A leaflet, for Craniosacral Therapy, stated “Craniosacral Therapy is a hands-on therapy which assists the body’s natural capacity for self-repair … Any trauma, stresses, strains, or tensions which remain in the body restrict the body’s functioning and may give rise to problems over the years.
A complainant challenged whether the ad's claim that Craniosacral Therapy (CST) was effective in treating the conditions listed could be substantiated, and the ads reference to serious medical conditions, such as stroke, cerebral palsy, autism and depression, could discourage essential treatment.
ASA Adjudication on Craniosacral Therapy Association
Craniosacral Therapy Association
27 Old Gloucester Street
8 September 2010
Health and beauty
Number of complaints:
A leaflet, for Craniosacral Therapy, stated “Craniosacral Therapy is a hands-on therapy which assists the body’s natural capacity for self-repair … Any trauma, stresses, strains, or tensions which remain in the body restrict the body’s functioning and may give rise to problems over the years. The effects may be both physical (such as back pain, migraine or digestive disorders) and emotional (such as anxiety or depression) … Craniosacral Therapy is suitable for people of all ages, from babies to the elderly … is often beneficial for fragile or acutely painful conditions, as well as during pregnancy, after an operation, accident, fall or injury, and for young babies. By helping raise vitality and supporting the body’s own self-healing processes Craniosacral Therapy may aid people with almost any condition". The back page of the leaflet stated "People have found Craniosacral Therapy helpful for the following conditions …" and listed forty different medical conditions of varying severity including "Arthritis … Asthma … Autism … Bronchitis … Depression … Headaches and migraines … Impotence … Infertility … learning difficulties … Stroke …”.
The complainant challenged whether:
1. the ad's claim that Craniosacral Therapy (CST) was effective in treating the conditions listed could be substantiated, and
2. the ads reference to serious medical conditions, such as stroke, cerebral palsy, autism and depression, could discourage essential treatment.
CAP Code (Edition 11)
1. The Craniosacral Therapy Association (CSTA) pointed out that the leaflet stated "People have found Craniosacral Therapy (CST) helpful for the following conditions" and argued that it therefore did not assert or imply that it either was effective in treating, or offered a cure for, the listed conditions. They said, however, that that possibility was left open because there was no evidence to show that it was not effective. They said the leaflet was carefully worded so that it did not say that Craniosacral Therapy could cure any particular condition and pointed out that the wording they had used was not proscribed by law. They said, in the strictest terms of contractual law, that their leaflet merely advised readers of the potential of their service who were then welcome to attend a therapist for further clarification without any obligation to engage in treatment.
The CSTA said they believed that the CST might help people in a number of ways, based on their practitioners common experience of how people had responded to CST. They said recipients of CST may be helped in the alleviation of distressing symptoms, helped to feel better about their lives, better able to come to terms with difficulties and disabilities, and may experience a marked improvement in underlying conditions. They said they made no promises and did not hold out the prospect of a cure for sufferers, and that it was up to the patient whether to try CST as a method of improving their health. They said these terms were made clear to clients when they first consulted a CST practitioner.
The CSTA referred to the inclusion of stroke in the leaflet as an example, and argued that no one would suppose that CST or any other therapy would, in all cases, restore full function to the brain of a stroke patient. They said that all any treatment for stroke could reasonably hope to do was to mitigate the effects of tissue damage. They said CST was no different in this regard and might work on a number of levels by, for example, helping the patient come to terms with a resulting disability. They said their practitioners may also, on occasion, work with sufferers of HIV and cancer on the basis that they might give comfort and alleviate pain and distress, and not because they offered a cure. They believed this approach was typical of many alternative therapies.
The CSTA acknowledged the value of evidence-based medicine but said that many aspects of medical care depended on individual factors, such as the quality and value of life judgements, which were only partially subject to scientific methods. They said that osteopathy and chiropractic were well-recognised as healthcare therapies but believed that they had no evidential or scientific basis. They also submitted copies of pages from the website of the Royal College of Psychiatrists which made various claims about the effectiveness of Cognitive Behavioural Therapy (CBT). They argued that CBT too had no evidential basis. The CSTA said they sought to educate and advise members of the public of where CST may, or may not, be of assistance.
The CSTA said it was almost impossible to test complementary and alternative therapies with double-blinded placebo trials on the orthodox medical model and believed this view had been expressed quite widely by reputable academics. They said the effectiveness of complementary and alternative therapies had many different factors including the relationship that built up between the therapist and the client, which arose from quantum entanglement, and they cited a number of publications that dealt with this issue. They said that with many complementary and alternative therapies the treatment itself rested so much with the practitioner that the practitioner would, by definition, know if they were conducting a dummy treatment or not and the entanglement effect could therefore not be tested by double-blind trials. They said efficacy could be tested in a straightforward manner by assessing whether a patient felt or got better from a particular complementary or alternative therapy.
Notwithstanding that, the CSTA said the effectiveness of CST had been demonstrated conclusively, and they referred to two studies which they believed supported that view.
2. The CSTA said that their practitioners did not offer diagnoses and were advised to do nothing to discourage or prevent anyone from seeking appropriate medical advice or treatment. They said that practitioners on many occasions advised patients to see their doctor and would be laying themselves open to disciplinary action if they failed to do so when it was clearly advisable, as this was a requirement of the CSTAs Code of Conduct.
The CSTA said they had a strict published Code of Conduct, of which they submitted a copy, and a Standards of Practice document which was pending publication. They said these demonstrated the very high standards to which they aspired in respect of their membership. They said members who fell foul of their regulations were disciplined, sanctioned or removed from their register.
The ASA considered that the claims; "Craniosacral Therapy is a hands-on therapy which assists the bodys natural capacity for self repair", "The therapist listens, via the hands, to what is going on in your body, and identifies and helps to relieve pain or tension held there", "Craniosacral Therapy is often beneficial for fragile or acutely painful conditions … by helping raise vitality and supporting the bodys own self-healing processes Craniosacral Therapy may aid people with almost any condition" and "People have found Craniosacral Therapy helpful for the following conditions", alongside a list of various medical conditions, would be interpreted by readers to mean that CST could treat the conditions named in the ad. We considered that those claims were breakthrough claims that required a body of robust scientific evidence, such as clinical trials conducted on people, in order to substantiate them.
We noted that the two studies referred to by the CSTA had been published in the CSTAs in-house journal. We noted that the first study assessed patients perceptions of changes in their health during their course of CST. We also noted that the study was not blinded or controlled, and that patients self-selected one or two related symptoms that they considered important, and self-assessed the improvement in those symptoms and their overall wellbeing. We noted that the second study was a short review article of existing research into the efficacy of CST, which concluded that there was no relevant, reliable primary research data into the effectiveness of CST and that further research was required. We considered that the studies were not sufficiently robust to support the claim that CST was effective in treating the conditions listed in the ad, and we therefore concluded that the ad was misleading.
On this point the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and beauty products and therapies).
We noted that the CSTA believed that the leaflet was merely inviting readers to try CST to see if it could alleviate some of their symptoms and did not discourage them from seeing a doctor. However, we considered that the list of serious medical conditions in the ad, and the references to the benefit and help provided by CST, could encourage readers to use CST to relieve their symptoms rather than seek advice from a medical professional. We therefore concluded that the ad could discourage readers from seeking essential treatment for serious medical conditions from a qualified medical practitioner.
On this point the ad breached CAP Code clause 50.3 (Health and beauty products and therapies).
The ad must not appear again in its current form.