The holistic nurse teaches the client self-assessment skills related to emotional status, nutritional needs, activity level, sleep–wake cycle, rest and relaxation, support systems, and spiritual needs. Nurses need to be aware that clients may self-prescribe herbs or medications for serious underlying physiologic or psychological conditions that have not been previously brought to the attention of a health care provider. If such a situation occurs, the nurse discusses with the client the importance of seeking appropriate medical attention to prevent potential medical complications, adverse reactions to self-prescribed herbs, or adverse herb–drug interactions.

After the client completes self-assessment, problems (diagnoses) are identified, and guidelines are provided to assist the client with problem-solving skills. The client and nurse discuss mutually agreed-on goals and outcomes. For example, suppose the client identifies the problem of overeating related to the inability to express anxiety. The client’s goal may be to develop positive coping skills when experiencing anxiety. Specific outcomes are developed with the client’s input and might include identifying events that contribute to anxiety, reporting which coping skills were used, and reporting fewer episodes of overeating. After the nurse and client agree on goals and outcomes, the client is encouraged to assume responsibility for making these changes. The nurse remains a support, coach, and assessor as the client actively participates in the intervention process. The nurse helps the client by reinforcing self-esteem, confidence, a sense of self-worth, and a positive outlook. Client self-evaluations and subjective comments are used to assess progress toward goals. It is important to remember that the client is a partner in all aspects of the holistic nursing process (Clark, 1999–2000).

Homeopathy, also called vitalism, is classified by the NCCAM as an alternative medical system that evolved independently of and prior to the conventional biomedical approach. (Other examples of alternative or whole medical systems include traditional Chinese medicine, Ayurvedic medicine, non-Western cultural medical traditions, and naturopathy.) Homeopathy is a specific healing therapy started in the late 1700s to early 1800s by Samuel Hahnemann, a German physician and chemist. He formulated the theory that the body possesses the power to heal itself. Therefore, a substance creating certain symptoms in a healthy person would cure an ill person exhibiting the same particular set of symptoms. For example, the symptoms of arsenic poisoning include abdominal discomfort, such as stomach cramping with burning pain, nausea, and vomiting. Arsenicum album is a homeopathic remedy used to treat people with symptoms of food poisoning, such as nausea, vomiting, and abdominal discomfort. The remedy “cancels out” the illness (O’Brien, 2002).

Aromatherapy, named by the French chemist Maurice René-Maurice Gattefosse in 1928, is classified as a biologically based practice. (Other examples of biologically based practices include herbal, special dietary, orthomolecular, and individual biological therapies.) Aromatherapy is the controlled, therapeutic use of essential oils for specific measurable outcomes. Essential oils are volatile, organic constituents of aromatic plant matter that trigger different nerve centers in the brain to produce specific neurochemicals (Mulligan, 2003).

Mind–body medicine includes techniques that assist in the mind’s ability to affect bodily functions and symptoms. Examples of these interventions include meditation, spiritual healing and prayer, and music therapy.

Mindfulness-based stress reduction (MBSR), a form of mind–body medicine, was introduced in 1979 by Jon Kabat-Zinn at the University of Massachusetts Medical School. Mindfulness is described as paying nonjudgmental purposeful attention in the present moment of time. Concentration is enhanced by focusing one’s attention on the physical sensations that accompany breathing. Clients are introduced to different forms of MBSR including breathing meditation, body scanning, walking meditation, and hatha yoga. MBSR has proven effective in the treatment of fibromyalgia, anxiety disorders, chronic pain, and recurrent depression. Approximately 240 academic medical centers, hospitals, university health services, and free-standing clinics use the MBSR model (Poss, 2005).

Manipulative and body-based practices include therapies that are applied to improve health and restore function. Examples include Tai Chi, massage therapy, chiropractic treatments, and yoga.

Energy medicine includes techniques that focus on energy fields originating in the body (biofields) or from other sources, such as electromagnetic fields. Biofield techniques are said to affect energy fields around the body. Examples include therapeutic touch, healing touch, and Reiki. Bioelectromagnetic-based techniques, which are a form of energy therapy, use electromagnetic fields to treat conditions such as asthma, migraine headaches, or other pain.