Research and commentary

Can acupuncture help to reduce anxiety in children and young people?

Considering the implications of studies into neonatal, child and adolescent health

Considering the implications of studies into neonatal, child and adolescent health


A pilot study has looked at the use of acupuncture to treat anxiety in children and young people
Picture: iStock

Leung B, Takeda W, Holec V (2018) Pilot study of acupuncture to treat anxiety in children and adolescents. Journal of Paediatrics and Child Health. doi.org/10.1111/jpc.13910.

Aim

To investigate whether acupuncture is a viable, tolerable and effective method for treating mild-to- moderate anxiety in children and young people aged 8-16 years.

Method

Twenty participants (aged 8-16 years) were randomised into two groups: an acupuncture and a waiting list control group. Children and young people in both groups had their anxiety assessed before the trial and five weeks later, using the Hamilton Anxiety Rating Scale (HAM-A) (Hamilton 1959), a parent and child report tool called the Multidimensional Anxiety Scale for Children (MASC-2) (Wei et al 2014) and the Clinical Global Impression (CGI) measure (Guy 1976).

The intervention group involved participants receiving one acupuncture session per week over five weeks. Acupuncture included needling, cupping and seeding, tailored to each individual at each session.

After five weeks the waiting list control group also then received the same five-week course of treatment as the acupuncture group with re-assessment of anxiety levels post-treatment.

Results

All 20 participants completed the five-week course, one person completed treatment but not all assessments. A statistically significant difference (P=0.008 (MASC-parent), P=<0.001 (HAM-A)) was recorded in anxiety scores pre- and post-treatment in the acupuncture group and between post-waiting list and post-treatment measures in the control group (P=0.048 (MASC-parent), P=0.007 (HAM-A)).

No significant difference was recorded between the initial and post scores for those in the waiting list control group providing evidence that no intervention meant there was no improvement in assessed levels of anxiety. Although a decrease in anxiety ratings post-intervention in both groups was recorded by nurses, no statistical significance could be shown. Over the course of the treatment four individual adverse events were recorded including a feeling of dizziness during treatment and headache following treatment.

Conclusion

This pilot study demonstrated that acupuncture may have a place in the treatment of anxiety in children and young people due to the initial efficacy demonstrated and its acceptability to the participants. Further, larger-scale studies are needed to confirm the effects and explore other contributing factors.

Complementary therapies in children’s nursing care

Future children’s nurses may need to draw on a wider range of different resources and interventions than traditionally used to enable holistic and effective care delivery for children and young people.

This study contributes to the expanding evidence base of complementary, also known as alternative, therapies use in children and young people’s care where other methods are proving ineffective or, as with selective serotonin reuptake inhibitors, the risk is considered to outweigh potential benefits.

In addition to the treatment effect reported in this study, acupuncture has previously reduced nocturnal enuresis when used alongside and independent of medication (Capozza et al 1991). Best outcomes were achieved when acupuncture and medication were used simultaneously. Other complementary therapies, such as reiki, have also been shown to reduce parental and child stress levels (Bukowski and Berardi 2014), and help to manage symptoms of pain and anxiety and related somatic symptoms in children with a terminal cancer diagnosis receiving palliative care (Thrane et al 2016).

The evidence does not suggest complete replacement of traditional methods with complementary therapies, but rather that they are used in a complementary way making holistic management of physical and mental health easier.

As children’s nurses, we are charged with caring for children and young people in a holistic manner, using effective and innovative interventions for the patient’s benefit. To achieve this, we need to be open to change and may need to explore less traditional ways of helping children and young people with today’s challenges.

 

References

  • Bukowski EL, Berardi D (2014) Reiki brief report: using reiki to reduce stress levels in a nine-year-old child. Explore: The Journal of Science and Healing. 10, 4, 253-255.
  • Capozza N, Creti G, De Gennaro M et al (1991) The treatment of nocturnal enuresis. a comparative study between desmopressin and acupuncture used alone or in combination. Minerva Pediatrica. 43, 9, 577-582.
  • Guy W (1976) ECDEU Assessment Manual for Psychopharmacology. US Department of Health, Education, and Welfare, Rockville MD.
  • Hamilton M (1959) The assessment of anxiety states by rating. Psychology and Psychotherapy: Theory Research and Practice. 32, 1, 50-55.
  • Thrane SE, Maurer SH, Ren D et al (2016) Reiki therapy for symptom management in children receiving palliative care: a pilot study. American Journal of Hospice and Palliative Medicine. 34, 4, 373-379.
  • Wei C, Hoff A, Villabø MA et al (2014) Assessing anxiety in youth with the multidimensional anxiety scale for children (MASC). Journal of Clinical Child and Adolescent Psychology. 43, 4, 566-578.

Compiled by Charlotte Bradbury, a children’s nursing student at Northumbria University, on behalf of the RCN’s Research in Child Health community.

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