Knowledge, attitudes, and usage of complementary-alternative medicine (CAM): A national survey of clinical psychologists in Indonesia

  • Andrian LiemEmail author
  • Peter A. Newcombe


This nationwide cross-sectional study aimed to explore Indonesian clinical psychologists’ (CP) knowledge, attitudes, and usage of complementary-alternative medicines (CAM). A link to the online survey was emailed to all 1045 registered CP in the Indonesian Clinical Psychology Association database. Participants were asked about: CAM knowledge, attitudes towards CAM, and CAM usage activities (personal purpose, recommendation, referral, and the use of CAM in practice). Two hundred and seventy-four CP completed the questionnaire (mean of age = 35.4 years, SD = 7.87) and were predominantly female (n = 237, 86.5%). Participants reported low CAM knowledge and positive attitudes towards CAM. Almost half of the participants reported personal experiences of using CAM as the main resource of CAM knowledge. The majority of participants (n = 239, 87.2%) had used CAM personally, had recommended CAM (n = 230, 83.9%), had made a referral to a CAM practitioner (n = 143, 52.2%), and had used CAM in their clinical practice (n = 180, 65.7%). Spiritual-religious therapy was the most often used method by participants. In exploring prediction models, it was found that age, knowledge of, together with attitudes towards CAM contributed to the prediction of CAM usage activities. In conclusion, despite low CAM knowledge, CP in Indonesia reported positive attitudes towards CAM and most had used CAM. Findings from this study might be used by professional organizations, psychology faculties, and the government to review the basic competency of CP and regulation in integrating CAM to psychology services.


Clinical psychology Knowledge Attitude Complementary and alternative medicine Indonesia 



The first author is supported by Indonesia Endowment Fund for Education Scholarship (LPDP RI) under a doctoral degree scholarship (20150122082410). The authors thank the Indonesian Clinical Psychology Association (IPK HIMPSI) for the permission to collect data and all participants. Data of this study is part of a larger study on CAM among clinical psychologists in Indonesia (the first author’s doctoral thesis). The authors thank Bryanna Wilson, BA (Hons) for the proofreading of the manuscript; and the anonymous reviewers for their constructive feedback.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the School of Psychology at the University of Queensland (#16-PSYCH-PHD-08-JH) and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Participation in the study was on a voluntary basis and anonymous. Electronic informed consent, by clicking ‘I agree’ on the online information and consent page prior to the survey, was obtained from all individual participants included in the study.


  1. Aki, O. E., Ak, S., Sonmez, Y. E., & Demir, B. (2013). Knowledge of and attitudes toward electroconvulsive therapy among medical students, psychology students, and the general public. Journal of Ect, 29, 45–50. Scholar
  2. Al Mansour, M. A., Al-Bedah, A. M., MO, A. R., Elsubai, I. S., Mohamed, E. Y., El Olemy, A. T., et al. (2015). Medical students’ knowledge, attitude, and practice of complementary and alternative medicine: A pre-and post-exposure survey in Majmaah University, Saudi Arabia. Advances in Medical Education and Practice, 6, 407–420.Google Scholar
  3. Al Sayyad, A. S., Al Saffar, R., Al Jasim, H., Al Reqraq, F., & Ahmed, B. S. (2015). Knowledge, attitude and practice of primary health care physicians in Bahrain towards complementary and alternative medicine (CAM). Middle East Journal of Family Medicine, 13, 52–59.CrossRefGoogle Scholar
  4. Balouchi, A., Rahnama, M., Hastings-Tolsma, M., Shoja, M. M., & Bolaydehyi, E. (2016). Knowledge, attitude and use of complementary and integrative health strategies: A preliminary survey of Iranian nurses. Journal of Integrative Medicine, 14, 121–127. Scholar
  5. Barnett, J. E., & Shale, A. J. (2012). The integration of complementary and alternative medicine (CAM) into the practice of psychology: A vision for the future. Professional Psychology: Research and Practice, 43, 576–585. Scholar
  6. Barnett, J. E., Shale, A. J., Elkins, G., & Fisher, W. (2014). Complementary and alternative medicine for psychologists: An essential resource. Washington, D.C: American Psychological Association.CrossRefGoogle Scholar
  7. Bassman, L. E., & Uellendahl, G. (2003). Complementary/alternative medicine: Ethical, professional, and practical challenges for psychologists. Professional Psychology: Research and Practice, 34, 264–270.CrossRefGoogle Scholar
  8. Bradshaw, M. L. (2016). Knowledge, attitudes, and personal use of complementary and alternative medicine among occupational therapy educators in the United States. Occupational therapy in Health Care, 30, 80–94.Google Scholar
  9. Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.CrossRefGoogle Scholar
  10. Honda, K., & Jacobson, J. S. (2005). Use of complementary and alternative medicine among United States adults: The influences of personality, coping strategies, and social support. Preventive Medicine, 40, 46–53.CrossRefGoogle Scholar
  11. HSPEC (Health Service Psychology Education Collaborative US). (2013). Professional psychology in health care services: A blueprint for education and training. American Psychologist, 68, 411–426. Scholar
  12. Human Rights Watch. (2016). Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia. Retrieved from Accessed 4 May 2016.
  13. IPK. (2008). Standar pelayanan psikologi klinis. Jakarta: IPK HIMPSI.Google Scholar
  14. James, P. B., & Bah, A. J. (2014). Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: A descriptive cross-sectional survey. BMC Complementary and Alternative Medicine, 14, 438–446. Scholar
  15. Jauhari, A. H., Jauhari, M. S. U. H., Utami, M. S., & Padmawati, R. S. (2012). Motivation and trust of patients in seeking medication to sinshe. Berita Kedokteran Masyarakat, 24, 1–7.Google Scholar
  16. Kementerian Kesehatan RI. (2007). Peraturan Menteri Kesehatan Republik Indonesia Nomor 1109/MENKES/PER/IX/2007 tentang penyelenggaraan pengobatan komplementer-alternatif di fasilitas pelayanan kesehatan. Menteri Kesehatan Republik Indonesia.Google Scholar
  17. Kementerian Kesehatan RI. (2008). Keputusan Menteri Kesehatan Republik Indonesia Nomor 121/MENKES/SK/II/2008 tentang Standar Pelayanan Medik Herbal.Google Scholar
  18. Kementerian Kesehatan RI. (2011). Standar pelayanan medik akupunktur. Jakarta: Kementerian Kesehatan RI.Google Scholar
  19. Kementerian Kesehatan RI. (2013). Riset kesehatan dasar 2013. Jakarta, Indonesia: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia.Google Scholar
  20. Koc, Z., Topatan, S., & Saglam, Z. (2012). Use of and attitudes toward complementary and alternative medicine among midwives in Turkey. European Journal of Obstetrics & Gynecology and Reproductive Biology, 160, 131–136.CrossRefGoogle Scholar
  21. Lesmana, C. B., Suryani, L. K., & Tiliopoulos, N. (2015). Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: The case of Bali, Indonesia. New Directions for Child and Adolescent Development, 147, 109–116. Scholar
  22. Liem, A. (2018). Interview schedule development for a sequential explanatory mixed method design: Complementary-alternative medicine (CAM) study among Indonesian psychologists. International Journal of Social Research Methodology, 21, 513–525. Scholar
  23. Liem, A., & Newcombe, P. A. (2017). Indonesian provisional clinical psychologists' knowledge, attitudes, and behaviours towards complementary-alternative medicine (CAM). Complementary Therapies in Clinical Practice, 28, 204–211.CrossRefGoogle Scholar
  24. Liem, A., & Rahmawati, K. D. (2017). The meaning of complementary, alternative and traditional medicine among the Indonesian psychology community: A pilot study. Journal of Integrative Medicine, 15, 288–294.CrossRefGoogle Scholar
  25. Liem, A., Newcombe, P. A., & Pohlman, A. (2017). Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study. Complementary Therapies in Medicine, 33, 14–19.
  26. Lombard-Salmon, C., & Sidharta, M. (2007). Traditional Chinese medicine and pharmacy in Indonesia–some sidelights. Archipel, 74, 165–204. Scholar
  27. Maramis, A., Van Tuan, N., & Minas, H. (2011). Mental health in southeast Asia. The Lancet, 377, 700–702. Scholar
  28. Miller. (2003). Complementary and alternative therapies: Psychologists' knowledge, perceptions, health beliefs, and practices. (Doctoral Dissertation), University of Northern Colorado, Greely, Colorado. Retrieved from Accessed 17 May 2013.
  29. Minas, H. (2009). Mentally ill patients dying in social shelters in Indonesia. The Lancet, 374, 592–593. Scholar
  30. Ningdyah AEM, Helmes E, Kidd G, & Thompson C. (2016). Preparing for mental health care services: Professional psychology curricula in Indonesia. Paper presented at the International Conference on Health and Well-Being, Surakarta, Indonesia.Google Scholar
  31. Nurjannah, I., Mills, J., Park, T., & Usher, K. (2015). Human rights of the mentally ill in Indonesia. International Nursing Review, 62, 153–161.CrossRefGoogle Scholar
  32. Pols, H. (2006). The development of psychiatry in Indonesia: From colonial to modern times. International Review of Psychiatry, 18, 363–370. Scholar
  33. Pols, H., & Wibisono, S. (2017). Psychiatry and mental health care in Indonesia from colonial to modern times. In H. Minas & M. Lewis (Eds.), Mental health in Asia and the Pacific (pp. 205–221). New York: Springer.CrossRefGoogle Scholar
  34. Ramakrishnan, P., Karimah, A., Kuntaman, K., Shukla, A., Ansari, B. K., Rao, P. H., et al. (2015). Religious/spiritual characteristics of Indian and Indonesian physicians and their acceptance of spirituality in health care: A cross-cultural comparison. Journal of Religion and Health, 54, 649–663. Scholar
  35. Setiyawati, D., Blashki, G., Wraith, R., Colucci, E., & Minas, H. (2014). Indonesian experts' perspectives on a curriculum for psychologists working in primary health care in Indonesia. Health Psychology and Behavioral Medicine: An Open Access Journal, 2, 623–639. Scholar
  36. Shorofi, S. A., & Arbon, P. (2010). Nurses’ knowledge, attitudes, and professional use of complementary and alternative medicine (CAM): A survey at five metropolitan hospitals in Adelaide. Complementary Therapies in Clinical Practice, 16, 229–234. Scholar
  37. Shorofi, S. A., & Arbon, P. (2017). Complementary and alternative medicine (CAM) among Australian hospital-based nurses: Knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Complementary Therapies in Clinical Practice, 27, 37–45. Scholar
  38. Stapleton, P., Chatwin, H., Boucher, E., Crebbin, S., Scott, S., Smith, D., & Purkis, G. (2015). Use of complementary therapies by registered psychologists: An international study. Professional Psychology: Research and Practice, 46, 190–196. Scholar
  39. White, K. P. (2000). Psychology and complementary and alternative medicine. Professional Psychology: Research and Practice, 31, 671–681. Scholar
  40. Wilson, L. A. M., White, K. M., & Obst, P. (2011). An examination of the psychologists' attitudes towards complementary and alternative therapies scale within a practitioner sample. Australian Psychologist, 46, 237–244. Scholar
  41. Wilson, L. A. M., Hamilton, K., & White, K. M. (2012). Students' beliefs about willingness to access Complementary and Alternative Therapies (CAT) training for future integration into psychology practice. ISRN Education, 2012, 1–7. Scholar
  42. Wilson, L. A. M., White, K. M., & Hamilton, K. (2013). Predicting psychologists' intentions to integrate complementary and alternative therapies into their practice. Australian Psychologist, 48, 149–158. Scholar
  43. Woodward, M. (2011). The Javanese dukun: Healing and moral ambiguity. In D. Tittensor (Ed.), Java, Indonesia and Islam (pp. 69–112). Dordrecht: Springer.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of PsychologyThe University of QueenslandSt LuciaAustralia

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