PTSD: National Center for PTSD
Complementary and Integrative Health (CIH) and PTSD
Complementary and Integrative Health (CIH) and PTSD
Practices that support whole person health may be used to enhance the effect of conventional treatments for mental health care, including PTSD. These "complementary" approaches may be integrated into a treatment plan. Learn about complementary and integrative (CIH) approaches that support evidence-based PTSD treatment and well-being.
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What are complementary and integrative health practices?
Today, health care may include practices that are used as a "complement" or supplement to conventional (or Western) medicine. Complementary approaches can be used to enhance the effect of conventional treatments or to improve overall wellness. We refer to this coordination of different types of care as complementary and integrative health (CIH).
CIH practices are becoming more popular in the U.S., both among Veterans and the general population. VA encourages the use of complementary or integrative practices in the Whole Health program. Some of the more common CIH practices include:
- Nutrition and supplements
- Physical practices, like massage or hot/cold therapy
- Psychological practices, like mindfulness and spirituality
- Mind-body practices that combine physical and mental elements, like yoga, meditation, tai chi, qigong, and breathing techniques
- Devices, like acupuncture and magnetic stimulation
Whole person health expands health care from a focus on illness and disease to include overall well-being. CIH practices support conventional medicine by helping people improve daily life and abilities through movement, mindfulness, relationships, spirituality, and community.
How many people use CIH?
As we would expect, certain types of CIH are used more often than others. CIH use also varies based upon the goal or health condition that is the focus of the practice. In general, between 1 in 4 (or 25%) and 1 in 2 (or 50%) of people report using CIH. Veterans use CIH at the same rate as the general population; and research suggests CIH use is similar, if not higher, in the military (active duty and Reserves).
In VA, 8 CIH practices are included in Veteran benefits: acupuncture, biofeedback, clinical hypnosis, massage therapy, meditation, guided imagery, tai chi/qigong, and yoga. Chiropractic care is also available at VA. Not all practices are recommended for all conditions, so it's helpful to talk to your provider about the best ways to complement your care. Veteran use of CIH is increasing as all VA medical facilities offer some CIH therapies.
How is CIH used with people who have PTSD?
For PTSD, mind-body practices have been studied the most, including Mindfulness Based Stress Reduction (MBSR) and other forms of meditation, as well as movement-based approaches, like yoga, tai chi and qigong. Currently, MBSR—an 8-week program focused on mindfulness training—is the only CIH practice for PTSD that was suggested in the VA/DoD Clinical Practice Guideline for PTSD. The strongest recommendation for PTSD treatment is for trauma-focused talk therapies.
One other CIH approach with some evidence for PTSD symptom relief is acupuncture. This practice involves the placement of thin needles into body tissues or muscles or in the ear. Ongoing research will help us understand how different types of acupuncture and needle placement may benefit PTSD specifically. Currently, acupuncture is not recommended in the CPG as a PTSD treatment, however.
Yoga is a CIH practice that includes movement, mindfulness, and spirituality. Yoga may be practiced in different ways and is shown to be safe for people who have PTSD. Although studies show that people who have PTSD and do yoga regularly report feeling improvement, currently yoga is not recommended as a treatment for PTSD. Research is helping us learn more about different types of yoga that may prove to be helpful. We are also learning more about tai chi and qigong for people with PTSD, which may also prove to help relieve PTSD symptoms.
What is VA's approach for using CIH with PTSD?
VA is committed to Whole Health and making CIH practices available to Veterans. VA facilities may offer CIH practices as an option along with evidence-based therapies and medications to support overall health and well-being. Veterans who are interested in CIH practices can learn more about VA's Well-Being Programs.
Summary
Overall, the use of certain CIH practices is safe for people who have PTSD and may benefit symptom relief. Research does show increasing use of CIH among those who have PTSD, including among Veterans. A 2020 report on Veteran use of CIH showed that about 1 out of every 3 Veterans (or 33%) who used CIH or chiropractic services had PTSD. A study in 2022 reported that almost all (96%) of the specialized PTSD treatment programs in VA offered CIH. The most common approaches used were mindfulness, stress management (or relaxation), progressive muscle relaxation, and guided imagery.
The most effective treatments for PTSD are trauma-focused psychotherapies. Talk with your mental health provider about how CIH practices might support your well-being, during or after evidence-based PTSD treatment.
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