Stress is a mechanism that assists the body to deal with emergency situations and a response to a set of external or internal stimuli (Selye, 1956). In our society stress is a major contributing factor in illness, absenteeism, reduced productivity, increased health care costs and other adverse health consequences for the individual (Easton, 1997, Nixon & King, 1997).
In Australia, there is increasing use of complementary therapies to reduce stress and stress related symptoms. One such complementary therapy is Three In One. This approach combines concepts from body-mind medicine, brain function and Eastern philosophy to identify and address the client’s negative emotional stress. Three In One is practised worldwide. There has been extensive anecdotal evidence that the Three In One approach is successful in reducing clients’ perception of stress and improving their ability to cope with life stressors. However there is a lack of substantiated data into Three In One effectiveness, making this an area ripe for research and evaluation.
In this study a quasi-experimental design was used with the one-group pre-test, post-test design to evaluate the effectiveness of Three In One in the reduction of stress. Using a triangulated approach, clients’ perception of their stress was measured pre and post consultation series and clients’ comments assessed to add meaning and understanding. Consultant comments were collected to add a secondary source of data and allow the researcher to check for accuracy and reliability.
Over thirteen months, fifteen Three In One consultants collected data from a total of eighty-one new clients. Clients had an average of four Three In One consultations on their presenting issue.
This study showed a significant reduction of clients’ stress (37%, p<0.0005) measured by Perceived Stress Scale -14, bringing their stress down on average to the population mean. Clients also reported a significant reduction of their stress on their presenting issue (65%, p<0.0005). Clients attributed the Three In One approach as 70% of the cause of this reduction in stress and improvement in coping skills, almost double the contribution of all other factors.
In relation to specific symptoms, over the period of these consultations clients reported a significant reduction in their pain (72%, p<0.0005). There was also a significant reduction in physical symptoms, interpersonal difficulties, interpersonal conflict and a significant improvement in energy levels for those clients who reported these symptoms. This was further supported qualitatively by clients’ comments. They reported that the Three In One approach resulted in a greater understanding of themselves and their issues feelings of wellbeing, happiness and a greater sense of empowerment.
This study suggests that a series of Three In One consultations by qualified consultants is an approach that reduces stress and assists healing. The positive results of this study indicate that replicated studies to verify the results would be worthwhile.
Sue Dawson Master of Health Science. Victoria University. 1999
Three In One Concepts consultations when appropriately applied by qualified facilitators, result in reduced stress and improved coping skills.
To determine by research whether Three In One Concepts made any real change in the stress levels and coping skills of ordinary Australians
81 clients self presented to 14 qualified Three In One Facilitators across Australia over 13 months. Seventy (67) were women and fourteen (14) were men reflecting the normal proportion who present for Health Treatments. Clients were over 18, had not had Three In One Concepts consultations and who considered themselves stressed or not coping enough to present to a Three In One Facilitator. A questionnaire was completed by each client prior to their first consultation (pre consultation) and after their last consultation for that issue (post consultation).
Due to the nature of the Three In One approach, the number of consultations required to address an issue varies with each individual and with the issue they wished to address so was not fixed in this study. The majority of clients had between one and six consultations. The median number of consultations was 4.
PSS-14 showed that average stress dropped to within 2% of normal, a reduction of 37%. The “Perceived Stress Scale – 14” (PSS-14), a psychologically validated instrument was one component of the questionnaire. The PSS-14 gave a measure of each client’s perceived stress and coping ability and provided a comparison between the mean stress of the clients in this study and the mean stress of the general public. Higher PSS-14 indicated more stress and reduced coping skills. Lower PSS-14 indicated lower stress and greater coping skills.
The mean of all PSS-14 results was 31.1 pre consultation and 19.87 post-consultation. The results suggest that the clients in this study experienced a statistically significant reduction in stress as measured by the PSS-14. ( t =11.00, n = 67, p < 0.001). Statistically, a difference of this size had less than 1 in 1000 chance of occurring by itself.
In addition The post consultation PSS-14 compares favourably with the mean PSS of the general population (19.62) and the standard deviation of the client results in this study was similar to the population standard deviation of 6.35.
The mean difference between the paired scores was 11.55 which implies that stress reduced by an average of 37% for the clients in this study and the clients ended the study with PSS scores within 2% of the mean score or the general population. This implies that the clients ended up with “normal” stress and coping skills. This was supported by the observed results that people reporting lower PSS-14 results pre-consultation also reported less of a change post consultation.
Clients were asked their estimation of how much the Three in One approach had contributed to changes in their lives during the study. This was measured by each client evaluating how much they felt the Three In One approach had contributed on a Likert scale from 0 = no contribution to 10 = maximum contribution. The mean of the client estimates was 7.2. Thus the results show that clients in this study felt the Three In One approach had contributed. When asked to estimate the contribution of all other factors, the mean of the client estimates was 3.9. Thus in this study the clients ascribed a larger contribution to the changes in their lives to the Three In One approach than any other factor.
Clients reported a mean reduction of 45% in their perception of the stress they were experiencing in their life. This was measured by each client evaluating how much stress they were feeling on a Likert scale from 0 = no stress to 10 = maximum stress. The mean of all client’s life stress evaluation was 7.08 pre-consultation and 3.88 post-consultation. The mean difference was 3.20 which shows a 45% reduction in stress. ( t = 12.87, n = 81, p < 0.001) This supports the reduction in stress measured by the PSS-14. Standard deviations of 1.68 pre consultation and 1.77 post consultation indicated a relatively wide spread in this subjective evaluation.
Clients supported this result with their post consultation comments including:
“I think this is a wonderful tool to use, to live life to the fullest, also to create the life that you want”
“I have felt real change taking place in my life”
“Treatment caused immediate response in my life – I have been able to alter my thinking and change my life remarkably for the better”
Each client reported the issue or issues that they wished to address using the Three In One approach. These presenting issues covered a wide range of stress related problems including:
General Health problems, Chronic fatigue syndrome, Constant fatigue, Skin problems, Eczema, Eating problems, Obesity, Underweight, Degenerative problems, Arthritis, Multiple sclerosis, Nervous problems, Insomnia, Dizziness, Irritable bowel, Allergies, Pain: Back pain, Headaches, Migraines
Fear, Lack of control in life issues, Dissatisfied with life direction, Stress, Relationship conflict, Identity, To find direction in life, Life purpose, Work related frustration, Career difficulties – work performance, Phobias, Claustrophobia, Fear of public transport, Compulsive eating, Repeating old patterns, Depression, Grief and Pain, Sexual abuse, Intimacy-sexuality and relationships, Low self esteem – lack of confidence, Learning difficulties
Clients reported a mean reduction of 63% in their perception of the stress they were experiencing in relation to the presenting issue. This was measured by each client evaluating how much stress they were feeling about that issue on a Likert scale from 0 = no stress to 10 = maximum stress. The mean of all client’s evaluations of the stress they were feeling in relation to the presenting issue was 7.64 pre consultation and 2.81 post consultation. Mean difference between paired scores was 4.83 with a percentage difference of 63% ( t = 16.70, n = 81, p < 0.001). thus statistically significant Standard deviations were 1.56 pre consultation and 1.96 post consultation again reflecting the wide range of results.
It was observed that some clients reported a greater reduction in life stress than their reduction in stress on the issue, other clients reported very much reduced stress on the presenting issue but little change in their overall life stress during the study. Similarly some clients reporting no change in stress as measured by the PSS-14 reported significant reduction in their subjective measure of issue stress. Perhaps these clients found a reduction of stress for the presenting issue but still lived stressful lives. Taking the three measures together indicates that the Three In One approach is effective in reducing stress and improving coping skills for stressed people.
A relationship between stress and physical/emotional symptoms has been shown in PNI research. Clients in this study were asked to indicate pre consultation how the stress they were experiencing was expressed in terms of symptoms. Post consultation, clients were again asked to indicate the symptoms they were experiencing that related to current stress.
Seven categories were offered:
Physical, Interpersonal difficulties, Low energy levels, Learning difficulties, Interpersonal conflict, phobias, Emotional stress
There was a significant reduction in all seven categories of symptoms experienced by clients. The was a very high percentage reduction in interpersonal conflict (90%). interpersonal difficulties (82%) and phobias (88.9%). Physical symptoms also reduced significantly by seventy percent (70%), low energy symptoms reduced by sixty percent (60.3%) and learning difficulties by sixty percent (60%). The decrease in emotional symptoms was forty eight percent (48.6%).
The Three In One approach does not work directly with symptoms. This result together with the Psycho Neuro Immunological research that links stress with disease suggests that the observed reductions in symptoms could be an outcome of reduced stress. It cannot be estimated from the results of this study how much of this reduction would have occurred through the normal passage of time without the intervention of the Three In One approach. It is, however, worth noting that many symptoms reported were chronic (eg back pain) and long term (eg weight problems) rather than temporary (eg headache).
There was, on average, a 50% reduction in the clients overall perception of the pain they were experiencing in their life. Again while this could be expected to reduce with time, this reduction supports
There was also a significant reduction in the clients perception of their pain when they evaluated their pain in categories of physical, emotional and mental pain. Physical Pain reduced by 56%, Emotional Pain by 57%, Mental Pain reduced by 66%
Clients reported reduced use of other treatment modalities.
While participating in this study, clients were not restricted from using other treatment modalities. In this study it was unusual for other modalities to be used so the results are not statistically significant, however it is notable that during their use of the Three In One approach, most of those clients attending other treatment modalities stopped attending or reduced the number of other treatments they were using. Few reported starting other treatment modalities during the study.
Of the small number of clients in this study who reported using medication pre consultation, there was a decrease in their use of medication. Few reported starting medication during the study.
Seventy-eight (78) clients indicated a high degree of agreement between outcome required and what had been achieved, two (2) clients stated that they were disappointed and one (1) stated that she could not comment as she had not completed the consultation series (after three sessions).
Clients expressed various responses about what they thought of the Three In One approach.
One indicated that she found the process “a little wacky” while another thought it “ a very sophisticated and comprehensive, integrative and holistic process” while another said that it “gets down to the nitty gritty”. Other comments included:
A very gentle and non invasive treatment that works.
It’s very gentle and spot on with identifying stress areas.
Much more geared toward emotional cause as root of the problem. I expected things such as identifying food allergy. Took me a little while to fully trust/believe because I was so entrenched in the medical model.
This has been a very effective method for releasing my childhood traumas which have been holding me back in my life and have helped me resolve things in my relationship so I am now doing what is best for me.
Three In One is a safe gentle approach to healing the whole person, which I have valued immensely.
I always investigate new therapies before I use them and I was convinced this was the one for me – finally! Unfortunately this wasn’t to be the miracle I wanted or needed.
For a newcomer, the initial session was quite an experience – unusual techniques, but very in tune with the way I was feeling, definitely beneficial and enjoyable. Good for bringing out subconscious thoughts.