Thank you for reading my blog and kindly sharing your perspectives. I believe the UK National Health Service (NHS) currently has a 2-tier evidence-based practice ethos. Higher quality evidence is required for therapies that are considered new or alternative than for established therapies. I for example still see physiotherapists using chest percussion, and only a few years ago saw interferential in use! I have seen evidence showing both of these modalities to be unpredictable and not effective, yet at least one of them is still used. If the principle of ‘evidence-based practice or no practice’ was strictly applied to conventional health-care I suspect things might be very different to the way they are now ( http://www.shef.ac.uk/scharr/ir/percent.html http://www.time.com/time/magazine/article/0,9171,1590448,00.html ). I agree that evidence-based practice is essential to ensure the quality of health-care. I also agree that the taxpayer should not fund interventions that are not underpinned by scientific evidence. I believe though, that the two-tier state of evidence-based practice today may be retarding innovation. As you are aware, controlled clinical trials are not the only source of scientific evidence, and are not always the most valid source either.

I do not have a clear understanding of the second paragraph of your comments. Are values taught and conditioned or are they innate, waiting to be uncovered? A girl that I am currently working with (for example) thinks a particular man (that happens to be in a relationship with another woman) is ‘important’ in her life, to the extent that she is depressed. Less than two months ago it was another man (possibly in a relationship with another woman) that was ‘important’ in her life and the reason she believed she was depressed. Do these men have anything to do with her spirituality? My personal understanding of spirituality is that ‘values that we hold dear’ are only related to spirituality in psycho-spiritually congruent individuals. I believe that values that we hold dear can actually be contra to our spirituality when the former are socially conditioned.

Have you assumed that reiki “no evidential support at all from science”? Personally I prefer not to pass judgment on anything that I have not experienced myself. I cannot broadly judge psychosis, illness or disability without first experiencing it and I may not be able to judge another person’s experience in this lifetime because I may never learn to be, or live any other person’s life. This does not mean that I will choose to become ill; I will simply choose not to judge. A couple of weeks ago for example I learnt some Sufi practices. I am not aware of any scientific evidence to support them, but I feel it would have been wrong to judge them on that basis alone. I could have chosen to accept that they are just something some people do that I was unable to judge, but instead I chose to experience them for myself. Either approach would have been fine in my book, but if I had just passed judgment on them due to a lack of scientific evidence (or my lack of awareness of scientific evidence) perhaps it would have been fair to call that ignorance.

Best wishes

V

Venthan J. Mailoo BSc (Hons) MCSP CertMgmt
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