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Acupuncture Today
November, 2000, Vol. 01, Issue 11
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Classifying CAM

Most People are Familiar with Acupuncture, but Few Have Tried It

By Michael Devitt

How does one classify complementary and alternative medicine (CAM)? It's a simple question, but the answer you get may well depend on who you ask.

Medical doctors, for instance, may classify CAM as anything that hasn't been scientifically proven by clinical trials. Legislators, meanwhile, may define CAM as any type of care not related to the practice of allopathic medicine. Insurance providers and managed care organizations may have their own unique definitions for what CAM entails, further clouding the waters of a field of care that already includes several separate and distinct therapies.

Perhaps the most important opinion as to what CAM is and does is that of the average consumer. The results of a recent study published in Complementary Therapies in Medicine suggest that lay people know exactly what complementary and alternative medicine is and believe they know how those therapies work, and that for the most part, they find CAM to be safe and effective.

In the study, nearly 600 participants (192 men, 387 women) from Great Britain completed a questionnaire that listed 39 different CAM therapies. Participants were asked to answer four questions related to each therapy:

  1. Had they ever heard of the therapy?
  2. Did they think they knew how it worked?
  3. Had they ever tried the therapy themselves?
  4. On a scale of 1-10 (10 being "very effective"), how effective did they believe the therapy to be?

In addition to answering those questions, participants provided details about their age, sex, marital status, and level of education.

Mixed Results for Acupuncture

On the positive side, acupuncture ranked as the most well-known of any therapy on the list; 97.2% of those surveyed said they had heard of it, followed by aromatherapy (95.5%) and herbal medicine (95.4%). Traditional Chinese medicine ranked 12th on the list, with 82.6% of respondents saying they had heard of it before.

Among those therapies that participants said they thought they knew how it worked, acupuncture finished second at 83.7%, less than half a percent behind massage. Herbal medicine ranked fifth at 74.3%.

Although acupuncture ranked at or near the top in terms of familiarity and the belief that people know how it works, a surprisingly low number of participants said they had actually tried it. Only 53 people - just over nine percent of those surveyed - wrote that they had tried acupuncture in the past. Similarly, only 62 people (10.5%) said they had tried traditional Chinese medicine. Nearly twice as many people (211) reported using herbal medicine as those who had tried acupuncture and TCM combined.

Those people who had tried acupuncture, however, considered it an effective form of care. It ranked fourth on a 10-point efficacy scale with a rating of 6.30, just behind massage, relaxation and counseling. Herbal medicine was ranked ninth (5.76), while traditional Chinese medicine finished 13th (5.24).

Table I: CAM therapy ratings.
Therapy Heard of (Yes/No) Works (Yes/No) Tried (Yes/No) Effectiveness(1-10, 10 being "very effective")
Acupuncture 513/11 493/57 53/516 6.30
Acupressure 326/255 262/197 45/455 5.00
Alexander technique

252/332 190/264 43/450 4.91
Aromatherapy 563/19 443/108 292/271 5.71
Art therapy 223/360 159/282 36/441 4.27
Autogenic training 29/551 23/260 4/426 2.87
Ayurveda 63/520 45/343 19/417 3.20
Bach flower remedies 191/391 119/302 81/382 3.91
Biochemical tissue salts 23/509 53/329 19/410 3.45
Biorhythms 285/296 137/311 30/451 3.54
Chiropractic 431/150 313/182 87/440 5.83
Chelation and cell therapy 64/517 41/340 2/435 3.18
Colonic irrigation 428/158 276/219 19/513 4.42
Color therapy 254/327 152/280 34/437 3.60
Crystal and gem therapy 269/312 116/332 32/447 2.95
Dance movement therapy 266/320 194/249 44/440 4.40
Healing 465/105 276/219 87/432 4.86
Herbal medicine 562/22 438/109 211/346 5.76
Homeopathy 506/74 71/162 164/392 5.64
Hypnosis 559/21 418/126 103/461 5.71
Magnetic therapy 165/419 80/337 18/447 3.57
Massage 552/33 495/46 360/195 7.04
Meditation 545/40 429/100 193/357 6.05
Music therapy 324/460 241/224 76/422 5.07
Naturopathy 100/484 61/245 19/427 3.46
Nutritional therapy 252/233 205/236 54/418 5.10
Osteopathy 423/161 309/180 86/419 5.83
Ozone therapy 43/539 24/362 7/426 2.82
Reiki 100/482 60/335 25/411 3.26
Reflexology 512/73 360/167 137/408 5.59
Relaxation 540/39 460/78 297/249 6.42
Shiatsu 325/255 183/255 49/247 4.62
Spiritual healing 450/105 228/263 67/446 4.45
Talk therapies and counseling 195/88 416/114 162/378 6.31
Traditional Chinese medicine 487/96 289/217 62/472 5.24
Therapeutic touch 200/383 108/313 18/440 3.69
Visualization 184/400 122/298 55/405 3.99
Voice and sound therapy 150/432 82/332 19/430 3.62
Yoga 559/23 430/113 183/381 6.17

Two clear findings were noted in the study. The first showed that while each of the therapies was rated on four different scales, there tended to be a high intercorrelation between each rating. The more people had heard of a therapy, for instance, the more likely they were to have tried it. In fact, of the ten therapies people had heard of most, nine of them also ranked in the top ten in terms of being tried.

"It seems quite clear that these different ratings are related," wrote Professor Adrian Furhnam, the study's author. "People are most likely to try those therapies they have heard of that they believe work."

The major exception to this rule, surprisingly, was acupuncture. Only 9.2% of those surveyed had ever tried it, ranking below such arcane forms of care as visualization (12%) and Bach flower remedies (17.5%).

Why the disparity between acupuncture and other forms of care? Although the paper didn't discuss the reasons behind such low use, geography may have played a factor (the population base hailed from the southeast of England, an area which may suffer from a lack of qualified acupuncture practitioners). Gender and education may also have played a role (more than twice as many women as men took the survey, and a third of the survey participants had no formal education beyond a school-leaving certificate).

Despite these factors, the survey produced another important finding: a pattern that provided some information about the average person's thoughts toward complementary therapies.

"It seems as if lay peoples' perception of CAM therapies is as much a function of knowledge based on media interest as their understanding of the philosophy or method underlying these therapies," wrote Furnham. "Experts tend to classify CAM therapies into structural, biomechanical or 'psychological' while lay people seem equally happy to classify them in terms primarily of familiarity and perceived effectiveness.

"Clearly, these results have implications for the education of lay people about CAM therapies," Furnham concluded. They also suggested that further studies be conducted, and that "more qualitative methods may be used to get a better insight into lay peoples' understanding of the nature of these therapies and the mechanisms and processes underlying them."


  • Furnham A. How the public classify complementary medicine: a factor analytic study. Complementary Therapies in Medicine 2000(8):82-87.


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