Outlook: Newsletter of the Society of Behavorial Medicine
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Conversation with an Exemplar for Integrative Medicine Research

Stephanie J. Sohl, PhD, CIM SIG Outlook Liaison
Mona Bingham, PhD, RN, CIM SIG Member

The Complementary and Integrative Medicine Special Interest Group (CIM SIG) was formerly known as the Complementary and Alternative Medicine SIG. This change in name more accurately reflects our objective, which is to complement the current best medical practices by integrating additional effective approaches into standard care, not to investigate alternatives to standard care. Along with this change in identity comes our association with the larger emerging field of Integrative Medicine. As defined by the Consortium of Academic Health Centers for Integrative Medicine, "Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing."

The Samueli Institute is an exemplar for conducting research in Integrative Medicine. This interview of Dr. Wayne Jonas, CEO and President of Samueli Institute, attained by Dr. Mona Bingham of the Complementary and Integrative Medicine (CIM) SIG and Senior Scientist at the Samueli Institute, provides insight into how the Samueli Institute has taken an active role in evaluating healing and wellness practices that can be readily translated into clinical practice.

Stephanie Jean Sohl, PhD
CIM SIG Outlook Liaison

Interview with Dr. Wayne Jonas, CEO and President of the Samueli Institute

Mona: October 4, 2011 marks the 10th Anniversary of Samueli Institute's work as a non-profit organization that researches and investigates the world of healing and wellness, including complementary, alternative and integrative health care and the ways in which it can transform the health care industry as we know it. As you look back on this decade of work, what do you remember as the highlights and major contributions of the Institute to transform health care and work toward healing and wellness?

Wayne: Over the past decade, the Samueli Institute developed the whole systems approach that we believe is necessary to establish a science of wellness and healing. This approach has led to the development of new healing frameworks that are being implemented by a number of health care organizations, the military, and other institutions. These include the Samueli Institute Optimal Healing Environments framework, which is now being used regularly in hospitals, outpatient clinics and other clinical settings. This evidence-based framework consists of eight domains of interrelated elements that facilitate healing. The OHE framework moves from the inner environment to the outer environment and is applicable to self (patient, family member, provider), organization, and system.

Our Total Force Fitness framework, developed in collaboration with the Department of Defense, has become a doctrine and primary framework for enhancing human health and fitness within military populations. The Wellness Initiative for the Nation (WIN), which we developed in collaboration with government and policy experts, has laid out a vision for health policy change. The WIN framework was the basis for a 16-agency National Prevention Council, which is now looking at the impact of policy on community health and wellness across the nation.

In the last decade, other more specific discoveries at the Institute have been in the area of dietary supplements and nutrition for the healing of brain injury. We have also made progress in the application of hormesis to clinical therapeutics, in which natural protective cellular responses can be stimulated by exposure to low doses of chemicals and other agents to produce protection or improvement across a number of conditions, including prostate cancer, and viral infections. Finally, the Institute continues to forge ahead in the important areas of mind-body medicine, consciousness and spirituality research. We are joining with other organizations to investigate these concepts, as well as the components of healing that underlie the placebo effect.

Mona: Would you share some of the future goals and projects that the Institute will be involved with and how the Institute's journey could be a model for other CIM programs and efforts?

Wayne: Healing cuts across the continuum of health and disease. Enhancing the healing processes of individuals means keeping people well, accelerating their recovery if they are sick, and helping with palliation and well-being if they cannot be physically cured of their disease. Thus, our work is a complement to cure but is not the same as cure.

As we move forward into the next decade, the Institute will be working to improve the whole systems frameworks of healing, to make them more practical for those who are delivering health care. Thus, our goal is to provide translational tools that can take the scientific knowledge of healing that we have helped build over the last 10 years and move it into settings so that these healing models of care are available to all. We are working to establish a knowledge translation service to facilitate this transfer from science to practice around the country and around the globe.

Mona: In the last Outlook newsletter, Dr. Cheatle, Pain SIG Chair, stated that SBM members share a common vision but often work in silos. Dr. Cheatle encouraged cross-SIG collaborations [especially] related to pain. It seems timely that the theme of the next SBM conference is "Engaging New Partners and Perspectives." As I look at this multidisciplinary organization of clinicians, educators, and scientists with 17 SIGs representing various populations, diagnoses, symptoms and behaviors, could you suggest ways our CIM SIG can engage new partners and perspectives to support Complementary and Integrative Medicine interdisciplinary work and also support the multiple disciplines and other SIGs of SBM. Can we break down the silos?

Wayne: Breaking down "silos" in health care is difficult, even for those who want to do it. One of the strategies we have used is to focus on pain research as it is an excellent arena in which to break down silos. We have found it is essential to provide cross-disciplinary activities with a number of practitioners working together to help facilitate pain treatment. This includes the merging of behavioral medicine techniques with the appropriate use of medication in interventional techniques, as well as "drugless" approaches such as acupuncture and mind-body therapies, manipulation and massage. It is this type of "team care" of the future that will begin to provide the optimal therapeutic and healing approaches that we all seek.

Mona: Thank you for your work and dedication. I look forward to the next decade of Samueli Institute's work with new partners, perspectives, and outcomes for improving the science and practice of healing.

Biographical Summaries of Contributors

Wayne B. Jonas, MD, President and CEO of Samueli Institute, has had a distinguished career as a student, practitioner, and researcher of conventional medicine and complementary and alternative medical (CAM) practices. In addition to his work at the Institute, he is currently an Associate Professor of Family Medicine at the Uniformed Services University of Health Sciences in Bethesda, Maryland, where he co-founded a CAM curriculum. Dr. Jonas served as Director of the Office of Alternative Medicine at the NIH from 1995-1999 and prior to that was Director of the Medical Research Fellowship at Walter Reed Army Institute of Research. He is trained in family medicine and clinical pastoral care, diet and nutritional therapy, mind-body methods, spiritual healing, electro-acupuncture diagnostics, homeopathy and bioenergy therapy. Dr. Jonas is a graduate of Davidson College, Davidson, North Carolina and Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Mona O. Bingham, PhD, RN, Senior Scientific Director at Samueli Institute, has made numerous contributions through her work in nursing and research. Dr. Bingham has served as a Colonel in the U.S. Army Nurse Corps and was a Consultant to the Army Surgeon General for Nursing Research before joining the Institute in 2010. She currently works in the Military Medical Research Program and investigates complementary and integrative practices that can augment physical and psychological, spiritual, and emotional care for service members and their families.