Music therapy has been a recognised form of therapy for mental illness for many years. This commentary on a Cochrane Review on music therapy for depression sheds light on the evidence. It aims to give further clinical context to the findings, to help guide practice and examine music therapy as an evidence-based practice. The review compares music therapy plus ‘treatment as usual’ (TAU) with TAU alone, music therapy with psychological therapy, and ‘active’ with ‘receptive’ music therapy (the two main types of music therapy). The review points to music therapy being beneficial for people with depression when combined with TAU (versus TAU alone) in the short term, as well as improving anxiety and functioning. We need more evidence looking at longer-term outcomes, comparing music therapy with psychological therapies and comparing different forms of music therapy.

There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice.

This research discusses contextual factors that influence the development of complementary and/or integrative therapies developed by local health units on street-level bureaucracy in Santos. Through a qualitative approach, the research verifies that street-level bureaucracy is free to suggest and implement the aforementioned therapies, even if they do not have formal support of the municipality; however, they need support from their immediate local supervisors so they can adjust and implement the practice’s routine, or the practice might not occur. Additionally, this text also presents guidelines in order to further develop the research.

Meditation, a component of ashtanga yoga, is an act of inward contemplation in which the mind fluctuates between a state of attention to a stimulus and complete absorption in it. Some forms of meditation have been found to be useful for people with psychiatric conditions such as anxiety, depression and substance use disorder. Evidence for usefulness of meditation for people with psychotic disorders is mixed, with reported improvements in negative symptoms but the emergence/precipitation of psychotic symptoms. This article narrates the benefits of meditation in psychiatric disorders, understanding meditation from the yoga perspective, biological aspects of meditation and practical tips for the practice of meditation. We also explain possible ways of modifying meditative practices to make them safe and useful for the patient population and useful overall as a society-level intervention.

Post-traumatic stress disorder (PTSD) is a common trauma and stressor-related disorder. Trauma-focused psychotherapies and selective serotonin reuptake inhibitors represent current state of the art treatment for PTSD, with current evidence favouring psychotherapy as first-line treatment. Much room remains for development of more effective therapeutics. This article give a brief update on diagnosis and treatment of PTSD.

There is growing evidence for yoga's neurobiological effects in people with psychiatric disorders. Postulated mechanisms of action include: (a) modulation of the hypothalamic–pituitary–adrenal (HPA) axis; (b) enhancement of GABAergic neurotransmission; (c) autonomic modulation; and (d) neuroendocrinological effects. Yoga as a therapeutic intervention in psychiatric disorders appears promising and merits further attention in clinical practice and research.

Advanced stage cancer patients experience debilitating physical symptoms as well as profound emotional and spiritual struggles. Advanced disease is accompanied by multiple changes and losses for the patient and the family. Palliative care focuses on the relief of overall suffering of patients and families, including symptom control, psychosocial support, and the meeting of spiritual needs. Music therapy and reflexology are complementary therapies that can soothe and provide comfort. When used conjointly, they provide a multifaceted experience that can aid in the reduction of anxiety, pain, and isolation; facilitate communication between patients, family members, and staff; and provide the potential for a more peaceful dying experience for all involved. This article addresses the benefits of the combined use of music therapy and reflexology. Two case studies are presented to illustrate the application and benefits of this dual approach for patients and their families regarding adjustment to the end of life in the presence of anxiety and cognitive impairment.

This study aims to examine two related contemporary issues in cancer care; why people with cancer use complementary therapies (CM) and what lessons there may be in this for Cancer Centre Services. The report is presented in two parts. Part 2 is in the current issue and Part 1 was published in the previous issue (Journal of Radiotherapy in Practice 2000; 2(1): 45–51). In Part 1, the main questions for the study were identified and contextualised within the current literature on complementary therapy use. In Part 2 the method, results and analysis the survey and interviews are explored. Of the patients attending the Leicestershire Cancer Centre, 148 returned questionnaires of whom 14 were interviewed in three separate focus groups. Patients from a cancer patient self help group were also interviewed as a fourth focus group. The qualitative data enabled a deeper analysis and evaluation of the quantitative data to be made. The discussion of the data places the main questions asked by the study into a wider context, including the Calman-Hine Report and patient-centred care. The conclusions are that although a significant minority of patients (13%) were using CM at the time of the survey a significant majority of respondents (73%) identified a role for CM alongside conventional cancer treatment and 78% responded that staff at the Cancer Centre should be trained to advise them on the use of CM. The respondents acknowledged the resource and educational implications for Cancer Centres but stated that equal status should be given to care and cure in managing malignant disease. This in line with the Calman-Hine Report. Far greater numbers of patients may use CM if appropriate levels of resources and information were available. The findings indicate that integration of CM could assist in promoting future improvements in quality of survival and patient-centred care as identified by Caiman-Hine and other recent health policy initiatives.

This study aims to examine two related contemporary issues in cancer care; why people with cancer use complementary therapies [CM] and what lessons there may be in this for Cancer Centre Services. The report will be presented in two parts. Part 1 is in the current issue and Part 2 will follow in the next. In Part 1 the main questions are identified and contextualised with the current literature on complementary therapy use. In Part 2 the method, results and analysis the survey and interviews will be explored. 148 patients attending the Leicestershire Cancer Centre returned questionnaires of whom 14 were interviewed in three separate focus groups. Patients from a cancer patient self help group were also interviewed as a fourth focus group. The qualitative data enabled a deeper analysis and evaluation of the quantitative data to be made. The discussion of the data places the main questions asked by the study into a wider context, including the Calman Hine Report and patient-centred care. The conclusions are that although a significant minority of patients [13%] were using CM at the time of the survey a significant majority of respondents [73%] identified a role for CM alongside conventional cancer treatment and 78% responded that staff at the Cancer Centre should be trained to advise them on the use of CM. The respondents acknowledged the resource and educational implications for Cancer Centres but stated that equal status should be given to care and cure in managing malignant disease. This in line with the Calman–Hine Report. Far greater numbers of patients may use CM if appropriate levels of resources and information were available. The findings indicate that integration of CM could assist in promoting future improvements in quality of survival and patient-centred care as identified by Calman–Hine and other recent health policy initiatives.

Objectives: To determine the incidence of use of complementary therapies in patients with vestibular symptoms undergoing vestibular assessment.

Design: A prospective, questionnaire-based study.

Setting: A UK university hospital department of audiology with secondary and tertiary referrals.

Participants: A consecutive series of 80 patients seen for vestibular assessment between November 2004 and May 2005.

Main outcome measures: Use of complementary therapies; actual therapies used and patients' subjective opinion of efficacy.

Results: Thirteen patients (16 per cent) had tried some form of complementary therapy for their vestibular symptoms. Ginkgo biloba and acupuncture were the two most popular treatments. Seven patients made their decision as to which treatment to try on the basis of personal recommendation. Six of the 13 patients (46 per cent) reported that their choice of treatment(s) helped them.

Conclusions: Sixteen per cent of patients seen for vestibular assessment had tried some form of complementary therapy for their vestibular symptoms. Clinicians should be aware of this and of the potential interactions between complementary therapies and conventional medicine.

Objectives: Setting funding priorities among research projects for complementary and alternative therapies is especially vulnerable to arbitrary, partisan criteria and opportunistic readings of controversial evidence. This study develops a procedural approach to characterizing, in a transparent and even-handed way, the available evidence on these treatments and demonstrates a simple analytical scheme for prioritizing competing, but typically incommensurable, research projects for public support.

Methods: A simple five-step scheme for categorizing therapies is developed and justified, based on a taxonomy of the study designs used to generate research evidence. Once identified, candidate therapies are assigned to ordered categories along these design criteria and effectively grouped into equivalence classes by type of evidence. Finally, a partial ordering on the therapies is formed within each class by means of secondary screening criteria.

Results: Twenty-five candidate therapies are assigned to equivalence classes. The intent, in effect, is to restrict comparisons to those therapies that fall within a particular class of similar study designs. Within-class orderings avoid the problem of having better-known or better-supported therapies crowd out lesser known ones when it comes to allocating dollars for more research. A set of criteria and procedure for prioritizing spending for further research is demonstrated.

Conclusions: Relying on an open, formal procedure for comparing unconventional therapies offers protection against prejudgment in setting funding priorities, especially when weak clinical evidence relates more to a low investment in research than lack of efficacy.Special thanks are due to Mary Ann Richardson, DrPH, formerly of the UT School of Public Health, currently with the National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland. Dr. Richardson introduced me to this problem and graciously provided information on several unconventional therapies. Partial funding was provided by UT's Center for Alternative Medicine through a contract with the Office of Alternative Medicine, U.S. National Institutes of Health.