Journal of Bodywork & Movement Therapies (2014) 18, 174e182

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HEALTH PSYCHOLOGY, CAM & MASSAGE THERAPY

Health psychology as a context for massage therapy: A conceptual model with CAM as mediator* Glenn M. Hymel, EdD, LMT a, Grant J. Rich, PhD, NCTMB b a

Department of Psychological Sciences, Loyola University, 6363 St. Charles Ave, New Orleans, LA 70118, USA b International Psychology Bulletin, Juneau, Alaska, USA Received 9 May 2013; received in revised form 1 July 2013; accepted 8 July 2013

KEYWORDS Health psychology; Complementary; Alternative; Medicine; Massage; Massage therapy

Summary Health psychology represents a context within which massage therapy research, education, and practice can be positioned for the mutual benefit of both. Furthermore, complementary and alternative medicine (CAM ) more often than not plays a mediating role in relating massage therapy to health psychology. On occasion, though, the linkage between health psychology and massage therapy can be quite direct without the mediating influence of CAM. This paper, accordingly, advances a conceptual model via both flowchart and Venn diagram displays for viewing the health psychology context for massage therapy with the possibility of CAM as a mediating factor. Attention is also given to the broad range of issues constituting contemporary health psychology as well as its correspondence to an equally diverse array of client populations and health conditions addressed in massage therapy research. Future directions in the areas of health psychology, CAM, and massage therapy are proposed with a view toward a mutual and reciprocal benefit accruing to these behavioral and health science arenas. ª 2013 Elsevier Ltd. All rights reserved.

One of the principal supporting disciplines of massage therapy is that of psychology. At its generic level, psychology has been defined as “the scientific study of

* An initial version of this paper was presented at the International Massage Therapy Research Conference; Boston; April 25e27, 2013.

behavior and mental processes” (Hockenbury and Hockenbury, 2011, p. 2). At a more specific level, this behavioral science discipline’s specialty of health psychology represents a context within which massage therapy can be positioned for the mutual benefit of both. One definition of health psychology is that is “focuses on the role of psychological factors in the development, prevention, and treatment of illness. Health psychology includes such areas

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Health psychology as a context for massage therapy as stress and coping, the relationship between psychological factors and physical health, and ways of promoting health-enhancing behaviors” (Hocken bury and Hockenbury, 2011, p. 15). The relationship between health psychology and massage therapy can take the form of a direct linkage in that the former can encompass or subsume the latter. Another possibility is that of a mediated linkage with the field of complementary and alternative medicine (CAM) serving as the mediator between health psychology and massage therapy. This paper, accordingly, proposes a conceptual model of health psychology as a broad context for massage therapy, with the likelihood of an extensive mediating function served by CAM. While biomechanical research also is essential, such theoretical work as is presented here is also valuable, as “a useful theory organizes research data into a meaningful structure, stimulates further research, and guides actions of the practitioner over the rough course of day-to-day problems” (Fiest and Feist, 2009; pp. 7e9). Raw data may be of comparatively less value to practitioners, unless organized by theory; thus, while by nature abstract, theory informs practice, and, as Fiest and Feist (2009) note: “useful theory has a mutual and dynamic interaction with research data. data flow back into the theory and restructure it. leading to more research and additional data, which in turn reshape and enlarge the theory even more. This cyclic relationship continues for as long as the theory proves useful” (p. 8). In support of this proposed theoretical model in this article, two recent American Psychology Association (APA) publications (Barnett and Shale, 2013a, 2013b) have actually extended the relevance of CAM to psychological research and practice in general, with massage therapy cited as one of the most widely used forms of CAM. As noted by Barnett and Shale (2013b, p.576): In recent years there has been a greater awareness of the many benefits of CAM for promoting health and wellness as well as for ameliorating a wide range of conditions and ailments treated by psychologists and other health professionals. One vision of the future of the practice of psychology includes each psychologist developing and maintaining competence in CAM and integrating it into each client’s care as is relevant and appropriate. Support is provided for the belief that CAM will play an important role in the practice of psychology for years to come. Fig. 1 presents a flowchart version of this conceptual model with an emphasis on (a) macro-, meso-, and microlevels of inclusiveness corresponding to health psychology, CAM, and massage therapy, respectively, and (b) a bidirectional flow of information among the three components. A Venn diagram of the model is provided in Fig. 2 with a more visual display of the levels of subsumption across the three components.

Health psychology, massage therapy, & CAM: meanings Health psychology As implied by the expression itself, health psychology refers to “the application of psychological principles and

175 Macro-Level Health Psychology

Meso-Level

Complementary & Alternative Medicine (CAM)

Micro-Level Massage Therapy

(Mediator)

Figure 1 Conceptual Model of Health Psychology As a Context for Massage TherapydPossibly Mediated by CAM (Flowchart Version). NB: Macro-, meso-, and micro-levels designate degrees of inclusiveness. Health psychology subsumes both CAM and massage therapy. Massage therapy is an immediate subset of health psychology when not mediated by CAM; otherwise, it becomes a subset of CAM. The bi-directional flow of information across levels implies that each component potentially informs, and is informed by, the other two components.

research to the enhancement of health, and the prevention and treatment of illness” (Straub, 2001, p.4). More specifically, Brannon and Feist (2010, p. 13) characterize this specialty as encompassing ‘.psychology’s contributions to the enhancement of health, the prevention and treatment of disease, the identification of health risk factors, the improvement of the health care system, and the shaping of public opinion with regard to health.” While overall, psychology as a discipline commonly is dated to the founding of its first laboratory by Wilhelm Wundt in 1879 in Europe (Hockenbury and Hockenbury, 2011, p. 4), health psychology has emerged more recently, and in 1978 the American Psychological Association founded its health psychology Health Psychology

CAM

Massage Therapy Mediated by CAM

Massage Therapy Not Mediated by CAM

Figure 2 Conceptual Model of Health Psychology As a Context for Massage TherapydPossibly Mediated by CAM (Venn Diagram Version). NB: The macro-, meso-, and micro-levels displayed earlier in Figure 1 are implied here, but in terms of a more visual display of CAM always being subsumed under health psychology. Although massage therapy is more often than not subsumed under CAM, it is always a subset of health psychology even when not mediated by CAM.

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Table 1 Representative coverage of psychosocial factors, diseases, disorders, life span periods, & special topics addressed in Nezu et al.’s (2003) Handbook of psychology: Vol. 9. Health psychology. Causal & Mediating Psychosocial Factors Stressful Life Events Coping & Social support Psychoneuroimmunology Diseases & Disorders Asthma Obesity Tobacco Dependence Arthritis & Musculoskeletal Conditions Diabetes Mellitus AIDS/HIV Headaches Psychosocial Oncology Pain Management Insomnia Coronary Heart Disease & Hypertension Chronic Fatigue Syndrome Irritable Bowel Syndrome Spinal Cord Injury Health Psychology Across the Life Span Child Health Psychology Adolescent Health Adult Development & Aging Special Topics Women’s Health Psychology Cultural Aspects of Health Psychology Occupational Health Psychology Complementary & Alternative Therapies

division, with its journal Health Psychology following in 1982 (Brannon and Feist, 2010; pp. 13e14). Since then, health psychology has rapidly grown and its influence has spread. In fact, in 2001, APA voted to include the word “health” in its mission statement. Notably, the history of health psychology in some ways parallels the history of behavioral medicine, which may be viewed as medicine’s version of “health psychology” and which developed after a 1977 Yale University meeting. Like health psychology, behavioral medicine focuses upon psychological factors in health and disease. The extensive scope of health psychology becomes readily apparent as one surveys the topical coverage in such reference works as Nezu et al.’s (2003) Handbook of psychology: Vol. 9. Health psychology, and Baum et al.’s (2001) Handbook of health psychology. As an illustration, Table 1 provides a representative listing of psychosocial factors, diseases, disorders, life span periods, and special topics addressed in the volume by Nezu et al. (2003).

Massage therapy Variations on the meaning of massage therapy can indeed be found in the professional literature. While most definitions, such as the one by Holey and Cook (2011, p. 5) mention that “massage is the manipulation of the soft

tissues of the body by a trained therapist as a component of a holistic therapeutic intervention,” the preferred denot ation here is that provided by Clay and Pounds (2003, p. 4) in their definition of clinical massage therapy as “.the use of manual manipulation of the soft tissues to relieve specific complaints of pain and dysfunction.” This preferred meaning is intended to accommodatedby way of encompassingdthe distinctions among such expressions as preventive massage therapy (i.e., stress-reducing massage & therapeutic massage), sports massage, and medical massage as argued for by Turchaninov (2000; cf. Turchaninov and Cox, 1998).

Complementary & alternative medicine (CAM) The expression complementary and alternative medicine (CAM) refers to the “.diagnosis, treatment, and/or prevention which complements mainstream medicine by contributing to a common whole, satisfying a demand not met by orthodoxy, or diversifying the conceptual framework of medicine” (Ernst, as cited in Ernst et al., 2001, p. 2). At a somewhat greater level of specificity, the National Center for Complementary and Alternative Medicine (NCCAM) identifies the following five domains of CAM (as cited in Straub, 2001): alternative medicine systems, mindbody interventions, biologically based therapies, manipulative & body-based methods, and energy therapies. (See NCCAM, 2001; http://nccam.nih.gov.)

Linkages in the model The direct linkage between health psychology and massage therapy, as portrayed in Figs. 1 and 2, is manifest whenever the objectives of health psychology are advanced by massage therapy intervention as part of conventional/mainstream health care. An obvious example here is that of massage therapy treatment for acute pain management being provided by physiatrists and osteopaths, or by physical therapists and massage therapists as medically prescribed. The mediated linkage between health psychology and massage therapy is apparent on those occasions when the concerns of health psychology are addressed by massage therapy intervention as an aspect of CAM. An illustration of this scenario might be that of massage therapists providing stress-reducing massage and/or therapeutic massage intervention for preventive purposes as an adjunct to conventional/mainstream treatment.

Massage therapy as a catalyst for advancing health psychology: an illustration The integrative research review by Field (1998) titled “Massage Therapy Effects” that appeared in the American Psychological Association journal American Psychologist provided an encouraging example of the diversity of client/ patient populations and health conditions addressed by massage therapy interventions. Since the publication of Field’s (1998) article, there have been a number of research publications by psychologists which also demonstrate the significance and relevance of health psychology

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Table 2 Client populations & conditions addressed in Field’s (1998) integrative research review of massage therapy effects and Massage Therapy Research (2006) book. Enhancing Growth Animal Models: (Pauk, Kuhn, Field, et al., 1986) Preterm Infants: (Dieter, Field, Hernandez-Reif et al., 2003) Cocaine-Exposed Infants: (Wheeden, Scafidi, Field, et al., 1993) HIV-Exposed Infants: (Scafidi and Field, 1996) Full-Term Infants: (Ferber, Laudon, Kuint, et al., 2002) Pregnancy Massage: (Field, Hernandez-Reif, Hart, et al., 1999) Pain Reduction During Painful Procedures Childbirth Labor: (Chang, Wang, & Chen, 2002) MT Prior to Debridement for Burn Patients: (Field, Peck, Krugman, et al., 1998) Postoperative Pain: (Nixon, Teschendorff, Finney, et al., 1997) Reducing Pain in Chronic Pain Conditions Juvenile Rheumatoid Arthritis: (Field, Hernandez-Reif, Seligman, et al., 1997) Fibromyalgia: (Field, Diego, Cullen, et al., 2002) Lower Back Pain: (Ernst, 1999) Migraine Headaches: (Hernandez-Reif, Field, Dieter, et al., 1998) Potential Models for Mechanisms of Touch & Pain Relief Gate Theory: (Field, 1998) Serotonin: (Field, 1998) Sleep Deficits: (Richards, 1998) Reducing Muscular Problems Multiple Sclerosis: (Hernandez-Reif, Field, & Theakston, 1998) Spinal Cord Injury: (Diego, Field, Hernandez-Reif et al., 2002) Enhancing Attentiveness Attention Deficits Autism: (Escalona, Field, Singer-Strunk et al., 2001) ADHD: (Field, Quintino, Hernandez-Reif et al., 1998) Enhancing Alertness: (Field, Ironson, Scafidi, et al., 1996) Alleviating Stress, Depression, & Anxiety Anxiety: (Field, Morrow, Valdeon, et al., 1992). PTDS: (Field, Seligman, Scafidi, et al., 1996) Child/Adolescent Psychiatric Patients: (Field, Morrow, Valdeon, et al., 1992) Eating Disorders in Women: (Hart, Field, Hernandez-Reif et al., 2001) Chronic Fatigue: (Field, Sunshine, Hernandez-Reif et al., 1997) Elderly Volunteers Massaging Infants: (Field, Hernandez-Reif, Quintano, 1998) Models w/Touch Alleviating Depression: (Field, Morrow, Valdeon, et al., 1992) Cardiovascular Symptoms of Stress: (Boone, Tanner, Radosevich, et al., 2001) Sexual Abuse Effects: (Field, Hernandez-Reif, Hart, et al., 1997) Premenstrual Syndrome: (Wheeden, Scafidi, Field, et al., 1993) Autoimmune Disorders Diabetic Children: (Field, Hernandez-Reif, LaGreca et al., 1997) Asthmatic Children: (Field, Henteleff, Hernandez-Reif et al., 1997) Immune disorders HIV-Positive Adults: (Ironson, Field, Scafidi, et al., 1996) Breast Cancer: (Hernandez-Reif, Ironson, Field, et al., 2004)

to massage therapy (e.g. Dryden and Moyer, 2012; Field, 2006; Rich, 2002, 2010). Table 2 identifies many of those populations and conditions reviewed by Field in her 1998 article and 2006 book, thereby, augmenting the listing of health psychology themes displayed earlier in Table 1. The overlap between the two is quite apparent and demonstrates the integral role that massage therapy can play in advancing health psychology. Notably, surveys of the massage therapy research literature have especially tended to focus upon several aspects

of massage therapy relevant to psychology. In particular, various studies, and indeed both traditional narrative reviews and meta-analyses, have highlighted the psychological effects of massage therapy upon anxiety and depression (e.g. Field, 1998; Moyer et al., 2004; Rich, 2010). In addition, examining the tables of contents of the several available recent massage therapy research books yields interesting results that point to disciplinary trends by noting scholarly foci. Table 3 identifies the tables of contents for Dryden and Moyer’s Massage Therapy: Integrating

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Table 3 Comparison of tables of contents of several massage therapy research books. These books each contain at least one chapter primarily focused on the noted domains below. Rich (2002) Yates (2004) Methods Prematurity/Elderly

Field (2006) Methods Reducing Prematurity/Enhancing Growth & Development Attention Psychological Depression/Aggression Effects

Dryden & Moyer (2012) Methods Pregnancy/Labor/Pediatrics/Elderly

(Some coverage interspersed throughout) Spinal Cord Injury

Anxiety/Depression/History of Sexual Trauma

Neuromuscular Function (spinal cord injury, cerebral palsy, Parkinson’s disease, etc.) Movement studies Blood/lymph circulation

Immune Disorders Cancer

Immune Function Cancer Athletes

Workplace (Some coverage interspersed throughout)

Muscle Pain

Pain reduction (Carpal Tunnel Syndrome, Low Back, Children’s Burn Treatment, Fibromyalgia, etc.)

Fibrosis Respiratory

Research and Practice (2012), Field’s Massage Therapy Research (2006), Rich’s Massage Therapy: The Evidence for Practice (2002), and Yates’ Physician’s Guide to Therapeutic Massage (2004). As implied at the outset of this paper (Barnett and Shale, 2013a, 2013b), it should also be noted that not only is massage therapy of significance for health psychology, but its relevance also applies to other major psychology subdisciplines (see Table 4), including clinical psychology and therapy (such as for anxiety and depression), developmental psychology (massage therapy effects across the life span, from pregnancy through adolescence and adults to the elderly and hospice), sensation and perception (understanding the sense of touch), and biological psychology (mechanisms underlying the effects of touch). Some work in massage therapy may also inform other psychology subdisciplines such as consciousness (e.g. massage therapy for sleep), and learning and cognition (e.g. massage therapy enhances alertness) (Hockenbury and Hockenbury, 2011).

Future directions In sum, health psychology, CAM, and massage therapy encompass overlapping areas of focus regarding diverse client/patient populations, health conditions treated, intervention options, and underlying explanatory mechanisms. Researchers, educators, and practitioners in these behavioral science and health science arenas have the

Pain (Head, Neck, Shoulders, Low Back, Fibromyalgia)

Scars

potential for mutual and reciprocal benefit if indeed appropriate collaboration can be established across relevant disciplines and professions. This type of collaboration could conceivably be brought about by any one or more of the following efforts: (a) research endeavors that emphasize a multidisciplinary focus regarding problems investigated, methodologies employed, and underlying explanatory mechanisms appealed to in the quest to accommodate as broad-based a spectrum of client/patient populations and health conditions as possible; (b) educational materials, methods, and programs that promote an awareness of and sensitivity to the mutual concerns among health psychologists, CAM proponents, and massage therapists; and (c) practitioner policies and activities that realistically provide clients and patients with viable biopsychosocial choices concerning their treatment, education, and self-care. With the best interests of clients/ patients in mind as well as the advancement of our health care system, the alternative to this appropriate type of professional collaboration is simply untenable. Practically speaking, while there have been numerous calls for more integration of research into the massage therapy curricula, with some notable exceptions such as publication of several massage therapy research methods texts (e.g. Dryden and Achilles, 2003; Hymel, 2006; BrownMenard, 2009), many programs remain unable to include substantial training on the topic for several reasons, including a lack of available hours to devote to the subject

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Table 4 Examples of massage therapy research as linked to various major subdisciplines in psychology beyond health psychology: Connections revealed by introductory psychology textbook chapter topics.

Chapter Titles from Hockenbury and Discovering Psychology Textbook (2011) Neuroscience and Behavior

Sensation and Perception

Consciousness and its Variations

Learning

Memory

Thinking, Language, and Intelligence

Motivation and Emotion

Lifespan Development

Social Psychology

Psychological Disorders

Therapies

Industrial/Organizational Psychology

Sample Relevant Massage Therapy Research Citations Dinse (2011). Brain plasticity and touch. Fraser & Kerr (1993). Psychophysiological effects of back massage on elderly institutionalized patients. Hsiao (2011). Biomechanical and neurophysiological basis of the processing of tactile stimuli. Nelson & Lumpkin (2011). Sensory processes of touch. Field & Hernandez-Reif (2001). Sleep problems in infants decrease following massage therapy Field (2006). Increasing attentiveness. Cigales, Field, Lundy, et al. (1997). Massage enhances recovery from habituation in infants. Hart, Field, Hernandez-Reif et al. (1998). improves following massage. Field, Ironson, Scafidi, et al. (1996). Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. Hart, Field, Hernandez-Reif et al. (1998). improves following massage. Field, Morrow, Valdeon, et al. (1992). Massage reduces anxiety in child and adolescent psychiatric patients. Hart, Field, Hernandez-Reif, et al. (2001). Anorexia nervosa symptoms are reduced by massage therapy. Dieter & Emory (2002). Supplemental tactile and kinesthetic stimulation for preterm infants. Remington (2002). Hand massage in the agitated elderly. Anderson (2011). Tactile traditions: Cultural differences and similarities in haptic communication. Feldman (2011). Gender and status patterns in social touch. Field, Seligman, Scafidi et al. (1996). Alleviating posttraumatic stress in children following Hurricane Andrew. Moyer (2012). Anxiety and depression. Field, Grizzle, Scafidi et al. (1996). on depressed adolescent mothers. Field, Schanberg, Kuhn, et al. (1998). Bulimic adolescents benefit from massage therapy. Cady & Jones (1997). Massage therapy as a workplace intervention for reduction of stress. Hodge et al. (2002). Employee outcomes following work-site acupressure and massage.

180 due to competing needs in time-delimited curricula (such as the need to cover subject matter required on credentialing exams in anatomy and physiology and on massage techniques), lack of appropriately credentialed faculty, and lack of appropriate teaching materials. In addition, with respect to psychology in particular, relevant research is poorly represented in typical massage therapy curricula. Two popular and otherwise helpful massage therapy texts serve as examples. In Mark Beck’s Theory and Practice of Therapeutic Massage (2006), which is 967 pages long, the word psychology appears just twice in the index (pp. 62 and 301). Likewise, in Susan Salvo’s Massage Therapy: Principles and Practice (2007), which is 904 pages long, the word psychology does not appear in the index, the term “psychiatric patients” appears there once (p. 96) and the term “psychotherapist” also appears there once (p. 894). Slightly more coverage is offered in two popular, more advanced special topics massage therapy texts on pathology. Werner’s A Massage Therapist’s Guide to Pathology (2013) offers a full chapter on nervous system conditions, including eighteen pages on psychiatric disorders (pp. 170e187). In similar fashion, Salvo’s Pathology for Massage Therapists (2009) offers a chapter on mental disorders (pp. 440e452). Nevertheless, while in general these pathology texts offer much of value, the sections of massage treatment for psychological disorders largely appear based on anecdotal or personal experiential evidence, rather than reporting of specific clinical trials or published empirical research for specific psychiatric conditions. Thus, this article aims to make a substantial contribution by documenting and highlighting relevant linkages between specific areas of health psychology, CAM, and massage therapy. Framing manual therapy in this wider landscape is valuable in itself, and becomes even more so when one views the psychological research cited here as resources for practicing massage therapists and instructors at educational institutions seeking concrete practical applications, that are research as opposed to anecdotally-based, and which move beyond available teaching resources typically found in current massage therapy classrooms and curricula. In such ways, abstract conceptual and theoretical work becomes directly linked to concrete, practical applications of relevance to research, education, and practice. To promote advancement of massage therapy as health psychology, researchers, educators, and practitioners must collaborate, and to paraphrase earlier comments by Feist and Feist, data gleaned from massage therapy practice flow back into theory and restructure it “leading to more research and additional data, which in turn reshape and enlarge the theory even more” (p. 8). This cyclic relationship between health psychology and massage therapy represents positive growth and development for both. Professional leadership may also play a vital role in this collaborative effort. Both in the past and the present AMTA has had several top leaders with psychology backgrounds. In the 1990s Elliot Greene, who holds a master’s in psychology, was a multiterm president of the organization. Greene is also coauthor of the book The Psychology of the Body (Greene and Goodrich-Dunn, 2013), an applied clinical approach to the topic, which quite recently has been revised and expanded. In addition, in 2012, Nancy M. Porambo became PresidentElect of AMTA. She has a master’s degree in health

G.M. Hymel, G.J. Rich psychology. Such elected leadership demonstrates that massage therapists understand the significance and relevance of health psychology for massage therapy. In fact, since the publication of Field’s 1998 integrative research review article cited earlier, evidence-based research in massage therapy has dramatically expanded, and several textbooks now focus on research methods for massage therapists (e.g. Brown-Menard, 2009; Hymel, 2006), and additional voices of psychologists have been introduced (e.g. Dryden and Moyer, 2012; Rich, 2002, 2010). Such publication projects have succeeded by utilizing an approach which, like integrative medicine itself, combines and synthesizes multidisciplinary perspectives from both psychologists and massage therapists and those dually-trained in both disciplines. Turf wars e whether between practitioners and researchers, or between various academic subjects e typically harm and slow progress. Working together, in contrast, is often the way by which creativity and innovation are enhanced and new knowledge, and indeed paradigms, are gained (Kaufman and Sternberg, 2010).

Appendix A. Research cited in Table 2 Boone, T., Tanner, M., Radosevich, A., 2001. Effects of a 10-minute back rub on cardiovascular responses in healthy subjects. American Journal of Chinese Medicine 29, 47e52. Chang, M.Y., Wang, S.Y., Chen, C.H., 2002. Effects of massage on pain and anxiety during labor: A randomized controlled trial in Taiwan. Journal of Advanced Nursing 38, 68e73. Diego, M.A., Field, T., Hernandez-Reif, M., et al., 2002. Spinal cord patients benefit from massage therapy. International Journal of Neuroscience 112, 133e142. Dieter, J. N. I., Field, T., Hernandez-Reif, M., et al., 2003. Stable preterm infants gain more weight and sleep less after five days of massage therapy. Journal of Pediatric Psychology 28, 403e411. Escalona, A., Field, T., Singer-Strunk, R., et al., 2001. Improvements in the behavior of children with autism. Journal of Autism and Developmental Disorders 31, 513e516. Ernst, E., 1999. Massage therapy for low back pain: A systematic review. Journal of Pain Symptom Management 17, 65e69. Ferber, S.G., Laudon, M., Kuint, J., et al., 2002. Massage therapy by mothers enhances the adjustment of circadian rhythms to the nocturnal period in full-term infants. Journal of Developmental and Behavioral Pediatrics 23, 410e415. Field, T., 1998. Massage therapy effects. American Psychologist 53(12), 1270e1281. Field, T., Diego, M., Cullen, C., et al., 2002. Fibromyalgia pain and substance P decrease and sleep improves following massage therapy. Journal of Clinical Rheumatology 8, 72e76. Field, T., Henteleff, T., Hernandez-Reif, M., et al., 1997. Children with asthma have improved pulmonary functions after massage therapy. Journal of Pediatrics 132, 854e858. Field, T., Hernandez-Reif, M., Hart, S., et al., 1997. Sexual abuse effects are lessened by massage therapy. Journal of Bodywork and Movement Therapies 1, 65e69.

Health psychology as a context for massage therapy Field, T., Hernandez-Reif, M., Hart, S., et al., 1999. Pregnant women benefit from massage therapy. Journal of Psychosomatic Obstetrics & Gynecology 20, 31e38. Field, T., Hernandez-Reif, M., LaGreca, A., et al., 1997. Massage therapy lowers blood glucose levels in children with diabetes mellitus. Diabetes Spectrum 10, 237e239. Field, T., Hernandez-Reif, M., Quintano, O., et al., 1998. Elder retired volunteers benefit from giving massage therapy to infants. Journal of Applied Gerontology 17, 229e239. Field, T., Hernandez-Reif, M., Seligman, S., et al., 1997. Juvenile rheumatoid arthritis: benefits from massage therapy. Journal of Pediatric Psychology 22, 607e617. Field, T., Ironson, G., Scafidi, F., et al., 1996. Massage therapy reduces anxiety and enhances EEG patterns of alertness and math computations. International Journal of Neuroscience 86, 197e205. Field, T., Morrow, C., Valdeon, C., et al., 1992. Massage reduces anxiety in child and adolescent psychiatric patients. Journal of the America Academy of Child and Adolescent Psychiatry 31, 125e131. Field, T., Peck, M., Krugman, S., et al., 1998. Burn injuries benefit from massage therapy. Journal of Burn Care and Rehabilitation 19, 241e244. Field, T., Quintino, O., Hernandez-Reif, M., et al., 1998. Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence 33, 103e108. Field, T., Seligman, S., Scafidi, F., et al., 1996. Alleviating posttraumatic stress in children following Hurricane Andrew. Journal of Applied Developmental Psychology 17, 37e50. Field, T., Sunshine, W., Hernandez-Reif, M., et al., 1997. Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome 3, 43e51. Hart, S., Field, T., Hernandez-Reif, M., et al., 2001. Anorexia nervosa symptoms are reduced by massage therapy. Eating Disorders 9, 289e299. Hernandez-Reif, M., Field, T., Dieter, J., et al., 1998. Migraine headaches are reduced by massage therapy. International Journal of Neuroscience 96, 1e11. Hernandez-Reif, M., Field, T., Theakston, H., 1998. Multiple sclerosis patients benefit from massage therapy. Journal of Bodywork and Movement Therapies 2, 168e174. Hernandez-Reif, M., Ironson, G., Field, T., et al., 2004. Breast cancer patients have improved immune functions following massage therapy. Journal of Psychosomatic Research 57(1), 45e52. Hernandez-Reif, M., Martinez, A., Field, T., et al., 2000. Premenstrual syndromes are relieved by massage therapy. Journal of Psychosomatic Obstetrics & Gynecology 21, 9e15. Ironson, G., Field, T., Scafidi, F., et al., 1996. Massage therapy is associated with enhancement of the immune system’s cytotoxic capacity. International Journal of Neuroscience 84, 205e217. Nixon, M., Teschendorff, J., Finney, J. et al., 1997. Expanding the nursing repertoire: The effect of massage on post-operative pain. Australian Journal of Advanced Nursing 14, 21e26. Pauk, J., Kuhn, C., Field, T., et al., 1986. Positive effects of tactile versus kinesthetic or vestibular stimulation on neuroendocrine and ODC activity in maternally deprived rat pups. Life Science 39, 2081e2087.

181 Richards, K.C., 1998. Effect of a back massage and relaxation intervention on sleep in critically ill patients. American Journal of Critical Care 7, 288e299. Scafidi, F., Field, T., 1996. Massage therapy improves behavior in neonates born to HIV positive mothers. Journal of Pediatric Psychology 21, 889e898. Wheeden, A., Scafidi, F. A., Field, T., et al., 1993. Massage effects on cocaine-exposed preterm neonates. Journal of Developmental & Behavioral Pediatrics 14, 318e322.

Appendix B. Research cited in Table 4 Anderson, P. A., 2011. Tactile traditions: Cultural differences and similarities in haptic communication. In M.J. Hertenstein, S. Weiss (Eds.), The Handbook of Touch. New York, NY: Springer, pp. 351e369. Cady, S. H., Jones, G. E., 1997. Massage therapy as a workplace intervention for reduction of stress. Perceptual & Motor Skills 84, 157e158. Cigales, M., Field, T., Lundy, B., et al., 1997. Massage enhances recovery from habituation in infants. Infant Behavior and Development 20, 29e34. Dieter, J.N.I., Emory, E.K., 2002. Supplemental tactile and kinesthetic stimulation for preterm infants. In G. Rich (Ed.), Massage Therapy: the evidence for practice. New York, NY: Mosby/Elsevier, pp. 135e164. Dinse, H. R., 2011. Brain plasticity and touch. In M.J. Hertenstein, S. Weiss (Eds.), The Handbook of Touch. New York, NY: Springer, pp. 85e119. Field, T., 2006. Increasing attentiveness. In T. Field (Ed.), Massage Therapy Research. New York, NY: Elsevier, pp. 61e86. Field, T., Grizzle, N., Scafidi, F., et al., 1996. Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence 31, 903e911. Field, T., Hernandez-Reif, M., 2001. Sleep problems in infants decrease following massage therapy. Early Child Development and Care 168, 95e104. Field, T., Ironson, G., Scafidi, F., et al., 1996. Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. International Journal of Neuroscience 86, 197e205. Field, T., Morrow, C., Valdeon, C., et al., 1992. Massage reduces anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry 31, 125e131. Field, T., Schanberg, S., Kuhn, C., et al., 1998. Bulimic adolescents benefit from massage therapy. Adolescence 33, 555e563. Field, T., Seligman, S., Scafidi, F., et al., 1996. Alleviating posttraumatic stress in children following Hurricane Andrew. Journal of Applied Developmental Psychology 17, 37e50. Fraser, J., Kerr, J.R., 1993. Psychophysiological effects of back massage on elderly institutionalized patients. Journal of Advanced Nursing 18, 238e245. Hall, J.A., 2011. Gender and status patterns in social touch. In M.J. Hertenstein, S. Weiss (Eds.), The Handbook of Touch. New York, NY: Springer, pp. 329e350. Hart, S., Field, T., Hernandez-Reif, M., et al., 1998. Preschoolers’ cognitive performance improves following massage. Early Child Development and Care 143, 59e64.

182 Hart, S., Field, T., Hernandez-Reif, M., et al., 2001. Anorexia nervosa symptoms are reduced by therapy. Eating Disorders 9, 289e299. Hodge, M., Robinson, C., Boehmer, J., Klein, S., 2002. Employee outcomes following work-site acupressure and massage. In G. Rich (Ed.), Massage Therapy: The evidence for practice. New York, NY: Mosby/Elsevier, pp. 191e202. Hsaio, S.S., 2011. Biomechanical and neurophysiological basis of the processing of tactile stimuli. In M.J. Hertenstein, S. Weiss (Eds.), The Handbook of Touch. New York, NY: Springer, pp. 123e142. Moyer, C.A., 2012. Anxiety and depression. In T. Dryden, C.A. Moyer (Eds.), Massage Therapy: Integrating Research and Practice. Champaign, IL: Human Kinetics, pp. 151e164. Nelson, A. M., Lumpkin, E.A., 2011. Sensory proce sses and touch. In M.J. Hertenstein, S. Weiss (Eds.), The Handbook of Touch. New York, NY: Springer, pp. 33e58. Remington, R., 2002. Hand massage in the agitated elderly. In G. Rich (Ed.), Massage Therapy: The Evidence for Practice. New York, NY: Mosby/Elsevier, pp. 165e185.

References Barnett, J.E., Shale, A.J., 2013a. Alternative techniques. Monitor on Psychology 44 (4), 48e56. Barnett, J.E., Shale, A.J., 2013b. The integration of complementary and alternative medicine (CAM) into the practice of psychology: a vision for the future. Professional Psychology: Research and Practice 43 (6), 576e585. Baum, A., Revenson, T.A., Singer, J.E. (Eds.), 2001. Handbook of Health Psychology. Lawrence Erlbaum Associates, Mahwah, NJ. Brannon, L., Feist, J., 2010. Health Psychology: an Introduction to Behavior and Health, seventh ed. Wadsworth, Belmont, CA. Beck, M.F., 2006. Theory and Practice of Therapeutic Massage, fourth ed. Thomson, Clifton Park, NY. Brown-Menard, M., 2009. Making Sense of Research, second ed. Curties- Overzet, Toronto, Canada. Clay, J.H., Pounds, d. M., 2003. Basic Clinical Massage Therapy: Integrating Anatomy and Treatment. Lippincott Williams & Wilkins, Philadelphia. Dryden, T., Achilles, R., 2003. Massage Therapy Research Curriculum Kit. AMTA Foundation, Evanston, IL.

G.M. Hymel, G.J. Rich Dryden, T., Moyer, C.A. (Eds.), 2012. Massage Therapy: Integrating Research and Practice. Human Kinetics, Champaign, IL. Ernst, E., Pittler, M.H., Stevinson, C., White, A. (Eds.), 2001. The Desktop Guide to Complementary and Alternative Medicine: an Evidence-based Approach. Mosby, New York. Field, T., 1998. Massage therapy effects. American Psychologist 53 (12), 1270e1281. Field, T., 2006. Massage Therapy Research. Elsevier, New York. Fiest, J., Feist, G.J., 2009. Theories of Personality. McGraw-Hill, Boston, MA. Greene, E., Goodrich-Dunn, B., 2013. The Psychology of the Body, second ed. Lippincott, Williams, & Wilkins, Philadelphia, PA. Hockenbury, D.H., Hockenbury, S.E., 2011. Discovering Psychology, fifth ed. Worth Publishers, New York, NY. Holey, E.A., Cook, E.M., 2011. Evidence-based Therapeutic Massage, third ed. Churchill Livingston Elsevier, New York, NY. Hymel, G.M., 2006. Research Methods for Massage and Holistic Therapies. Elsevier, St. Louis, MO. Kaufman, J.C., Sternberg, R.S. (Eds.), 2010. The Cambridge Handbook of Creativity. Cambridge University Press, New York, NY. Moyer, C.A., Rounds, J., Hannum, J.W., 2004. A meta-analysis of massage therapy Research. Psychological Bulletin 130, 3e18. National Center for Complementary and Alternative Medicine (NCCAM), 2001. Considering Complementary and Alternative Medicine Therapies? National Institutes of Health, Washington, DC. http://nccam.nih.gov//. Nezu, A.M., Nezu, C.M., Geller, P.A. (Eds.), 2003. Handbook of Psychology. Health Psychology, vol. 9. John Wiley & Sons, Hoboken, NJ. Rich, G. (Ed.), 2002. Massage Therapy: the Evidence for Practice. Elsevier, New York. Rich, G., 2010. Massage therapy: significance and relevance to professional practice. Professional Psychology: Research and Practice 41 (4), 325e332. Salvo, S., 2007. Massage Therapy: Principles and Practice, third ed. Elsevier, St. Louis, MO. Salvo, S., 2009. Pathology for Massage Therapy, second ed. Elsevier, St. Louis, MO. Straub, R.O., 2001. Health Psychology. Worth Publishers, New York. Turchaninov, R., 2000. Therapeutic Massage: a Scientific Approach. Aesculapius Books, Phoenix, AZ. Turchaninov, R., Cox, C., 1998. Medical Massage. Aesculapius Books, Phoenix, AZ. Werner, R., 2013. A Massage Therapist’s Guide to Pathology, fifth ed. Lippincott, Williams, & Wilkins, Philadelphia, PA. Yates, J., 2004. A Physician’s Guide to Therapeutic Massage, third ed. Curties-Overzet Publications, Toronto, Canada.