive disorder that doesn’t improve with medications or other treatments

#Parkinson’s disease, epilepsy, and certain other conditions that cause movement problems or seizures

*Tourette syndrome that doesn’t improve with medications or other treatments

ECT may be a good treatment option when medications aren’t tolerated or other forms of therapy haven’t worked. In some cases ECT is used:

#During pregnancy, when medications can’t be taken because they might harm the developing fetus

#In older adults who can’t tolerate drug side effects

#In people who prefer ECT treatments over taking medications

#When ECT has been successful in the past

Risk factor:
Patients are given short-acting anaesthetics, muscle relaxants and breathe pure oxygen during the short procedure in order to minimise the risks. However, although ECT is much safer than it was, there are still side effects to the treatment. The most common are headache, stiffness, confusion and temporary memory loss on awaking from the treatment – some of these can be reduced by placing electrodes only on one side of the head. Memory loss can be permanent in a few cases, and the spasms associated with the seizure can cause fractured vertebrae and tooth damage. However, the recommended use of muscle relaxant nowadays makes the latter a very rare occurrence. Patients can also experience numbness in the fingers and toes.

The death rate from ECT used to be quoted as one for every 1,000 patients, but with smaller amounts of electric current used in modern treatments, accompanied by more safety techniques, this has been reduced to as little as four or five in 100,000 patients.

Recomendations:
A common argument against ECT is that it destroys brain cells, with experiments conducted on animals in the 1940s often cited as evidence. However, modern studies have yet to reproduce these findings in the human brain.

Some activists, however, still campaign against the widespread use of ECT in psychiatry, quoting those cases which have resulted in long-term damage or even death, whether because of the built-in chance of problems, or through errors by doctors.

Experts say that given the correct staff training, and when used for the right clinical conditions, ECT can ‘dramatically’ benefit the patient. An audit of ECT in Scotland between February 1996 and August 1999 said concerns about unacceptable side effects, effectiveness of the treatment and disproportionate use on elderly people were ‘largely without foundation’.

It said that in nearly three quarters of cases people with depressive illness showed ‘a definite improvement’ after ECT. Women were more likely to receive the treatment than men, but the auditors said this was because they were twice as likely to suffer from depression. Only 12 per cent of patients who got ECT were aged over 75. However, the Royal College of Psychiatrists has admitted that in the past the treatment has been administered by untrained, unsupervised junior doctors. However, modern guidelines have changed this and ECTAS (ECT Accreditation Services) exist to check that such treatment is being given safely and efficiently.

Guidelines on ECT from NICE (2003) recommend that it’s used only to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment. options has proven ineffective and/or when the condition is considered to be potentially life-threatening, in individuals with:

•Severe depressive illness
•Catatonia
•Prolonged or severe manic episode

NICE also says that ‘valid consent should be obtained in all cases where the individual has the ability to grant or refuse consent. The decision to use ECT should be made jointly by the individual and the clinician(s) responsible for treatment, on the basis of an informed discussion. This discussion should be enabled by the provision of full and appropriate information about the general risks associated with ECT and about the risks and potential benefits specific to that individual. Consent should be obtained without pressure or coercion, which may occur as a result of the circumstances and clinical setting, and the individual should be reminded of their right to withdraw consent at any point. There should be strict adherence to recognised guidelines about consent and the involvement of patient advocates and/or carers to facilitate informed discussion is strongly encouraged.’

 

Click to learn more  in detail  about  Electro-Convulsive Therapy

You may click to see:-

Keep fighting even when depression treatments don’t work
Video:Electroconvulsive therapy

DSM-IV Codes
Harold A. Sackeim
Insulin shock therapy
History of electroconvulsive therapy in the United Kingdom
Psychiatric survivors movement
Consumer/Survivor/Ex-Patient Movement
List of people who have undergone electroconvulsive therapy

 

Resources:
http://www.mayoclinic.com/health/electroconvulsive-therapy/MY00129
http://www.bbc.co.uk/health/physical_health/conditions/electro_convulsive_therapy.shtml
http://en.wikipedia.org/wiki/Electroconvulsive_therapy

http://www.minddisorders.com/Del-Fi/Electroconvulsive-therapy.html

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Dance Therapy

Dance therapy, also referred to as Movement therapy, is the psychotherapeuticemotional, cognitive, social, behavioural and physical conditions, essentially a combination of creative arts and therapy. The belief is that movement and dance can encourage the healing of the body and mind. The therapy explores the nature of all movement with the idea that body and mind are interconnected. The therapy is based on the notion that everything in the universe is in constant motion and the basic unit of motion is through our own bodies.

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Societies around the world have used the therapy since the beginning of time to express feelings, promote fertility, and to create personal well being. This type of therapy is still practiced widely throughout the world and is an essential part of many traditions, although these cultures may not identify the activity as a therapy.

The therapy is used in clinical settings as well. Certified therapists often provide the therapy after achieving a master’s level of training in aiding physical, mental, behavioral and emotional healing. It is also used among psychotherapists with a variety of clients including the elderly, and abused or autistic children and adults.

There are numerous approaches to the therapy; some emphasize awareness to inner sensations and ease of bodily movement, while others are used to express deep emotional issues. Some therapies use specific sequence movements, which correlate with gravity, and others use spontaneous movement, which is believed to promote healing of the body or mind.

The therapy with an Eastern influence began as a spiritual movement and included self-defense practices. Yoga, Taichi and Qigong, were taught among Taoist monks with an emphasis on meditation and specific breathing patterns. A key component of the discipline was to focus attention inward. These practices are still widely practiced today and are believed to promote increased health and longevity.

Many traditional Western movement therapies focus on physical healing and strength and were patterned after sports and physical therapies. This type of therapy is also used to aid in healing and avoiding injury, and was mainly created by dancers and choreographers. Pilates, a method popular with a broad range of people, is done on the floor or with specialized equipment. It focuses on developing a strong inner core and physical strength as well as balance.

The physical benefits to the therapy include increased muscle tone, joint strength, increased coordination and flexibility, enhanced circulation, cardiovascular benefits and the prevention of injuries. The mental benefits include peace of mind, increased self-awareness, improved overall attitude and increased self-esteem.

It is a complete body workout which can burn more calories than walking, swimming or riding a bicycle besides correcting the posture. So if you want to shake your blues away and lose a few kilos then check into a dance class

Dance can be emotionally therapeutic too. In many forms of meditation dance is used to bring about a peaceful mental state and to usher in positive energy. Dancing makes you feel good, is a worthwhile hobby and also easy on the pocket.  So go ahead, dance your blues away.

Continuum Movement blends a range of subtle intrinsic movements with dynamic expression and a rich variety of breaths and sounds, to awaken the experience of the Mystery of the Body.

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The Healing Power of Magnets

Magnets have been used for their healing properties since ancient times, and now a new study has found that they can reduce swelling when applied immediately after an inflammatory injury.

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In their initial study, researchers from the University of Virginia set out to investigate the effect of magnetic therapy on microcirculation, which is blood flow through tiny blood vessels.

They placed magnets of 70 milliTesla (mT) field strength, which is about 10 times the strength of the common refrigerator magnet, near rats’ blood vessels and found that they dilated constricted blood vessels, and constricted vessels that were dilated. The results suggested that the magnetic filed could relax blood vessels and increase blood flow.

In the more recent study, the researchers used magnets on rats’ paws that had been treated with inflammatory agents to simulate tissue injury. The magnets significantly reduced swelling in the rats’ paws by up to 50 percent when applied immediately after the injury.

Dilation of blood vessels is a major cause of swelling, and it’s thought that the magnets worked by limiting blood flow.

Muscle bruising and joint sprains are the most common injuries worldwide, and since injuries that don’t swell heal faster, the magnet therapy could have widespread applications.

The researchers envisioned using magnets in place of ice packs and compression to treat injuries in high school, college, and professional sports teams, as well as among retirement communities.

Click to learn  more about magnet healing………..(1)..……(2).…….(3)
Sources:
Science Daily January 3, 2008
American Journal of Physiology: Heart and Circulatory Physiology November 2, 2007