Knowledge, attitudes, and usage of complementary-alternative medicine (CAM): A national survey of clinical psychologists in Indonesia
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.
KeywordsClinical 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.
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.
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.
- 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
- 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. https://doi.org/10.1016/S2095-4964(16)60245-5.CrossRefGoogle Scholar
- 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
- Human Rights Watch. (2016). Living in Hell: Abuses against People with Psychosocial Disabilities in Indonesia. Retrieved from https://www.hrw.org/sites/default/files/report_pdf/indonesia0316web.pdf. Accessed 4 May 2016.
- IPK. (2008). Standar pelayanan psikologi klinis. Jakarta: IPK HIMPSI.Google Scholar
- 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. https://doi.org/10.1186/1472-6882-14-438.CrossRefGoogle Scholar
- 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
- 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
- Kementerian Kesehatan RI. (2008). Keputusan Menteri Kesehatan Republik Indonesia Nomor 121/MENKES/SK/II/2008 tentang Standar Pelayanan Medik Herbal.Google Scholar
- Kementerian Kesehatan RI. (2011). Standar pelayanan medik akupunktur. Jakarta: Kementerian Kesehatan RI.Google Scholar
- Kementerian Kesehatan RI. (2013). Riset kesehatan dasar 2013. Jakarta, Indonesia: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia.Google Scholar
- 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. https://doi.org/10.1002/cad.20092.CrossRefGoogle Scholar
- 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. https://doi.org/10.1080/13645579.2018.1434864.CrossRefGoogle Scholar
- 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. https://doi.org/10.1016/j.ctim.2017.05.003.
- Miller. (2003). Complementary and alternative therapies: Psychologists' knowledge, perceptions, health beliefs, and practices. (Doctoral Dissertation), University of Northern Colorado, Greely, Colorado. Retrieved from https://bit.ly/2P4VsYh. Accessed 17 May 2013.
- 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
- 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. https://doi.org/10.1007/s10943-014-9906-3.CrossRefGoogle Scholar
- 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. https://doi.org/10.1080/21642850.2014.912946.CrossRefGoogle Scholar
- 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. https://doi.org/10.1016/j.ctcp.2010.05.008.CrossRefGoogle Scholar
- 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. https://doi.org/10.1016/j.ctcp.2017.03.001.CrossRefGoogle Scholar
- Woodward, M. (2011). The Javanese dukun: Healing and moral ambiguity. In D. Tittensor (Ed.), Java, Indonesia and Islam (pp. 69–112). Dordrecht: Springer. https://doi.org/10.1007/978-94-007-0056-7_2.