The NADA Protocol-Thinking Outside The BoxThinking...The NADA Protocol – Thinking Outside The Box...

The NADA Protocol – Thinking Outside The Box 26th May 2015 Research Dissertation Level 6 AC6906

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COLLEGE OF INTEGRATED CHINESE MEDICINE, READING, UK

The NADA Protocol-Thinking Outside The Box

Research and Reflective Practice Level 6 AC6906

Dissertation

Deborah Trafford 12.2

26th May 2015

Word Count 9,439


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(Straun 2015)


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Acknowledgements

Surveys are always reliant on the generosity of the people who participate in them so I am

grateful to all the practitioners who gave time and attention to complete the questionnaire,

especially those who gave their names for future contact. I particularly thank the

interviewees Gisela Norman, Nic Constable, Christine Smyth, Emma Guy and Maria

Okereafor for their generosity and insights into personal perspectives on NADA as an

amazing treatment for any number of reasons. Their passion and excitement really

motivated my investigations.

To Rachel, thank you for your belief in me and all your support in getting this investigation

off the ground. Your passion for NADA has inspired me.

With thanks to NADA-UK Trustees and Caroline for giving me access to the contact

database.

Thank you to Alison Savory, dissertation supervisor, for your enthusiasm for my project,

your support and expert advice.

With thanks to Mark Bovey at CICM for being available, supportive and helpful especially

with developing the questionnaire.


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Contents

Page

Acknowledgements ii

List of Tables, Charts and Appendices iv

Abstract vi

Introduction 1

Aims and Objectives 2

Rationale 2

Literature Review 3

Methodology 7

Sample 8

Data Collection 8

Rationale 9

Interviews 10

Pilot 10

Results 12

Introduction 12

Quantitative Analysis 13

Qualitative Analysis 22

Interviews 25

Discussion 36

Principle Findings 37

Strengths and Weaknesses 39

Meaning of the Study 41

Future Research 42

Personal Learning 43

Conclusion 45

References 47-49

Appendix 1


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List of Tables, Charts and Appendices

Tables

Table 1 Advantages and disadvantages of internet survey platform

Table 2 Results from Questions 1&2

Table 3 NADA-UK 2013-14 Survey – Type of Clinic ‘Other’ Category

Charts List

Results

Chart 1 Type of clinic

Chart 2 Work for/within

Chart 3 Take medical history

Chart 4 Use other points

Chart 5 Relieves bodily pain

Chart 6 Reduces general headaches

Chart 7 Reduces migraine

Chart 8 Reduces high blood pressure

Chart 9 Helps mesnstrual problems

Chart 10 Depression

Chart 11 Mental health

Chart 12 Frequency of Comment


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Appendices

1. About the NADA protocol

2. Auricular points and functions

3. NADA-UK 2013-14 Questionnaire

4. On-line survey of NADA Practitioners – Questionnaire

5. NADA-UK 2013-14 Results

6. On-line survey of NADA Practitioners – Extra results


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Abstract

The standardised ear acupuncture protocol known as the NADA protocol consists of 5

acupuncture points: Shenmen, Sympathetic, Kidney, Liver and Lung. Its main use is in the

fields of substance misuse, addiction and rehabilitation as a supportive adjunctive treatment

to alleviate the symptoms of withdrawal. As use of this simple, safe and cost effective

treatment grew in popularity and spread worldwide it has provided relief to thousands of

people in other different settings such as mental health and humanitarian aid.

The aims of this investigation were to discover whether the NADA protocol is being provided

for patients in settings/clinics outside of drug and alcohol rehabilitation services (D&A) and

what the benefits to those patients are.

A survey of NADA qualified practitioners was carried out by on-line questionnaire to

discover the types of clinics where they work, independently or through a service provider

and their opinions on the benefits of NADA for seven types of health problems. Multiple

choice questions returned quantitative data and the option to provide personal opinions

analysed qualitatively. A semi-structured interview of five NADA practitioners provided

insights and anecdotal evidence.

The paucity of primary source research specifically into NADA outside D&A meant that a

liberal approach was taken to the literature review. It uncovered personal journeys, news

stories and some research evidence for NADA benefiting patients in cancer care, high stress

environments, with migraine and Post Traumatic Stress Disorder.

Results showed that 52% of practitioners work in D&A settings as all or a part of their work;

range of settings included private acupuncture practice, residential facilities, GP surgery,

RAF community centre, school, prison, hospice, workplace and relaxation group. For specific


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client groups: youth, elderly, homeless, leaning disabled, cancer, harm reduction, staff in

D&A clinics as well as clients and community NADA groups.

Results showed that NADA has benefits to health, including mental health, reducing

depression, anxiety and panic, inducing calm relaxation. Emotional and bodily pain is

alleviated, also headaches and migraine and hypertension. Benefits to menstrual problems

were inconclusive. Strong evidence shows NADA to be beneficial for hot flushes associated

with cancer treatment in men and women.

In conclusion, NADA has a place in the spectrum of acupuncture treatment as it seems to

provide health benefits to a diverse range of people in a wide range of settings. More

research needs to be carried out to build an evidence base of the benefits of NADA

treatment.


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INTRODUCTION

The NADA protocol is a standardised 5-point auricular acupuncture protocol which has a

balancing effect on the body and mind. Inspired by the use in China of electro-auricular

acupuncture, it has become an internationally recognised treatment since it was developed

in America over 40yrs ago as a supportive component in drug detoxification settings

(Appendix 1).

5 needles are placed bilaterally in the ear auricle at specific points which are Shenmen,

sympathetic, Kidney, Liver and Lung each having a specific effect on the Qi and functions of

the Organs (Appendix 2).

In addition to the specific auricular acupuncture points, the original criteria for the protocol

included being:

Non-verbal;

Non-diagnostic - no need for medical history or health complaints, nor disclosure of

psycho-emotional issues.

Given in sessions with patients sitting quietly together for about 45 minutes.

Part of a multifaceted approach, not a stand-alone treatment.

5 needles are placed bilaterally in the ear auricle at specific points: Shenmen, sympathetic,

Kidney, Liver and Lung. Without the group setting the procedure would be more accurately

called 5-needle, or point, auricular acupuncture but the term NADA has become shorthand

for describing auricular acupuncture of just the 5 points and will be used throughout this

report.


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The NADA protocol is simple, safe and easy to learn and as such has become widely

practiced by people with no training in traditional acupuncture as well as being part of the

3-4yr training of acupuncture practitioners of East Asian Medical systems. The ease of use,

cost effective and standardised nature of the NADA protocol means it has evolved into a

treatment that can have a wide range of applications from open access community

acupuncture to schools and prisons; from reducing stress in the workplace to reducing side

effects of cancer treatment; from the local community to the world wide community

affected by war or disaster.

Aims and Objectives

The aims and objectives of this dissertation are to explore the wider applications of the

NADA protocol by discovering the range of settings where NADA treatment is currently

provided, ie. types of clinic and what kinds of patients; and to ascertain what opinions and

beliefs NADA practitioners have about the benefits of NADA treatment and its application to

other mental, physical and emotional symptoms and conditions outside of the original

purpose of addiction rehabilitation. The research question is:

In what settings are UK NADA practitioners using the NADA protocol and what are their

opinions on the health benefits of the treatment?

Rationale

The practice of acupuncture in the West is normally based on one-to-one, individualised

treatment that aims to identify and treat the underlying imbalances and causes of the


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patient’s disease patterns and symptoms. NADA is a standardised treatment that is neither

diagnostic nor requires a diagnosis but research and anecdotal evidence shows that it can

make a significant contribution to improving people’s physical, mental and emotional health

both by the acupuncture treatment itself and in the way that it is delivered.

In recent years NADA has been used effectively in areas of mental health and wellbeing,

recovering from trauma (Thick 2010), helping ameliorate side effects from drug treatment in

cancer (de Valois 2012, Harding 2009), helping relaxation in young people with behavioural

disorders (Douglas 2004), aiding recovery from benzodiazepine dependency and providing

relief in stress, anxiety and panic disorders (NADA-UK 2014).

NADA-UK (Appendix 2) is a training provider for the NADA protocol and in their 2013-14 re-

registration process they became aware that their practitioners were using their skills,

knowledge and generosity of spirit to take NADA into different communities and settings

and were observing surprising benefits (Peckham 2014).

The purpose of the current survey of practitioner’s current clinics and treatment outcomes

is to raise awareness of the NADA protocol’s wider applications. The evidence may suggest

areas for future trial based research on the benefits of NADA treatment and supportive

research evidence will assist practitioners aiming to access funding for clinics or to set up

their own NADA clinics.

Literature Review


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Dr Michael O. Smith, director of the Lincoln Recovery Centre, the home of the NADA

protocol explains that the 5-point auricular acupuncture protocol was originally discovered

as a supportive element in drug and alcohol settings where it helped control withdrawal

symptoms and it continues to play an important role in rehabilitation treatment (Smith

2009). Since that time research into the effectiveness of NADA has been mainly focussed on

treatment for addiction to various substances (Bemis 2013). The randomised control trial,

the gold standard of medical research to validate quantitative data, has often been

employed by research in this area and Peckham (2005) cites (Bullock (1989), Washburn

(1993), Lipton (1994), Otto (1998), Avants (2000) and Margolin (2002) in this regard. Despite

methodological weakness in most research into the effects of acupuncture in general for the

treatment of substance abuse (Robinson and Bovey 2007) the NADA protocol continues to

be popular. In general NADA has been shown to be an effective treatment for reducing

symptoms of addiction and promoting certain benefits such as reduced craving and

intensity of withdrawal symptoms, improved sleep, increased sense of calm and relaxation

but can the treatment be beneficial for other conditions and symptoms and what evidence

is there?

A search was made on using PubMed, AltHealthWatch and Google scholar using the key

words: NADA, NADA protocol and auricular acupuncture. Results were excluded for non-

human, acupressure, electro-therapy, substances or addiction, body acupuncture,

unspecified auricular points used and non-English language. There is a paucity of research

into the treatment outcomes of NADA outside of D&A available to review, especially

primary sources so a more liberal approach was taken to the literature review taking in

human interest stories and anecdotal evidence.


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Review took place from July 2014 to May 2015

Two particular articles inspired the investigation into the role that NADA can play in health

care: Peckham (2014), 24 years of NADA, in the BAcC journal and a moving article by de

Valois (2006) describing her journey from acupuncturist to NADA practitioner, to

researching the effects of NADA on women experiencing severe vasomotor symptoms from

adjunctive treatment for breast cancer (hot flushes): an early ‘outside the box’ research into

the wider applications of NADA on a physical health condition. Further papers and research

have grown out of this seminal work, for example most recently de Valois et al (2014)

released results of a pre-research project looking at NADA treatment for men with prostate

cancer who experience hot flushes and other physical, mental and emotional symptoms

showing positive results and concluding that further investigation is warranted. This is

supported by work on NADA to reduce vasomotor symptoms resulting from treatment with

luteinising-hormone releasing agonist in prostate cancer by Harding (2008).

Some understanding of how NADA works leads to speculation on its wider applications and

questions about why and how it benefits health were reviewed in an article by Toomin

(2007) which explains the effect of the NADA points in relation to JingShen, a spiritual

concept in Chinese Medicine, and the functions of the specific 5 auricular points in the

Auriculotherapy Manual by Oleson (2003). Summarised in Appendix 2.

The internet search revealed 3 papers that satisfied the “Outside the Box” criteria:


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Oyola-Santiago T. et al (2013) looked into the provision of auricular acupuncture

and acupressure in a university setting a tool to enhance harm reduction and

mental health services.

Reilly et al (2014) trialled NADA treatments to relieve stress and anxiety in

healthcare workers in order to alleviate burnout and renew compassion and care

at work.

Preliminary results by Ceccherelli et al (2012) support the effectiveness of

auricular acupuncture for migraine at 6 months follow up.

All three studies show NADA to be an effective treatment to alleviate symptoms and

improve well-being.

The Times Educational Supplement published an article by Douglas (2004), about NADA

being provided in a school in the UK for boys aged 11-16 who had been excluded from

mainstream education because they suffer from severe behavioural and emotional

difficulties. NADA has been helping students for the past 9 years and Jason Knowlessar, a

teacher at Starhurst School for Boys, has provided NADA treatment for 4 years, finding it

helps the boys relax, improve concentration and sometimes reduce smoking. (Peckham

2014)

Unimagined Bridges, a video produced by Acudetox, US, is inspirational in showing how

NADA is benefitting members of US communities affected by severe trauma and

environmental disasters such as following the terrorist devastation in New York known as

9/11, in 2001 and following Hurricane Katrina in 2005. (Acudetox 2014)

The NADA-UK website hosts video talks from Scandinavian nurses whose work in psychiatric

care has been transformed by using NADA for their patients. (NADA-UK 2012)


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Smyth (2012) carried out a trial of family carers in a small community in the UK. Results

showed that there was marked improvement in measured mental states such as depression

anxiety and stress and significant improvement in measures of well-being, energy levels and

emotions/mood. A study by Cronin (2013) looked at whether NADA could help insomnia and

symptoms associated with Post Traumatic Stress Disorder (PTSD) experienced by combat

service members and veterans and concluded that NADA is a useful tool to reduce the

development of PTSD following combat trauma. Similarly a case study by Golden (2012)

showed that 6 months of NADA relieved a variety of symptoms including chronic fatigue,

depression and grief, general anxiety, headaches, insomnia, nightmares, irritability, and

panic attacks. At seven months follow up indicated that some level of relief was retained for

a majority of the reported symptoms and that some of the symptoms were completely

resolved.

Guidepoints, published 6 times a year by Acudetox, America, gives updates on

developments concerning the use of NADA and its practitioners, including from the UK

sometimes. (Acudetox 2015)

NADA in humanitarian work is published on websites such as World Medicine (2015) and

Acupuncturists without Borders (2015) where news and blogs about the inspirational work

of acupuncturists using NADA can be found.

Methodology


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Collaboration was established between the researcher and NADA-UK with the common goal

of practitioner survey. The NADA-UK 2013-14 survey had 96 completed forms from re-

registration of trained practitioners. The questionnaire is in Appendix 3.

Collation and analysis of the 2013-14 data was done by the researcher to identify the types

of clinics where practitioners worked and anecdotal evidence of the benefits of NADA

treatment. Results are available in Appendix 5.

Advantages of collaboration for the dissertation:

Adapting the format of the 2013-14 form

Using results of 2013-14 survey as basis for the on-line questionnaire

Access to database of over 1500 NADA trained practitioners

Email sent out by NADA-UK would be a recognised contact and more likely to be

opened

The questionnaire would be officially endorsed by NADA-UK thereby encouraging

responses.

A new on-line Survey was carried out of all the practitioners in the NADA-UK database and

members of the Association of Community and Multibed Acupuncture Clinics (ACMAC) who

advertise that they offer NADA treatment on the NADA-UK website. The nature of multibed

clinics is often to make acupuncture more affordable and accessible and therefore NADA is a

useful technique for multibed acupuncturists.


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Sample

The edited NADA-UK database consisted of 2380 email addresses of practitioners trained in

NADA. There were 70 ACMAC members advertising NADA treatment on the NADA-UK

website. It was feasible to send the questionnaire to all of them by email.

Data Collection

The method of data collection was by questionnaire and interviews.

Rationale

The research question needed to elicit both facts and opinions from practitioners. The

quantitative results of the questionnaire would be balanced out and enhanced by the

qualitative data from personal insights and opinions.

Use of an internet survey platform to design an on-line questionnaire was easy to do and

free. The questionnaire was quick and easy to complete with 10 questions that were either

yes/no or multiple tick-box plus an open question to add anecdotal information or opinion

(See Appendix 4).

Respondents could provide contact details or remain anonymous. This was to ensure

respondents felt secure and comfortable giving personal opinions.

There are advantages and disadvantages to using an internet survey platform:

Table 1


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Advantages Disadvantages

free to use option

easy to use design templates

questionnaires sent by email –

no paper or postage costs

link can be embedded or sent

directly

undelivered email returned

responses collated into a

spreadsheet

results summarised into charts

email message may go into

junk mail as from an unknown

source

impersonal so the respondent

might ignore it

if the link doesn’t work the

respondent might give up

no record of addresses sent to

so cannot eliminate

respondents from any

reminder mailing

Interviews

Individuals who had submitted their contact details could be selected for telephone

interview. They were chosen from the data if they had submitted interesting details about

their clinic or had observed surprising benefits to NADA treatment. Consent to identification

was given in emails (Appendix 7).

Interviews had a semi-structured format that gave the interviewee freedom to express

thoughts and feelings about their NADA related work that arose naturally from the initial

questions. The interviewer had the freedom to follow their lead and ask relevant and

related questions.


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The interviews had broad questions

- What type of acupuncture work do you do?

- What benefits do you see from NADA treatment?

- Can you give examples?

Pilot

The pilot questionnaire was sent to a NADA-UK teacher and practitioner to ensure the

questions were relevant, easy to answer and elicited relevant and useful data. The pilot

ensured the internet platform operated easily via email and the responses submitted

correctly into the spreadsheet. As a result of feedback, additional choices were added to the

questions about the type of clinic and where working. The survey platform worked

perfectly.


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Results and Data Analysis

Introduction

Although the questionnaires provided by NADA-UK are relevant to the research question,

provide valuable data and inspired the current investigation they are a separate survey. The

results are shown in Appendix 5.

Both questionnaires used multiple choice questions to generate quantitative data and the

option to add personal comments about the respondent’s experiences of providing NADA

treatment generated qualitative data. In addition selected respondents were chosen for

interview to expand on their opinions about and experiences of providing NADA treatments.

Quantitative analysis of the multiple choice questions will be presented in charts. As the

purpose of the survey was to discover evidence of the NADA protocol being provided

outside of the addiction detox and rehabilitation settings the highest frequency response

may not be the most relevant to the research question. Likewise, the frequency results of

the questions pertaining to the benefits of the NADA treatment (Q9). The main points of the

results with regard to the research question will be presented with each chart.

The qualitative data generated by the personal insights and responses of individual

respondents and interviewees was analysed using a thematic framework of key issues and

themes and is presented as charts and tables to summarise the main points relevant to the

questions of settings and benefits.


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On-line Survey of NADA practitioners and acupuncturists

Results and Quantitative Analysis

Appendix 6 shows how the sample was generated from the NADA-UK database (2,524)

through to response rate of 9.8%.

Table 2 Questions 1 and 2; from 192 responses

Question

No.

Question YES % of

192

No % of

192

1. Do you have an acupuncture

practice?

145 75.5 47 24.5

2. Do you use the NADA 5-point

auricular acupuncture

protocol?

146 76.0 8 4.2

Results and analysis of 146 practitioners of the NADA protocol:


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Question 3 Type of clinic

The term D&A is shorthand for drug and alcohol addiction and rehabilitation settings or

work and will be used for convenience onwards.

Chart 1

The NADA protocol is traditionally used in drug and alcohol rehabilitation and the training of

practitioners is primarily aimed at those working there. The purpose of this survey is to

discover the variety of new settings, so the figure for D&A can be discounted and more

notice taken of the range of settings. However, the fact that 52% of respondents work in

D&A means that subsequent results may be biased towards patients with addiction

problems and practitioners working with them.

Response error was introduced here because the question stated that the questionnaire

should be answered for EACH type of clinic but respondents did not do this, they often listed

all types of clinic in one questionnaire. Some practitioners had their own private practices

and also worked in D&A.

52

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12 11 7 5 5 5 4 4 2 1 1 0

Type of clinic

% NADA practitioners


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In the ‘Other’ category respondents included the following:

Colleagues at work

Open access drop-in

Relaxation and stress management

Community group

Men and women charity group

Harm reduction program

Free charity

Staff in D&A clinic (2)

Residential addiction rehabilitation

2 not specified

Table 3 the results from the ‘Other ‘category of the NADA-UK 2013-14 questionnaire are:

Supported Housing

Private Practice

Residential detox/rehab

Old people

Homeless centre

Day care

Youth Justice

GP surgery

Cancer support centre

16-25 age group

School pupils

Community clinic

Salvation Army

Aftercare Programme

Hospice

RAF community centre


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Question 4 Work for or within?

Chart 2

!4 respondents (9.6% ticked all the places they worked rather than one clinic per

questionnaire, results included all the settings ticked.

In the ‘Other’ category respondents included the following:

Co-operative multibed

Not for profit social enterprise

Recovery café

Local authority (2)

Hospice for cancer and end of life

Unspecified

42

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13 11 9 5

Charity Own privatepractice

NHS Other Privatecompany

Government

Work for or within



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Question 5 How many practitioners? Results not directly relevant to the research question

but presented Appendix 6.

Question 6 Do you routinely take a medical history from your patients?

Chart 3

Even though the NADA protocol was designed as a non-diagnostic technique it is interesting

to note that the majority of practitioners take some sort of medical information. This gives

the practitioner a broader knowledge of the client’s or patient’s symptoms and enables

them to observe or appreciate treatment outcomes.

It is good practice for any treatment to have a record of the patient and their symptoms as

recommended in Standards of Practice for Acupuncturists (BAcC 2009). It is also a useful

tool for survey and audit.

Question 7 Do you combine NADA with other points in the same treatment?

Chart 4

76

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6

Yes always

Yes usually

No

Take medical history


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17

68

Often

Sometimes

Never

Use other points



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Other points could include other auricular points or points on the body. The majority of

respondents work in D&A clinics where the NADA protocol is the only acupuncture used.

Respondents who are qualified acupuncturists are more likely to use other points on the

body or other auricular points. Other auricular points can be used by any practitioner once

they are sure of the point location. Eg point zero, toothache etc.

Question 8 Frequencies of treatment

Results not directly relevant to the research question.

Question 9

This investigation sets out to discover whether the NADA protocol benefits patients in ways

other than to improve insomnia, reduce anxiety and help PTSD. Question 9 asks if, in their

experience, NADA practitioners have observed that the NADA protocol benefits certain

other specific physical, mental or emotional conditions.

The number of respondents answering “Don’t know” can be discounted because this has no

bearing on whether NADA helps the condition or not. Of more interest are the other

categories answered as these assume that the practitioner has noticed the conditions in

their patients, whether NADA treatment helps and how much.


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Since 52% of practitioners answered that they work in D&A there is a bias of the results

towards D&A settings. This is particularly relevant here where the question asks for

practitioner’s opinion on how much they think the NADA treatment benefits certain

conditions. For example, Question 9a bodily pain; results show that NADA treatment was

beneficial quite often. However, as the majority of respondents work in the drug and

alcohol setting, where pain can be a problem for patients/clients in detox and

rehabilitation, the positive result that NADA helps reduce bodily pain must mainly (ie 52%)

apply to patients experiencing bodily pain in drug and alcohol settings. It cannot be inferred

that this level of relief of bodily pain would be experienced by the general population or

non-D&A patients.

Although the same level of bias towards D&A settings applies to all the conditions

questioned some D&A clients may be have been clean for some time and in recovery so still

attending for support.

Question 9)a

Chart 5

NADA treatment

relieved bodily pain

quite often and

slightly.

Question 9)b

Chart 6

29 28 25

12

1

Quite often Don't know Slightly Often Not at all

Relieves bodily pain


38

27 18

12

1

Quite often Don't know Slightly Often Not at all

Reduce headaches

% NADA practioners


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NADA treatment helped reduce headaches quite often and slightly.

Question 9c)

The majority of practitioners didn’t know if NADA helped reduce c) migraine or d) high

blood pressure but of those that did most of them said it helped them both slightly and

quite often.

Chart 7

Question 9d)

Chart 8

53

16 14 10 1

Don't know Slightly Quite often Often Not at all

Reduce high blood pressure


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22 18

9 3

Don'tknow

Slightly Quiteoften

Often Not at all

Reduce migraine



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Question 9)e

Chart 9

Not many practitioners

noticed if menstrual

problems were helped

by NADA; it may help

slightly and quite often.

The two questions, f) and g), help ground the questionnaire and the data because the

results showing that NADA helps depression and mental health agree with the NADA-UK

survey and so add weight to the validity of the responses.

Question 9)f

Chart 10 NADA helps depression

quite often and often.

Question 9)g

Chart 11

34 28

21

13

0

Quite often Often Slightly Don't know Not at all

Depression

% NADA practioners

57

14 12 8 3

Don't know Slightly Quite often Often Not at all

Menstrual problems


36

27

17 16

1

Quite often Often Don't know Slightly Not at all

Mental health



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The result here shows that NADA helps mental health roblems quite often and often.

Summary

Health benefits

Results of the quantitative analysis show that practitioners think that NADA

treatment quite often benefits bodily pain and headaches, depression and other

mental health issues.

Results are inconclusive with regard to whether NADA treatment helps migraine,

high blood pressure and menstrual problems. Of those that have an opinion the

highest response is NADA benefits the symptom ‘slightly’.

The “Don’t know” category does not necessarily mean that NADA treatment does

not have a benefit; it may well do but if the practitioners are not questioning the

patients or asking for specific feedback then the answer is ‘don’t know’.

Qualitative analysis

The open question and the interviews gave the respondent opportunity to share personal

insights into the benefits of the NADA protocol or ways of working with NADA. The text of

the comments and transcripts of the interviews were reduced using key words and themes

for the benefits to patients or clients. Chart 12 shows the categories and frequencies of

comments.

Frequent most comments confirmed information already stated in the questionnaire or

already covered by question 9, such as helping sleep, reduce anxiety, depression and


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cravings. These benefits are the foundations on which the NADA protocol has been built and

so when these were mentioned they were excluded from the data which seeks to find new

insights into the benefits of the NADA treatment.

Chart 12 Respondents’ and interviewees’ personal perspectives on the benefits of the NADA

protocol, excluding helping sleep, reduce anxiety, depression and cravings.

Some practitioner’s reports are fascinating and intriguing. They are reproduced in the

practitioners’ own words in Appendix 6 and summarised:

Conditions and settings

Children with Asperger’s, ADHD and Autism became calmer and less aggressive.

Hair loss of unknown cause was reduced.

In fertility treatment – for anxiety

For hot flushes - cancer treatment side-effects

In hospice for cancer care and end of life. (Emma Guy, interview)

1

1

1

1

2

3

4

8

9

12

Feeling grounded

Clearer thinking

Benefits blood sugsr levels

Improves appetite

Reduces panic attacks

Reduces agitation and enabling sitting still

Reduces hotflushes and night sweats

Improves energy and well being

Reduces stress

Calming and relaxing

Frequency of comment



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Community NADA groups

One of the core principles of the original NADA protocol in recovery was that treatment be

given in a group setting. Some acupuncturists have continued the principle of group

treatment and taken NADA out of the D&A field and into the community welcoming and

treating people with a wide range of conditions. Two of these practitioners were selected

for interview to expand on their experiences (See Interviews).

NADA in the workplace

The safety, efficacy and simplicity of NADA lend itself to workplace clinics. One practitioner

had excellent results reducing stress and improving the sleep of work colleagues using one

point – Shenmen. (Okereafor Interview, Appendix 6, Table A4)

Medical history

The NADA protocol does not require practitioner to take medical history of patients so

practitioners may not have records to show how NADA treatment has benefitted their

patients. Some feedback from practitioners on this subject illustrated this particular

limitation of investigating the benefits of NADA treatment. In contrast, Chart 3 shows that

76% of respondents do take some form of medical history.

Working in drug and alcohol clinics

Although the intention of this survey was to gather information from non-D&A practitioners

and settings there were comments from D&A practitioners (Appendix 6, Table A5) that add

quality to the survey. They have observed the effects of NADA treatment, in particular

mental, emotional and physical benefits and benefits of treating in a group.


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Combining NADA

One of the original core principles of the NADA protocol was that it was used in a recovery

setting alongside other supportive treatments or processes. Some current practitioners,

including those outside D&A, have continued that principle by combining NADA treatment

with other techniques and therapies. Examples given in comments:

Traditional Chinese Medicine – body acupuncture

Hypnotherapy, NLP, Counselling, Psychotherapy and EMDR (Eye Movement

Desensitising and Reprocessing)

Mindfulness and relaxation

Qi Gong exercises

Five-finger Qi Gung

Magnet therapy

Electro-Acupunctoscope

Offering herbal teas, fresh fruit and fresh water to encourage changes to eating

habits.

Interviews

Christine Smyth and Nic Constable

The comments of these two practitioners stood out with regard to NADA in the community.

They had given their contact details and agreed to a telephone interviews to expand on


34

their work and give interesting examples of patient’s experiences. There were similarities to

their work so a precise follows.

Community NADA groups

Both Constable and Smyth are fully qualified acupuncturists who have developed a passion

for what NADA treatment can do for people in the community particularly that the NADA

groups welcome and benefit people with a wide range of health issues. They work in

different parts of the UK and provide weekly open access auricular acupuncture sessions

that last for 1 hour and patients are treated on a group basis.

Benefits of NADA

Both say that NADA is a simple, safe and highly effective treatment allowing a large number

of people to experience relaxation, well-being and other benefits in a profound way without

the need for in depth questioning to reach a diagnosis. The NADA treatment is especially

good for patients experiencing high stress, anxiety, depression and emotional pain or

distress and insomnia resulting from any physical illness, life event or circumstances.

Examples from patients included cancer, fibromyalgia, Parkinson’s, severe loose bowels (12

times a day), constipation, severe insomnia associated with PTSD; people experiencing

emotional distress from grief, victims of crime, emotionally demanding work, mental ill

health, degenerative and terminal illness, motor neurone disease and the demands of IVF.

When asked why do they think NADA is so beneficial to people Smyth said it has a clearing

and calming effect especially in the way that it calms the Fullness on pulses (seen in patients

in her private practice) and evident in reduction of high blood pressure and heart rate. This

Fullness is also seen in patients who are having chemotherapy and often manifests as hot


35

flushes in men and women. Smyth’s experience of the benefit of NADA for hot flushes is

supported by trials by de Valois (2012 ) and she gave an example of a patient in the NADA

group:

“A lady came in who was on her third dose of chemo for breast cancer and she’d had

a mastectomy. She’d never had acupuncture before. She’d been having 14 hot

flushes a night, stripping the bed, stripping her clothes off, really very distressed. I

spoke to her the next day and the most amazing thing was, she’d had ONE sweat!

She was over the moon. She wasn’t at work because she was so ill and I gave her two

more NADA treatments. She went back to work, feeling great, NO sweats! Amazing!

That was the fastest response I’d ever seen.”

Constable said that he feels NADA connects with the Shen, strengthening the spirit of the

Heart giving a positive outlook and healthy self-awareness that strengthens the immune

system, calms the body reducing pain and improving sleep patterns. Constable explains the

diversity of benefits of NADA on this fundamental spiritual connection.

Often examples of the effects of NADA treatment were more about the psycho-emotional

benefits than about treating the physical illness such as cancer patients saying they feel

calmer and more psychologically able to cope with the illness. A particular example from

Constable illustrates this:

“A man and his wife ran business and when he got cancer he physically could not

work in the business. The treatment he’s getting is as brutal as can be but he comes

to the clinic for NADA and afterwards he can go into work. He just does 2 or 3 hours,

but that gives him a sense of real value and purpose and makes him feel a


36

worthwhile member of the family again. It reduces the guilt and the depression and

anxiety that go with it as well.”

Smyth also had an example of NADA helping with the emotional side of serious illness:

“A really impressive example was a man who had just been diagnosed with prostate

cancer. He had to take time off work and go into hospital. He was very distressed,

incredibly angry and red in the face. There was no way that he would want me to

start talking to him and asking questions. I explained that I would put 5 needles into

each of his ears, to just relax and breathe, “if you fall asleep that would be great.” He

fell asleep! At the end of it he said he wasn’t expecting that, at all. The NADA just

took the anger out of him because of the Liver point and the fear from the Kidney

point; he was full of grief at having to go into hospital and family issues so the Lung

point helped with that. It’s such a simple treatment and he felt great, it made such a

difference to him.”

Constable said that treatment tends to benefit mainly physical issues such as physical pain

but both he and Smyth had examples of NADA helping mental health problems:

“A young girl of 23 with depression was absolutely fearful of going into work and of

the crowded spaces. She had not had acupuncture before. I said we’ll keep it simple

today, just do ear acupuncture and get her used to having some needles put in. She

came back 2 weeks later and I didn’t recognise her! I thought oh my goodness she

looks totally different! She said she felt so much better so went back to work.”

(Smyth)


37

“People with depression say they feel much calmer and more able to cope with it.

One lady in a community mental health clinic needed personal transport to get her

there because she couldn’t cope with public transport. It was literally only a 10

minute journey. After 8 weeks of just NADA she got the confidence to get on a bus -

it was amazing! It gave her a sense of hope and opened up other possibilities, she

had more of her self-respect.” (Constable)

Group treatment

It is normal to have no chatting during treatment, just relaxation and sometimes sleep but

the actual being together is energetically very powerful. The powerful effects of treating in a

group were very apparent to both Smyth and Constable and one of the main important

elements of group NADA treatment. The idea of strong healing energies being generated in

group treatment is also supported by Deadman (2003). Constable observed that patients

can become isolated in the community because of their illness but when people who may

not ordinarily talk to each other come to the group the social barriers diminish and he said

“it is a really important part of community acupuncture; to facilitate a space where people

get to talk, interact or to just be with others.” When the social connection can develop it

becomes another layer of support for patients.

Constable described his approach to running the NADA group. He does 15 minutes of TaiQi

or QiGung beforehand to focus his energy and intention to treat. Then, when the group is

together and settled in their treatment, he does a meditation, often Loving Kindness, to

create a space of healing for the individual and for the group.


38

As qualified acupuncture practitioners both Smyth and Constable are knowledgeable in and

skilled at treating a wide range of illnesses and conditions but both say that they think it is

hugely important that acupuncture is available as a spectrum of treatment options that suit

individuals with different needs at different times. They say that group NADA provides

opportunities for a diverse range of people to experience improved health and well-being

without the need to focus on any particular illness. Smyth said that patients can be

introduced to acupuncture through the NADA treatment and might move on to having one-

to-one body acupuncture once they feel comfortable with the practitioner and with

needles. Sometimes it benefits the patient the other way, having NADA as a top-up or

maintenance which is cheaper for them too.

Other settings

Smyth said she was aware that NADA was developing into a technique being used

successfully in a wide range of settings in the UK. The NADA-UK conference videos on the

website showed how NADA was being used in psychiatry in Scandinavian countries and

Acudetox in America promote the use of NADA in their publication Guidepoints.

Interview 3

Gisela Norman

Gisela was known to the researcher through acupuncture college as a lecturer and agreed to

be interviewed about NADA being used in humanitarian projects.


39

Gisela is a fully qualified acupuncturist with her own practice; she has volunteered for World

Medicine working in Burma and the Occupied Territories of Gaza providing acupuncture to

hundreds of citizens and refugees who had suffered from the physical and emotional effects

of trauma and war. She also trained the medical teams in the NADA protocol so that they

could treat patients with Post Traumatic Stress and continue the work.

You are obviously very passionate about using NADA.

Yes, absolutely! It is an excellent front line tool for humanitarian aid.

It is safe, effective, treats large numbers of people efficiently and cheaply.

It is a standardized treatment so eliminates the need for individual diagnosis and treatment.

As a non-verbal treatment it can be given despite any language barriers.

Everyone knows what treatment has been given and so their response and benefits are

attributable to the protocol.

The protocol can be easily taught so creating autonomy for the local medics and continuity

for the patients.

Did you keep any records of the beneficial effects of NADA treatment?

We did have some records at the time but unfortunately they were lost.

Can you remember any particularly interesting examples of people benefitting from NADA

treatment?


40

Most recently, in Gaza, the team had a local driver who was renowned for his crazy, fast and

risky driving. After having the NADA treatment he had a much more laid back style and

people commented on how relaxed and calm he was. Being a passenger was less scary!

One of the most interesting and unexpected benefits was for the children. Many of the

children suffered from nocturnal enuresis (uncontrolled urination at night) due to stress and

fear causing over stimulation of their nervous systems. After the children received the NADA

treatment many parents were reporting that their children had slept through the night

without wetting the bed.

There were profound benefits to the community with regard to poor sleep and insomnia.

The people were suffering from poor sleep in a more detrimental way than a peace-time

community can really appreciate. Their minds can never really switch off as they remain on

alert at a sub-conscious level and this can remain so for many weeks. Their sleep is never

truly restorative and in the long term is detrimental to health. The most common and

profound feedback we had was that following the NADA treatment people would often

experience a quality of sleep that was profoundly deep and restorative. This made a huge

difference to their sense of well-being and their ability to cope with their situation.

Did you do body acupuncture as well as NADA?

I didn’t but I would often have conversations with other acupuncturists who claimed that

the NADA protocol was not enough of a treatment and that other commonly used and

effective body points should be used as well as the NADA ear points. I don’t agree with this.

I believes that “less is more” in acupuncture treatment. Also, in those environments training

people to use other body points requires some level of diagnosis which complicates the


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treatment process and makes training more involved than it needs to be since the NADA

points are highly effective anyway.

Interview 4

Emma Guy

Emma came to the attention of the researcher because she commented on using NADA in a

hospice for cancer and end of life care as well as being an acupuncturist with her own

private practice.

Can you tell me some more about the work you do in the hospice?

I started doing acupuncture as a volunteer about 3 years ago and now I’m employed

because the managers saw the great results that acupuncture gave the patients. It is

generally patients that come into the day care either living with cancer or post treatment. It

includes people with any type of cancer – breast, prostate, lungs, brain, anything. I do body

acupuncture as well as NADA. We are well trained in cancer care from understanding grief

and loss through to specific protocols such as not needling on a side where there is or could

be oedema such as from removed lymph nodes.

I have about 20 patients per week in a group session and there is always a waiting list. I now

have a student acupuncturist as a volunteer to help me.

Can you tell me how and when you would use NADA?

I tend to turn to NADA if I’m not getting anywhere with the body acupuncture or if there are

times when I can’t needle the body directly due to the site of the cancer or operations or

swelling. I also use some of the NADA points separately and combine with body points.


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How does NADA treatment help?

It helps improve sleep, reduce anxiety and stress and reduces hot flushes in men and

women on anti-cancer medication. I’ve noticed it reduces some of the side effects of

medications; it helps the body cope better with the drugs. It helps with back and shoulder

problems.

I really find NADA useful for reducing anxiety clearing the qi stagnation that I often see

when men have emotional difficulties. Men often are not able to express or understand

their emotions in our society and this leads to qi stagnation which the NADA points help to

clear.

You mentioned NADA for pain. What have you noticed?

I’ve used the Kidney point for back pain. I’ve used Shenmen. One lady with back pain

due to heavy lifting was helped and so was her thyroid function too. She had an

overactive thyroid and every time she went to the doctor to have it monitored the

level was improved.

NADA has helped patients reduce or come off pain medication and is useful when

people are already on high medication and their consultants really don’t want to put

them on any more. Especially in the hospice, where I work closely with the

oncologists and end of life patients.

My acupuncture friends ask me why I go to the NADA-UK reassessments every year and I

say that I use NADA every day, maybe 2 or 3 times a day and if find it incredibly useful. I use

it for back pain, emotional pain, stress and anxiety, diet and weight control, hot flushes.


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What other conditions have you seen NADA help?

A male patient had a cluster of verrucae on his foot and he had been to the foot

clinic regularly over 4 or 5 years to have the skin removed but the verrucae always

came back. His wife was my patient and sent him to me. I decided to use the

Sympathetic ear point to boost the immune system and after just a few treatments

the verrucae completely went away.

I have a 29 year old who has a brain cancer, had a stroke and is paralysed in a

wheelchair. I used NADA points only. When she came back she said she had slept

better, felt more energised and she looked so different wearing bright clothes and

looking brighter.

NADA is great for athletic recovery. I have 4 patients who run marathons and I give

them NADA 24-48 hours after the run and it helps their body recover quicker – they

swear by it. So does the personal trainer who trains 11 times a week. NADA helps

before an event too by clearing and detoxing which helps performance. There was a

study on basketball players who had NADA after a game and they had blood and/or

urine tests to measure their recovery. They were ready to play again 24hrs earlier

than the ones who didn’t have NADA.

One lady, with several cancers had a cough so I used the Lung point, only, and the

cough went away. NADA is particularly useful in end of life care when quite often

you don’t want to pierce the body at all.


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Another lady was seriously addicted chocolate, eating 2½lbs every day. She has now

lost 4 stone and although she still has a little chocolate every day it is so much less.

NADA really helped.

Discussion

Observations of the process that affect results

Factors influencing low response rate (9.8%):

Some individuals had more than one address in the NADA-UK database so received

the email twice. This could not be quantified.

Email sent from unknown address rather than NADA-UK may have gone into junk

mailbox or unopened.

IT issues within NADA-UK meant that the response deadline for the on-line survey

was limited and did not allow for reminders to be sent out.


45

Practitioners working for service providers may have moved on or ceased providing

NADA treatments.

Motivation to fill in the questionnaire may be dependent on whether acupuncture is

the main or smaller part of a person’s work. People for whom doing NADA is just a

requirement of their job may not have a strong feeling about acupuncture as a

health care system; nor realise the significance of the technique to benefit health in

general; the separate mail out to the fully qualified acupuncturists working in

multibed clinics (ACMAC group) yielded a much better response rate, 27%.

Question 9 asks specifically what effect NADA has on certain conditions. However, two

factors have a bearing on the validity of the results:

i) the bias towards drug and alcohol settings ii) answering ‘Don’t know’.

i) Bias.

Chart 4 shows that 52% of the practitioners who answered ‘Yes’ to practicing the

NADA protocol answered ‘Yes’ to working in D&A (drug and alcohol addiction detox

and rehabilitation) so the results of later questions are influenced by this bias but it

is not quantified. Interpretation of the results takes the bias into consideration.

ii) Answering “Don’t Know”

Affects the validity of the results because the practitioner’s answers rely on their

awareness of a) patient’s health conditions and b) potential benefits of NADA, to

gain information about response to treatment. As the NADA protocol does not

require practitioners to ask for health or medical information practitioners may not


46

be aware of conditions that NADA treatment might help and the questions have not

been asked directly of the patient.

The fact that the open question had the option for anonymity, meant that the opportunity

to follow up interesting information was lost, so potentially limiting the qualitative data. The

case in point was the practitioner who said she/he was doing work with children with

ADHD/Autism but as there was no name or contact details this perfect “outside the box”

example could not be pursued.

Principle findings

The investigation set out to discover to what extent practitioners in the UK of the NADA 5

point auricular acupuncture protocol use the treatment outside of the original addiction

detox and rehabilitation field of healthcare.

The results of the literature review of the use of the NADA protocol and two surveys of

NADA practitioners and acupuncturists show that the 5 point auricular acupuncture

technique has evolved into an effective healthcare intervention that can be applied widely

throughout different communities to alleviate some health conditions or assist in the

psycho-emotional support of patients with serious illness or traumatised environments.

Participants were asked to choose one clinic to answer questions about but they often

ticked all applicable choices, meaning that NADA treatment outcomes could not be

differentiated or compared with regard to type of clinic. It was unrealistic to expect

practitioners to complete a questionnaire for each clinic they worked. Research into each

clinic could be considered an audit and may be an option for future research.


47

The results of the survey show that although practitioners work in a variety of settings

addiction detox and rehabilitation (referred to by abbreviation D&A) is still the main area of

provision. Practitioners have observed a range of benefits to patient’s health and were able

to give relative values to their opinions of efficacy via the multiple choice questionnaire.

Positive anecdotal evidence for the benefits of the NADA protocol in terms of alleviating

physical ill health and promoting general health and well-being through the actual

treatment and the context of group treatment was gained through personal comments and

interviews.

Some results were interpreted by excluding factors influenced by D&A. The range in the

results is often more important than the statistically significant particularly if there is a bias

towards D&A. For instance in Chart 1 the highest number of practitioners works in D&A but

this can be discounted in favour of noting the range of places worked. Similarly, in the NADA

2013-14 data, Appendix 5, the benefits with the highest frequency in Chart A3 were

excluded from the on-line survey with the expectation of eliciting greater frequencies of

benefits to add to those with the lowest frequency in Table A2.

Analysis of the qualitative data derived from the open questions showed that practitioners

had noticed a range of interesting benefits for patients but in general not enough data was

generated to develop statistically significant results, such as when a particular benefit or

improved symptom was only mentioned once. The data could have been reduced further

into broader categories such as mental, physical and emotional but the interesting and

intriguing aspects of the results would have been lost.

The interviews of practitioners give much more personal insights into the provision of NADA

treatment. Strongly portrayed is the passion and commitment of those practitioners in


48

providing NADA treatment in difficult environments such as volunteering in a developing

country, in a war zone and an end of life hospice; free to socially isolated members of a UK

community; regular NADA groups for anyone with any health concern. The personal stories

also show how practitioners run a NADA service and illustrate how the NADA protocol is not

just about the needles but about the group energy and about intention to treat.

One of the original NADA protocol’s principles was that treatment was part of a programme

of support and therapy and this continues to be fulfilled by practitioners who are combining

the acupuncture treatment with other techniques such as meditation, QiGung, mind and

talking therapies and body treatments. The fact that NADA can be readily combined with

other techniques means that some of the quantitative data has some element of

interference by these factors.

Strengths and weaknesses

The NADA-UK 2013-14 data was available for collation but the quantitative analysis was

limited because of lack of robust statistics. However, the qualitative data was relevant,

interesting and inspired the on-line survey.

The on-line survey was targeted appropriately through the database of the training provider

NADA-UK and the collaboration between the researcher and NADA-UK gave it added

authenticity. The invitation to participate in the survey was an opportunity to explain the

need to gather evidence from practitioners and was strongly worded to motivate response.

(See Appendix 4)

However, collaboration meant that the researcher was not solely responsible for

implementing the survey. Challenges arose concerning IT and personnel which delayed


49

sending out of the on-line questionnaire and the questionnaire sent out in separate phases.

The latest phase, which had the greatest number of recipients, was sent out with a short

time period for participants to complete the questionnaire.

The response data (Appendix 6, Chart A5) shows that the response to the questionnaires

usually occurs in the first 2 days or not at all as the email slips down the inbox list,

illustrating the need for reminders.

Limitations of the study were due to bias towards D&A because the questionnaire did not

differentiate between D&A and non D&A practitioners or clinics in a quantifiable way.

Factors contributing to the low response rate (9.8%) are:

Email sent from unknown address rather than NADA-UK may have gone into junk

mail or unopened.

Late mail out and insufficient time to send reminders.

Practitioners working for service providers may have moved on or ceased providing

NADA treatments.

Issues particularly pertinent to the difficulties of collecting data from D&A agencies

are that they are often charities suffering from lack of funding, staff shortages and

reliant on high levels of volunteers. As clients of D&A services often live chaotic

lifestyles the organisations can become chaotic in trying to meet their needs.

(Peckham, personal communication 2015)

The method of using an internet platform for the questionnaire was easy to design and

implement and free. The responses were collected in spreadsheets making analysis straight

forward and reducing processing errors.


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The qualitative approaches of an open question and interviews balances the dry restriction

of the questionnaire as they allow practitioners to explore their experiences, feelings and

opinions about the NADA protocol. The semi-structured format of the interview means that

practitioners have the freedom to control the conversation eliciting information that may

not otherwise come to light. However, there is greater risk of superfluous information being

gathered that still has to be reduced and analysed before being discarded.

Meaning of the study

Practitioners and healthcare workers using the NADA 5 point auricular acupuncture protocol

consider it to be a useful tool that could be taken into a wide range of settings. This study

demonstrates the potential for further and continued enquiry of practitioners to build up

more evidence of the value that NADA has in various settings and for a diverse range of

patients and conditions.

The results showing positive outcomes of treatment could inspire acupuncture practitioners

to provide NADA treatment in their general community or for specific groups such as eating

disorder clinics, youth units, homeless or street assistance or anywhere where people would

benefit from NADA’s gentle but potentially profound healing. Any health promoting

intervention that reduces the impact of stress in people’s lives must be valuable in terms of

national health. According to the UK Health and Safety statistics the total number of cases

of stress contributing to work-related illness in 2011/12 was 40% (Health and Safety

Executive 2014).


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There is potential for this investigation to evolve into a means to develop a database of

evidence for the application and efficacy of the NADA 5 point auricular acupuncture

protocol outside of the drug and alcohol detox model.

Future research

There are 1,757 practitioners who didn’t answer the questionnaire who may have

interesting stories and insights that would give more evidence of settings and benefits so

further investigation is warranted but with improvements to the methodology and survey

questions:

The participants of a survey of the same research question should be segregated into

non-D&A clinics or practitioners to generate more valid data.

For on-line survey an internet platform that records the respondent’s address would

enable appropriate reminders to be sent over a period of time and more accurate

targeting of contacts.

NADA could be used differently by NADA only practitioners and professional

acupuncturists; future surveys could address this.

This study could be a precursor to a larger scale study where clients themselves could be

surveyed regarding benefits in their health from using NADA. Funding would need to be

generated for this as it would be on a large scale and the study may help to attract local

authority funding or small grants etc.

A standardised audit could be carried out between the community NADA groups and the

results correlated and analysed centrally to build up a body of evidence. This would be

particularly relevant to the current research question because it is a non-D&A setting.


52

The questionnaire can be used by NADA-UK to continue to build a body of evidence in order

to provide acupuncturists and NADA practitioners with evidence to justify funding and

promote NADA treatment to service and healthcare providers or clinics. As the

questionnaire would be a requirement for the individual it would have to be named

meaning that interesting information could be followed up.

Further analysis could be performed on the data from this study to support a proposal to

run a trial into the benefits of NADA treatment on a particular client group, for example

eating disorders.

Personal learning

As an acupuncturist I have 3 years of training in diagnosis and treatment in Chinese

medicine and I am still inspired by the benefits that can be derived for patients from this

simple protocol. One of the main meanings for me is accessibility. The NADA protocol can

provide meaningful treatment easily, widely and affordably. Providing NADA treatment in

the community is a way to bring knowledge, understanding and appreciation of the benefits

of acupuncture as a system of medicine to a greater number of people and feedback from

the community practitioners indicates that providing affordable NADA in the community

complements private practice from an economic perspective and also personal

development.

Dogged determination, attention to detail, at the same time as visualising all aspects of the

bigger picture, are all qualities that have developed in me during the research process. More

importantly has been the opportunity to read around my chosen subject and ferret out


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interesting pieces of information. The cut and thrust of deciding what to keep and what to

discard has been both painful and liberating.

CONCLUSION

NADA has a place in the spectrum of acupuncture treatment.

The NADA protocol has come to be defined by the use of 5 specific acupuncture points in

the ear (Shenmen, Sympathetic, Kidney, Liver and Lung). But this is a simplified version of

the original protocol designed to help reduce the difficult symptoms experienced by people


54

detoxing from drug and alcohol addiction and included non-verbal, non-diagnostic

treatment in a group and as component of a larger programme.

Treatment in a group is still an important and fundamental feature of the healing nature of

this auricular treatment and this is experienced and promoted by those practitioners who

lead NADA treatment groups whether in client specific, or open access.

The NADA protocol is a highly adaptable technique in its application to different settings; a

simple, safe, effective treatment protocol that can be easily taught and learned while at the

same time having profound benefits to health and well-being.

This investigation shows that NADA is being used in a in a wide range of settings in the UK:

in private acupuncture practice, residential facilities, GP surgery, RAF community centre,

school, prison, hospice, workplace, relaxation group. For specific client groups: youth,

elderly, homeless, leaning disabled, cancer, harm reduction, staff in D&A clinics as well as

clients. Community NADA groups are open to people with a diverse range of symptoms and

conditions.

This investigation has revealed that NADA has benefits to the health and well-being of mind,

body and spirit and includes benefitting mental health by reducing depression, anxiety and

panic, inducing calm relaxation and having a coping and preventative effect. Results show

that emotional and bodily pain is alleviated, also headaches and migraine and reducing

blood pressure. Benefits to menstrual problems are inconclusive. Strong evidence shows

NADA to be very beneficial for hot flushes associated with cancer treatment in men and

women.


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There are many people who are passionate about using NADA – the teachers and assessors,

the practitioners of community open access groups and those working in humanitarian aid

environments. Its power is often in the hands of passionate individuals having profound

experiences alongside the individuals who benefit from its gentle healing and

transformative potential. The purpose of this investigation is to bring this information

together to inspire further research.


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Westminster

Peckham R. (2014) NADA-UK 24 years on, The Acupuncturist, British Acupuncture Council,

Spring

Reilly, P.M. et al (2014) Auricular Acupuncture to Relieve Health Care Workers’ Stress and

Anxiety: Impact on Caring, Dimensions of Critical Care Nursing: Volume 33

http://www.hse.gov.uk/statistics/causdis/stress/index.htm%20accessed%2011/09/2014

http://www.hse.gov.uk/statistics/causdis/stress/index.htm%20accessed%2011/09/2014

http://www.nadauk.com/

http://www.nadauk.com/nada-uk-conference-2012.html


58

Robinson N. and Bovey M. (2007) Substance Abuse and Acupuncture, The evidence for

effectiveness, Briefing Paper No. 7, Acupuncture Research Resource Centre, British

Acupuncture Council

Smith M.O., (2009) Ear Acupuncture Protocol Meets Global Needs Medical Acupuncture

Volume: 21 Issue 2

Smyth C. (2012) 'Prick Up Your Ears'': A Small Scale Pilot Study into the Effectiveness of the

NADA-UK Protocol on Carers of Early Stage Dementia Patients in Their Home Environment,

BSc Dissertation College of Integrated Chinese Medicine

Straun T-C., (2015) Image; Available from: http://www.straunhealth.com/auricular-

acupuncture-1/ Accessed 20/05/2015

Thick K. et al (2010) World Medicine; Taking Acupuncture to Palestine, Journal of Chinese

Medicine Number 92

Toomin R., (2007) Beyond the Basics – Understanding the Greater Implications of the NADA

Protocol, American Acupuncturist, Accessed July 2014

Golden, G (2012) The Lasting Effects of Using Auricular Acupuncture to Treat Combat-

related PTSD: A Case Study. American Acupuncturist. Summer

Oleson T., (2003) Auriculotherapy Manual Chinese and Western Systems of Ear Acupuncture,

3rd Edition, Churchill Livingston

Oyola-Santiago T., et al (2013) Provision of auricular acupuncture and acupressure in a

university setting, Journal of American College Health, Vol.61(7)

World Medicine (2015) Available from: http://www.worldmedicine.org.uk/

http://www.straunhealth.com/auricular-acupuncture-1/

http://www.straunhealth.com/auricular-acupuncture-1/

http://www.ncbi.nlm.nih.gov/pubmed/?term=Oyola-Santiago%20T%5BAuthor%5D&cauthor=true&cauthor_uid=24010498

http://www.worldmedicine.org.uk/


59

APPENDIX 1

About The NADA Protocol

The NADA protocol is a simple ear acupuncture treatment consisting of 5 acupuncture

points (sometimes 3 points) which have fine needles inserted and retained for 30-50

minutes while the patient/client sits or lays quietly relaxing. Fig A1 shows the location of the

points.

Figure A1 Locations for needling NADA points (Oleson 2003)

The National Acupuncture Detoxification Association (NADA) was founded by Dr Michael

Smith, a psychiatrist specialising in acupuncture and addiction at the Lincoln Hospital

Recovery Centre in New York, in 1985. Originally inspired by the use of electro-acupuncture

on the ear auricle by Dr HL Wen in Hong Kong, he devised a simple 5- point auricular

acupuncture protocol to support patients experiencing difficult symptoms when recovering

from substance addiction. Since that time the NADA protocol has made an international

contribution to addiction recovery but also found a place in trauma and conflict situations

where its gentle non-verbal, calming and balancing effects have been highly valued by

Sympathetic point

Shen Men

Liver

Lung

Kidney


60

humanitarian and medical agencies, as well some psychiatric and mental health services.

(Smith 2009)

In addition to the specific auricular acupuncture points, the original criteria for the protocol

included being:

Non-verbal;

Non-diagnostic - no need for medical history or health complaints, nor disclosure of

psycho-emotional issues.

Given in sessions with patients sitting quietly together for about 45 minutes.

Part of a multifaceted approach, not a stand-alone treatment.

5 needles are placed bilaterally in the ear auricle at specific points: Shenmen, sympathetic,

Kidney, Liver and Lung. Without the group setting the procedure would be more accurately

called 5-needle, or point, auricular acupuncture but the term NADA has become shorthand

for describing auricular acupuncture of just the 5 points and will be used throughout this

report.

How and by whom it is used

The simplicity of the NADA treatment and its cost-effectiveness has meant that large

numbers of non-acupuncturists have been trained to carry out the treatment as well as it

being part of the training of professional acupuncturists. Since its inception the NADA

protocol has been used throughout the world and thousands of people have benefitted

from the treatment in a variety of settings. As practitioners have observed beneficial

outcomes or created opportunities to utilise its benefits the NADA protocol has evolved and

other applications have been discovered. (Peckham 2014)

An internet search for NADA training for non-acupuncturists in the UK shows it is provided

by three main organisations – SMART UK, NADA-UK and Yuan Clinic.

NADA-UK

NADA-UK was founded by John Tindall in 1991 and established as a non-profit making,

membership organisation that supports education and training related to the use of the

NADA protocol for the treatment of drug and alcohol problems. It helps to relieve symptoms


61

during detoxification, prevent relapse and support long term recovery. Currently, NADA-UK

has approximately 1500 NADA-UK practitioners working in over 500 agencies, both

voluntary and statutory including HM Prisons, NHS Trusts and street agencies. (NADA-UK

2014)

Practitioners who train with NADA-UK and who wish to maintain their annual registration

and membership are required to complete a questionnaire so that the organisation can

monitor where and how the NADA protocol is being used and to document any interesting

practices or treatment outcomes. This has helped to illustrate that the NADA protocol is

being used effectively in other areas of mental health and wellbeing: recovery from trauma,

ameliorating side effects from drug treatment in cancer, recovery from benzodiazepine

dependency, helping relaxation in young people with behavioural disorders, and providing

relief in stress, anxiety and panic disorders (NADA-UK 2014).

In the US, post-trauma treatments have been given to people in the community following

9/11 and Hurricane Katrina, and is routinely given to members of the US fire service. In

Europe, India and Thailand NADA is being used to help communities and military personnel

affected by war and social displacement (Smith 2009).


62

APPENDIX 2

Auricular Acupuncture Points and their functions

The NADA protocol is part of a system of medicine called auriculotherapy and when needles

are used called auricular acupuncture. Auricular acupuncture has been researched and

developed in Oriental medicine as well as in Europe. The ancient Oriental theory of

microsystems supports the notion that the ear auricle reflects the whole body and that

stimulating specific areas or points influences the health of the body. In France in 1957 Dr

Paul Nogier developed the concept of that the inverted foetus could be mapped onto the

ear and provide locations for the anatomy of the body. Recent research in Western science

uses neurophysiology to explain the somatic (of the body) responses to stimulation of the

ear auricle, such as release of neuro-chemicals. (Oleson 2003)

The auricular acupuncture points used in the NADA protocol are related to the Yin organs:

Shenmen, Spirit Gate – Connects to the Heart; it is one of the master points that alleviates

stress, pain, tension, anxiety, depression, insomnia and restlessness. It calms the mind and

connects with essential spirit. It reduces fever and coughs, inflammation, high blood

pressure and epilepsy.

Kidney – The Kidney point Tonifies Kidney Qi deficiency regulates the fluid passages and

enriches essence. In TCM the Kidneys are responsible for the bones and teeth, hearing and

hair. Physical symptoms alleviated by the Kidney point include kidney disorders, and

urination problems.

Liver – In Oriental medicine the Liver Nourishes Yin and Restrains Yang purging Liver Fire so

the Liver point assists in alleviating blood disorders, liver disorders, improves circulation,

digestive disorders, convulsions, dizziness, PMS and hypertension. The Liver point also

benefits the ligaments, tendons and sinews.

Lung – relieves respiratory disorders such as asthma, bronchitis, coughs, flu, stuffy chest and

sore throat. In TCM the Lungs assist in detoxification because they release carbon-dioxide

with each exhalation thus the Lung point facilitates detoxification from any toxic substance,


63

particularly drugs. The Lungs are associated with the skin so this point can help alleviate skin

disorders. The Lung point disperses Qi and dispels Wind. The Lung point was discovered to

be essential for auricular acupuncture analgesia.

Sympathetic – Autonomic point. This master point balances the sympathetic nervous

system activation with the parasympathetic sedation. It improves blood circulation by vaso-

dilation, corrects irregular heart-beats, relaxes spasm of the smooth muscle and relieves

pain.

(Point functions taken from Oleson 2003).

Balancing the emotions

In TCM and 5-element Chinese medicine theory the Yin organs correspond with the 5

elements of Wood. Fir, Earth, Metal and Water and they each correspond with the

emotions. So stimulating the 5 NADA points will help to balance the emotions, specifically:

Wood – Liver - Anger

Fire – Heart -Joy

Earth – Spleen – Sympathy

Metal – Lung – Grief

Water – Kidney – Fear

(Hicks, Hicks and Mole 2011)

The spirit of NADA

Rachel Toomin looks at the NADA protocol from the spirit perspective of Chinese medicine

in an article for American Acupuncturist (2007) in which she shares insights gained from

translations of the ancient texts Ling Shu. For interest a summary follows:

The ear points are categorised as ‘extraordinary’ points and as such they access the Jing, a

deep source of the body’s energy which can be accessed in times of need. It is also the

essence that becomes Ying or nutritive Qi so supporting the body from its deepest


64

foundations.The ancient text spoke of Jingshen which is the purest form of energy

susceptible for transformation into the mental/spiritual energy.

So the NADA points, as extra-ordinary points act on the Jingshen as well as the spiritual

aspects of the organs related to the specific points as follows:

Lung – Jingshen Po, the sensitive soul; release of grief and sense of loss

Liver – Jingshen Hun, the creative soul; creating a new way of life

Kidney – Jingshen Zhi, the will; release of fear

Shenmen – Jingshen Shen, mental/spirit; supports strength of mind and spirit with a

release of anxiety

(Toomin 2007)

It is not surprising, therefore, that the NADA protocol can have such transformative effects

on people who are affected by illness and trauma of mind or body or spirit. As Nic Constable

said in his interview “NADA seems to help everybody; well the people we see anyway”.

Appendix 3

NADA-UK Survey 2013-14 Questionnaire


65

Re-assessment Questionnaire Please circle/underline/tick all relevant options on all questions Name: Organisation

Date: Assessor 1. What type of establishment do you practice in? a) Prison b) Hospital c) Hospice d) Mental Health Unit e) School e) Drug/Alcohol Clinic f) Other (please state)___________________________________ 2. How do you use the NADA Protocol in your place of work? a) 1:1 b) group setting c) 1:1 and group settings d) throughout the day e) once per daily f) weekly g) twice monthly h) monthly i) every 2 or 3 months j) every 6 months or more 3. How many clients do you see in one week? a) less than 5 b) 5-10 c) 10-30 d) 30-50 e) 50+ 4. What are your clients receiving NADA treatments for? a) Alcohol Addiction b) Class A Drugs c) Cannabis Addiction

d) Prescribed meds e) Nicotine addiction f) Stress g) Anxiety h) Sleep disorders i) Mental health j) General wellbeing k) Stress relief for Carers l) PTSD please specify any others not listed 5. Have you had any issues during treatment? a) lost needles b) needle stick injury c) client fainting d) client becoming unwell e) client removing own needles f) client complaining about treatment 6. Have you had any remarkable experiences? a) client relieved of all symptoms

b) client relieved of majority of symptoms c) client relieved of other unknown symptoms not mentioned d) client saying treatment has not helped at all We would like to know a little about your personal experience of using NADA over the last year please tell us about it in a few sentences – eg. Have you enjoyed it, do you feel comfortable treating, have you had any really good success stories which have enhanced your belief in the NADA


66

Protocol, would you like to be able to use it more if there was more opportunity to do so on a voluntary basis.

Would you be willing to let us quote from your text above or write a small piece about your experience using the NADA Protocol for our website it can be anonymous if you wish? a) Yes b) Yes Anonymously c) No

Thank you! Please hand into your Assessor once complete

Appendices 4

On-line Survey of NADA Practitioners


67

NADA-UK Practitioners' Survey Dear NADA Member/Practitioner

This survey is a collaboration between NADA-UK and 3rd yr acupuncture student

researching the benefits of the NADA protocol.

We know you are busy! But it is REALLY REALLY important to us that you complete the

survey below.

If you already completed it in the last couple of months THANK YOU - NO NEED to do it

again!

Your information is hugely important so that NADA-UK can promote the benefits of the

NADA protocol in various healthcare settings, apply for funding and get NADA into more

places where it can make a huge difference to people’s lives.

The growth and evolution of the NADA protocol is due to its practitioners – YOU - BUT we

don’t know how this is happening unless YOU tell us!

PLEASE answer the 10 easy questions, it takes about 5 minutes, it is anonymous with the

option to provide your contact details.

YOUR CONTRIBUTION IS VITAL TO US - THANK YOU, WE REALLY APPRECIATE

YOU FOR TAKING THE TIME.

CLOSING DATE IS 24th March

NB. data is collected and collated by NADA-UK, analysis and results will form part of an

acupuncture degree dissertation for College of Integrated Chinese Medicine, Reading by

Deborah Trafford.

* Required

In the last 12 months have you run NADA sessions? *

o Yes

o No - please go to submit box at the end so that I can record your response

2. Do you use the 5-point auricular acupuncture protocol?

This refers to the NADA 5-point auricular acupuncture points of Shenmen,

Sympathetic, Liver, Kidney, Lung

o Yes - please continue to Q3

o No - please go to the submit box at the end so I can record your answer to this

questionnaire

3. Choose ONE of your clinics. What type of clinic is it?

Tick all that apply to this clinic, you can do a separate questionnaire for each clinic.


68

o Multibed

o One-to-one

o Pain clinic

o Cancer clinic

o Eating disorders clinic

o Drug/Alcohol addiction clinic

o Smoking cessation

o Mental health clinic

o 16-25 age group

o Women only group

o Men only group

o Elderly

o Disaster/War

o Other:

4. Do you work for/within . . .

o Private company/organisation

o Own private practice

o NHS clinic

o Government eg prison, hospital, school, military

o Charity

o Other:

5. Clinics can be staffed by a team or an individual. On average how many

acupunturists offer the 5-point protocol in your clinic per session?

o 1

o 2

o 3

o 4

o 5

o >5

6. Do you routinely take a medical history from your patients? This would

include health issues as well as their main complaint.

o Yes, always

o Yes, usually

o No

7. Do you combine the 5-point protocol with other points in the same treatment?


69

o Never

o Sometimes

o Often

8. Of the 5-point only patients over the last 6months, on average, how many have

the following frequencies of treatment?

0 1-5 5-10 10-15 15-20 >20

More than

once in a

week

Weekly

Fortnightly Monthly We already know that NADA improves insomnia, reduces anxiety, helps PTSD

and sometimes remarkable cases of NADA helping specific physical problems

comes to light.

In your experience have you found that using the NADA 5-point protocol helps or

benefits the following conditions?

Don't know Not at all Slightly Quite often Often

Improves

bodily pain

Reduces

general

headaches

Reduces

migraine

Lowers blood

pressure

Improves

menstrual

problems

including PMS

Improves

depression

Improves other

mental health

problems

10. Please feel free to add anything here that you feel is important or interesting.

It would be great to build a picture of just how remarkable the 5-point protocol

is.


70

Some respondents may be selected for follow up or interview. If you would be

willing to be contacted please give your name and contact details in the box

below. Your details will remain CONFIDENTIAL.


71

APPENDIX 5

NADA 2013-14 survey results

98 paper questionnaires from the original NADA-UK annual re-registration survey were

returned and made available for collation and analysis. Calculation of response rate is not

possible because the number of questionnaires sent out is unknown. The main sections

relevant to the overall investigation were:

Q1. the type of establishment NADA was offered in,

Q2. whether 1:1 or group setting

The individual comments about the benefits of the NADA treatment.

Question 3 - details about the number of clients, and Question 4, what NADA was treating,

were not relevant to the overall investigation.

Question 1. Answers to Question 1 confirm that NADA treatment was primarily given in

drug & alcohol settings. This was expected and is illustrated in Chart A1 along with the other

settings choices.


72

Chart A1

Practitioners could fill in the option for “Other” establishments. Table 1 shows these other

settings where NADA treatments were provided by practitioners in order of frequency.

Table A1

Supported Housing 6

Private Practice 3

Residential detox/rehab 1

Old people 1

Homeless centre 1

Day care 1

Youth Justice 1

GP surgery 1

Cancer support centre 2

16-25 age group 2

School pupils 1

Community clinic 1

Salvation Army 1

Aftercare Programme 1

Hospice 1

RAF community centre 1

Question 2

Chart A2 illustrates how the respondents use the NADA protocol in their place of work.

Some drug and alcohol clinics are residential and in these settings the treatment can be

given every day and even throughout the day. The results show that practitioners most

12

1

0

1

2

61

Prison

Hospital

Hospice

Mental Health Unit

School

Drug/Alcohol clinic

Establishments NADA practiced in


73

often give NADA treatment in a group on a weekly basis. And some practitioners work both

one-to-one and in a group.

Chart A2

Respondents had the opportunity to share their experiences of the benefits of the NADA

protocol in their own words. The data was coded and categorised and Chart 3 shows how

these were grouped in order of frequency.

Chart A3

9

40

37

8

5

42

2

2

One-to-one

Group

Both 1:1 and group

Through the day

Once a day

Weekly

Twice a month

Monthly

How do you use the NADA protocol in your place of work?

Numberof practitioners treating:


74

The benefits mentioned once are listed in Table A2. Table A2 Effects of NADA treatment noticed by respondents

Better behaviour

Pass more urine

Willing to change behaviour

Increase in motivation

Reduce mood swings

More able to express self

Diet control

Athletic recovery

Increase in coping

“brought back” from Bi-polar episode

More open to other treatments

Enjoy non-verbal contact

Ear seeds useful for needle fear clients

Client in crisis helped

Conclusion

The questionnaire was introduced into the NADA-UK re-registration process because it had

become apparent that practitioners were using the technique in different settings. Building

a database of its wider application would be useful to future research and development. The

results show that NADA-UK practitioners have taken the protocol into a range of different

17

14

13

9

7

7

6

4

4

3

2

2

2

2

2

Relaxing

Reduce anxiety

Improved sleep

Reduce stress

Reduce craving

Reduce pain

Restore sleep pattern

General well being

Calmer

Reduce hot flushes

Group bond

Mood lifted

Reduce anger

Increase engagement

Gateway to body acupuncture

Most commonly mentioned benefits

Number of comments


75

settings and have noticed benefits to patients that affect physical, mental and emotional

well-being in a positive way. Some of the comments made by practitioners confirmed

current thinking on the benefits and effects NADA treatment on patients in addiction

rehabilitation ie induce relaxation, improve sleep, reduce craving, reduce anxiety and stress.

This information contributed to the design of the on-line questionnaire.


76

Appendix 6

On-line Survey of NADA Practitioners – extra results

Table A3 Sample generated from:

NADA-UK contact list 2,524 email addresses;

Edited for duplicate address

Undelivered emails returned

Viable NADA-UK contacts

ACMAC contacts from NADA-UK website

2,380 email addresses

501

1,879

70

TOTAL active email questionnaires (1879 + 70) 1,949

Respondents

Response rate

192

9.8%

Question 5 How many acupuncturists provide NADA in your clinic per session?

Chart A4

The majority of NADA practitioners work on their own. This could be one-to one or treating

a group of patients.

Table A4 Interesting settings and conditions, expanded from Results

Children with

Asperger’s, ADHD

and Autism

Remarkable results: showing calmer moods and less

aggression. Parents are really interested and sit in the clinic for

a treatment with their children.

62.3

20.5 7.5 2 2.7 3.4

1 2 3 4 5 more than 5

Number of acupuncturists per session

Number of NADA practitioners per session



77

Hair loss of unknown

cause

1to1, pain, smoking,

own private practice

45 year old female patient reported striking improvement in a

long standing problem of hair loss. She had been treated by

various dermatology/cosmetic specialists for years and had no

medical cause apart from stress/anxiety. I had asked for any

other benefits from NADA apart from improvement in sleep

and coping with stress. Before NADA she was losing >300

hair/day and soon after ~30 hair/day.

Hospice for cancer

care and end of life.

In my private clinic I use the NADA protocol within my body

treatments as an Acupuncturist. I run an acupuncture clinic

twice a week in my local Hospice and use the NADA protocol on

hot flushes and the results I get are fantastic.

Fertility treatments I use it in my fertility practice as many of these patients are

very anxious. Beverly de Valois recommends it for her post

treatment Breast cancer patients and I have found it to be very

useful. I do a general body treatment first and then add the

NADA needles after about 10-15 mins. Patients will often

remind me if they think I have forgotten to do it!

Workplace setting,

Maria Okereafor,

Interview

I worked in a hospital where the cut backs affected staff

workload badly. When I went to see my patients on the ward, I

would sometimes see nurses crying due to work related stress.

This was thought provoking to me. I remembered that the 5-

point protocol helps me when I feel stressed and depressed. I

spoke to the hospital managers and offered to give the

treatment free to staff and they agreed. I treated our staff with

just 1 point (Shenmen) and the feedback from them was simply

humbling. They were able to relax, get quality sleep, and

reduce stress levels, as well as able to think clearer. The news

spread like wild fire and this led to an interview with the trust

magazine who published the story.


78

Table A5 Comments from practitioners working in D&A

D&A charity I have not ceased to be amazed at how much support and how

many areas of people's lives it has a positive effect on. For most

treatments I use it in combination with mindfulness. Those who

have the greater challenges (such as panic attacks when detoxing

etc.), over time find quietness within the treatment and then

begin to arrive with that same quietness. Then you know that a

real change has come about for them. Being pain free is also such

a fundamental aspect of emotional and mental wellbeing and

being able to alleviate this also allows for calm and reduces

agitation/stress.

The group setting also creates a supportive, we are in it together

feeling. Those who have been longer welcome the new, talk about

their experiences, offer tips for the others to manage the detox

effects etc. It's such a great environment.

I also used it once on a teenager with acute tooth pain where

codeine and antibiotics had not worked. I added point zero and

toothache, in one minute she had calmed down. The heat and

redness of her face from the agitation caused by the increasing

pain went straight down; her breath and body relaxed. 15 minutes

later she even asked if she still needed to go to the dentist (yes)!

One-to-one, D&D,MH,

NHS

Reducing blood pressure, headaches, back pain. All say they would

have this treatment again and look forward to the next session.

After a session some will say they experienced colours. I explain

what the colour aura means and they are amazed on how

accurate it is about themselves.

D&A local authority Their day to day life e.g. stress, anxiety, reduce panic attacks and

emotions along with sleep problems, depression, improve

appetite etc. I have noticed that 30 to 40 minutes acupuncture


79

treatment has huge impact on our regular client's eating habits as

I don't allow our clients to drink tea, coffee within the treatment

sessions. Instead I offer herbal teas, fresh fruit and fresh water.

People are able to change their habits and that is proven by our

clients, most of them are buying herbal teas and eating much

more healthily than before they have joined the clinic.

D&A, Government,

private company

Lower high blood pressure

men, women, charity As well as the physical benefits of acupuncture, there is a

therapeutic effect of all groups coming on a regular basis as a

social function. Often they will move on together to a drop in or

other social group activity.

D&A charity Sense of community

Response charts from Google Sheets – showing responses to questionnaires tailing off after

the first few days.

Chart A5


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Phase 1 7th December 2014

Phase 2 5th February 2015

Phase 3 18th March 2015

7 Dec 4 Feb

5 Feb 18 Feb

18 Mar 10 Apr

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