).
DEFINING COMPLEMENTARY AND ALTERNATIVE MEDICINE
The National Center for Complementary and Integrative Health (NCCIH; 2018) elaborates on what the National Institutes of Health (NIH) define “complementary,” “alternative,” and “integrative” as within the evolving paradigm of medicine. While “alternative” and “complementary” are often used interchangeably, they are not synonymous. As healthcare professionals utilizing such methods, it is essential to know how and when to use such terms appropriately when articulating the value and efficacy of services provided.
If a non-mainstream practice is used together with conventional medicine, then it is considered "complementary."
If a non-mainstream practice is used in place of conventional medicine, then it is considered "alternative."
An approach to health care that brings conventional and complementary approaches together in a coordinated way. Integrative healthcare emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system.
One of the greatest benefits that emerge from the integrative approach of blending conventional with complementary approaches is that it empowers the client to be a more active participant in their healthcare intervention process rather than mainstream healthcare models allow (Hilbers & Lewis, 2013). Complementary and alternative medicine (CAM) practices allow the patient to seize control of actionable strategies toward their wellness goals. In the perspective of occupational therapy, these actionable pursuits are of primary concern to intervention philosophy and therefore may serve as viable options for intervention strategies when approaching the care of the depressed postpartum women from a holistic perspective.
The benefits of expressive writing have been well studied and documented across multiple patient populations, with research indicating that this easily accessible form of intervention has significant implications for successful impact upon major depressive disorders (Krpan et al., 2013). Looking specifically at the postpartum population, an Italian study of 113 women utilizing expressive writing as a medium for processing and defining their birthing experiences showed significant improvement at follow up 3-months later (Blasio et al., 2015). These writing sessions were conducted while in the hospital at three days postpartum and consisted of two sessions of 10-minute writing, separated by a minimum of four hours (Blasio et al., 2015). Horsche and colleagues (2016) similarly found that expressive writing was both a statistically significant and cost-effective therapeutic approach of addressing maternal posttraumatic stress and depressive symptoms in mothers of very preterm infants.
The profession of occupational therapy has a long-standing and deeply rooted connection to the use of creative arts (e.g., painting, drawing, creative writing, music, and textile arts and crafts) as a treatment medium for improving health and wellbeing across multiple dimensions of mental illness (Perruzza & Kinsella, 2010). Such emphasis has existed on behalf of art as a therapeutic medium that realm of Art Therapy, an integrative health profession, has evolved from influences in the fields of psychology, education, and art (Czamanski-Cohen
& Weihs, 2016).
In a critical review of the literature on art-based practices and their impact on mental health recovery, Van Lith, Schofield and Fenner (2013) found that art-based practices benefited various forms of psychological healing through improvement in self-esteem, self-discovery, empowerment, self-expression, rebuilding of identity, self-validation, motivation, sense of purpose, and focus and cognition (p. 1319). In a study explicitly investigating the postpartum population, Morton and Forsey (2014) found in their pilot study significant evidence in support of a creative arts group based intervention method to improve a sense of wellbeing and qu