Reflexology is growing in popularity in its use for a wide range of conditions such as pain management, to ease the effects of cancer treatment, and indeed mental health problems.

Reflexology, a complementary therapy, has been around for many years and its main purpose is ultimately to aid relaxation and restore energy. Literature suggests that it may improve quality of life and promote well-being. An increasing demand for Complementary and Alternative Medicine’s (CAMS) emphasises the need for more research, therefore this research proposal suggests that further research is required to understand more clearly the benefits perceived by clients when reflexology is utilised in conjunction with their exiting plan of care.

SEARCH STRATEGY

A comprehensive literature search was conducted in relation to reflexology for mental health illness, in particular anxiety and anxiety related disorders. It was the intention to locate valid and reliable research carried out within the last ten years, however expanding this period located much more research that was considered relevant, and thus has been included within the literature review.

The main databases for the literature included Cumulative Index to Nursing and Allied Health (CINAHL), Web of Knowledge, Swetwise, PubMed, British Nursing Index (BNI), Internurse,Wiley Interscience, Allied and Complementary Medicine Database (AMED) , EBSCO, and DARE (Centre for reviews and dissemination).

Keywords used within the search strategy included: reflexology, anxiety, mental health, complementary therapies, complementary medicine, perceptions of reflexology, CAMS for enduring mental health, holistic care in psychiatry, holistic approach to mental health, zone-therapy and therapeutic touch. Additional literature was sourced from The Association of Reflexology. A manual search was also conducted for relevant books and leaflets.

Searching literature revealed much quantitative and qualitative research on the topic of reflexology, the majority of which was related to reflexology for physical conditions such as cancer (of various types), multiple sclerosis, and skeletal ailments. A relatively small number was associated with mental health illnesses.

LITERATURE REVIEW

As mentioned there is an abundance of information and research with regards to the perceived benefits of CAMS including reflexology, however methodological flaws exist within some of these studies. Here, the researcher will attempt to give a critical, yet an evaluative account, on some of the research already published on the topic of reflexology. In addition, the researcher will draw upon previous research that has been carried out on ‘why clients use reflexology’, thus understanding reasons as to why it is becoming a popular complimentary therapy.

Complimentary and alternative therapies incorporate a wide spectrum of approaches, however according to the National Centre for Complementary and Alternative Medicine (2007) they can be grouped into five main categories which are alternative medical systems, mind-body interventions, biologically based therapies, manipulative and body based therapies, and energy therapies. It is important to point out that these diverse modalities to not aim to neither diagnose or cure an illness; they merely aim to promote wellness and enhance wellbeing (Mamtani and Cimino, 2002). In recent years complementary therapies have seen an increase in popularity (Harris and Rees, 2000; Kessler et al, 2001; Russinova, 2009) for all age groups (Barnes and Bloom, 2008) and the reasons for this are varied.

The Complementary and Alternative Medicines Project (2008) was commissioned by the Department of Health Social Services and Public Safety (DHSSPS) in 2000. ‘Get Well UK’ a non-profit organisation was appointed to oversee the project. A large sample of 713 clients who had either musculoskeletal or mental health conditions were referred to the study by their General Practitioner (GP) with the aim of exploring the potential use of CAMS within existing primary care services. Utilising the ‘measure yourself medical outcome profile’ allowed data to be generated through a validated measurement. Respondents were asked to complete this before their first treatment and again after their final treatment. Additionally there were independent surveys conducted via post to the participants, the GP’s and the CAMS practitioners involved.

The modalities of CAMS within the study included reflexology, aromatherapy, homeopathy, acupuncture, massage, chiropractor and osteopathy. Upon evaluation, it was concluded that 79% of those who took part felt an improvement in the mental health, 69% reported an improvement on their well being, and 84% reported that improvement of their well being was directly due to the CAM treatments. In addition, 94% stated that they would definitely recommend CAM treatments to others with similar complaints to themselves. Since the research, The Prince of Wales has called for a £10 million investment into research of CAMS.

Whilst the conclusion of this research appears promising for the various therapies involved, a closer look reveals that only a minority of mental health conditions were included in the selection criteria, which were anxiety, stress and depression. If the inclusion criteria allowed for a range of mental health conditions, their findings may have been different. However, strength is that it had a large sample size, which many other studies have failed to have.

In response to the above research project, the Government strongly hold the view that more evidence is required, and recommended that research should attempt to contribute to the existing evidence based using the same rigorous methods that is required and desired of conventional medicine (Department of Health, 2001).

Reflexology has been described as a technique used to promote the healing powers of the body that works on the premise that certain areas of the feet correspond to areas of the body. It is a non-evasive therapy where gentle pressure is applied to areas of the foot. It is believed that reflexology was practiced in china as early as 4000 BC. Reflexology, originally named ‘zone therapy’ emerged from America during early 20th century.

Reflexology is increasing being utilised in palliative care settings and have found to be effective in alleviating anxiety, additionally improving their physical, emotional, spiritual and psychological well being. Gambles et al (2002) carried out semi-structured interviews to identify cancer patients’ perceptions after a course of reflexology was offered. The main aim of this study was to evaluate the usefulness of reflexology offered in outpatients. Positive results were derived from the analysis demonstrating that reflexology was beneficial for this group of clients. The majority of the clients indicated that the main benefits perceived were a reduction in anxiety levels. Other clients highlighted a reduction in pain, and some noted an improvement in their sleep pattern. The lack of negative comments in this study indicates that reflexology was positively received by the client group. However as the findings were mainly gathered from narrative, thus subjective data, it could be said that lack of objective measurement reduces it value. However, the paper included some of the ‘raw data’ in the form of quotations which enhanced the validity and credibility of the research.

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