Last in a series on integrative healing in the Twin Cities
Dr. Tim Culbert, director of Integrative Medicine at Children’s Hospitals, is a nationally recognized leader in integrative medicine and currently heads up the longest running pediatrics program in North America.
Early on in his training, Dr. Culbert had the opportunity to work with Dr. Karen Olness, a renowned pioneer who documented and implemented an approach to help children with chronic pain and illness through self-regulation techniques. Dr. Culbert learned about non-drug strategies like nutrition, biofeedback and hypnosis, and he proceeded to adapt and integrate these concepts into his own pediatric practice.
During a medical fellowship, he expanded his focus by learning more about integrative medicine and how to apply it to children. During this 18-month sabbatical, he visited experts like Dr. Andrew Weil and Dr. David Eisenberg, known leaders in the complementary medicine movement in the United States. At the time, no one was applying integrative medicine to the care of children.
“Children are not little adults,” Dr. Culbert says. “They have developmental differences, but more importantly, there are anatomic and biological concerns, so it is necessary to be more cautious. On the other hand, kids are open to mind-body therapies and there is very good research on hypnosis and biofeedback. Kids are great at learning these types of skills.”
The Integrative Medicine program at Children’s Hospitals in the Twin Cities began in 1999, and Dr. Culbert was recruited as its director in January 2000. Since then, the program has revolutionized how children are cared for in the Twin Cities.
“We have a really robust outpatient clinic and inpatient consultative service, as well research and education,” Dr. Culbert says. “It is also about changing the culture by going beyond the department, throughout the system. An example of this is the training of nurses in integrative therapies twice a year. They can apply these practices right at the bedside. It is very exciting to take the idea of integrative medicine, offer it throughout the hospital in our care of children and see great results.”
One example of ongoing research at Children’s Hospitals is a published study on aromatherapy that demonstrates the effectiveness of using peppermint to manage nausea among children with cancer. Dr. Culbert says it is exciting to offer alternatives that reduce the amount of medication given to sick children and give kids a self-care option that is safe and effective.
Dr. Culbert says family involvement is vital. “Some would say it is not the child who is the patient, but that the family is the patient. It is important to create a situation where the parents can be good coaches and help create balance.” A lecture series at The Marsh this summer focuses on whole family wellness by emphasizing stress management, nutrition, exercise, sleep and emotional regulation.
Beyond his creative vision of expanding integrative medicine across the Children’s Hospitals system and collaborating with partners locally on the topics of wellness, Dr. Culbert has focused on creating tools for children. He has published four books on holistic, non-drug, self-care tools for kids on the following topics: pain, stress, sleep, strength and exercise, and obesity. He has led a research project at the hospital in which an actual tool kit box – called the Cancer Comfort Kit – is provided to children. It contains essential oils, acupressure beads, pinwheels, bubbles and cards to teach the children how to develop the skills of breathing, meditation, relaxation, aromatherapy and acupressure to manage their cancer symptoms. The comfort kit also includes a book to help family members become better coaches.
“It really worked beautifully,” Dr. Culbert says. “We also did a kit for kids getting surgery. The vast majority – 87 percent – of families that used the kit said it was fabulous and that they would recommend it. The kids were better able to manage pain and anxiety.” He said the comfort kit is time efficient and cost effective, as it does not require a nurse, doctor or psychotherapist to consult with families on these issues. Children’s Hospitals has just launched a Cancer Comfort Kit research project in four hospitals across the country to expand documentation on how it can be an effective self-care strategy.
Dr. Culbert is sought after nationally to speak with other physicians and professionals on the use of complementary medicine strategies – integrative medicine – in caring for children.
“The vast majority of pediatric doctors have stated in surveys that they want to learn more about this and how to use it,” he says, “but there is nowhere to get trained. They want to know how to do in a safe, organized way.”
What are the greatest challenges for the expansion of integrative medicine? “There are not enough research trials,” Dr. Culbert says, “so doctors are less likely to try. On the other hand, there is plenty to suggest that many of these therapies are safe – like massage – but it is difficult to get reimbursement.” He says more research needs to be gathered to document the value of such therapies so greater insurance reimbursement is possible.
“Regardless of where the insurance industry and the professional people like myself are at,” he says, “consumers are using integrative medicine every single day. The point I always make is this: Even though the data is not perfect, consumers are already doing this stuff. Wake up. Be well educated about this and be better advocates for the kids and the parents. We need to learn more about it – whether we like it or not.”
Children’s Hospital is located in Minneapolis at 2525 Chicago Ave., and in St. Paul at 345 N. Smith Ave. For further information, call 612.813.6000 or 651.220.6000 or visit www.childrensintegrativemed.org.