This study aimed to explore the experiences of midwives who were also homeopaths as they attempted to straddle the different philosophical and practice paradigms they encountered in each domain. It also explored the implications of their experience on their practice. Over recent decades the National Health Service (NHS) has moved towards a scientific-bureaucratic perspective, in which the emphasis is on the use of evidence-based frameworks. It has been argued that this development has moved the focus in healthcare away from ‘caring’. In parallel, there has been an increase in the demand for complementary and alternative medicines in the United Kingdom (UK), and elsewhere. In responding to this call a number of midwives have taken up training opportunities in massage, aromatherapy, hypnotherapy, acupuncture and homeopathy, amongst others. There are no studies however, that have examined the impact of training as a homeopath on midwives and their practice. After a comprehensive analysis of existing literature, this study used an interpretive hermeneutic framework to explore the experience of midwives who trained as homeopaths. In-depth interviews were conducted with seven midwife homeopaths. The findings were analysed using three different lenses. The first of these conceptualised and explored the midwives narratives as personal and professional metamorphoses, as they changed from midwife to homeopath or midwife homeopath. Secondly, the data were framed using a Heideggerian lens, which illuminated a process of transformation into being authentic practitioners. This demonstrates how authenticity allowed the participants to (re) engage with, and further value the therapeutic relationship as a fundamental element of their clinical practice. The final lens explored the impact engendered of being authentic on the therapeutic relationship that developed between midwife homeopath and the women in their care. The conclusion was drawn that the therapeutic relationship developed by an authentic practitioner via a homeopathic consultation is transferable to other healthcare practitioners, and offers a challenge to practice based in notions of scientism and bureaucracy. Further exploration of these phenomenon’s could help to deliver on the drive to deliver compassionate personalised care across the NHS as a whole.

The apparent success of homeopathy is often attributed to a collaborative, holistic and empathic consultation and to the practitioner patient relationship. However most research into the homeopathic consultation has focussed on patients’ experiences although the practitioner is a crucial component of the therapeutic context and may have an important part to play in optimising health outcomes in homeopathy. Therefore the aim of this research was to gain an in depth understanding of homeopathic practitioners’ perceptions and experiences of the consultation. An additional aim was to generate a theoretical model to explain the processes that underpin the homeopathic consultation. A qualitative approach was taken using constructivist grounded theory methodology employing a process of two phases of data collection. Medical and non medical homeopaths were sampled from the registers of the Faculty of Homeopathy and the Society of Homeopaths. Phase 1 involved face to face in-depth interviews with homeopaths. From these interviews a theoretical model of the homeopathic consultation was developed. Phase 2 of data collection involved observations of homeopathic consultations and the use of solicited practitioner reflective diaries in order to confirm, refute or enlarge on the model which developed from phase 1. The emergent theoretical model entitled “a theoretical model of a UK classical homeopathic consultation” describes how homeopaths view and enact the consultation process. The findings indicate that the consultation consists of processes which are interlinked and dependent on each other. I have labelled these processes exploring the journey together, finding the level, responding therapeutically and understanding self. Central to these processes is the core category which I have labelled connecting. This study has highlighted that the whole process of the homeopathic consultation is important and aspects that are unique to homeopathy such as the process of identifying and matching the homeopathic remedy cannot be separated from the rest of the consultation and must be considered as part of the whole process. Additionally the ritualistic and symbolic aspects of the consultation that are embedded in this process are of paramount importance and provide meaning, highlighting the power of the consultation to promote beneficial effects for the patient. This research has implications for all stakeholders and signals many future avenues for research.

Homoeopathic practitioners in the United Kingdom can be divided into two groups,those with medical qualifications and those without, professional homoeopaths. This study examines these two groups to discover how they practise homoeopathy and why. Also examined are any tensions that may exist, both between the two groups and within the groups. Collecting qualitative and quantitative data using questionnaires and interviews, a randomly selected sample of homoeopaths was studied. All subjects were members of either the Faculty of Homoeopathy or the Society of Homoeopaths. The study starts by examining the development of homoeopathy over its almost 200 year history. Following this section data regarding the practice of homoeopathy and the opinions of homoeopaths on this practice are discussed. The homoeopath's opinions regarding their opposite numbers are also discussed, that is professional homoeopath's opinions of medically qualified homoeopaths and vice versa. The data highlighted a number of tensions that exist between medically qualified homoeopaths and professional homoeopaths. Medically qualified homoeopaths questioned the wisdom of allowing non-medically qualified people to practice homoeopathy and the professional homoeopaths questioned the validity of the homoeopathic methods used by medically qualified homoeopaths. Tensions within professional homoeopathy were also identified between pro and anti professionalisation and registration subgroups. Another tension identified was between those professional homoeopaths who claim to use the original, 'classical' formulation of homoeopathy and those using a more eclectic therapeutic regime with changes to the original method incorporated into their practices. Finally, the utility of the concept of heresy when describing both medically qualified homoeopaths and professional homoeopaths in the United Kingdom was addressed. Although the labelling of heretics is properly reserved for those members of the orthodoxy, not for researchers, a small number of homoeopaths were identified as holding potentially heretical ideas. On the whole the medically qualified homoeopaths and the majority of professional homoeopaths could not be regarded as heretics or dissenters in any way. In the light of the tensions that were identified, and the policies being promoted by the professional bodies, the conclusion examines the possible future of homoeopathy in the United Kingdom in the first years of the new millennium. A thoroughly modernist medicine in a possibly postmodern era.

The subject of this thesis is the lived experience of training in non-orthodox health care professions1 or CAM (complementary and alternative medicine) as it is commonly known. The thesis focuses both on the nature of the knowledge and skills acquired during training (knowledge of the body) and the changing embodiment of the students (embodying knowledge). It is based on ethnographic research, conducted over one academic year, at two case-study sites: the anonymized Colleges of Homeopathy and Osteopathy. The data presented in this thesis offers four distinct contributions. Methodologically, it offers insights into the embodied experience of conducting sociological research and the deep impact that this experience has on the researcher, further supporting the argument that reflexivity is a vital component of valid and reliable research. Empirically, it contributes to our understanding of an under-researched area, the ?Tactice of CAM therapies generally, and the training of practitioners particularly. Theoretically, the explicit focus of both the participants in the study .and myself, as researcher, on 'bodies' makes it a worthwhile topic of study to contribute to the growing discipline of embodied sociology. Finally, from a social policy perspective, the explosion of interest in CAM in recent years, and particularly the growing pressure on practitioners to regulate their professions, makes research into the nature of professional knowledge and practice very timely. The thesis concludes that it is of critical importance to consider embodiment in any understanding of healthcare knowledge or practice. In particular, an embodied sociological perspective permits recognition of the depth and nature of the knowledge and skills that healthcare practitioners learn to deploy on a day-to-day basis.

Background & Aim: Osteoarthritis (OA) sufferers frequently turn to complementary and alternative medicine (CAM), of which the most common are acupuncture and homeopathy, to improve manageability of their condition. However, there is little extant evidence of effectiveness for these treatments for OA, particularly for homeopathy. One criticism of homeopathic studies is that treatment protocols do not reflect true homeopathy. The nature of true homeopathy is not documented in extant literature. In the current study a mixed methods approach was used to investigate the use of homeopathy for osteoarthritis using a survey, conducted with a parallel acupuncture survey for comparison, follow up interviews with homeopaths and a patient-centred study in a homeopathic department offering treatment on the NHS, in order to inform future studies. Method: The current study involved three phases; (1) A descriptive survey conducted on n=362 medical and non-medical homeopaths and acupuncturists, was used to , investigate practice of the therapies (2) Follow up interview of n=28 of the homeopathic practitioners. (3) A patient-centred study of n=11 patients with OA receiving homeopathy in the primary care setting. Results: (1) Most commonly encountered conditions were chronic diseases. Medical and non-medical acupuncturists practised very different forms of acupuncture particularly in terms of diagnostic techniques used and theoretical underpinning. Homeopathic practitioners used individualised treatments, abiding by classical homeopathy. Differences between medical and non-medical homeopaths included time spent in the consultation (p= 0.01), strength of confidence in homeopathy for asthma (p=0.01), musculo-skeletal (p=0.046) and acute conditions (p=0.01)., and confidence in conventional medicine (p=0.01). There was a belief amongst acupuncturists and homeopaths that the treatments may work on electrodynamic fields in the body. (2) A similar approach was taken by participants during a detailed initial consultation. However, irrespective of medical status, varied approaches were used to identify the remedy, potency, and remedy f6mi, and the source of remedy also varied. Main themes regarding the modus operandi of homeopathy included stimulation of self healing mechanisms and identifying in detail events at the point where the initial health imbalance occurred. Identification of this point together with the patient was considered a potential trigger for the healing process to begin, adding a particular importance to the role of the consultation. (3) OA patients in the primary care setting identified pain or stiffness as the most common primary complaint., with an emotional factor such as anxiety and limitations caused by their condition as a secondary complaint. A desire to reduce their medication or to improve the manageability of their condition was a common theme for interest in receiving homeopathy, with access to NHS homeopathic treatment and perceived safety of receiving treatment from medical doctors being important factors. Following 6 months of' homeopathic treatment, most participants reported an improvement in the manageability of their condition. This, however was not supported by results from VAS pain, VAS stiffness, MYCAW scores or SF36 subscore, or salivary concentration of substance P results which were not found to be significant. Few correlations were found between outcome measures. Substance P level was strongly correlated with the functional limitations sub-score of the SF36 (p=0.01), indicating a potential role for this biochemical measure in future studies. Conclusion: Findings from the current study can inform future studies on how to enhance the evidence base for homeopathic and acupuncture treatment, and inform the integration debate. Future advances in the understanding of subtle processes in the body, the placebo response, and the nature of cure may add to our understanding of' CAM treatments. However, it is likely that in order to advance the evidence base on the effectiveness of homeopathy for OA, more effective tools that are sensitive to changes in biopsychosocial dimensions of health will be necessary. Future research on combination therapies is also warranted.