This PPT covers how to use integrative health in the practice of psychotherapy.

1. Integrative Health in Psychotherapy
Charles M. Ware, D.H.Ed., M.S., CHES

2. You are stranded on a deserted island!
You …
 Are alone for one year
Have access to clean filtered water
Can only have one food
Must pick a food that you think would be best for
your overall health.

3. Objectives of this course
 Explain the importance of a healthy lifestyle in preventing premature
disease and promoting wellness.
 Define each of the four components of psychosocial health.
 Identify the basic traits shared by psychosocially healthy people.
 Explain how mental health professionals can play a role in preventing
specific types of psychosocial health problems.

 Define integrative health and medicine.
 Identify three integrative health practices to use in psychotherapy.

4. What is integrative health?
Integrative healthcare is a practice that reaffirms the
importance of the relationship between practitioner and
patient, focuses on the whole person, is informed by evidence
and makes use of all appropriate therapeutic approaches,
healthcare professionals, and disciplines to achieve optimal
health and healing (Academy of Integrative Health & Medicine,
2015).

5. Definition of Health and Wellness
Health
The ever-changing process of achieving individual
potential in the physical, social, emotional, mental,
spiritual, and environmental dimensions.
Wellness
The achievement of the highest level possible in
each of several dimensions.
To some, health means the antithesis of sickness, to
others it means being in good enough physical shape
to resist illness.

6. Dimensions of health and wellness
Physical health
Social health
Intellectual health
Environmental heath
Emotional health
Spiritual health

7. Dimensions of health and wellness
Physical
Includes body functioning, physical fitness, and ability to
perform activities of daily living (ADLs)
Social
Ability to have satisfying interpersonal relationships
Intellectual
Using “brain power” effectively to meet challenges
Ability to think clearly and to reason objectively

8. Dimensions of health and wellness
Environmental
Appreciation of the external environment and one’s role
to preserve, protect, and improve its conditions
Emotional
Self-esteem, self-confidence, self-efficacy, and
other emotional reactions and responses
Spiritual
Feeling as if part of a greater spectrum of existence

9. Dimensions of health and wellness
Social Health: Interactions with Others
Aspect of psychosocial health that includes interactions
with others, ability to use social supports, and ability to
adapt to various situations
Social bonds
Social support
Tangible support
Intangible support

10. Dimensions of health and wellness
Intellectual Health
“Thinking” or “rational” part of psychosocial health
Mentally healthy people tend to respond to life’s
challenges constructively.
Irrational thinking may indicate poor mental health.

11. Dimensions of health and wellness
Emotional Health: The Feeling You
The “feeling” or subjective side of psychosocial health
that includes emotional reactions to life
Emotions are intensified feelings and complex patterns:
Love, hate, frustration, anxiety, and joy

12. Dimensions of health and wellness
 Other important concepts:
Mental health
A broad concept that encompasses dimensions of
emotional, social, spiritual, and intellectual health
The thinking part of psychosocial health
Includes your values, attitudes, and beliefs
Spiritual Health-Holistic approach to health
Emphasizes the integration and balance of mind,
body, and spirit

13. How does psychosocial health play
a role in integrative healthcare?
 Psychosocial health encompasses
the mental, emotional, social, and
spiritual dimensions of what it
means to be healthy.
 Psychosocial health is the result of
complex interaction between a
person’s history and his or her
thoughts about and interpretations
of the past and what the past
means to the present.

14. Maslow’s Hierarchy of Needs
In the 1960s, human theorist
Abraham Maslow developed a
hierarchy of needs to describe the
certain basic needs that a person
must have in order to be a socially
healthy individual.

15. Maslow’s Hierarchy of Needs
According to Maslow’s theory, a
person’s needs must be met at each
of these levels before that person
can ever truly be healthy. Failure to
meet one of the levels interferes with
the person’s ability to address the
other levels.

16. Maslow’s Hierarchy of Needs

17. Base level of needs?

18. Base level of needs?

19. Base level of needs

20. Sleep time vs. Sleep efficiency
 Previous research stated we needed at least 60 hours
of cumulative sleep a week.
 Dr. William Seiber (2015) states that the goal of sleep
should be sleep efficiency and NOT sleep time.
 Poor sleep and fatigue leads to overactive amygdala.
 Remember that the amygdala is the integrative center
for emotions, emotional behavior, and motivation.

21. Sleep time vs. Sleep efficiency
 Studies show that those who get less than 6 hours of sleep are
42% more likely to get diabetes. Compared to…those with the
most disturbed sleep are 97% more likely to die in the next 20
years.
 Poor sleep may make you more prone to pre-diabetes, anxiety,
and upsetting emotions.
 Less sleep also affects appetite and eating.
 Leptin is the hormone that lowers our appetite, and ghrelin is the
hormone that increases appetite. With sleep deprivation our
leptin goes down, and our ghrelin goes up (it also does it with
overeating!).

22. Why water?
Water is necessary for:
Electrolyte and pH balance
Transporting cells and molecules (every heard of
water soluble vitamins?)
Lack of water
Dehydration can impair short-term memory
function and the recall of long-term memory

23. How much water?
Weight in pounds (lbs)
Divide by two (2)
Answer equals number of ounces (oz) of
water per day
Example:
230 lbs. /2 = 115 oz.
This is equivalent to 7 bottles of 16.9 oz (500ml)
bottles of water.

24. Studying the Nutrition-Brain-Behavior
Connection
The study of how nutrition affects the brain and
behavior is relatively new.
Scientists have just begun to understand how
changes in particular nutrients alter the brain and
how these neural changes then affect intelligence,
mood, and the way people act

25. Studying the Nutrition-Brain-Behavior
Connection
There is a link between poor nutrition and
environmental factors.
Therefore, changes in behavior may not be due to
poor nutrition only.
Other factors such as education, social or family
problems may affect behavior.

26. Studying the Nutrition-Brain-Behavior
Connection
It is difficult to alter only one substance in the
human diet.
Therefore, it is difficult to determine if a particular
vitamin or mineral has a certain effect on behavior.

27. Studying the Nutrition-Brain-Behavior
Connection
People respond to different modifications in
different ways.
In other words, there is a large individual variation
in the body's response and need for different
nutrients.

28. Studying the Nutrition-Brain-Behavior
Connection
A change in diet may have a placebo effect.
The placebo effect occurs because a
person thinks something will have an effect.
In other words, if a person thinks a change in diet
will affect behavior, it may actually affect behavior
even if the nutrients are not causing the change.

29. Nutritional Psychology
Potential impact diet has on the diagnosis and
treatment of mental disorders, including possible
misdiagnosis of non-psychiatric conditions created
by today's modern dietary lifestyle.

30. Diet and Neurotransmitters
Certain foods contain precursors (starting
materials) for some neurotransmitters. If a diet is
deficient in certain precursors, the brain will not be
able to produce some neurotransmitters.
Neurological and mental disorders may occur
when the balance of neurotransmitters is upset.

31. Diet and Neurotransmitters
Aspartic Acid
Used to make aspartate; found in peanuts, potatoes,
eggs and grains.
Spinal cord neurotransmitter
Also has pre-synaptic membrane function

32. Diet and Neurotransmitters
Choline
Used to make acetylcholine; found in eggs, liver
and soybeans.
Is an excitatory neurotransmitter
Controls skeletal and smooth muscles
Helpful in patients with multiple sclerosis

33. Diet and Neurotransmitters
Glutamic Acid
Used to make glutamate; found in flour and
potatoes.
Most common neurotransmitter in the brain.
Sodium/Potassium exchange

34. Diet and Neurotransmitters
Phenylalanine
Used to make dopamine; found in beets, soybeans,
almonds, eggs, meat and grains.
Dopamine, like epinephrine, produces arousal.
Is also in aspartame
Some research suggests that patients with ADHD
have lower levels of amino acids such as
phenylalanine, so there was hope that providing
phenylalanine might treat ADHD.

35. Diet and Neurotransmitters
Tryptophan
Used to make serotonin; found in eggs, meat,
skim milk, bananas, yogurt, milk, and cheese.
High carbohydrate meals affect glucose levels
by increasing insulin secretion.
The drowsiness induced by serotonin is a
common effect of a large carbohydrate meal.
High-estrogen contraceptives may have
contributed to depression by lowering serotonin
levels in the brain

36. Diet and Neurotransmitters
Tyrosine
Used to make norepinephrine; found in milk, meat,
fish and legumes.
As a stress hormone, norepinephrine affects parts of
the brain where attention and responding actions are
controlled.
Norepinephrine, along with dopamine, has come to
be recognized as playing a large role in attention and
focus.

37. Malnutrition and the Brain
Vitamin and mineral deficiencies can be caused
by:
Starvation
Poor diet
Poor absorption of vitamins and minerals
Damage to the digestive system
Infection
Alcoholism

38. Obtaining Essential Nutrients
Vitamins
Potent, essential, organic compounds
Promote growth and help maintain life and health
Two types
Fat soluble—absorbed through intestinal tract with
the help of fats. A, D, E, and K vitamins are fat
soluble.
Water soluble—dissolve in water. B-complex
vitamins and vitamin C are water soluble.
Few Americans suffer from vitamin deficiencies.
Overusing them can lead to a toxic condition known as
hypervitaminosis.

39. Obtaining Essential Nutrients
 Antioxidants
 Most common are vitamin C, vitamin E, and beta-carotene
 Free radicals damage or kill healthy cells.
 Antioxidants scavenge free radicals, slow their formation, and
repair oxidative stress damage.
 Carotenoids
 Lycopene (in tomatoes, papaya, pink grapefruit, and
guava) reduces the risk of cancer.
 Lutein (in green leafy vegetables, spinach, broccoli, kale,
and brussels sprouts) protects the eyes.

40. Obtaining Essential Nutrients
Minerals
Inorganic, indestructible elements that aid the body
Vitamins cannot be absorbed without minerals
Macrominerals are needed in large amounts.
Sodium, calcium, phosphorus, magnesium,
potassium, sulfur, and chloride
Trace minerals are needed in small amounts
Iron, zinc, manganese, copper, and iodine
Excesses or deficiencies of trace minerals can cause
serious problems.

41. Obtaining Essential Nutrients
Sodium
Necessary for regulation of blood and body fluids,
transmission of nerve impulses, heart activity, and
certain metabolic functions.
Recommended consumption less than 1 teaspoon of
table salt per day
Pickles, snack foods, processed cheeses, canned
soups, frozen dinners, breads, smoked meats, and
sausages contain large amounts.

42. Obtaining Essential Nutrients
Calcium
Plays a vital role in building strong bones and teeth,
muscle contraction, blood clotting, nerve impulse
transmission, regulating heartbeat, and fluid balance
within cell
Recommended amount 1,000 to 1,200 mg/day
Milk, calcium-fortified orange juice, soy milk, broccoli,
cauliflower, peas, beans, nuts, and molasses are good
sources.

43. Obtaining Essential Nutrients
Iron
The most common nutrient deficiency globally
Women aged 19 to 50 need about 18 mg per day, and
men aged 19 to 50 need about 10 mg.
Iron-deficiency anemia—body cells receive less
oxygen, and carbon dioxide wastes are removed less
efficiently
Iron toxicity—ingesting too many iron containing
supplements
Men who consume excess iron have a higher risk of
gallstones.

44. A Guide to Water-Soluble Vitamins

45. A Guide to Water-Soluble Vitamins

46. A Guide to Fat-Soluble Vitamins

47. A Guide to Major Minerals
Continued

48. A Guide to Major Minerals

49. A Guide to Trace Minerals

50. Using Integrative Health in Psychotherapy
Emotional, physical, and nutritional needs must
be addressed when developing a wholistic
(holistic) therapeutic plan.
Psychosocially healthy people are emotionally,
mentally, socially, intellectually, and spiritually
resilient.

51. Develop integrative plan where…
Healthy people…
Feel good about themselves
Feel comfortable
Control tension and anxiety
Meet demands of life
Curb hate and guilt
Maintain a positive outlook
Value diversity
Appreciate and respect nature
Enrich the lives of others

52. Is laughter the best medicine?

54. When psychosocial health
deteriorates…so do other dimensions
Any disorder that disrupts thinking, feeling, moods,
and/or behaviors and causes a varying degree of
impaired functioning in daily life is defined as…?
THOUGHTS become WORDS
WORDS become BEHAVIORS
BEHAVIORS become HABITS
HABITS become VALUES
VALUES become YOU

55. References
 Academy of Integrative Health & Medicine. (2015). What is integrative health & medicine.
Retrieved from https://aihm.org/about/what-is-integrative-medicine/
 Brick, J. & Erickson, C.K. (1998). Drugs, the brain, and behavior: The pharmacology of
abuse. New York: Haworth Press.
 Chafetz, M.D. (1990). Nutrition and neurotransmitters: The nutrient bases of behavior.
Englewood Cliffs: Prentice Hall, Inc.
 Coleman, M. & Gillberg, C. (1996). The Schizophrenias. A biological approach to the
schizophrenia spectrum disorders. New York: Springer.
 Dhopeshwarkar, G.A. (1983). Nutrition and brain development. New York: Plenum Press.
 Donatelle, R. (2011). Health the basics: Green edition. San Francisco, CA: Pearson
Benjamin Cummings.
 Edelson, E. (1998). Nutrition and the brain. New York: Chelsea House.
 Fredrickson, B. (2000). Cultivating positive emotions to optimize health and well-being.
Prevention and Treatment.3(a).
 Gordon, A.M. (2014). The psychology of nutrition: Are you stereotyping food? Retrieved
from https://www.psychologytoday.com/blog/between-you-and-me/201403/the-psychology-
nutrition
 Grosvenor, M.B., & Smolin, L.A. (2014). Visualizing nutrition: everyday choices (3rd ed.).
Hoboken, NJ: John Wiley & Sons, Inc.
 Mahan, L.K. & Escott-Stump, S. (1996). Krause's food, nutrition, and diet therapy.
Philadelphia: W.B. Saunders.
 Seiber, W. (2015). Calming an overactive brain.
 Weil, A. (2015). What is integrative medicine. Retrieved from https://vimeo.com/9412862