Context and literature review

Complementary and alternative medicine can be defined as the diagnosis, treatment or

prevention which is integral to mainstream medicine as it contributes to a common whole, by
satisfying a demand not met by biomedicine or by diversifying the conceptual frameworks of
conventional medicine (Ernest, 2000). It encompasses a broad array of techniques, with both
therapeutic and diagnostic techniques. Health as defined by WHO (2019) constitutes
physical, social and mental well-being and not the mere absence of disease and infirmity.
Therefore, CAM is a proactive, preventive approach designed to achieve optimum levels of
health, social and emotional functioning

Various studies have been done that investigated the use of complementary and alternative
medicine in the youth. For instance, a research was done by Kemper et. al (2013) to
investigate the use of CAM therapies in the youth with mental health concerns. A sample of
5651 individuals representing 7 million youth with one or more mental health concerns,
undertook a survey of whether or not they use CAM therapies and which ones they
employed. It was found that 28.9% of the youth used one or more types of CAM therapies
that excluded vitamins and minerals, and 11.6% without mental health issues used CAM
therapies (Kemper et al., 2013). Furthermore, among the youth with one or more mental
health concern, the most commonly used CAM therapies where related to mind-body
therapies in 16.3% of the sample, 11% used biologically based CAM therapies, 18.6%
employed higher therapies that can be directly accessed, 11.8% had therapy delivered in
groups and 10.2% used health professionals. Essentially, this research by Kemper et al.
(2013) shows that 56.2% of the participants use CAM therapies such as acupuncture,
biofeedback, deep breathing exercises, energy healing therapy, herbs and other non-
vitamin/mineral dietary supplements, hypnosis, massage, naturopathy, movement techniques
e.g. pilates, guided imagery, homeopathy, meditation, progressive relaxation, support group
meetings, and/or stress management class, traditional healers like Shaman, special diets like
vegetarian, tai chi, and yoga (Kemper et al., 2013). However, the multivariable regression
model states that demographic factors significantly affected the employment of CAM
therapies. Essentially this model looks at the relationship between multiple predictor
variables and outcome variables. For instance, predictor variables being the subject’s income,
level of parental education, chronic health conditions, whether subject used prescribed
medication, and difficulties in affording mental health counselling, and outcome variables
being the methods of treatment the subjects opt for. As such, the context of this research will
largely inform this current study as it provides an insight on how and why the youth choose
to use CAM therapies.

Another study done by Bethell et al (2013) on youth using CAM to treat recurring headaches,
found out that within pediatrics, adolescents seem to be the most common users of CAM
therapies and have the highest prevalence of recurring headaches. Based on clinical and
population specific studies, adolescents most commonly use biologically based dietary
approaches and mind-body practices, many of which can be implemented at costs lower than
CAM therapies requiring professional assistance (Bethell et al., 2013: 1174). Improved
sleeping behavior is another fundamental strategy to prevent recurring headaches, such as
migraines (Bethell et al., 2013: 1174). Stress Management strategies, such as slow deep
breathing, self-hypnosis, autogenic training, biofeedback, mindfulness meditation, and
progressive muscle relaxation were also found to be highly recommended to the youth
(Bethell et al., 2013: 1173). Therefore, Bethell et al.’ (2013) research will inform the current
study in exploring the use of CAM by the youth in maintaining their health and treating
health problems.

There seems to be a growing number of youth who use alternative methods to deal with
health issues (Bethell et al., 2013: 1173 ). For example, Wu’s (2007) study found that most
participants stated that the reason for using CAM therapies was because these treatments is a
‘natural approach’. Furthermore, they believed that the treatments were corresponding with
their own cultural values and beliefs, and past experiences (Wu, 2007). It has been suggested
that it is also because some of the conventional medical therapies had caused unpleasant side
effects or had seemed ineffective (Wu, 2007). Another study found that a major motivating
factor was having the sense that complementary and alternative therapies were in harmony
with the users' values and "philosophical orientations towards health and life" (Astin, 1998:
1550). Whereas Unützer, Klap, Sturm, Young, Marmon, Shotkin and Wells (2000: 1853)
found that the high rates of use of complementary and alternative medicine among
individuals were among those who were relatively dissatisfied with the conventional and
traditional biomedical health care services. These included mental health care services.
However, the particular types of CAM therapies these users chose for themselves were not
examined in relation to these motivational factors (Wu, 2007). Therefore, this current study
will explore the various motivational factors of participants opting for CAM rather than using
biomedicine.

Subsequently, some individuals as stated by Wu (2007) prefer to use spiritual methods in

handling mental illnesses. Although western medicine has a way of diagnosing and treating
mental illnesses, there are some that are culture specific or region specific and can only be
dealt with spiritually rather than medically (Ross, Friedmann, Bevans & Thomas, 2013). For
example, some take up yoga and meditation as a way of maintaining positive thoughts and
energies (Ross et al., 2013). Furthermore, the conventional anti-depressant medication is
viewed as synthetic and not good for the body (Ross et al., 2013). Therefore, they chose to
eat healthily, by eating foods that boost energy and naturally rectified hormonal production
rather than consuming pills (Ross et al., 2013).

Additionally, apart from yoga and meditation others seek herbalists and traditional healers
within their cultures who can help treat illnesses (Lund & Swartz, 1998). As Lund and Swartz
(1998) argue that some mental illnesses that are seen by the western conventional medicine as
psychosis and schizophrenia, are actually a result of denying an ancestral calling
(amafufunyana). Therefore, one would need to visit a traditional healer and elders in their
culture in order to be treated (Lund & Swartz, 1998). As such, cases like these are relevant to
the current study as they speak to how one chooses to employ alternative methods in treating
illness based on their cultural beliefs.

Crawford (1983: 35) terms healthism as a concept that “represents a particular way of
viewing the health problem and is characteristic of the new health consciousness and
movements”. Pelters (2016: 131) argues that health religion is an emotionalized commitment
to health as an authority, therefore understanding and preserving it are moral obligations.
‘Culture’ and religion can be analysed at three levels, which are what people say they do,
what they are actually observed to do, and the underlying ,and often unconscious belief
systems that drive their behaviours. As such, following cultural and religious backgrounds
and practices using a healthism conceptualization, this research is able to understand the
reasons why people opt to use CAM methods rather than biomedical solutions to health
issues. Moreover, Crawford (1980: 368) claims that CAM therapies are a part of “holistic”
health movements. Essentially, religious imagery is usually paired with the concept of
‘health’ in this “biomedicalized, healthistic time” (Crawford, 1980: 368). However, it begs
the question of whether or not if it is enough to qualify the structural characteristics of the
presentations and practices of health as a present-day health religion (Pelters, 2016: 133).
The emergence of a new philosophy around nature and holism related to a postmodern value
system (Gale, 2014) is interrelated to religious practices such as the mind-body medicine
(Peltzer, 2009). Hence, this current research will use healthism to conceptualize
contemporary health practices that are CAM based and further understand the reasons that lie
behind why students at Rhodes chose to utilise CAM methods for treatment of health issues
and prevent illness.
In order for researchers to understand the universal sense in which every human being is
guided by abstract principles that form a foundation of their practices, they need to look at the
combination of beliefs about ontology ( what the nature of the participant is? What kind of
human being the participant is?), epistemology ( the relationship between the inquirer and the
known) and methodology ( how the participants gain knowledge about the world and what
the know about it) (Guba, 1990: 18) As such these epistemological, ontological and
methodological beliefs for an interpretive paradigm of framework that can be viewed as
“basic set of beliefs that guides action” (Guba, 1990: 17) Although some beliefs may be
viewed as controversial and problematic, and others taken for granted, or assumed, the
interpretivist research paradigm allows the researcher to look at the subjective experiences of
the participants through an unbiased lens. As such the researcher focuses on how the
participants’ beliefs guide their practices and actions and influence their subjective
experiences. Concisely, this study will follow an interpretivist paradigm so as to understand
and conceptualize the subjective experiences of the participants with CAM and how their
beliefs influence their choice to use CAM. Profoundly, it would be more useful for this study
to explore cultural theory as a criticism as it looks at social context, cultural practices and
subjectivities of the participants (Denzin & Lincoln, 2011: 13). Additionally, Marxism will
aid in exploring the systems of race, class and gender while looking at the historical context
so as to provide a critical sociocultural analysis of Rhodes students using CAM in order to
deal with health issues.

In essence, most research done in this field on CAM focuses on the adult, infant and
adolescent population. Therefore, this study will explore the use of CAM in the youth,
university students to be specific as there is a diverse variety of cultures, religions and classes
in the institution. Furthermore, this study will facilitate in helping to understand how different
belief systems influence health practice of the students. This can potentially aid in
universities acknowledging the various health practices that students employ, and the reasons
why they choose to do so and can therefore provide appropriate health care and support for
students’ health in universities.
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