Quantifying Aromatherapy
Aromatherapy is one of the most popular forms of Complementary and Alternative Medicine (CAM). The Professional Standards Authority states that aromatherapy satisfies the definition of healthcare, as laid down in the National Health Service Reform and Health Care Professions Act 2002, section 25E (8) – “Health care’ includes: all forms of health care for individuals, whether relating to physical or mental health; and procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition.”
Aromatherapy can work alongside clinical interventions, or can be a help in cases where no conventional treatment is offered, following diagnosis by GPs/ consultants. All CAM and alternative therapies are subject to rigorous investigation and provide compelling evidence of their effectiveness, together with strict guidelines and policies for training, registration and governing of its practitioners. Aromatherapy is no exception.
The IFA is the first and longest serving aromatherapy organisation to represent aromatherapy and to be registered with the Charities Commission of England and Wales for the public benefit. This means that aromatherapy has met and continues to meet the UK operational guidance model, which sets out the basis of an acceptable framework for selecting and evaluating evidence of benefit. The accepted model of evidence is usually a randomised double-blind study - the same model as used by pharmaceutical organisations. Although more research is always required to show the full extent of the benefits of aromatherapy, you can find peer reviewed research in the public domain on such sites as, The Lancet, BMJ (British Medical Journal), RCCM (Research Council for Complementary Medicine), Pubmed.gov and in journals such as the IFA’s Aromatherapy Times, which is registered with the British Library.
In assessing conflicting or inconsistent evidence, one should always consider the independence, size, and exact nature of any conflicting studies. Evidence as to efficacy, or otherwise, may develop over time, and is constantly ongoing and updating as new evidence emerges. If there is primarily evidence as to efficacy for example, but only minimal conflicting evidence, then it may be considered effective (see research page for more information).
The House of Lords select committee for Science and Technology stated in its report of 1999 – 2000, that there is little funding available for full-scale Randomised Controlled Trials (RCTs) in the complementary health sector, which unfortunately is still true today despite the growing popularity and use of CAM by the public. Due to the costs involved in undertaking research projects in the UK you may find that a lot of the robust research is conducted abroad supported by their individual country’s government, but is currently not available in the UK. In previous years the IFA has funded and conducted research projects in aromatherapy and endometriosis and a rheumatoid arthritis research trial at the Royal Masonic Hospital with positive results. In December 2018 the All-Party Parliamentary Group for Integrated Healthcare issued a report crying out for the inclusion of complementary therapies to help the struggling NHS (see report).
Public demand has also led to a large number of hospices, cancer wards, palliative care centres and mental health charities providing access to aromatherapy. Despite the lack of RCTs - case histories, clinical audits and patient reported outcome measures (PROMS) all support the benefits of aromatherapy especially with mental health, back pain, cancer and palliative care. Many people seek out aromatherapy when they are currently using or have been through mainstream healthcare services or is recommended by professionals when people are discharged from such services. The IFA register of qualified aromatherapists is referred to by organisations and charities such as the Alzheimer's Society, Cancer Research UK etc, as well as local NHS hospitals and hospices.
The National Institute for Clinical Excellence (NICE) which serves both the English NHS and the Welsh NHS also make recommendations about complementary healthcare. For example, the guidelines, which have recently been updated, recommend massage therapy in combination with other disciplines to address lower back pain, sciatica and palliative care. When aromatherapy is provided for example, on a palliative basis only, then clearly it is a complementary, rather than an ‘alternative’ approach in this case. Aromatherapy with or without the application of massage can be used in combination with other CAM disciplines and we encourage this approach.
The government has invested considerable funding into the development of National Occupational Standards (NOS) which are statements that describe the minimum performance criteria an individual needs to be able to do, know and understand in order to be safe and competent to practise. It includes identifying contra-indications and the scope and limitations of practice and when to refer to medical practitioners. The IFA professional Diploma courses, leading to a listing on our accredited register, have clear aims and learning outcomes which incorporate the National Occupational Standards (NOS), Qualifications and Credit Framework (QCF) and surpasses the aromatherapy Core Curriculum requirements.
The General Medical Council (GMC) has confirmed that doctors only refer patients to practitioners on accredited registers. Our role as an awarding body and professional body is to monitor the educational and professional standards required in aromatherapy and ensure the public have access to safe and competent practitioners through our accredited register. In addition we ensure our members are accountable to the public for their actions through our official Codes of Conduct, Ethics and Practice and disciplinary and complaints procedures. We investigate complaints about alleged breaches of our professional codes and impose disciplinary sanctions in keeping with regulatory healthcare guidelines. Importantly, in the work place, some government bodies, employers and clients will expect practitioners to be a member of a well-established complementary therapy governing body. The IFA is regarded by many such places as the organisation that can deliver dedicated and experienced professional practitioners.
Our training, qualifying standards and rules by which we regulate provide a framework for registrants. Our responsibility is to make boundaries clear for aromatherapists, and define the extent and limits of use of essential oils, massage, and other methods and mediums used to apply essential oils to allow the public to make informed decisions. For example, aromatherapists do not diagnose or prescribe essential oils or an aromatherapy treatment as a medical intervention or as medicine in the sense that a biomedical trained doctor, pharmacist, or herbalist would. They do not advise or prescribe the internal oral or rectal use of essential oils for medical conditions as aromatherapists are not trained to practice in this way or at this level (unless they have co-existing professional pharmaceutical medical qualifications and apply essential in the context of their existing practice - for which they will be bound by relevant protocols and covered by appropriate medical insurance). Aromatherapy is not practised as a medical model. Aromatherapists boundary of practice embraces support of wellness and wellbeing, therefore they cannot make medical claims about essential oils in this context.
Essential oils are used extensively across many boundaries of practice, from beauty therapy to pharmaceutical preparations and remedies, to inclusion in foods, and household products. Part of an aromatherapists training includes identification of contraindications - symptoms that may indicate deeper systemic issues, conditions or diseases that require medical referral. Aromatherapists must always advice clients and the general public of their boundaries and to seek medical advice and / or treatment if they are presented with symptoms which they are not professionally trained to treat, or remedy. Aromatherapists apply essential oils remedially within a wellness and wellbeing boundary; stress and conditions caused by stress can also fall into this category, including stress-related chronic conditions. Evidence that supports wellness and wellbeing (safety and efficacy model), can include qualitative, anecdotal, phenomenological evidence. Evidence that supports the use of essential oils as medicine / pharmacology remedies (safety and efficacy): biomedical model - requires more stringent evidence, RCT etc.
Members of the IFA can enjoy the IFA’s research library where we have filtered and categorised research for easy reference. The IFA actively disseminates and promotes research in aromatherapy and essential oils therapy and continuously updates and reviews its case studies and research guidelines so that our members submissions can be worthy of academic interest. In the members area we provide supportive notes to our students and practitioners so that they may understand the vocabulary used in research papers and how to measure and interpret results with the aim of developing their own research projects.