In order to contribute to the scientific understanding of the psychotherapeutic applications of aroma, touch, sound, and other sensory processes, the Psychosensory Aromatherapy Research Project (PARP) was developed as a long-term collaborative program. Research began in 1997, as a partnership between the Atlantic Institute of Aromatherapy and the University of South Florida. Since we are in the early stages at this point, this paper describes the preliminary findings.

ABSTRACT:

Psychotherapy and aromatherapy can be regarded as complementary procedures in the psychological treatment of children with behavior and emotional disorders. We will present initial research findings about the application of safe (non-toxic, non-irritant) blends of essential oils in contributing to the effectiveness of treatment for children with disorders such as autism, attention deficit disorder and sensory defensiveness.

Examples of research will include the effect of children's preferred personal blends of essential oils, both with aroma and application to the skin, in the development of new skills such as relaxation, interpersonal communication, and concentration. In addition, the role of parents as participants in therapy and the use of essential oil blends in enhancing widespread effects of treatment will be presented. In this paper we present preliminary data and impressions so far from our project. This is our second status report.

INTRODUCTIONS:

Trevor Stokes, Ph.D., is a licensed Psychologist who is Professor and Director of the Psychosocial Health Complications Program at the University of South Florida, in Tampa Florida USA. Professor Stokes is an internationally recognized scholar and clinical researcher in behavior analysis and therapy. His research over the past 25 years has related to the treatment of behavior and emotional disorders of childhood. He is a native of Perth, West Australia.

Sylla Sheppard-Hanger, NHCP, LMT has twenty years experience with essential oils as a Natural Health Care Practitioner and licensed Massage Therapist. She is the Founder and Director of the Atlantic Institute of Aromatherapy (Tampa, Florida) and author of The Aromatherapy Practitioner Correspondence Course, and of the Aromatherapy Practitioner Reference Manual (1995). Besides her research, Sylla teaches classes, consults for private label aromatherapy companies and maintains a private Aromatherapy practice (as a licensed massage therapist and cosmetologist) in Tampa, Florida.

BACKGROUND:

This research project was conceived several years ago and officially began in January 1997. Because of the longstanding relationship between the two researchers, many discussions lead to the actual formalized studies. For Sylla, it began when she noticed that one of her child clients, diagnosed as slightly autistic, was obsessed with smells. Of course, he was fascinated with the essential oils and also aromatic plants in the office garden. After consultation with Trevor, also a client, we tried a blend on his client, another autistic child and received a favorable response! We realized there could be a direct relationship between smelling and behavioral modification. This led to the formalized study.

As a Professor and Clinical Psychology researcher and practitioner in the academic world, Trevor became curious about the effectiveness of aromatherapy massage. Sylla provided the opportunity to consider these issues from the perspective of being a client. His sometimes intense and stressful professional life included cases of suicide, abuse, aggression, and all kinds of nastiness, despair, and unhappiness. In his own words, "It was valuable to learn how to relax my body and to allow myself to let the pressures of my daily schedule be put aside while someone else helped me to relax. In fact, I truly learned what relaxation meant. Prior to this experience with aromatherapy massage, I understood and taught relaxation during psychotherapy, but not to the extent that I understand it now. I also found myself thinking of the associations related to the aromas present during my massage. One was that of hot dry summers in Perth (sandalwood) and another that of the Australian bush (eucalyptus). These were pleasant, nostalgic, and relaxing associations. I came to appreciate the power of good aromatherapy. I was impressed and curious as a scientist-practitioner in psychology."

Sylla, observed that one of her child clients, diagnosed as autistic, was acutely interested in smell. He was fascinated with the essential oils and also the aromatic plants in her office garden. She begain to discuss these observations with Trevor. These observations and many converstations lead to the actual formalized studies. After consulation with Trevor, they tried a blend on his client, another child with autism, and received a favorable response suggesting possible therapeutic applications. Trevor noted, " . . . When Sylla started to discuss science and practice issues with me, my interest increased. Eventually, after I had been informed by Sylla's competency and interest in expanding the knowledge base of aromatherapy and psychology, we collaborated on the development of a research protocol for review by my university, the University of South Florida, a major state research university with 35,000 students."

After USF approved the research for human participants, we proceeded and developed the Psychosensory Aromatherapy Research Project, (PARP), one component of Trevor's USF Psychosocial Health Complications Program and Sylla's Atlantic Institute of Aromatherapy.

We began to examine the effectiveness of aroma and the application of sage blends of essential oils in psychotherapy with children who have behavioral and emotional disorders. Our intitial questions included: Can we determine whether the child has a preference for a particular essential oil blend? Does this choice remain constant over time? Can we teach others to assess this preference? Our consent forms noted that this is a "Voluntary participation" and it "may not be effective . . . nevertheless, the participants may enjoy participating."

PREFERENCE ASSESSMENTS:

We developed a protocol to determine a preferred essential oil blend for the person, using paired comparisons, presented randomly. We then blended the choices and used it in our interventions with them to assess their effect on behavior.

Following the premise of aromatherapy that the "perfume becomes the medicine," the attraction to certain essential oils because of their fragrance indicates that they may be therapeutic for that individual as well. Both parent and child were assessed to determine choices. In some cases, the children could not speak at all and the mother's confirmation of an affirmative answer was necessary. Starting with 20 oils and by a formal process of initial deletions and randomized paired comparisons, selections were narrowed down systematically to the 3 most preferred oils.

Scientific proof requires that results must be repeatable by different individuals. So we wanted to see if an inexperienced person could introduce, affirm, and blend the essential oil choices into a pleasing overall aroma. To assess this, Trevor did all the oil presentations, under Sylla's suprevision. Trevor was able to do this without any prior training, indicating that an inexperienced person could carry out the task.

MATERIALS AND METHODS:¹

We developed an initial kit of sixteen oils, to which we later added several more, ending with twenty total oils. The particular oils were chosen with the exception of rose and jasmine, for their availability to the non-aromatherapists. We chose oils based on their variety (e.g., woods, spices, herbals, flowers) and also those that represented the ranges of top, middle, and base notes in fragrance. We tried to stay away from heavily medicinal smelling oils and those with rare chemotypes. We also kept in mind safety factors and used only oils that had been formally tested for safety, toxicity and skin reactions, since we would be using them on the skin as well as inhalation.

Originally rose and jasmine were diluted to 20%, but we reverted to full strength to keep all oils the same aroma strength. Oils were numbered and placed in 5-ml bottles with inserts to prevent spillage. Other materials included small disposable pipettes that fit into the bottle insert and a separate bottle of alcohol to clean pipettes in field use. Sample bottles (2-ml perfume sampler vials) were used to make blends and those used for "sniffer" blends contained a cotton blotter.

PROCEDURES:

By process of elimination, using a rating scale of 1 to 3, 20 original essential oils were narrowed down to between 8 and 12 in the first round. Oils were then presented, two at a time, in the form of a paired comparison or forced choice. Random pairing was accomplished by computer-generated number pairing. Eventually these were narrowed down to five choices, which were compared to each other to determine the final three, from which the blend was made. Participants inhaled directly from the bottle, which was held under the nose for up to three seconds. This presentation style saved time and helped prevent adaptation and burnout during assessment.

ASSESSMENT OUTCOMES:

Outcome choices are presented below. During the assessment period of one week to two months, we removed obviously disliked oils and substituted others. The original samples remained the same with the exception of one. Our lemon sample had become contaminated by peppermint due to an accident so we obtained a fresh sample and bottle.

Similarities between mother and child were noted. In most rounds, both mother and child chose at least one of the same oils, which is consistent with aromatherapy theories that close relationships often are attracted to similar or complementary oils.

Another question we asked was concerning the stability of choices. Do they remain over time? In most cases the oils chosen between the first and second assessment were consistent. Due to our adding several more choices, the second round changes often included some of the oils that were added.

DISCUSSION:

One purpose of the research was to explore effective strategies in psychotherapy that included the use of aroma. The development of collaborative actions required flexibility and communication between our two areas, psychotherapy and aromatherapy. We tried to approach these case studies without preconceived notions of procedures or outcomes, allowing us to quickly adjust the assessment and treatment procedures according to what we learned from the project participants.

Therapeutic activities were based on psychological principles found within the fields of clinical psychology, learning, motivation, and behavior analysis. The first principle relates to psychological motivation for learning - aroma motivation. As applied to this research, there is an emphasis on the sensory consequences of a person's behavior and emotions, specifically as they result in pleasure or painful experience for the person. That is, is the behavior or emotion followed consistently with effects that cause pleasure or pain? Does the access to the aroma make the person feel good? If a person makes an effort toward improvement, does the pleasure of the presented aroma reinforce that improvement? Technically, this is called reinforcing function.

The principle relates to the therapeutic experience itself - aroma memory. This involves associations, which have developed prior to therapy or are developed during therapy. Aroma memory may help a person feel relaxed, sad, excited, or a host of other emotions because of the meaning they have for a person. Technically, this is called a discriminative function.

CLINICAL EXAMPLES:

The general goal was to contribute to the quality of life of the children and families involved. The procedures discussed were part of a general therapy program, which included other interventions not relevant here.

This presentation is based on preliminary results and impressions using data collected by direct observation and participant records. As these are initial case studies, no claims are made as to the experimental control of the effects or to the general application of these outcomes to other cases. Obviously, replication will be necessary before definitive conclusions can be drawn in a manner consistent with scientific standards regarding probability and experimental control.

CONCLUSION:

Acknowledging these to be preliminary findings, we, nevertheless, feel that the research is quite successful. Overall, we had very good consistent results, and the promise of more concrete findings is quite exciting. In spite of the difficulty of a right-brained therapists submitting to the rigors of working with a scientist, our collaboration shows this is entirely possible and preferable to get the results appreciated. Obviously, it is necessary for the aromatherapist to associate with a highly qualified psychotherapist, but these preliminary findings for both of our fields, aromatherapy and psychology, is quite promising indeed.

Working within the scientific field to produce and evaluate results is the only way aromatherapy can be incorporated into mainstream psychotherapy and anyone so interested should not hesitate to use his or her skills to do so. We discovered that, despite the discomfort of learning to work together from different perspectives, we could produce valuable results. Our relationship as friends, as well as our therapist-client relationship, and our mutual respect for each other's individual competencies definitely enhanced our work. So much remains to be done to aid those afflicted with autism and behavioral disorders. The use of aroma is definitely a more pleasant route toward this therapeutic goal. Let us not forget that what each of us can offer as a seemingly small step in this field can be monumental in adding to the overall knowledge that can ultimately affect the well being of the entire universe.

¹ The oils and paper smell strips were donated by the Lebermuth Company, South Bend, Indiana (USA). Diffusors were used for the sleep disorder studies and were graciously donated by The Aromatherapist, Aliso Viejo, (USA). The oils were tested for purity by GC/MS and authenticated by Robert Pappas, Ph.D. Lynn Passmore Gonzalez and Susan McQuown provided valuable assistance with procedures and data analysis.