Our Clinical Practice: Buddhist Ayurvedic Counselling and Psychiatry (BACP; Galmangoda, 2015)

Mental health problems represent the largest single cause of disability and sickness absence in England and accounted for 70 million sick days in 2007. One in four adults experience at least one diagnosable mental health problem in any given year, mental health problems have been estimated to cost the UK economy around £105 billion a year, and people with mental illness die on average 15-20 years earlier than those without, often from avoidable causes.

Developing and implementing new and better interventions for mental health and wellbeing is a top priority. Mindfulness-based, compassion-focused and other Buddhist-derived interventions (BDIs) for mental health are increasingly adopted, and some individuals prefer mindfulness-based interventions that more closely resemble a traditional Buddhist approach.

Buddhist Āyurvedic Counselling and Psychiatry (BĀCP; Galmangoda, 2015)

Buddhist Āyurvedic Counselling and Psychiatry (BĀCP; Galmangoda, 2015) is a new subject in the area of Buddhist Studies, developed in Sri Lanka over the past decade, and its practice has been recognized and valued by the World Health Organisation (p.15, WHO, 2009; p.39, WHO, 2012).

Whilst BĀCP theory remains grounded in premodern Buddhist and Āyurvedic texts, Manasa Ayurveda is now introducing BĀCP in England as a newly developing intervention for mental health and wellbeing.

Theory & treatment methods

According to BĀCP theory, mental health problems are defined in terms of affected mental functions. In particular (but not exclusively) functions relating to intellectual discriminative function (buddhi) and the capacity for memory and mindfulness (smṛti).

Mental health problems have many causes and conditions including both physical and mental factors. The symptoms according to premodern Buddhist and Āyurvedic texts have some agreement with those recognized within the ICD-10/DSM-5.

In BĀCP, indicated treatment plans are established and interventions targeted through case formulation based on assessment which draws upon specific theoretical constructs (e.g. tridoṣa, triguṇa, triakuśalamūla, khandhas). Treatment methods in BĀCP include traditional Āyurvedic physical therapies, behaviour and situation change (e.g. through diet and lifestyle counselling), and methods for developing concentration and insight into reality (through a more personally tailored approach to mindfulness and meditation training).

Evidence-base

Although currently there appear to be no published Randomised Controlled Trials (RCTs) on BĀCP protocols, some small scale RCTs have been conducted (mostly in India) on Āyurvedic treatment methods for mental health (included within BĀCP).

To establish the evidence base, RCTs are required on specific treatment methods, but importantly also on BĀCP protocols. In addition, alongside service user feedback, in England consistent use of standard clinical outcome measures in routine clinical practice (e.g. the CORE-OM; Evans et al., 2000) will enable practice-based evidence to be gathered.

Process

Manasa Ayurveda has modelled a process for the delivery of BĀCP in England using a treatment protocol originally developed in collaboration with international experts in Sri Lanka. Current BĀCP clinical practice in England is based on this protocol and mental health service users in England (from a range of ethnic, cultural and religious backgrounds) have given positive feedback on their experience of BĀCP. Further protocol development by Manasa Ayurveda (based on clinical practice in England) continues.