OSTEOPATHY

The Interpretation of Intention in Osteopathy: An exploratory qualitative study

Outline

Spinal pain is a common reason for consulting general practitioners (GPs), and complementary therapists such as osteopaths and chiropractors. Patients express greater satisfaction with the care from chiropractors and osteopaths, because they are perceived as having more empathy, diagnostic skill, and effective treatment, but their attitude to a GP providing an osteopathy service is unknown. Painful conditions of the spine are a common reason for consulting general practitioners and complementary practitioners. In the USA and UK, patients expressed greater satisfaction with the care received from chiropractors and osteopaths for spinal pain, than from GPs. Qualitative studies examining patients' attitudes to the treatment of their spinal pain in primary care have uncovered a high level of dissatisfaction. Although good listening and communication skills were appreciated, patients were frustrated by absent or conflicting diagnoses. The seriousness of their symptoms was minimized, and they did not receive a satisfactory explanation for their symptoms. They felt that their GPs failed to examine them thoroughly, lacked interest, were dismissive of their suffering, and unable to help. They disliked the 'ruling out' process, whereby investigations ceased once certain pathologies were excluded. Despite this, back pain patients frequently consulted their GP, because it performed important social functions, legitimising their sick role, their re-organized family relationships, and receipt of state benefits. I have found little research in osteopathy dealing with the effects of approach and mental state/concentration of the practitioner on treatment outcome. Perhaps, more measurable elements that can account for a treatment success such as increased movement, reduction of pain and general well-being has captivated research interest in osteopathy and that intention may be seen as too difficult a phenomena to quantify. This may explain the scarcity of research in osteopathy dealing with the intention effect. A better understanding of how osteopaths view their success offers insight into developing methods to enhance the osteopathic approach. Is intention purely mindful, can it be unconscious or something inexplicable? By revealing how osteopaths hone their intentional skill, prepare the treatment space and what practices they adopt to develop intention, and light may be shed on how osteopathy is aided by intention.

This investigation also directly asks to what degree osteopaths believe treatment outcomes are influenced by the application or focus of their intention. In a recent study, a preliminary investigation by (Brooks, 2000, pp.107-123) looked into 'patient perception of practitioner intention in osteopathy in the cranial field'. This study was conducted to determine whether patients had been able to detect whether the practitioner was concentrating with intention during treatment (Goldberg, 1998, pp. 1-3). The participants were naïve to the cranial method of treatment. Each participant received two different treatment sessions, one involving intention and the other a 'sham' or non-intention. It was found that the participants reported experiencing the feeling of a form of communication occurring between themselves and the practitioner. This communication resulted in a sense of connection and relaxation, which was better achieved in the treatment ...