Scenario Analysis: This scenario presents a professional challenge stemming from a potential conflict between a practitioner’s personal beliefs and the established ethical and professional standards of mind-body medicine practice. The practitioner’s desire to integrate a personal spiritual practice into client sessions, while seemingly well-intentioned, raises concerns about client autonomy, informed consent, and the potential for imposing personal beliefs. Careful judgment is required to ensure that client well-being and professional integrity remain paramount, adhering strictly to established guidelines. Correct Approach Analysis: The best professional practice involves a thorough assessment of the proposed integration against established ethical codes and professional competencies. This includes evaluating whether the personal spiritual practice aligns with the evidence-based principles of mind-body medicine, whether it could potentially influence the client’s therapeutic journey in unintended ways, and most importantly, whether it can be introduced transparently and with explicit, informed consent from the client. The core of this approach is prioritizing client autonomy and ensuring that any therapeutic modality, including those with personal origins, is presented in a way that allows the client to make a fully informed decision without coercion or undue influence. This aligns with the ethical imperative to practice within one’s scope of competence and to always act in the best interest of the client, respecting their right to self-determination. Incorrect Approaches Analysis: One incorrect approach involves immediately incorporating the personal spiritual practice into all client sessions without prior consultation or assessment. This fails to respect client autonomy and informed consent, as clients are not given the opportunity to understand or agree to the inclusion of this specific practice. It also risks imposing the practitioner’s personal beliefs, which is ethically problematic and can undermine the therapeutic alliance. Another incorrect approach is to dismiss the personal spiritual practice entirely without considering its potential, if any, to enhance client care within ethical boundaries. While caution is necessary, a rigid refusal to explore potentially beneficial, ethically sound integrations can limit the practitioner’s ability to offer comprehensive care and may stem from an overly conservative interpretation of professional guidelines. A third incorrect approach is to subtly weave the personal spiritual practice into sessions without explicit disclosure, hoping the client will benefit without knowing its origin. This is a breach of professional integrity and transparency. It deprives the client of the ability to make an informed choice and erodes trust, as it is fundamentally deceptive. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes ethical considerations and client welfare. This involves: 1. Self-reflection: Understanding one’s own beliefs, biases, and motivations. 2. Ethical Consultation: Reviewing relevant professional codes of conduct and seeking guidance from supervisors or ethics committees when in doubt. 3. Client-Centeredness: Always placing the client’s needs, autonomy, and informed consent at the forefront of all decisions. 4. Evidence-Informed Practice: Ensuring that any therapeutic approach is grounded in evidence or, if novel, is introduced with rigorous ethical oversight and transparency. 5. Transparency and Disclosure: Openly communicating with clients about all aspects of their care.

Governance review demonstrates a need to clarify the Applied Global Mind-Body Medicine Board Certification’s blueprint weighting, scoring, and retake policies. A certified practitioner, Dr. Anya Sharma, has expressed concern that the current retake policy, which allows unlimited attempts with a fee, may inadvertently devalue the certification and create an uneven playing field for those who pass on their first attempt. This scenario is professionally challenging because it requires balancing accessibility and fairness with the integrity and perceived rigor of the certification. It necessitates a careful assessment of how policy decisions impact the value proposition of the certification for both candidates and the broader professional community. The best professional approach involves a comprehensive review of the certification’s blueprint weighting and scoring mechanisms to ensure they accurately reflect current best practices and the core competencies of mind-body medicine. This review should then inform a revised retake policy that maintains accessibility while upholding the certification’s standards. This might include a limited number of retake attempts, a mandatory period of further study or supervised practice between attempts, or a requirement to retake specific sections of the exam. Such an approach is correct because it directly addresses the potential devaluation of the certification by ensuring the assessment itself is robust and that repeated attempts are not a substitute for genuine mastery. It aligns with ethical principles of professional integrity and fair assessment, ensuring that the certification remains a credible indicator of competence. An incorrect approach would be to maintain the current policy of unlimited retakes with a fee without any further review. This fails to address the governance review’s findings and Dr. Sharma’s valid concerns about devaluing the certification. Ethically, it risks undermining the credibility of the board certification and could be perceived as unfair to those who invest significant effort to pass on their initial attempt. Another incorrect approach would be to immediately implement a strict limit on retakes, such as only one attempt allowed, without first re-evaluating the blueprint weighting and scoring. This could unfairly penalize well-prepared candidates who may have encountered unforeseen circumstances or minor errors on their first attempt, and it fails to address the root cause of potential assessment weaknesses that might contribute to retakes. A further incorrect approach would be to increase the retake fee significantly without any changes to the assessment or retake structure. While this might generate revenue, it does not address the core issue of ensuring the certification’s rigor and could disproportionately affect candidates with fewer financial resources, creating an equity concern. Professionals should approach such situations by prioritizing a data-driven and principles-based decision-making process. This involves: 1) Acknowledging and investigating stakeholder concerns. 2) Conducting thorough reviews of assessment tools and policies against established standards and best practices. 3) Considering the impact of policy changes on accessibility, equity, and the overall integrity of the credential. 4) Engaging in transparent communication with stakeholders regarding proposed changes and the rationale behind them.

This scenario is professionally challenging because it requires an individual to navigate the specific requirements for board certification in Applied Global Mind-Body Medicine, ensuring their qualifications align with the established purpose and eligibility criteria. Misinterpreting these criteria can lead to wasted effort, financial loss, and a delay in achieving professional recognition. Careful judgment is required to accurately assess one’s own background against the certification body’s standards. The best approach involves a thorough review of the official documentation provided by the Applied Global Mind-Body Medicine Board Certification body. This documentation will clearly outline the purpose of the certification, which is to establish a recognized standard of competence and ethical practice in the field, and detail the specific eligibility requirements. These requirements typically include educational prerequisites, supervised practice hours, examination success, and adherence to a code of conduct. By meticulously comparing one’s own professional background, training, and experience against these explicit criteria, an individual can accurately determine their eligibility. This direct engagement with the certifying body’s guidelines ensures that the assessment is grounded in the established regulatory framework and ethical standards of the profession, thereby maximizing the likelihood of a successful application and upholding the integrity of the certification process. An incorrect approach would be to rely on anecdotal evidence or informal discussions with peers about what constitutes eligibility. While peer insights can be helpful for understanding the general landscape, they do not substitute for the definitive requirements set forth by the certifying body. This can lead to misinterpretations of educational equivalencies or practice hour validations, potentially resulting in an application being rejected on technical grounds. Furthermore, assuming eligibility based on a broad understanding of mind-body medicine without verifying the specific nuances of the Applied Global Mind-Body Medicine Board Certification can lead to a fundamental misunderstanding of the specialized knowledge and skills being assessed. Another incorrect approach is to focus solely on the perceived prestige or marketability of the certification without first confirming if one meets the foundational eligibility criteria. This outward-focused perspective neglects the essential inward assessment of qualifications against the stated purpose and requirements. It can lead to pursuing certification without the necessary groundwork, which is inefficient and undermines the rigorous nature of board certification. Finally, an incorrect approach would be to interpret the purpose of the certification as a general endorsement of any practitioner who engages in mind-body techniques, regardless of formal training or specific experience. This broad interpretation fails to acknowledge that board certification is designed to identify individuals who have met a specific, high standard of expertise and ethical commitment within a defined scope of practice. The professional reasoning process should begin with identifying the certifying body and locating their official website or published guidelines. The next step is to carefully read and understand the stated purpose of the certification and then meticulously review each eligibility criterion. This involves a self-assessment of one’s education, training, supervised experience, and any required examinations or assessments. If any criteria are unclear, direct communication with the certifying body for clarification is essential. This systematic and evidence-based approach ensures that decisions regarding pursuing certification are informed, accurate, and aligned with professional standards.

Scenario Analysis: This scenario is professionally challenging because it requires the candidate to balance the desire for comprehensive preparation with the practical constraints of time and available resources, while also adhering to ethical guidelines regarding professional development. Misjudging the timeline or the quality of resources can lead to inadequate preparation, potentially impacting patient care and professional standing. The pressure to master a broad and evolving field like Mind-Body Medicine necessitates careful planning and resource selection. Correct Approach Analysis: The best approach involves a structured, phased preparation strategy that prioritizes foundational knowledge and evidence-based practices, followed by exploration of specialized areas and integration of practical application. This method aligns with the ethical imperative for continuous professional development and competence. It ensures that candidates build a robust understanding before delving into more nuanced or experimental aspects, thereby minimizing the risk of superficial learning or misapplication of techniques. This phased approach also allows for iterative refinement of study plans based on initial assessments of understanding, a hallmark of effective adult learning and professional growth. Incorrect Approaches Analysis: One incorrect approach involves solely relying on a broad, uncurated list of resources without a clear study plan or timeline. This can lead to information overload, superficial engagement with material, and a lack of focus on core competencies. It fails to demonstrate a systematic and disciplined approach to professional development, which is implicitly expected of certified professionals. Another incorrect approach is to focus exclusively on advanced or niche topics without first establishing a strong foundation in core principles and evidence-based practices. This can result in a skewed understanding of the field, potentially leading to the application of less validated or even inappropriate interventions. It neglects the ethical responsibility to practice within one’s demonstrated scope of knowledge and skill. A third incorrect approach is to adopt an overly rigid and inflexible timeline that does not account for the complexities of learning or unexpected challenges. This can lead to rushed preparation, burnout, and a failure to adequately absorb and integrate the material. It demonstrates a lack of adaptability and realistic self-assessment, which are crucial for effective professional practice. Professional Reasoning: Professionals should approach board certification preparation with a strategic mindset. This involves: 1) Thoroughly understanding the scope of the certification and its core competencies. 2) Conducting an honest self-assessment of existing knowledge and skills. 3) Developing a realistic, phased study plan that prioritizes foundational knowledge and evidence-based practices. 4) Selecting high-quality, reputable resources that align with the certification’s objectives. 5) Incorporating regular self-assessment and practice questions to gauge progress and identify areas needing further attention. 6) Maintaining flexibility to adjust the plan as needed. This systematic and self-aware approach ensures comprehensive and effective preparation, upholding professional standards and ultimately benefiting patient care.

This scenario is professionally challenging because it requires balancing the client’s autonomy and self-determination with the practitioner’s ethical obligation to promote well-being and facilitate sustainable behavior change. The practitioner must navigate the client’s fluctuating readiness and potential resistance without imposing their own agenda or resorting to coercive tactics. Careful judgment is required to select an intervention that respects the client’s current stage of change while fostering intrinsic motivation. The best professional practice involves utilizing a client-centered approach that prioritizes understanding the client’s perspective and collaboratively developing strategies. This approach, which involves active listening, empathy, and reflecting the client’s ambivalence, aligns with the core principles of motivational interviewing. Motivational interviewing is ethically justified as it respects client autonomy, empowers individuals to explore their own reasons for change, and avoids the ethical pitfalls of imposing external pressure or judgment. It is grounded in the understanding that sustainable behavior change arises from within the individual. An approach that focuses solely on providing a comprehensive list of health risks and consequences without assessing the client’s readiness or engaging them in a dialogue about their values and goals is professionally unacceptable. This can be perceived as lecturing or judgmental, potentially increasing resistance and undermining the therapeutic alliance. It fails to acknowledge the client’s current stage of change and may overwhelm them, leading to disengagement rather than motivation. Another professionally unacceptable approach would be to immediately prescribe a rigid, prescriptive plan without co-creating it with the client. This disregards the client’s lived experience, preferences, and potential barriers to implementation. It can lead to a plan that is unrealistic, unsustainable, and ultimately contributes to feelings of failure and demotivation. Ethically, it infringes on the client’s right to self-determination in their health journey. A third professionally unacceptable approach involves dismissing the client’s current feelings of ambivalence and pushing for immediate commitment to change. This fails to acknowledge the natural process of behavior change, which often involves periods of contemplation and doubt. It can create a sense of pressure and invalidate the client’s experience, making them less likely to engage in genuine exploration and commitment. The professional reasoning process should involve first conducting a thorough whole-person assessment to understand the client’s current situation, values, and readiness for change. This assessment should then inform the application of motivational interviewing techniques to explore ambivalence and elicit change talk. The practitioner should collaboratively set achievable goals with the client, focusing on small, sustainable steps. Ongoing assessment and flexible adaptation of strategies based on the client’s progress and feedback are crucial for fostering lasting behavior change.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the imperative to integrate mind-body medicine principles into a healthcare system with the need to ensure that such integration is evidence-based, ethically sound, and compliant with established professional standards. The challenge lies in moving beyond anecdotal evidence or personal conviction to a systematic, data-driven approach that respects patient autonomy and professional accountability. Careful judgment is required to avoid premature adoption of unproven modalities or the misapplication of established ones, which could compromise patient safety and organizational integrity. Correct Approach Analysis: The best professional practice involves a systematic, evidence-based impact assessment of proposed mind-body interventions. This approach prioritizes the rigorous evaluation of efficacy, safety, and cost-effectiveness through pilot studies, literature reviews of high-quality research, and the development of clear outcome measures. It aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) by ensuring that interventions are introduced only after demonstrating a positive risk-benefit profile. Furthermore, it supports professional accountability by grounding practice in verifiable data and established scientific consensus, thereby meeting the implicit standards of responsible healthcare innovation. Incorrect Approaches Analysis: One incorrect approach involves the immediate and widespread implementation of mind-body techniques based solely on anecdotal testimonials or the personal enthusiasm of practitioners. This fails to meet the ethical obligation to provide evidence-based care and risks exposing patients to interventions that may be ineffective or even harmful. It bypasses the necessary due diligence required to establish safety and efficacy, undermining professional responsibility and potentially violating principles of patient welfare. Another incorrect approach is to dismiss the potential of mind-body medicine entirely due to a lack of familiarity or a rigid adherence to traditional biomedical models, without undertaking any form of objective assessment. This approach can lead to missed opportunities for improving patient care and well-being, and it may reflect a failure to engage with evolving scientific understanding and patient needs. It can also be seen as a failure to uphold the principle of exploring all reasonable avenues for patient benefit. A third incorrect approach is to adopt mind-body interventions based on their popularity or market trends, without a specific assessment of their relevance to the organization’s patient population or its existing care pathways. This prioritizes external validation over internal efficacy and patient-centeredness, potentially leading to the introduction of interventions that are not well-integrated, are poorly supported by available evidence for the specific context, or do not address the actual needs of the patients being served. This can result in wasted resources and a dilution of focus on interventions with proven value. Professional Reasoning: Professionals should adopt a decision-making framework that begins with a clear understanding of the problem or opportunity. This is followed by a comprehensive search for evidence, considering the quality and relevance of available research. Next, potential interventions are evaluated against established ethical principles and professional standards, including patient safety, efficacy, and feasibility. Pilot testing and phased implementation, coupled with ongoing monitoring and evaluation, are crucial steps. Finally, decisions should be transparent, documented, and communicated effectively to all stakeholders, ensuring continuous learning and adaptation.

Scenario Analysis: This scenario is professionally challenging because it requires a practitioner to navigate the integration of evidence-based complementary and traditional modalities within a framework that prioritizes patient safety and efficacy. The challenge lies in discerning which modalities have sufficient empirical support to be considered safe and effective, and how to ethically present these options to patients without overstating their benefits or misrepresenting the scientific consensus. Careful judgment is required to balance patient autonomy and the desire for holistic care with the practitioner’s ethical obligation to provide evidence-informed interventions. Correct Approach Analysis: The best professional practice involves a rigorous assessment of the existing scientific literature for each complementary and traditional modality. This includes evaluating the quality and consistency of research findings, considering the methodology of studies (e.g., randomized controlled trials, systematic reviews), and understanding the potential risks and benefits. Modalities with a robust body of evidence demonstrating efficacy and safety for specific conditions are those that should be prioritized and recommended. This approach aligns with the core ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as the professional responsibility to practice within the scope of evidence-informed care. Incorrect Approaches Analysis: One incorrect approach involves recommending modalities based solely on anecdotal patient testimonials or personal belief in their efficacy, without regard for empirical evidence. This fails to uphold the principle of evidence-informed practice and can lead to patients receiving ineffective or potentially harmful treatments, violating the duty of care. Another incorrect approach is to dismiss all complementary and traditional modalities outright, regardless of any emerging scientific support. While caution is warranted, a blanket rejection can limit patient options and disregard potentially beneficial interventions that have demonstrated efficacy through rigorous research. This can be seen as paternalistic and may not fully respect patient preferences for holistic care when evidence exists. A further incorrect approach is to present modalities with limited or inconclusive evidence as definitively proven or as substitutes for conventional medical treatment. This misrepresents the scientific standing of the modality, potentially leading to delayed or forgone conventional care, which can have serious negative health consequences for the patient. This constitutes a failure in professional integrity and ethical communication. Professional Reasoning: Professionals should adopt a systematic approach to evaluating complementary and traditional modalities. This involves actively seeking out high-quality research, critically appraising study findings, and staying abreast of scientific consensus. When considering recommending a modality, practitioners should ask: “What is the strength of the evidence supporting this intervention for this specific condition?” and “What are the potential risks and benefits compared to other available options?” Transparency with patients about the level of evidence is paramount, empowering them to make informed decisions in partnership with their healthcare provider.

Scenario Analysis: This scenario is professionally challenging because it requires balancing a client’s expressed desire for a specific therapeutic intervention with the practitioner’s ethical obligation to provide evidence-based care and avoid making unsubstantiated claims. The practitioner must navigate the potential for placebo effects, the client’s autonomy, and the responsibility to uphold professional standards without overstepping into medical advice or diagnosis. The core challenge lies in managing client expectations and ensuring that interventions are aligned with established knowledge and ethical practice, particularly when dealing with complex health conditions. Correct Approach Analysis: The best professional practice involves a comprehensive assessment of the client’s overall health status, including their current lifestyle, nutritional intake, and the specific mind-body therapeutics they are interested in, within the context of their diagnosed condition. This approach prioritizes understanding the client holistically and integrating evidence-based lifestyle and mind-body strategies that are known to support well-being and complement conventional medical treatment. It requires open communication with the client about the potential benefits and limitations of various approaches, ensuring that any recommendations are grounded in scientific understanding and ethical guidelines for complementary and integrative health practices. This aligns with the principle of “do no harm” by ensuring interventions are safe, appropriate, and do not replace necessary medical care. Incorrect Approaches Analysis: Recommending a specific, unproven mind-body therapy solely based on the client’s request, without a thorough assessment of their overall health and the scientific evidence for that therapy’s efficacy in their specific condition, is ethically problematic. This approach risks making unsubstantiated claims and could lead the client to forgo or delay evidence-based medical treatment, potentially causing harm. Another incorrect approach is to dismiss the client’s interest in mind-body therapeutics outright without exploring their potential benefits or understanding the client’s motivations. This can undermine the therapeutic alliance and fail to leverage potentially beneficial complementary strategies. Finally, focusing exclusively on the mind-body therapy without considering the client’s lifestyle and nutritional habits neglects a crucial aspect of holistic health and may limit the overall effectiveness of any intervention. Professional Reasoning: Professionals should adopt a client-centered, evidence-informed approach. This involves a thorough initial assessment that encompasses the client’s medical history, current lifestyle, nutritional status, and their understanding and desires regarding complementary therapies. Following this, practitioners should engage in shared decision-making with the client, discussing evidence-based lifestyle modifications, nutrition, and mind-body techniques that are appropriate for their condition and align with professional scope of practice. Transparency regarding the evidence base, potential benefits, and limitations of all recommended interventions is paramount. Continuous professional development and adherence to ethical codes are essential for navigating complex client requests and ensuring the highest standard of care.

Scenario Analysis: This scenario is professionally challenging because it requires the practitioner to navigate the complex and potentially dangerous landscape of interactions between herbal supplements, over-the-counter medications, and prescribed pharmacologics. The “natural” perception of herbal remedies can mask significant risks, and a failure to thoroughly assess these interactions can lead to adverse events, treatment failures, and harm to the patient. The practitioner must balance the patient’s desire for complementary therapies with the imperative of ensuring safety and efficacy of their overall treatment plan. Correct Approach Analysis: The best professional practice involves a comprehensive, evidence-based approach to assessing potential herbal, supplement, and pharmacologic interactions. This entails proactively inquiring about all substances the patient is taking, including prescription medications, over-the-counter drugs, and all dietary supplements and herbal products. The practitioner must then consult reliable, up-to-date resources (e.g., reputable databases, peer-reviewed literature) to identify documented or potential interactions. Based on this evidence, the practitioner should engage in a shared decision-making process with the patient, explaining the identified risks, potential consequences, and alternative strategies. This approach prioritizes patient safety, informed consent, and evidence-based practice, aligning with ethical principles of beneficence and non-maleficence. Incorrect Approaches Analysis: One incorrect approach involves relying solely on the patient’s self-reporting of their current medications without independently verifying or researching potential interactions with supplements. This fails to acknowledge that patients may not be aware of all potential interactions or may not consider supplements as “medications” requiring disclosure. It also neglects the practitioner’s professional responsibility to actively identify and mitigate risks. Another unacceptable approach is to dismiss the patient’s use of herbal supplements as inconsequential, assuming they are inherently safe or unlikely to interact with prescribed pharmacologics. This demonstrates a lack of due diligence and a failure to adhere to the principle of comprehensive patient care. Such an assumption can lead to overlooking serious adverse drug reactions or therapeutic failures. A further professionally unsound approach is to recommend discontinuing all herbal supplements without a thorough, evidence-based assessment of specific interactions. While some supplements may pose risks, a blanket recommendation without individual evaluation is overly cautious, potentially undermines patient trust, and may disregard beneficial effects the patient experiences from these supplements, provided they can be used safely. Professional Reasoning: Professionals should adopt a systematic process for managing herbal, supplement, and pharmacologic interactions. This process begins with a thorough patient history that explicitly probes for all ingestible substances. Following this, a critical review of potential interactions using credible resources is essential. The practitioner must then communicate findings clearly and collaboratively with the patient, empowering them to make informed decisions about their health. This iterative process of assessment, communication, and shared decision-making is fundamental to safe and effective patient care.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the innovative nature of integrative care program development with the stringent ethical obligations and the need for demonstrable outcomes. The integration of mind-body modalities, often less standardized than conventional medical treatments, necessitates a robust framework for ethical practice and rigorous evaluation to ensure patient safety, efficacy, and responsible resource allocation. Professionals must navigate potential conflicts between client expectations, provider scope of practice, and the evidence base for emerging therapies, all while adhering to established ethical principles and regulatory expectations for healthcare programs. Correct Approach Analysis: The best approach involves a comprehensive program development strategy that prioritizes ethical considerations and outcomes tracking from inception. This includes establishing clear ethical guidelines aligned with professional codes of conduct for all practitioners, defining measurable outcomes that reflect both client well-being and the specific goals of the integrative program, and implementing a systematic process for data collection and analysis to track these outcomes. This approach is correct because it proactively addresses potential ethical pitfalls by embedding ethical principles into the program’s design and ensures accountability and continuous improvement through rigorous outcomes measurement. This aligns with the ethical imperative to provide safe, effective, and evidence-informed care, and the professional responsibility to demonstrate the value and impact of integrative interventions. Incorrect Approaches Analysis: One incorrect approach involves prioritizing rapid program expansion and client acquisition without a foundational ethical framework or a clear plan for outcomes tracking. This fails to meet ethical obligations by potentially exposing clients to unproven or inadequately supervised interventions and neglects the professional duty to demonstrate efficacy, which can lead to misallocation of resources and erode public trust. Another incorrect approach is to focus solely on anecdotal client testimonials as evidence of success, while neglecting systematic data collection and analysis. While testimonials can be valuable, they are subjective and do not constitute robust evidence of program effectiveness or safety. This approach falls short of the ethical requirement for evidence-based practice and the professional need for objective data to inform program development and justify its continuation. A further incorrect approach is to develop the program with a strong emphasis on theoretical ethical principles but without establishing concrete mechanisms for tracking client outcomes. This creates a disconnect between ethical intent and practical application, making it impossible to assess whether the program is achieving its stated goals or to identify areas for improvement, thereby failing to uphold the ethical responsibility to ensure client benefit and minimize harm. Professional Reasoning: Professionals should adopt a phased approach to program development, beginning with a thorough needs assessment and stakeholder consultation. This should be followed by the development of a detailed program plan that explicitly outlines ethical guidelines, practitioner qualifications, scope of practice, and a comprehensive outcomes measurement strategy. Pilot testing with rigorous data collection and ethical oversight is crucial before full-scale implementation. Continuous evaluation, ethical review, and adaptation based on outcomes data are essential for long-term success and responsible practice in integrative care.