One of the key challenges in the successful use of herbs is actually ingesting the plant preparation, known as compliance. This is a basic issue and one that often gets overlooked. Regardless of the quality of the herb or the herbal tradition from which it is given, herbal medicine will not be successful if the client doesn’t actually use the herbs.
For many people, the first visit to an herbalist, whether a formal consult or a family friend, is a walk on the wild side. This is a new form of healthcare. The person may be unsure about what to expect, the validity of herbs, the safety of herbs and what they (the client) should be doing. These same issues apply to lifestyle and diet recommendations made during the consult.
One of the many roles of the community or clinical herbalist is to address these issues both during and after the consult. This is an ongoing process. The herbalist is part educator and part psychologist.
The Challenges
- Duration and Depth of the Herbal Consult
Typically, an herbal consult takes 1 – 3 hours to get to know the person and gather the needed info. There may be phone calls, emails, looking at tongues, inquiring about bowel movements and many other questions about topics that aren’t obviously related to the initial reason for seeking help.
Be aware of the client’s personal or cultural comfort level, especially during the initial consult. Some info may need to wait until the follow-up. Explaining the reason for a specific request is helpful. - Types of Herbal Preparation
Culturally, most people in the US are familiar with taking pharmaceutical pills 1 – 3 times a day. Herbally, we are asking people to use herbs with eye droppers, neti pots, add herbs to the cooking, inhale aromas, rub stuff on their skin and simmer smelly decoctions on a daily basis.
Ask the client what they can or are willing to do and really listen to their response. Think of this as a long term process. You may need to begin with something as simple as peppermint tea for digestive issues and eventually build up to more involved or unusual remedies. - Flavor and Texture of the Herbs
Most pharmaceuticals are not tasted. They are quickly swallowed or have a tasty coating. Most liquids have been artificially flavored and are smooth to swallow.
With herbs, tasting is important yet the flavors may be very foreign. The texture may be slimy or grainy. Talk about all this. Listen to find out where the limits are for the client. Using a form (capsules) or flavor (mint, cinnamon, ginger) that is familiar makes a difference. - Bedside Manner of the Herbalist
Be honest in what you can and can’t do. Be sincere. Never violate confidentiality.
One of the most powerful parts of a consult is listening and caring. Aside from addressing the primary health issue, you can always listen, care and be respectful. - Making Herbal Preparations
Are they willing and able to make decoctions every day? How can they take herbs at work?
Demonstrating how to prepare herbs in a timely manner is helpful.
Use the Nightstand – Kitchen Cupboard – Medicine Cabinet – Day Bag approach. - Adding New Herbs
Research herb-drug interactions. If already using other herbs, does the client need more? Can you streamline the daily routine? Can you provide just diet and lifestyle guidelines with no additional herbs? - Amount of Information
Demonstration and written info are extremely helpful for both herbal preparation and general guidelines of what to do.
There is such an abundance of new information presented during a consult, the client will never remember verbal explanations and important details will be confused.
It can be helpful to have the client take notes rather than giving a pre-written instruction sheet. This makes the client pro-active and they can personalize the information. Don’t assume the client is relaxed or understands something basic to you as an experienced herbalist (squirting a tincture into your mouth). - Making Diet Changes
Diets are emotional.
People are attached either culturally or personally to certain types of food.
Taking away food leads to feelings of scarcity and resistance.
It is better to add a new healthy food before taking away an unhealthy but familiar food.
Next, do substitution rather than take away – olive oil instead of canola – Butter instead of margarine – Whole fat milk instead of low fat
Emphasize what the person likes that can be eaten w/o restriction – blueberries, almond butter, apples, olive oil, etc
Eventually, unhealthy food needs to be eliminated but following the above steps makes this less difficult and increases compliance.
Do this gradually. Remember, this is a process. A long term relationship with follow-ups is most effective. This is the beauty of community herbalism compared to clinical herbalism. The duration and frequency of herbalist-client interactions is a given with family members. - Physical Movement
How do you present the topic of physical movement?
Is it one more should in a crowded schedule or something that is integrated into the lifestyle? There is an important difference between going to the gym and sharing a bike ride with the family. Can natural movements be emphasized instead of formal exercise? - Affordability
Are the herbal medicines too expensive?
Learning how to prepare herbs at home takes time but is much more affordable. Some herbs – supplements – health food have become unavailable to working class or poor people. - Maintaining Motivation and Commitment
The client may lose motivation if the herbs are not effective enough quickly enough or dramatically enough.
At each visit, use a 1 – 10 scale to rate the severity, duration and/or frequency of the health problem.
Gradual improvement is often not apparent without this process. Seeing measurable numerical progress is a way to maintain motivation.
