Atlas›Domain XII · Complementary, energy & biofield›Guide 174
Guide XII-174

Holistic nursing

1981United States
A 28 · L 63 · M 912 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the United States model published by the American Holistic Nurses Association (AHNA) with the American Nurses Association (ANA), Holistic Nursing: Scope and Standards of Practice (3rd ed., 2019; structure as set out in the 2nd ed., 2013), and certification as published by the American Holistic Nurses Credentialing Corporation (AHNCC) in 2026. The Canadian Holistic Nurses Association (CHNA) Holistic Nursing Standards of Practice (2020) is noted where it differs.

Holistic nursing is a nursing specialty carried out by licensed nurses. It is not a psychotherapy method. A psychotherapist does not practise it, sell it, prescribe it or recommend it. Sections 1–3 describe holistic nursing as its own organisations publish it. Section 4 is the psychotherapist's own work when a client receives care from a holistic nurse, or uses modalities a holistic nurse has offered.

What it is. Holistic nursing is a way of practising nursing rather than a set of therapies. AHNA describes the holistic nurse as taking a mind-body-spirit-emotion approach to traditional nursing [source: Kinchen 2014, quoting AHNA]. An early AHNA definition gives its goal as healing the whole person from birth to death [source: Frisch 2001]. AHNCC describes care of the whole person as an integrated being who cannot be separated from their environment. In this model the client is the expert on their own needs. The nurse acts as a therapeutic partner in a process aimed at healing and wholeness, and the client's culture, perceptions, values and beliefs are respected. AHNCC also says holistic nursing is "not setting dependent": it is defined by how the nurse thinks about and approaches people, not by which therapies the nurse uses [source: AHNCC certification page]. Frisch (2001) states that holistic nursing should not be defined by its use of "alternative" modalities. She calls it a way of thinking, reflecting, practising and being-in-the-world. The CHNA calls it a way of being that honours the mind-body-spirit-environment connection, with the nurse as an instrument of healing [source: CHNA 2020].

How change is said to happen. Healing is described as coming from the nurse–client relationship. The nurse supports, through presence and shared decision-making, the client's own recognition of patterns in life and health. Shared decision-making is framed as "a process of engagement versus compliance" [source: Kinchen 2014, quoting Mariano 2009]. Complementary modalities may be added when the client wants them or when they are indicated. Using such modalities is not, by itself, what makes care holistic [source: Kinchen 2014; Frisch 2001].

History and organisations.

  • AHNA was founded in 1981 [source: NSNA AHNA page; Kinchen 2014]. Its founding individual is [uncertain: not verified].
  • AHNA standards were first drafted in 1995, approved in 1999 and published in 2000 [source: Frisch 2001].
  • ANA recognised holistic nursing as a specialty in 2006 [source: Klebanoff & Hess 2013; Kinchen 2014].
  • ANA and AHNA have published joint Scope and Standards in three editions: 2007, 2013 and 2019. ANA now lists the 2019 edition as available "for historical reference" because it is more than five years old [source: ANA product page; ANA 2nd-ed. contents].
  • AHNCC was founded in 1997 [source: Klebanoff & Hess 2013]. The CHNA was founded in 1986 [source: CHNA 2020].

What a client experiences.

  • An assessment wider than usual nursing assessment: physical, emotional, social, spiritual and environmental, including the client's own health beliefs and values [source: Frisch 2001; ANA 2nd-ed. contents].
  • Goals set together with the client.
  • Nursing care that may include complementary modalities alongside conventional treatment. Sources list these examples: guided imagery, meditation, music, humour, focused breathing, biofeedback, prayer, massage, reflexology, aromatherapy, and the energy modalities Therapeutic Touch, Healing Touch and Reiki [source: Sparber 2001; NYSNA 2018; CHNA 2020; Frisch 2001].
  • Health teaching, coaching and care coordination, in hospitals, community services, private practice and other settings [source: AHNCC; ANA 2nd-ed. contents].
  • The energy modalities are described by their practitioners as working with a human energy field. NCCIH states that there is no scientific evidence that such a field exists [source: NCCIH Reiki]. For the individual touch and energy methods, see their own guides in this domain.

Who practises it. Registered nurses and advanced practice registered nurses. AHNCC offers four board certifications:

  • HN-BC (Holistic Nurse Board Certified)
  • HNB-BC (baccalaureate)
  • AHN-BC (advanced, graduate)
  • APHN-BC (advanced practice, which requires an APRN licence)

Eligibility includes:

  • a current, unrestricted US RN licence, or verified equivalency for international candidates
  • 2,000 hours or one year full-time of holistic nursing practice within five years
  • 48 continuing-education hours in holistic nursing within the three years before applying (this period changed from two years in March 2026)
  • graduation from an accredited nursing programme at the level the credential requires

An exam is based on AHNCC's Core Practice Competencies and on the Scope and Standards. Credentials may not be used once a licence is restricted or inactive [source: AHNCC certification page]. Nurses certified before AHNCC's current titles used "HNC" [source: Frisch 2001].

Regulation and licensing.

  • United States. A holistic nurse practises under their state Nurse Practice Act and is regulated by the state board of nursing. Specialty certification is voluntary.
    • In 2001, 25 of 53 boards permitted some complementary therapies by nurses and 21 had no formal position. Boards expected documented education and competence, and restricted titles such as "nurse massage therapist" to those certified in that modality [source: Sparber 2001]. Board positions have changed since then. Check the board of the state concerned.
    • Example: the Minnesota Board of Nursing statement (adopted 2003, reaffirmed 2017) requires patient safety first, current competence, a recognised body of nursing knowledge, informed consent, recording of integrative-therapy use and outcomes, inclusion in the care plan, agency policy, and collaboration. Therapies that need their own licence, such as acupuncture, must meet that licence's rules [source: Minnesota BON statement].
    • The New York State Nurses Association position (2007, revised 2018) treats complementary therapies as adjuncts to conventional regimens. Nurses must stay within RN scope and fully disclose pros and cons [source: NYSNA 2018].
  • Canada. The CHNA standards add to provincial and territorial RN standards and do not replace them. The nurse remains accountable to their provincial regulator and to the CNA Code of Ethics [source: CHNA 2020].
  • United Kingdom, Australia and elsewhere. Whether a holistic-nursing specialty credential comparable to AHNCC exists is [uncertain: not verified]. Nurses remain under their national nursing regulator.

Regulatory status (one line): holistic nursing is licensed nursing practice. ANA recognises it as a specialty (US, 2006). Certification is voluntary, through AHNCC. Individual complementary therapies fall under each state board's scope rulings.

Evidence status (one line): holistic nursing is a practice framework, not a single treatment, so evidence depends on the component modality. For energy modalities such as Reiki, NCCIH states it has not been clearly shown to be effective for any health-related purpose [source: NCCIH Reiki].

2. Framework

There is no set course of sessions. Holistic nursing follows the nursing process, renamed the "holistic caring process". It applies in any setting, for whatever length the nursing episode lasts [source: Frisch 2001; AHNCC]. In the AHNA/ANA standards the phases are as follows [source: ANA 2nd-ed. contents, 2013]:

  1. Assessment (Standard 1): whole-person data collection, including the client's health beliefs, values, patterns, spirituality and environment.
  2. Diagnosis (Standard 2): naming patterns, problems and needs. Frisch (2001) describes this as client patterns, problems and needs addressed in an atmosphere of caring.
  3. Outcomes identification (Standard 3): goals for healing that nurse and client decide together.
  4. Planning (Standard 4): a care plan, which may include complementary modalities alongside conventional care. The Minnesota board requires these to be consistent with the overall treatment plan.
  5. Implementation (Standard 5): has four parts:
    • 5A Coordination of care
    • 5B Health teaching and health promotion
    • 5C Consultation
    • 5D Prescriptive authority and treatment, for advanced practice nurses within their licence
  6. Evaluation (Standard 6): reviewing outcomes with the client.

Standards of professional performance (7–16 in the 2nd ed.) cover ethics, education, evidence-based practice and research, quality, communication, leadership, collaboration, professional practice evaluation, resource utilisation and environmental health. The 3rd edition has 17 standards in total [source: ANA product page]. Their names were [uncertain: not verified].

Moving between phases: as in the nursing process. Evaluation feeds back into reassessment. Published criteria for moving between phases: [uncertain: not verified].

The psychotherapist's parallel process [synthesis]:

  • Hear about the holistic-nursing care.
  • Explore what it means to the client.
  • Clarify roles with the nurse and the doctor (with consent).
  • Watch for risk.
  • Review at natural points: a new modality, a change in medical treatment, or a change in the client's health.

This runs inside ordinary psychotherapy sessions and does not add sessions of its own.

3. Guiding principles

As holistic nursing organisations publish them

AHNA/ANA core values, 2nd ed. [source: ANA 2nd-ed. contents; Klebanoff & Hess 2013]:

  • Holistic philosophy, theories and ethics: care rests on a stated whole-person philosophy and on nursing ethics.
  • Holistic caring process: the nursing process widened to the whole person.
  • Holistic communication, therapeutic healing environment and cultural diversity: the environment and the client's culture are part of care.
  • Holistic education and research: practice is informed by education and evidence.
  • Holistic nurse self-reflection and self-care: the nurse's own wellbeing and reflection are a professional duty.

Other principles:

  • Client as expert and decision-maker. The nurse partners with the client and respects their choices. The CHNA calls the nurse an "option-giver" [source: AHNCC; CHNA 2020].
  • Engagement, not compliance. Decisions are shared [source: Kinchen 2014].
  • Presence and intention. The nurse is consciously focused on the client [source: Kinchen 2014].
  • Modalities are not the definition. A complementary modality is added when the client wants it or it is indicated [source: Frisch 2001; Kinchen 2014].
  • Complementary, not instead. Therapies are adjuncts to conventional care [source: NYSNA 2018; CHNA 2020].
  • Within licence and competence. The nurse uses only modalities in which they have current competence and that their board allows. Therapies that need a separate licence follow that licence's rules [source: Minnesota BON; Sparber 2001].
  • Informed consent and documentation. The client is told what a therapy is, its risks, contraindications, purpose, expected benefit, duration and cost. Its use and its effect are recorded [source: Minnesota BON].

The psychotherapist's own stance alongside

  • Curious, not judgemental. The client's use of holistic nursing is information about their values. It is not, in itself, a problem [synthesis].
  • Not the decider about the modality. You do not perform, sell, prescribe or recommend the modality. Questions about whether a therapy is safe or effective for a body go to the nurse, the doctor or the pharmacist [synthesis; APA 2.01 Boundaries of Competence].
  • Collaborate with consent. Cooperate with other professionals when appropriate. Share information only with consent or where the law requires it [source: APA 3.09, 4.05].
  • Avoid conflicts of interest. Take no referral fees, and do not have a business link with a client's practitioner [source: APA 3.06, 6.07].
  • Avoid harm. Act when the client is delaying medical care or is at risk, without coercing them [source: APA 3.04; synthesis for application].
  • Attribute claims about energy. Describe energy and spiritual concepts as the method holds them. Do not state them as fact and do not dismiss them [synthesis].

4. Intervention inventory

These are the psychotherapist's tasks when a client receives holistic-nursing care. You do not deliver holistic nursing or any of its modalities, unless you separately hold the licence and training that a modality requires. Even then, you keep that role separate from the psychotherapy. All example language is illustrative.

4.1 Asking routinely and without judgement, and recording

  • Purpose: to learn which complementary care the client receives, from whom, and why. Clients often leave this out unless asked. Holistic-nursing standards already expect nurses to ask about and record integrative-therapy use [source: Minnesota BON]. The psychotherapist does the same from their own side [synthesis].
  • When: at intake, at reviews, and when health, medicines or care providers change.
  • Steps:
    1. Make it routine: ask every client about practitioners and practices they use for health and wellbeing, as part of the health history.
    2. Use open, neutral wording. Name a few examples so the client sees the question is ordinary.
    3. If the client sees a holistic nurse, note:
      • their credential (RN or APRN; HN-BC or another AHNCC credential, if any)
      • their setting (hospital, clinic, private practice)
      • the modalities used (for example imagery, relaxation, touch or energy work, aromatherapy, coaching)
      • how often
      • whether the client's doctor knows
    4. Record facts and the client's own words, without evaluative comment.
    5. Return to it at reviews.
  • Example language (illustrative):
    • "Many people use other kinds of care alongside their medical treatment — a holistic nurse, massage, meditation, energy work, supplements. What do you use at the moment?"
    • "What does your nurse do in a typical visit?"
  • Watch for: a guarded or apologetic answer, which suggests the client expects disapproval. Notice anything the client keeps from their doctor. It is working when the client brings up changes without being asked.

4.2 Exploring meaning, hopes, expectations and the explanatory model

  • Purpose: to understand what the holistic-nursing relationship gives the client. Holistic nursing emphasises presence, being heard and whole-person attention [source: Kinchen 2014; Frisch 2001]. For some clients that relationship matters more than any particular modality [synthesis].
  • Steps [synthesis]:
    1. Ask what draws them: feeling cared for as a whole person, time and attention, control over their health, a spiritual framework, distrust of or hurt by medical care, identity, or community.
    2. Ask how they understand their illness or distress: physical, emotional, spiritual, energetic, environmental.
    3. Ask what they hope will change, and how they will know whether it has.
    4. Separate comfort and wellbeing hopes from hopes for curing a disease. Note which is which.
    5. Reflect back without endorsing or disputing energy or spiritual concepts. Attribute them, for example "in the way your nurse explains it…".
    6. Link what you learn to the psychotherapy goals, for example meaning-making, coping with illness, or grief.
  • Example language (illustrative):
    • "What does it give you, seeing her, that you don't get elsewhere?"
    • "When she does the energy work, what is that like for you, and what do you understand it to be doing?"
    • "If this goes the way you hope, what will be different in three months?"
  • Watch for:
    • expectations of cure for a physical disease
    • hopes that are not being reviewed against what actually happens
    • a client who idealises the nurse while devaluing the medical team
    • signs that the client gets presence and attunement only from the nurse, which may point to unmet relational needs. This can be explored in therapy [synthesis].

4.3 Supporting informed, values-based decisions without coercion

  • Purpose: to help the client make their own decisions about complementary care with full information, consistent with their values, and without pressure from you, the nurse or others.
  • Steps:
    1. Ask whether the client has been told the elements nursing boards expect in consent for an integrative therapy [source: Minnesota BON]:
      • what the therapy is
      • its risks and side effects
      • contraindications
      • its purpose and expected benefit
      • how long it lasts
      • what it costs
    2. Encourage them to ask the nurse about anything missing. Questions about bodily safety or effectiveness go to the nurse, the doctor or the pharmacist, not to you [synthesis].
    3. Help them name their values (comfort, autonomy, avoiding side effects, staying with conventional treatment, spiritual meaning). Lay out the options they are weighing, including combining options and doing nothing new [synthesis].
    4. Check that complementary care is being added to conventional care and is not replacing it. Holistic-nursing bodies themselves describe these therapies as adjuncts [source: NYSNA 2018; CHNA 2020].
    5. Respect the decision. Record the discussion. A published decision aid specific to holistic nursing: [uncertain: not verified].
  • Example language (illustrative):
    • "Has anyone gone through what this involves, what it costs, and anything you shouldn't combine it with?"
    • "Which of your values does this choice serve best?"
    • "I'm not the person to say whether it's right for your body — that's a question for your nurse and doctor — but I can help you think through what matters to you."
  • Watch for:
    • urgency
    • all-or-nothing framing ("natural" versus "toxic")
    • decisions made to please someone
    • a client who wants you to decide for them

4.4 Coordinating with the holistic nurse, the doctor and the pharmacist, with consent

  • Purpose: to keep care joined up and safe, and roles clear. Holistic-nursing standards include coordination of care and collaboration [source: ANA 2nd-ed. contents, Standards 5A and 13]. The APA Code supports cooperation with other professionals [source: APA 3.09].
  • Steps:
    1. Get specific written consent. Agree with the client what will be shared and with whom [source: APA 4.05].
    2. Contact the holistic nurse. Introduce your role, ask what care is being given and what the goals are, and agree how you will communicate.
    3. Prompt the client to tell their doctor about all complementary care. NCCIH advises discussing treatment decisions with one's health care provider [source: NCCIH Reiki].
    4. For any substance used, such as aromatherapy products or supplements, direct questions about interactions to the pharmacist or prescriber. Do not comment on medicines yourself [synthesis].
    5. Document the contacts and what was agreed.
  • Example language (illustrative):
    • To the client: "Would it help if your nurse and I were in touch, so we're not pulling in different directions? Let's decide together what I'd share."
    • To the nurse: "I'm seeing [client] for psychotherapy. With their consent I wanted to introduce myself and understand how your care fits with what we're working on."
  • Watch for: the client refusing any coordination. Explore this rather than overriding it, unless there is risk. Watch also for inconsistent messages between providers.

4.5 Clarifying overlapping roles

  • Purpose: holistic nurses may offer guided imagery, meditation, relaxation, health coaching or supportive counselling [source: Sparber 2001; NYSNA 2018; Klebanoff & Hess 2013]. These overlap with psychotherapy. Clear roles prevent duplication, mixed messages and splitting [synthesis].
  • Steps [synthesis]:
    1. Map who does what. For example, the nurse provides relaxation and imagery within nursing care, and you provide trauma processing and psychological treatment.
    2. If the client is doing emotional or trauma work with the nurse, discuss pacing and safety with the client and, with consent, with the nurse.
    3. Agree how the client will bring up material that arises in nursing sessions.
    4. Review the arrangement at intervals.
  • Example language (illustrative): "It sounds like some big feelings came up during the imagery with your nurse. Would you like to bring those here, so she can stay focused on the relaxation side?"
  • Watch for:
    • a client describing the nurse as their "real therapist"
    • comparisons used to avoid difficult work in therapy
    • feelings of rivalry in yourself (monitor your countertransference)

4.6 Talking about touch and energy modalities: consent, trauma and boundaries

  • Purpose: holistic nurses may use touch or hands-near-the-body modalities: massage, reflexology, Therapeutic Touch, Healing Touch and Reiki [source: Sparber 2001; NYSNA 2018]. For clients with trauma histories, being touched, or lying still with eyes closed, can trigger reactions. The psychotherapist helps the client know and use their rights [synthesis].
  • Steps [synthesis]:
    1. Ask whether the care involves touch, and where on the body.
    2. Ask whether the client was asked for consent before touch began and during it, and whether they know they can stop at any time.
    3. Ask whether a hands-off option was offered. Practitioners describe these methods as working on or just above the body [source: NCCIH Reiki].
    4. Explore past experiences of touch and any reactions during sessions: freezing, dissociation, intrusive memories.
    5. Rehearse ways the client can say no, pause, or ask for hands-off or clothed-only work.
    6. Make clear that touch in a care relationship is never sexual and never involves intimate areas outside clearly explained, clinically indicated nursing care.
  • Example language (illustrative):
    • "When she places her hands, do you feel free to say 'stop' or 'not there'?"
    • "What happens in your body when you're lying still with your eyes closed?"
  • Watch for:
    • dissociation during or after sessions
    • a client who does not feel able to refuse
    • secrecy
    • gifts, or meetings outside the care setting
    • any sexualised comment or touch, which is a boundary violation to address at once (see 4.11)

4.7 Checking credentials and scope

  • Purpose: to help the client confirm that the person calling themselves a holistic nurse holds a nursing licence, and that what they offer is within it [synthesis].
  • Steps:
    1. Explain that "holistic nurse" describes a licensed nurse practising in this way. The nursing licence can be checked with the state or provincial nursing regulator [source: AHNCC; CHNA 2020].
    2. Board certification is voluntary. AHNCC states that only certified nurses may use its credentials, and not while their licence is restricted or inactive [source: AHNCC].
    3. Some therapies need their own licence (for example acupuncture), and some boards restrict titles [source: Minnesota BON; Sparber 2001].
    4. Note possible scope concerns:
      • advising the client to stop prescribed medicines
      • claiming to cure a disease
      • diagnosing outside nursing scope
      • selling products
    5. Encourage the client to raise these with the nurse or the board. Do not investigate yourself [synthesis].
  • Example language (illustrative): "It's usual to check that a practitioner is licensed. Would you like to look up the board register together?"
  • Watch for: someone using "holistic nurse" without a nursing licence. Watch also for practitioners selling supplements or devices to the client [synthesis].

4.8 Recognising and responding to risk

  • Purpose: to notice when complementary care, or the beliefs around it, starts to cause harm [synthesis unless cited].
  • Risk signals and responses:
    • Stopping or delaying medical care or medicines.
      • Ask directly and without blame.
      • Explore the reasons: fear, side effects, beliefs.
      • Encourage an urgent conversation with the prescriber.
      • With consent, contact the doctor. Without consent, act only where there is serious, imminent risk and the law permits [source: APA 4.05].
      • Holistic-nursing bodies place these therapies alongside conventional care, not instead of it [source: NYSNA 2018].
    • Children. A parent may be relying on complementary care in place of the child's medical care, or the child may be given products that could harm them. Follow your safeguarding procedures and consult early. Children's assent and parents' consent both matter.
    • Pregnancy. Prompt the client to check every product and procedure with their midwife or obstetrician.
    • Eating disorders. Watch for nutrition or "cleansing" advice that the client uses restrictively. Screen and refer according to standard eating-disorder practice.
    • Financial exploitation. Watch for:
      • escalating packages
      • prepaid courses
      • multi-level-marketing products
      • pressure to recruit others
    • Group pressure. Watch for a practice community that discourages medical care or outside relationships.
    • Boundary violations by the practitioner. Watch for sexual contact, dual relationships, or secrecy (see 4.6 and 4.11).
    • Suicide and self-harm. Use standard risk assessment, whatever framework the client uses to explain their distress.
  • Example language (illustrative): "You mentioned you've stopped your tablets since starting the sessions. Can we talk about how that decision came about, and whether your doctor knows?"
  • Watch for:
    • deterioration in physical or mental health
    • secrecy
    • money worries
    • isolation

4.9 Health anxiety and somatic symptom presentations

  • Purpose: some clients seek whole-person and energy-based care because of persistent health worry or bodily symptoms that medicine has not explained. Others may have idiopathic environmental intolerance.
  • Steps [synthesis]:
    1. Assess using established approaches for health anxiety and somatic symptom presentations; see Domain II.
    2. Explore whether repeated sessions, checking or reassurance-seeking with any practitioner keep the worry going.
    3. Work collaboratively on the client's own goals, without disputing their explanatory model.
    4. Coordinate with the doctor so that investigations are neither repeated without need nor missed.
  • Example language (illustrative): "I notice that after each session you feel better for a day or two, then the worry comes back stronger. Shall we look at that pattern together?"
  • Watch for:
    • rising frequency of visits
    • new "sensitivities"
    • narrowing of daily life

4.10 Serious illness and psycho-oncology contexts

  • Purpose: holistic nurses often work in hospital, cancer and palliative settings [source: AHNCC; ANA 2nd-ed. contents]. Clients may experience holistic care as comfort and dignity. Some may hope it will treat the disease itself. No holistic modality is presented here as treating cancer or any physical disease.
  • Steps [synthesis]:
    1. Support use of complementary care for comfort and quality of life alongside oncology care. See Integrative oncology (172).
    2. If the client considers alternatives instead of treatment:
      • hold a respectful conversation about values, fears and information
      • with consent, involve the oncology team
      • consider a palliative-care referral where appropriate
    3. Work with family conflict about the choices being made.
    4. Later, work with grief and regret.
  • Example language (illustrative): "What would it mean to you to use these sessions for comfort while also continuing with the treatment your team has offered?"
  • Watch for:
    • missed oncology appointments
    • family splits
    • guilt
    • regret

4.11 Reporting routes

  • Purpose: to know where concerns go.
  • Routes:
    • Nurse conduct or scope (US): the state board of nursing, which defines and enforces scope [source: Sparber 2001; Minnesota BON]. Use of a certification credential: AHNCC [source: AHNCC].
    • Canada: the provincial or territorial nursing regulator [source: CHNA 2020].
    • Other countries: the national nursing regulator [uncertain: not verified].
    • Products, devices and advertising: the national medicines or device regulator and the advertising or consumer regulator [uncertain: not verified].
    • Children and vulnerable adults: local safeguarding or child-protection services.
    • Your own duties: follow your profession's confidentiality rules. Disclose without consent only as the law requires or permits [source: APA 4.05].
  • Steps:
    1. Support the client to make the complaint themselves wherever possible.
    2. Consult a supervisor or your professional body.
    3. Document your reasoning.
  • Example language (illustrative): "What happened isn't acceptable in any care relationship. You can report it to the nursing board. Would you like help with that?"
  • Watch for: fear of retaliation, and loyalty to the practitioner. Go at the client's pace unless there is a safeguarding duty.

4.12 Managing your own role, competence and conflicts of interest

  • Purpose: to stay inside your scope [source: APA 2.01, 3.05, 3.06, 6.07].
  • Steps:
    1. Do not recommend, sell, perform or refer to a specific holistic practitioner in exchange for any benefit.
    2. Do not offer touch or energy modalities within psychotherapy unless you are trained and licensed for them and your board permits it. Even then, discuss role separation in supervision [synthesis].
    3. Declare any personal or business link with the client's practitioner.
    4. Keep your own views about energy concepts out of the client's decisions [synthesis].
  • Example language (illustrative): "I don't recommend particular practitioners, but I'm glad to help you think through how to choose."
  • Watch for:
    • pressure from the client to endorse or condemn the practitioner
    • your own enthusiasm or scepticism steering the client

5. Handling problems

The holistic-nursing sources do not discuss psychotherapists working alongside holistic nurses. All guidance in this section is [synthesis] unless a source is cited.

  • The client won't talk about it (expects judgement).
    • Normalise the question. Say plainly that you will not tell them to stop.
    • Show interest in what the care gives them.
    • Come back to the topic later rather than pressing.
  • The client wants you to endorse or condemn the nurse or the modality.
    • Explain that questions about bodily effect belong with the nurse and the doctor.
    • Your part is helping them think through what matters to them (4.3).
    • Avoid debates about energy concepts. Describe them in the client's or the method's own terms.
  • Splitting between providers. The nurse is "the only one who listens" and the doctor or therapist "doesn't get it".
    • Validate the experience of being heard.
    • Explore what is missing in the other relationships, including your own.
    • With consent, align messages through coordination (4.4).
  • Rupture after you raise a risk. For example, the client feels you are against their choices after you ask about stopped medicines.
    • Name the rupture. Acknowledge that the question landed as criticism.
    • Restate that you respect their autonomy, and why you asked.
    • Repair before going on.
  • Overwhelm or dissociation after touch, imagery or energy sessions.
    • Stabilise and ground the client in session.
    • Work out what triggered it.
    • Help the client ask the nurse for changes: hands-off work, eyes open, shorter or paused work, or stopping altogether.
    • With consent, share relevant trauma-safety information with the nurse (4.5, 4.6).
  • Non-adherence to medical treatment framed as "listening to my body".
    • Explore the reasons: fear, side effects, cost, meaning.
    • Support a conversation with the prescriber.
    • Do not advise on the medicine yourself.
    • Escalate if risk is serious (4.8).
  • Stuck in a cycle of repeated sessions for persistent symptoms. Treat this as possible health anxiety or a somatic symptom pattern, using Domain II approaches (4.9).
  • Escalating spending or recruitment pressure.
    • Look at the finances openly.
    • Explore the social pull of the practitioner's community.
    • Watch for high-control group features.
    • Support the client's own decisions about whether to continue.
  • A boundary or sexual violation is disclosed.
    • Believe and support the client.
    • Attend to their safety.
    • Explain the reporting routes (4.11).
    • Consult supervision.
    • Meet any mandatory reporting duty that applies.
  • The nurse refuses or ignores contact.
    • Respect this.
    • Keep coordinating through the client and the doctor.
    • Document your attempts.
  • Conflict between your theoretical model and the client's holistic or spiritual framework.
    • Seek supervision.
    • Consider whether a culturally or spiritually informed consultation would help.
    • Do not impose your worldview.
  • Children or dependent adults are involved.
    • Safeguarding concerns override the wish to keep the alliance comfortable.
    • Explain your duties early in therapy so that later action does not come as a betrayal.

Sources

Web sources:

Books (cited from the publisher's description and table of contents):

  • American Nurses Association & American Holistic Nurses Association (2013). Holistic Nursing: Scope and Standards of Practice (2nd ed.).
  • American Nurses Association & American Holistic Nurses Association (2019). Holistic Nursing: Scope and Standards of Practice (3rd ed.).
  • Detailed content of the 3rd edition and of the AHNCC Core Practice Competencies [uncertain: not verified].
← Previous · XII-173Lifestyle medicineNext · XII-176 →Iridology