Naturopathy National Competency Standards

I. INTRODUCTION

Guiding Principles:

Article II, Section 15 of the Philippine Constitution ensures that the “State shall protect and promote the right to health of the people and instill health consciousness among them.” Section 16 of the same article mentions that the State shall likewise protect and advance “the right of the people to a balanced and healthful ecology in accord with the rhythm and harmony of nature.”

Article XIII of the constitution also establishes a particular mode by which the State shall uphold the right to health, through the adoption of an “integrated and comprehensive approach to health development.” While “integration” refers to a unified health delivery system with both public and private sector participation as well as utilization of western and indigenous health care systems, “comprehensiveness” implies delivery of services and the undertaking of activities relating to health promotion, disease prevention, education and planning.

Article XIII furthermore emphasizes that health services shall be made available at “affordable” cost, and that free medical care must be given to impoverished and the disadvantaged. It is clear from all this, therefore, that although the State’s obligation to uphold the right to health of all, a clear bias is established in favor of the vulnerable sectors – the poor and underprivileged, elderly, disabled, women and children.

A law that introduces a fresh and innovative approach to improving access to health care and medical treatment is the Traditional and Alternative Medicine Act of 1997 which promotes research into and utilization of “traditional and alternative health care systems”^{^[1]}. The clear intent of this law is to improve the quality and delivery of health services through the development of traditional and alternative medicine, and its gradual integration into the national health care delivery system.

PITAHC, the institution created under Republic Act 8423, is created and tasked to conduct research and study of traditional and alternative medicine, train nurses, physicians and health workers in the use of such techniques, educate the public, and formulate rules and guidelines for the regulation of the practice and usage of traditional and alternative medicine^{^[2]}.

Considering these principles and the state of affairs in Naturopathyas part of pluralistic practice of medicine or integrated medicine in the Philippine setting, the Competency Standard for Naturopathy for health care professional and workers is directed towards the enhancement of naturopaths who are not only scientifically and technologically competent on Naturopathy but who are committed to comprehensive community health development consistent with the holisticphilosophy and paradigm of traditional andintegrative medicine. This is also consistent with primary health care principles, the core components of the right to health.

PURPOSE:

This Competency Standard defines the MINIMUM required stock of knowledge, skills, attitude for medical and non-medical health care professionals and workers in the area of Naturopathy The competency also defines the proper roles and orientation needed for practice relevant and appropriate to the Philippine setting.. National Certificates are issued by PITAHC when the prescribed units of competencies have been achieved.

This Competency Standard is herein formulated and developed to ensure that Naturopathy practice meets the minimum levels of adequate knowledge, skills and awareness of indications and contraindications. Specifically, the purpose of this benchmark document are as follows:

To upgrade the level of professional education and training of Naturopathsin Traditional/ Complementary and Alternative Health Care (T/CAHC) with the end view of quality patient care, setting and maintaining standards of competence and integrity, and providing quality life-enhancing and well-being services and products;

To serve as basis in the establishment of a competency assessment and certification system, which can be used for setting up a classified/ qualified pool of naturopaths ready to serve domestic needs primarily (medical, and community clinics, hospitals, etc.) and overseas requirements secondarily;

To serve as guide / basis for the Professional Regulation Commission and the various Philippine Health Professional Associations in the accreditation of the practice of Naturopathy;

To serve as basis for Philippine Health Insurance Corporation’s future guidelines for reimbursement of practitioner/ patient Naturopathy services;

To serve as guide/ basis for the development of training programs in Naturopathy for community health workers and other health workers.

To serve as a basis for the development of training programs over the full range of training modalities including those of technical institutions, apprenticeships, and community-based programs;

To pursue the Philippine Institute for Traditional and Alternative Health Care (PITAHC’s) goal of formulating policies, standards, guidelines, and practices towards improving the quality and delivery of health services through the comprehensive (preventive, curative, rehabilitative, and promotive) development of traditional, complementary and alternative medicine, and its eventual integration into the national health care delivery system.

To contribute to bringing about paradigm shift towards value formation, ethical and social transformation using the holistic philosophy of traditional, complementary and alternative systems of medicine through integrated multi-disciplinary and developmental approaches to TCAHC trainings.

UNITS OF COMPETENCIES

UNIT I Perform Naturopathic Health Assessment

Unit Descriptor

This unit covers the skills required to observe the condition of the client/patient and gather information relevant to the case, according to a naturopathic framework.

ELEMENTS	PERFORMANCE CRITERIA
Determine the scope of the assessment and the client/patient’s needs Client/patient’s purpose for consultation is established and symptoms experienced are identified Client/patient’s eligibility for service is determined using clinic/personal policies Provide services and explain clearly the limitations of available services Client/patient’s expectation of the service/clinic are explored and clarified Factors likely to have a negative impact on assessment are identified in consultation with the client/patient and strategies implemented to minimize the effects of these factors wherever possible Personal abilities, level of professional competence and parameters of role are defined to the client/patient and determine practice at all times Clients/patients are referred to other health care providers where the needs identified are beyond the scope of the services that can be provided Legal rights of the client/patient are identified and promoted
Obtain and record an accurate history of the client/patient Information required from the client/patient for the client/patient’s history is sought in a respectful way with all inquiries asked in a purposeful, systematic and diplomatic manner Accurate, relevant and well organized information is collected and recorded in a form which can be interpreted readily by other professionals Information is treated as confidential and stored securely

ELEMENTS	PERFORMANCE CRITERIA
Manage the health assessment Informed client/patient consent is obtained prior to conducting tests in accordance with legislative requirements Abnormal findings are pursued and investigated in a deliberate, logical and appropriate manner Reliability of data obtained is assessed and appropriate clinical correlation with the client/patient’s complaints is established where possible Questions are used to clarify results and gain further information in a manner relevant to the client/patient’s needs and test results Any decision to carry out laboratory tests is based on the integration of previously obtained clinical data and history The protocol required in ordering tests is adhered to Adequate time is allowed during consultation to gather critical information Factors that may interfere with the information gathering process are identified and minimized Essential requirements for the maintenance of clinical and practitioner hygiene are identified, established and routinely observed Potential sensitivities of the client/patient are anticipated, the practitioner’s approach is adapted accordingly to take these into account and steps are taken to ensure the client/patient’s dignity are maintained at all times
Make a comprehensive assessment of the client/patient Signs of health conditions and further observations are identified according to naturopathic framework Specific details of signs and symptoms of the presenting complaint/s are elicited Other appropriate assessment techniques are used All information is accurately recorded in a systetmatic manner in accordance with clinic guidelines

RANGE OF VARIABLES

Factors likely to have a negative impact on assessment may include:	Language difficulties Disabilities Emotional trauma Lack of privacy or focus due to additional parties being present Cultural or gender factors
Other health care professional may include:	Doctors Social Workers Alternative and complementary health practitioners Counsellors Nutritionist-Dietitians
Client history may include:	Date of presentation Identifying personal details Source of referral (if applicable) Main complaint or reason for consultation Presenting symptom picture General state of health - Physical - Emotional - Allergies - Dietary picture - Sleep pattern - Exercise - Leisure activities Childhood and adult illness Accidents, injuries, operations Hospitalizations Occupational history and environment Other current medical therapeutic intervention Medication, supplements and natural remedies-current and previous Social lifestyle including social drug usage Family history Details required for homeopathic case
Potential sensitivities may include:	Gender Ethnicity Language Religious beliefs Cultural heritage Sexuality Ability Present health condition and personal history
Signs of health condition may refer to:	Precipitating factors Relieving factors Associated manifestations Indications of stage and status of illness Symptom qualities Functional and pathological disturbances All procedures must be conducted according to legislative and regulatory requirements.
Other appropriate assessment techniques may include:	Observation Discussion Vital Signs (Pulse, respiratory, temperature) Palpation andPercussion External physical examination (skin, hair and nails) Comprehensive Iridology techniques Sclerology Live blood analysis Urine tests Assessment of growth (height, weight, head circumference) and development Overview of system – inquiring about the presence of previously diagnosed organic diseases and functional disorders Any other method in which the practitioner has been trained to a competent standard

EVIDENCE GUIDE

Critical aspects of assessment:	Knowledge of physical signs and symptoms of health conditions Ability to identify location, stage and characteristics of health conditions Knowledge of pathophysiology and health conditions Demonstrated observation skills Demonstrated ability to conduct external physical examination Demonstrated ability to use a range of medical equipment used in external physical examinations Demonstrated communication skills Demonstrated respect for practitioner/ client/patient boundaries Knowledge of the cost benefit ratio of special tests or studies Demonstrated record keeping skills Ability to detect and record symptoms and signs present including precipitating factors, relieving factors and associated manifestations Knowledge of and ability to use appropriate terminology related to specific discipline
Concurrent assessment and relationship with other units:	Communicate effectively with clients/ patients Contribute to the control of infection Work within a Naturopathic framework
Underpinning knowledge and skills:	Knowledge of critical information required for assessment and therapeutic intervention according to naturopathic framework Knowledge of anatomical terminology and levels of organization Knowledge and understanding of anatomical system including: - Musculo-skeletal including muscles, bones, cartilage, joints, head, upper trunk, upper limb, pelvis, and lower limb - Nervous system, including peripheral, autonomic and central nervous systems - Cardiovascular (including haemopoetic) including vascular system, spleen, heart and pericardium, systemic arteries, systemic veins, portal veins, and foetal circulation - Lymphatic including thoracic viscera, abdominal and pelvic viscera, alimentary tract, urinary and genital systems, trunk and limbs, deep and superficial lymph nodes - Gastrointestinal including mouth, salivary glands, tongue, pharynx, esophagus, abdomen and peritoneum, stomach, small intestine, large intestine, liver, biliary system, and pancreas - Respiratory including larynx, trachea, lungs and mediastinum, and pleura - Urogenital (reproductive and urinary) and endocrine incuding kidneys, ureter and bladder, male genital organs, female genital organs, thyroid, parathyroid glands, pituitary gland, adrenal gland, and thymus gland - ENT and special senses including hearing and equilibration, vision, smell, and taste Knowledge of physiology including - General physiology including cell structure and function, metabolism, and levels of organization in the body - Basic physiology including physiology of musculoskeletal system – muscles, posture and movement - Nervous system including central, peripheral and automatic nervous systems - ENT and other senses including hearing and equilibration, vision, smell, and taste - Respiratory system including pulmonary function - Cardiovascular system including heart, and circulation - Lymphatic system including lymph, immunity and allergy - Gastrointestinal including motility, secretions, movement of food, digestion and absorption - Urogenital and endocrine including renal function, micturition, extracellular fluid, metabolism, thyroid gland, hormones, and reproduction Knowledge of biochemistry Knowledge of symptomology and pathology according to naturopathic practice Knowledge of anatomy and physiology according to various stages of life Knowledge of pathophysiology and disease processes of common clinical diseases and interactivity between them, to a level necessary to support the making of a screening assessment of the client/patient’s condition to support the practice of natural/traditional medicine Knowledge of pathophysiology and disease processes affecting the nervous system including - Central and peripheral nervous tissue, brain, spinal cord and associated nerves, sensory, motor and integrative systems, and autonomic nervous system - Endocrine system including thyroid, parathyroid and adrenal glands, pancreas, calcium and bone metabolism, pituitary gland, and pineal gland - ENT and special senses including vision, hearing, smell, and taste - Respiratory system including pulmonary function, gas transport, regulation of respiration, and respiratory adjustments - Cardiovascular system including blood, clotting, erythropoitin, and cardiac cycle - Lymphatic system including immunity, and allergy - Urogenital system including renal function, fluid balance, male and female reproductive systems Knowledge of prostaglandins, development, inheritance, DNA, RNA, and introduction to genetics Knowledge of factors affecting transmission of disease and choice of therapeutic interventions of common infectious diseases Knowledge of identification of infectious organisms, indications, complications, epidemiology, occurence, mode of transmission, vectors, incubation period, period of communicability, presentation, assessment, therapeutic intervention, management and prevention Knowledge of clinical features and pathophysiology of common bacterial and viral diseases to assess the client/patient, its stage, severity and likely prognosis Knowledge of dietary impact on health and symptoms Knowledge of relevant testing and assessment options and procedures Demonstrated physical examination procedures Applications of method of keeping medical records Demonstrated ability to understand and discuss medical reports Ability to use equipment and technology competently and safely Demonstrated ability to access and interpret up-to-date information Philosophical approach to assessment and its therapeutic intervention Knowledge and strict adherence of the legal and ethical requirements for confidentiality Knowledge of time managment requirements during consultation Ability to communicate effectively to gain required information Knowledge of ethical and legal implications of inquiry
Resource implications Resource requirements include all the relevant resources commonly used by specific discipline. Specific tools may include:	An appropriately stocked and equipped clinic or simulated clinic environment Skilled assessors Relevant assessment instruments Appropriate assessment environment
Method of assessment Assessment may include:	Observation of performance Examples of assessment notes Simulated assignments Written or verbal answer tests Practical demonstrations and exercises Research work or written reports of observations in a practical setting Oral questioning on technique or assessment strategy Case studies and scenarios as basis for discussion of issues and strategies to contribute to best practice in the work environment
Context of assessment:	This unit is most apropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may be on more than one occasion to cover a variety of circumstances

UNIT II Manage Work Within the Naturopathic Framework

Unit Descriptor

This unit describes the skills required to manage the effective work practices of self and others within a naturopathic framework: Maintain an effective work environment.

ELEMENT	PERFORMANCE CRITERIA
Communicate knowledge of naturopathic philosophy, principles and practices Standard forms of assessment and therapeutic approach can be effectively communicated on a one-on-one or group basis Definition, central philosophies and historical developments of naturopathy can be explained Recent developments and new practices are integrated into client/patient services
Demonstrate commitment to ethical work practices Confidentiality of client/patient information is maintained by storing and disposing of records according to clinic requirements Work practices are reviewed periodically to ensure skills and practices are kept current Work practices show respect for staff and client/patient rights Work practices adhere to legal, regulatory and clinic practice guidelines Measures are implemented to ensure accountability for professional practices
Manage workplace relationships Effective communication and interpersonal skills are used to ensure all workplace interactions contribute to the achievement of clinic objectives and the promotion of the practice Workplace relations reflect consideration of the full range of individual and cultural differences Issues related to the well-being of work colleagues are dealt with promptly and in accordance with clinic procedures Potential and actual workplace conflicts are handled to minimize disruption
Manage the achievement of quality standards Personal hygiene and infection control guidelines are established and practised throughout the organization Hazard control measures and reporting procedures are undertaken according to clinic practice guidelines Individual and clinic performance is reviewed against established standards
Ensure ongoing development of self and team Self performance is regularly monitored against workplans, clinic objectives and client/patient needs Opportunities for formal and informal development of skills and knowledge are sought out and accessed to optimize performance Individual performances are monitored and developed to enhance team performance, where appropriate Coaching and mentoring contributes effectively to development of workplace knowledge, skills and attitudes

RANGE OF VARIABLES

The major and minor forms of assessment may include:	Observation Discussion Vital signs (pulse, respiratory, temperature) Palpation and Percussion External physical examination (skin, hair, nails) Comprehensive Iridology techniques Sclerology Live blood analysis Urine tests Assessment of growth (height, weight, head circumference) and development Overview of system – inquiring about the presence of previously diagnosed organic diseases and functional disorders Any other method in which the practitioner has been trained to a competent standard Procedure which is conducted according to legislative and regulatory requirements
Therapeutic intervention practices may include:	Nutrition therapies including the use of specific micronutrient supplements and food therapy Herbal medicine Homeopathy (acute)/Homotoxicology (PITAHC-certified) Active and Passive Bodyworks e.g. massage, reflexology, shiatsu; exercise regimen Hydrotherapy Psychological Trauma Therapy Oxygen Therapy Aromatherapy Art Therapy( movement, visual, music, sound) Body and Mind (meditation) Bach Flower Therapy Energy Healing (w or w/o device) Acupuncture (PITAHC Certified) Health and Wellness Advice
Definition of naturopathy is:	Naturopathy is a distinct method of wholistic healing, underpinned by a philosophical perspective which recognizes that all living forms possess a self-regulatory, inherent ability for self-healing. This inherent ability, or vital force, operates in an intelligent, orderly fashion. Naturopathic approaches to health care are aimed at supporting and enhancing the body’s own ability to heal itself.
Central philosophies include:	Primum Non Nocere (“first do no harm”) Vis medicatrix naturae (the healing power of nature) Tolle causam (identify and treat the cause) Docere (doctor as teacher) Treat the whole person Prevention
Measures implemented could refer to:	Supervision of practice Financial documentation Government regulatory requirements (ie.business permit, FDA, IPO, etc.) Documentation of therapeutic intervention with or without devices Case notes Practitioner qualification/ certification from PITAHC Performance reviews (internal) Current certification for special services offered-where appropriate Organizational standards and procedures
Effective communication and interpersonal skills may include:	Active listening skills Ability to establish rapport and trust Eye contact Verbal communication skills Written communication skills Empathy and respect Ability to clarify needs Conflict resolution skills Negotiation skills Presentation Honesty and integrity
Opportunities for formal and informal development of skills and knowledge may include:	Articles, public presentations, interviews and other communications Attendance at lectures or other education activities Participation in research projects Attendance at association meetings Subscription to professional journals Clinic supervision Provision of or attendance at training Study, distance-based learning

EVIDENCE GUIDE

Critical aspects of assessment:	Ability to work or model work which demonstrates an understanding of underpinning values and philosophies in the naturopathy framework Knowledge of the philosophies, principles and tools of naturopathic practice Knowledge of a range of alternative and complementary therapies Demonstrated ability to correctly identify information needs Demonstrated ability to seek out and implement new findings and practices Demonstrated documentation skills Demonstrated ability to explain relevant products and services Demonstrated communication skills in a one-on-one and group setting Demonstrated ability to explain clinic practice guidelines (CPG) and legislation Demonstrated ability to undertake performance reviews Demonstrated ability to provide leadership, coaching and/or mentorship Demonstrated management skills Team development skills
Underpinning knowledge and skills:	Knowledge of philosophical Traditional and Alternative Health Care (TAHC) systems Knowledge of sociology of health and the health care system Knowledge of ethical issues in natural medicine Knowledge of Occupational Health and Safety (OHS) requirements in the workplace Knowledge of the current political context of health care Knowledge of the dynamic interchange between the physical, mental, social, environmental and spiritual landscape Knowledge of the rationalistic, analytical approach to an understanding of disease Knowledge of the vitalistic, empirical approach to health Knowledge of the naturopathic integration of these approaches to health Knowledge of the qualitative, quantitative, cultural and traditional lines of evidence used in naturopathy Knowledge of the philosophy, principles and practices of other alternative and complementary therapies including homeopathy, herbal medicine, nutrition and bodywork Knowledge of the principles of naturopathic practice: Primum Non Nocere (“first do no harm’), vis medicatrix naturae (the healing power of nature); tolle causam (identify and treat the cause); docere (doctor as teacher); treat the whole person (prevention) Knowledge of how naturopathy works with the conventional health model Knowledge of philosophy, principles and practices of the different naturopathic modalities Knowledge of ethical issues in management Knowledge of Occupational Health and Safety (OHS) requirements in the workplace Ability to identify ethical issues Communication skills in one-on-one and group settings Knowledge of management issues and responsibilities Knowledge of competency standards for naturopathy Knowledge of team development issues
Resource implications Resource requirements may include:	Relevant texts on naturopathy and medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration and simulations Short tests and essays Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering wide range of clinical situations.

UNIT III Apply Naturopathic Assessment Framework

Unit Descriptor

This unit covers the skills required to interpret information gathered in the health assessment and make and review accurate assessment over the course of therapeutic intervention, according to the naturopathic framework.

ELEMENTS	PERFORMANCE CRITERIA
Analyze and interpret information received Results of the health assessment are correlated with case history Signs and symptoms of condition in the client/patient are recognized and identified as pre-requisites for therapeutic intervention/care Information gathered is assessed and assigned priorities in consultation with the client/patient using the knowledge and experience and theoretical principles applied by the practitioner Information is gathered, recorded and organized in a way which can be interpreted readily by other professionals Patterns are analyzed and differentiated by assessing signs and symptoms Condition is identifed according to stage and related implications (e.g. acute/chronic) by applying principles of assessment Professional judgement is used to draw sound conclusions and prognosis from the data collected All signs and symptoms are elicited in a thorough and objective manner to avoid premature conclusions Client/patient’s progress is systematically monitored in order to confirm the initial assessment or clinical impression
Clinically evaluate the assessment An ongoing critical evaluation of the assessment is applied Appropriate assessment tools/methods are selected Re-evaluation of the case is carried out whenever considered necessary by the practitioner History and clinical data are effectively combined to obtain a differential assessment and prognosis
Inform the client/patient Rationale of the assessment/prognosis is discussed with the client/patient Practitioner is able to repond to client/patient inquiries using language the client/patient understands Referral and collaborative options are discussed with the client/patient if necessary

RANGE OF VARIABLES

Signs and symptoms of conditions may include:	Physical evidence Behavioural evidence States of disorder Test or examination results Sensations Onset Duration Location Causation Ameliorating and aggravating factors Symptom qualities (intensity, severity, nature of complaint) Non-verbal signs and symptoms Functional and pathological disturbances
Patterns may refer to:	Temperaments – humoral theory e.g. choleric/sanguine Iridology Constitutional Types: Lymphatic, Biliary, Hematogenic Constitutional states e.g. neuresthenic Syndromes e.g. adrenal exhaustion Functional disorders e.g. functional hypoglycemia Health conditions

EVIDENCE GUIDE

Critical aspects of assessment include:	Demonstrated ability to interpret investigative findings Demonstrated differential assessment skills Ability to prioritize presenting conditions Knowledge of referral process Establishment of urgency for therapeutic intervention required
Concurrent assessment and relationship with other units:	Perform health assessment Communicate effectively with clients Work within a naturopathic framework
Underpinning knowledge and skills:	Knowledge of anatomy and physiology of the body systems Knowledge of relevant testing and assessment options and procedures Knowledge of signs and symptoms of health conditions and disorder/ dysfunction Knowledge of disease process Ability to apply differential assessment Knowledge and understanding of types of further investigation available Demonstrated ability to access and interpret up-to-date information Ability to write referrals, appraisal letters for insurance companies and other documentation Knowledge of the contribution of the different schools of thought and historical theories of clinical practice
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based assessment environment
Method of assessment Assessment may include:	Written assignment with practical demonstration Assessment from notes or simulated assessments Oral questioning Case studies and scenarios as a basis for discussion of diagnostic technique Short answer tests
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work condition. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

UNIT IV Work Within a Naturopathic Framework

Unit Descriptor

This unit describes the skills required to work effectively within a naturopathic framework.

ELEMENT	PERFORMANCE CRITERIA
Demonstrate commitment to the central philosophies of naturopathic practice Definition of naturopathy and the naturopathic system of therapy is provided Historical development of naturopathy is provided Central philosophies of naturopathy are identified and explained Practitioner applies naturopathic philosophy to his/her own health practices Practitioner draws on naturopathic philosophy to interpret health issues
Identify and describe the principles and practices of naturopathy Major methods of therapeutic intervention used by naturopaths are identified and described Other complementary therapies used by naturopaths are identified and described Traditionally used methods of healing are identified and described Naturopathic assessment techniques are identified and described
Develop knowledge of complementary therapies Principles and practices of other healing systems are identified and described Information on other complementary therapies is provided Relationship between therapies is identified
Represent naturopathic framework to the community Practices and principles of naturopathy can be explained in an easily understood way in a one-on-one and group setting Inquiries are clarified and appropriate information is provided Requests for client/patient to bring relevant data to the consultation are made Alternative sources of information/advice	are discussed with the client/patient
Work within clinic and regulation guidelines Clinic practice guidelines are accessed and followed Legal and regulatory guidelines are accessed and followed Relevant documentation is undertaken

RANGE OF VARIABLES

Definition of Naturopathy is:	Naturopathy is a distinct method of healing, underpinned by a philosophical perspective which recognizes that all living forms possess a self-regulatory, inherent ability for self-healing. This inherent ability, or vital force, operates in an intelligent, orderly fashion. Naturopathic approaches to health care are aimed at supporting and enhancing the body’s own ability to heal itself.
Central philosophies of naturopathy are:	Primum Non Nocere (First do no harm) Vis medicattrix naturae (the healing power of nature) Tolle causam (identify and treat the cause) Docere (doctor as teacher) Treat the whole person Prevention
Major methods of therapeutic intervention include:	Nutrition therapies including the use of specific micronutrient supplements and food therapy Herbal medicine Homeopathy Bodywork e.g. massage, reflexology, shiatsu Acupuncture Health and Wellness Advice
Other complementary therapies may include:	Aromatherapy Flower essence therapy Energy Medicine (pranic healing, reiki,etc) Relaxation, Creative and Art Therapies (music, movement dance, visual arts) Body-mind interventions (prayer, meditation) Therapies in which the practitioner is trained
Traditionally used methods of healing include:	Fresh air Pure water Fresh, whole foods Diet therapy Detoxification Herbs Sunlight Rest and relaxation Exercise Massage Hydrotherapy Hilot Cupping/Ventosa Moxibustion
Appropriate assessment techniques may include:	Observation Discussion Vital signs (pulse, respiratory, temperature) Palpation and Percussion External physical examination (skin, hair, nails) Comprehensive Iridology techniques Sclerology Live blood analysis Urine tests Assessment of growth (height, weight, head circumference) and development Overview of system – inquiring about the presence of previously diagnosed organic diseases and functional disorders Any other method in which the practitioner has been trained to a competent standard Procedure which is conducted according to legislative and regulatory requirements
Other healing systems may include:	Traditional Chinese Medicine (TCM) Ayurveda
Information on other complementary therapies may include:	Historical development Current availability Tools and techniques Interactions between different therapies When therapies may be used Underpinning philosophy
Relationship between therapies may include:	Contra-indications to therapeutic intervention Effects of one therapeutic intervention over or with another Therapeutic intervention according to stage of condition
Inquiries may require explanation of:	Duration of therapeutic intervention Expected therapeutic intervention outcomes Possible approaches to therapeutic intervention Estimated cost of therapeutic intervention Availability of health fund rebates Work cover eligibility Professional status of practitioner Availability of home visits After hours service Provision for hospital visits
Appropriate information may include:	Confirmation of appointment date and time Clinic location and directions Cost of initial consultation Payment options
Clinic’s guidelines may include:	Clinical Practice Guidelines (CPGs) Purpose or mission statement Code of ethics or practice Level of competency and degree of supervision Partnership/group decisions, agreed practice
Legal and regulatory guidelines may include:	Occupational Health and Safety (OHS) guidelines Anti-discrimination legislation Privacy Act Infection Control Guidelines
Relevant documentation may include:	Nature of inquiry Client/patient contact details Recording of incidents Appointment details

EVIDENCE GUIDE

Critical aspects of assessment:	Ability to work or model work which demonstrates an understanding of underpinning values and philosophies in the naturopathy framework Knowledge of the philosophies, principles and tools of naturopathic practice Knowledge of a range of alternative and complementary therapies Demonstrated ability to correctly identify client/patient information needs Demonstrated ability to provide client/patient with required information Demonstrated ability to appropriately record details of client/patient inquiries according to clinic practice guidelines Demonstrated ability to explain relevant products and services Demonstrated communication skills in a one-on-one and group setting
Concurrent assessment and relationship with other units:	Work effectively in the health industry
Underpinning knowledge and skills:	Knowledge of philosophical tradition of science/western medicine Knowledge of sociology of health and the health care system Knowledge of ethical issues in natural medicine Knowledge of Occupational Health and Safety (OHS) requirements in the workplace Knowledge of the current political context of health care Knowledge of the dynamic interchange between the physical, mental, social , environmental and spiritual landscape Knowledge of the rationalistic, analytical approach to an understanding of disease Knowledge of the vitalistic, empirical approach to health Knowledge of the naturopathic integration of the approaches to health Knowledge of the qualitative, quantitative, cultural and traditional lines of evidence used in naturopathy Knowledge of the philosophy, principles and practices of other alternative and complementary therapies including homeopathy, herbal medicine, nutrition and bodywork Knowledge of the principles of naturopathic practice: Primum Non Nocere ( First do no harm); vis medicatrix naturae (the healing power of nature); tolle causam (identify and treat the cause); docere (doctor as teacher); treat the whole person; prevention Knowledge of how naturopathy works with the conventional health model Communication skills
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration and simulations Short tests and essays Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples of a range of clinical situations.

UNIT V Plan the Naturopathic therapeutic intervention strategy

Unit Descriptor

This unit describes the skills required to prepare for therapeutic intervention of clients/patients and negotiate a therapeutic intervention management plan with them using a naturopathic framework.

ELEMENTS	PERFORMANCE CRITERIA
Determine therapeutic intervention strategy Appropriate therapeutic principles of therapeutic intervention are determined according to assessment of client/patient and within the skills of competence of the practitioner Contra-indications to therapeutic intervention and possible complicating factors are ascertained and therapeutic intervention strategy used is modified according to naturopathic principles Therapeutic intervention and advice provided by other health care professionals is taken into consideration in determining the strategy to be used in therapeutic intervention Therapeutic intervention strategy appropriate to the client/patient’s condition is selected, supported on the basis of established naturopathic practice Specific therapeutic intervention options take into consideration possible client/patient compliance issues
Discuss the therapeutic intervention strategy with the client/patient The proposed therapeutic intervention strategy is discussed with the client/patient Sufficient time is allocated to discuss the therapeutic intervention strategy, appropriate to the client/patient’s needs Client compliance is negotiated Discrepancies between the practitioner’s and the client/patient’s perception of the condition are clarified Any relevant information from medical or assessment reports is communicated, where appropriate Any perceived risks of the client/patient’s condition and therapeutic intervention are explained Responsibilities of practitioner and client/patient within the therapeutic intervention plan are clarified Management of selected therapeutic intervention in relation to any other current therapies is negotiated Therapeutic intervention evaluation strategies are discussed

RANGE OF VARIABLES

Contra-indications to therapeutic intervention and possible complicating factors may include:	Acute surgical and medical conditions such as cardiac arrest, acute hypovolaemic shock, paralytic ileus and loss of consciousness Traumatic injuries or conditions requiring immediate medical attention Life threatening situations Personal or life circumstances Ability or willingness to comply with therapeutic intervention Allergies/sensitivities Past therapeutic intervention history Current conditions/disease state Current medications/therapeutic interventions Contraindications for use of certain excipients and bases
Therapeutic interventions may include:	Nutrition therapies including the use of specific micronutrient supplements and food therapy Herbal medicine Homeopathy Bodywork eg. Massage, reflexology, shiatsu Acupuncture Health and Wellness Advice
Client/patient compliance refers to:	Ability to follow instructions or suggestions Willingness to follow instructions or suggestions
Discrepancies may include:	Client/patient is unaware of the immediate danger of their condition Client/patient is over anxious about their condition Client/patient is unaware of maintaining causes acting on their condition Practitioner is unaware of some implications of the client/patient’s condition Practitioner and client/patient have a different view of what the main problem is
Practitioner responsibilities may include:	Following instructions/advice during and post therapeutic intervention Advising clients/ patients of any relevant contraindications or potential complications to therapy Advising clients/ patients of compliance issues Commitment to the therapeutic plan
Therapeutic intervention evaluation strategies may include:	Discussing and reviewing of response to therapeutic intervention Reviewing achievement of therapeutic intervention Monitoring time-frame for achieving therapeutic intervention goals

EVIDENCE GUIDE

Critical aspects of assessment:	Demonstrated ability to identify therapeutic intervention options and establish therapeutic intervention regimen Demonstrated ability to prepare therapeutic intervention plans Demonstrated ability to understand and discuss medical reports and other data relevant to the health conditions Knowledge of remedies /therapeutic interventions and dosages used to heal particular health conditions Demonstrated ability to prescribe remedies/therapeutic interventions according to the time-frame appropriate to the client/patient condition and the remedies/therapeutic interventions selected, and to the dosage recommended for the client/patient age group Demonstrated ability to select dietary regimen for specific conditions Knowledge of legal and ethical considerations in treating clients with remedies/therapeutic interventions Knowledge of lifestyle factors relevant to therapeutic intervention of specific health conditions Demonstrated consideration of the impact of client/patient vitality on selected remedies/therapeutic interventions Knowledge of possible obstacles to healing Knowledge of community resources and support services Demonstrated communication and negotiation skills Demonstrated ability to provide advice
Concurrent assessment and relationship with other units:	Work within a naturopathic framework Communicate effectively with clients Apply assessment framework
Underpinning knowledge and skills:	Knowledge of common health conditions and functional problems of each bodily system Knowledge of the principles and practice of healing common conditions Knowledge of the active principles of the remedies/therapeutic interventions used for each condition/system Knowledge of the principles of formulation including dosage and duration of therapeutic intervention Knowledge of supplementary measures in the management of the condition/system (dietary considerations, exercise) Ability to apply methods of managing the healing process of each system using naturopathic remedies/therapeutic interventions Knowledge of the derivation of the materia medica from provings, clinical and toxicological sources Knowledge of major remedies with respect to their use for general symptoms, psychological and physiological indications Knowledge of minor remedies in respect to their most important indications Knowledge of groups of remedies and how to distinguish between them Knowledge of the clinical indications of remedies relevant to specific circumstances – infectious diseases, First Aid and injuries Knowledge of the interaction of remedies/therapeutic interventions with foods, herbs, nutritional supplements and drugs Knowledge of pharmacology Awareness of allopathic drugs, their classifications, usage and side effects and adverse reaction Advanced knowledge of medical terminology Knowledge of pharmacokinetics – drug administration, absorption, distribution, metabolism and excretion Knowledge of pharmacodynamics and the theory of drug action, factors modifying drug effect and dosage, drug toxicity and toxicology Knowledge of drug abuse – signs, consequences, therapeutic intervention, community resources available Knowledge of drugs used in pregnancy and breast feeding Knowledge of drugs used to treat disorders of each system of the body Knowledge of medical reports and diagnostic procedures Knowledge of the possible responses and contra-indications to therapeutic interventions Knowledge of drug interactions Knowledge of pathogenesis of the remedies/therapeutic interventions administered Ability to access and understand reference material of the effects of current conventional drug therapies and their withdrawal Ability to access and interpret up-to-date information Knowledge and understanding of methods of preparing therapeutic intervention and management plans Knowledge of the correct preparations required for specific therapeutic intervention Interpersonal and questioning skills
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Documented process to enable the access and interpretation of up-to-date information Relevant assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations for plan preparations Oral questioning and discussion Practical assignments Written, multiple choice or short answer tests Case studies and scenarios Observation in a practical setting Research work
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

UNIT VI. Provide the Naturopathic therapeutic intervention

Unit Descriptor

This unit describes the skills required to administer client/patient according to a naturopathic framework.

ELEMENT	PERFORMANCE CRITERIA
Manage therapeutic intervention Factors which may interfere with the effectiveness of the therapeutic intervention are explained Mode of administration and management of the therapeutic intervention are explained to the client/patient Client/patient is requested to monitor reactions and contact practitioner are required Consent for therapeutic intervention is ensured Reactions to therapeutic intervention (adverse or otherwise) are recognized and promptly responded to, if necessary Time, location and content of future sessions are clearly explained to the client/patient Recommendations are fully documented Therapeutic intervention is provided according to the therapeutic intervention plan
Apply therapeutic techniques Therapeutic intervention/remedies are applied, recommended, dispensed or prescribed Therapeutic intervention is delivered according to regulations Other health care professionals are referred to or collaborated with, as required
Advise the client/patient The client/patient is educated in relevant and practical techniques for promotion and maintenance of optimum health Client/patient queries are answered with clarity, using appropriate language Appropriate interpersonal skills are used when explaining therapeutic intervention plans and recommendations to the client/patient Client/patient independence and responsibility in therapeutic intervention are promoted wherever possible Counselling within naturopathic framework is provided, when appropriate
Review therapeutic intervention Progress is reviewed with the client/patient Effects of previous therapeutic intervention are identified and recorded Previous therapeutic intervention plan is reviewed Need for ongoing and/or additional therapeutic intervention is evaluated Changes to the plan are negotiated with the client/patient to ensure optimal outcomes

RANGE OF VARIABLES

Factors which interfere with the effectiveness of therapeutic intervention may include:	Other medical therapeutic intervention being undertaken Client/patient’s physical and psychological readiness and/or wellness Cultural factors Contra-indications to therapeutic intervention Post therapeutic intervention activity
Mode of administration may be:	Oral Topical Inhaled
Responses to reactions may include:	Adjusting therapeutic intervention accordingly Seeking appropriate expertise Discussing reaction with the client/patient Adherence to clinic guidelines for response to accidents and emergencies Using First Aid procedures according to Philippine National Red Cross or other appropriate First Aid training Institutions Accessing local emergency services
Consent for therapeutic intervention refers to:	Informed consent according to the local and national regulations and legal guidelines
Regulations may include:	Hygiene and infection control regulations Occupational Health and Safety (OHS) regulations Clinic or professional practice guidelines Complying with national legislation in the practice of naturopathy
Advise the client/patient refers to:	Providing relevant literature or information materials Referring client/patient to other information sources Providing advice regarding self-care Advising client/patient of suggested resources Providing of details which help to fully inform patient/client of relevant information Providing of referrals to other health professionals Availability of products required or suggested for therapeutic intervention
Practical techniques that promote and maintain optimal health may include:	Nutritional advice Advice on lifestyle modification Excercise suggestions Stress management techniques

EVIDENCE GUIDE

Critical aspects of assessment: Therapeutic intervention plans are implemented to achieve optimal health and rehabilitation, or to improve quality of life. These involve:	Appropriate preparation of the client/patient for therapeutic intervention Therapeutic intervention of a range of health conditions Incorporation of the philosophies and beliefs of the practice of naturopathy Demonstration of the application of commonly used therapeutic intervention practices Provision of therapeutic intervention in accordance with the individual, the condition and the presence of complicating factors Provision of the safest, most efficacious and cost effective therapeutic intervention method Use of health/nutrition advice within naturopathic consultation as an aid to therapeutic intervention Provision of therapeutic intervention in accordance with the intervention plan Complete documentation of all recommendations and client/patient responses Review of therapeutic intervention plan Demonstrated interpersonal skills
Concurrent assessment and relationship with other units:	Communicate effectively with clients Contribute to the control of infection Work effectively within the health industry Prepare and dispense herbal medicines Homeopathy in a naturopathic framework Prepare and dispense homeopathic medicines
Underpinning knowledge and skills:	Knowledge of common health conditions and functional problems of each bodily system and the principles and practice of managing each system/condition Knowledge of the active principles of the main naturopathic remedies/therapeutic interventions used for each system/condition Knowledge of the principles of formulation (including dosage and duration of therapeutic intervention) Knowledge of supplementary measures in the management of conditions (dietary considerations, exercise) Ability to apply methods of managing the health condition of each system using naturopathic remedies/therapeutic interventions Knowledge of how to select best remedies/therapeutic interventions within best current practice Knowledge of how to correctly prepare and dispense naturopathic remedies/therapeutic interventions Knowledge of the role of nutrition in health and ability to determine the nutritional and dietary needs of a client/patient Knowledge of the process of digestion, absorption and metabolism Knowledge and understanding of the components of food and dietary supplements Knowledge of the appropriate dietary therapeutic intervention of common health conditions Knowledge of types of diets (omnivore, vegetarian, lacto-vegetarian, vegan, fruitarian, zen macrobiotic) Knowledge of medical reports and assessment procedures Knowledge of the possible responses to therapeutic interventions Knowledge of contra-indications of therapeutic intervention Knowledge of drug interactions Knowledge of the pathogenesis of the remedies/therapeutic interventions administered Ability to access reference materials on the effects of current conventional drug therapies and their withdrawal Knowledge and understanding of methods of preparing therapeutic intervention and management plans Knowledge of the correct preparations required for specific therapeutic intervention Demonstrated ability to access and interpret up-to-date information Interpersonal and questioning skills Ability to write referrals, appraisal letters for insurance companies and other documentation
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

UNIT VII Provide the Herbal Medicine therapeutic intervention

Unit Descriptor

This unit describes the skills required to administer client/patient therapeutic intervention according to a naturopathic framework.

ELEMENT	PERFORMANCE CRITERIA
Manage therapeutic intervention Factors which may interfere with the effectiveness of the therapeutic intervention are explained Mode of administration and management of the therapeutic intervention are explained to the client/patient Client/patient is requested to monitor reactions and contact practitioner as required Consent for therapeutic intervention is ensured Reactions (adverse or otherwise) to therapeutic intervention are recognized and promptly responded to, if necessary Time, location and content of future sessions are clearly explained to the client/patient Recommendations are fully documented Therapeutic intervention is provided according to the therapeutic intervention plan
Apply therapeutic tehniques Herbal medicines, extemporaneous preparations, herbal plasters, poulticxes, ointments or other topical applications are applied, recommended, dispensed or prescribed Therapeutic intervention is delivered according to regulations Other health care professionals are referred to or collaborated with as required
Advise the client The client/patient is educated in relevant and practical techniques for promotion and maintenance of optimum health Client/patient queries are answered with clarity, using appropriate language Appropriate interpersonal skills are used when explaining therapeutic intervention plans and recommendations to the client/patient Client/patient independence and responsibility in therapeutic intervention are promoted wherever possible Counselling within a herbal medicine framework is provided when appropriate
Review therapeutic intervention Progress is reviewed with the client/patient Effects of previous therapeutic intervention are identified and recorded Previous therapeutic intervention plan is reviewed Need for ongoing and/or additional therapeutic intervention is evaluated Changes to the plan are negotiated with the client/patient to ensure optimal outcomes

RANGE OF VARIABLES
Factors which interfere with the effectiveness of therapeutic intervention may include:	Other medical therapeutic intervention being undertaken Client/patient’s physical and psychological readiness and/or wellness Cultural factors Contra-indications to therapeutic intervention Post therapeutic intervention activity
Mode of administration may be:	Oral Topical Inhaled
Responses to reactions may include:	Adjusting therapeutic intervention accordingly Seeking appropriate expertise Discussing reaction with the client/patient Adhering to clinic guidelines for response to accidents and emergencies Using First Aid procedures according to Philippine National Red Cross or other appropriate First Aid training institutions Accessing local emergency services
Consent for therapeutic intervention refers to:	Informed consent according to the local and national regulations and legal guidelines
Regulations may include:	Hygiene, sanitation and infection control regulations Occupational Health and Safety (OHS) regulations Clinic or professional practice guidelines Complying with national legislation pertinent to naturopathy
Advise the client/patient refers to:	Providing relevant literature or information materials Referring client/patient to other information sources Providing advise regarding self-care Advising client/patient of suggested resources Providing of details which help to fully inform patient/client of relevant information Providing of referrals to other health professionals Availability of products required or suggested for therapeutic intervention
Practical techniques that promote and maintain optimal health may include:	Nutritional advice/counselling Advice on lifestyle modification Exercise suggestions Stress management techniques

EVIDENCE GUIDE
Critical aspects of evidence Therapeutic intervention plans are implemented to achieve optimal health, rehabilitation, or to improve quality of life. These involve:	Appropriate preparation of the client/patient for therapeutic intervention Therapeutic intervention of a range of health conditions Incorporation of the philosophies of the practice of herbal medicine Demonstration of the application of commonly used therapeutic intervention practices Provision of therapeutic intervention in accordance with the individual, the condition and the presence of complicating factors Provision of the safest, most efficient and cost effective therapeutic intervention method Understanding of the function and contraindications of each herb dispensed The use of counseling within herbal medicine consultation as an aid to therapeutic intervention Provision of therapeutic intervention in accordance with the therapeutic intervention plan Complete documentation of all recommendations and client/patient responses Review of therapeutic intervention plan Demonstrated interpersonal skills
Concurrrent assessment and relationship with other units:	Communicate effectively with clients Contribute to the control of infection Work effectively within the health industry Prepare and dispense herbal medicines
Underpinning knowledge and skills:	Knowledge of common health conditions and functional problems of each bodily system and the principles and practice of managing each system/condition Knowledge of the active principles of the main herbal medicines used for each system/condition Knowledge of the principles of formulation (including dosage and duration of therapeutic intervention) Knowledge of supplementary measures in the management of the conditions (dietary considerations, exercise) Ability to apply methods of the health conditions of each system using herbal medicine Knowledge of how to select best therapeutic intervention/medicine within best current practice Knowledge of how to correctly prepare and dispense herbal medicines Knowledge of medical reports and assessment procedures Knowledge of possible responses to therapeutic interventions Knowledge of contraindications, adverse reactions, drug-herb interactions Ability to access reference material on the effects of current conventional drug therapies and their withdrawal Knowledge of the function and contra-indications of each herb dispensed Knowledge and understanding of methods of preparing therapeutic intervention and management plans Knowledge of the correct preparations required for specific therapeutic intervention Knowledge of dosage principles Demonstrated ability to access and interpret up-to-date information on health practices and medicines Interpersonal and questioning skills Ability to write referrals, appraisal letters for insurance companies and other documentation
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations

UNIT VIII Provide Naturopathic nutritional therapeutic intervention

Unit Descriptor

This unit describes the skills required to provide naturopathic advice on dietary modification and nutritional supplements according to a naturopathic framework

ELEMENT	PERFORMANCE CRITERIA
Manage therapeutic intervention Factors which may interfere with the effectiveness of the therapeutic intervention are identified and explained The use of dietary modification and management of the therapeutic intervention are explained to the client/patient Client/patient is requested to monitor reactions and contact practitioner as required Consent for therapeutic intervention is ensured and contraindications are identified Reactions to therapeutic intervention (adverse or otherwise) are recognized and promptly responded to, if necessary Time, location and purpose of future sessions are clearly explained to the client/patient Recommendations are fully documented Therapeutic intervention is provided according to the therapeutic intervention plan
Apply therapeutic techniques Determine the appropriateness of dietary modification and/or nutritional supplementation Identify and manage the therapeutic intervention of food allergies/food sensitivities Evaluate the influence of environmental and other factors on nutritional status Care is taken to evaluate cultural barriers to dietary modification and/or supplement prescription Deliver therapeutic intervention according to regulations Refer to or collaborate with other health care professionals as required
Advise the client Client/patient is educated in relevant and practical techniques for promotion and maintenance of optimum health, which include dietary and lifestyle modification Client/patient queries are answered with clarity, using appropriate language Appropriate interpersonal skills are used when explaining therapeutic intervention plans and recommendations to the client/patient Client/patient independence and responsibility in therapeutic intervention are promoted wherever possible Dietary advice within a nutritional framework is provided when appropriate
Review therapeutic intervention Progress is reviewed with the client/patient Effects of previous therapeutic intervention are identified and recorded Previous therapeutic intervention plan is reviewed Need for ongoing and/or additional therapeutic intervention is evaluated Changes to the plan are negotiated with the client/patient to ensure optimal outcomes

RANGE OF VARIABLES

Factors which interfere with the effectiveness of therapeutic intervention may include:	Age Cultural factors Other medical therapeutic intervention being undertaken Client/patient’s physical and psychological readiness and/or wellness Contraindications to therapeutic intervention Post therapeutic intervention activity Malabsorption
Dietary modification may include	Exclusion of some foods or food groupings Inclusion of some foods or food groupings Increased consumption of some foods or food groupings Decreased consumption of some foods or food groupings Inclusion of nutritional supplements
Consent for therapeutic intervention refers to:	Informed consent according to the local and national regulations and legal guidelines
Contra-indications to therapeutic intervention may include:	Pregnancy and breastfeeding Drug-nutrient and nutrient-nutrient interactions Known allergies Specific illnesses and conditions Other medical therapeutic intervention being undertaken
Responses to reactions may include:	Adjusting therapeutic intervention accordingly Seeking appropriate expertise Discussing reaction with the client/patient Adhering to clinic guidelines for response to accidents and emergencies Using first Aid procedures according to Philippine National Red Cross or other appropriate First Aid training institutions Accessing local emergency services
Nutritional and supplementation may include:	Vitamins Minerals Amino acids Omega oils Celloids Tissue salts Other nutritional extracts or substances
Environmental factors may include:	Food additives -intentional -non-intentional Food contamination (microbiological) Pollution
Other factors may include:	Pharmaceutical drugs Self-prescribed medication Cultural Dental problems Food cravings Food aversions Food preparation techniques Age Special dietary needs e.g, acquired and genetic conditions
Cultural barriers may include:	Religious restrictions Dietary choices e.g., vegetarian, vegan
Regulations may include:	Hygiene, sanitation and infection control regulations Occupational Health and Safety (OHS) regulations Clinic or professional practice guidelines Complying with state or national legislation in the practice of naturopathy
Advise the client/patient refers to:	Providing relevant literature or information materials Referring client/patient to other information sources Providing advice regarding self-care Advising client/patient of suggested resources Providing details which help to fully inform patient/client of relevant information Providing referrals to other health professionals Availability of products required or suggested for therapeutic intervention
Relevant and practical techniques that promote and maintain optimal health may include:	Exercise suggestions Stress management techniques
Lifestyle modification may involve:	Use of alcohol consumption Use of tobacco consumption Use of social/recreational drugs Living arrangements Working conditions

EVIDENCE GUIDE

Critical aspects of assessment:	Therapeutic intervention plans are implemented to achieve optimal health, rehabilitation, or to improve quality of life. These involve: -Demonstrated ability to assess nutritional needs according to naturopathic principles -Appropriate preparation of the client /patient for therapeutic intervention -Therapeutic intervention of a range of health conditions -Incorporation of the philosophies and beliefs of the practice of naturopathy -Demonstration of the application of commonly used therapeutic intervention practices -Provision of therapeutic intervention in accordance with the individual, the condition and the presence of complicating factors -Provision of the safest, most efficacious and cost effective therapeutic intervention method -The use of counselling within the nutritional consultation as an aid to therapeutic intervention -Provision of therapeutic intervention in accordance with the therapeutic intervention plan -Complete documentation of all recommendations and client/patient responses -Review of therapeutic intervention plan Demonstrated ability to design and implement dietary modifications in manner acceptable to the client/patient Demonstrated interpersonal skills Demonstrated ability to assess the components of food found in common diets Demonstrated ability to advise on nutritional suplements and determine the most appropriate supplementation
Concurrent assessment and relationship with other units:	Communicate effectively with clients Contribute to the control of infection Work effectively within the health industry Provide the therapeutic intervention
Underpinning knowledge and skills:	Knowledge of common health conditions and the functional problems of each bodily system, and the principles and practice of treating each system/condition Knowledge of naturopathic nutritional status assessment methods Knowledge of appropriate dosage levels of nutritional supplements including the difference between dietary replacement levels and pharmacologic dosage ranges Knowledge of the main nutritional supplements used for each system/condition Knowledge of food classifications, categories and composition including grains, legumes, pulses, meat, fish, eggs and protein alternatives, dairy foods, fruit and vegetables, nuts and seeds Knowledge of foods containing macronutrients and micronutrients, vitamins and minerals, carbohydrates, fats and proteins Knowledge of bioavailability of nutritional supplements Knowledge of the components of common diets Knowledge of current national health and medical research council recommendations for ‘healthy diets’ Knowledge of diet construction with regard to preventive approaches to health Knowledge of the requirements of the individual within a diet program Knowledge of nutrient types Demonstrated ability to identify foods containing various nutrients Knowledge of foods containing carbohydrates, fats, proteins, vitamins, minerals and phytonutrients Ability to identify foods deficient in nutrients Knowledge of the process, anatomical structure and physiology of digestion Knowledge of the function of fiber in the body Knowledge of amino acids (essential and non-essential) Knowledge of fibrous and plant proteins Knowledge of basic biochemistry as it relates to diet and nutrition Knowledge of types of diets (omnivore, vegetarian, lacto-vegetarian, vegan, fruitarian, zen macrobiotic), milk categories and processed foods Knowledge of eating patterns, foods affecting the mind and moods, food labelling, food additives, preservatives and colouring Knowledge of types of tests available to nutritionists Knowledge of the principles of formulation (including dosage, dosage form, bioavailability and duration of therapeutic intervention) Knowledge of supplementary measures in the management of conditions (lifestyle considerations, other modalities of therapeutic intervention) Ability to apply methods of treating and managing the disease process of each system using nutrition Knowledge of how to select the best therapeutic intervention/medicine within best current practice Knowledge of medical reports and diagnostic procedures Knowledge of cultural restrictions on diet and nutritional supplementation e.g. gelatin in capsules Knowledge of the principles of formulation (including dosage, dosage form, and duration of therapeutic intervention) Knowledge of supplementary measures in the management of conditions (lifestyle considerations, other modalities of therapeutic intervention) Knowledge of how to correctly prepare and dispense nutritional supplements Knowledge of standards nutritional requirements for a range of life cycle stages and human conditions e.g. pregnancy, health and fitness Knowledge of the potential impact of supplementation on the health condition, including preventive action Knowledge of the possible responses to therapeutic interventions Knowledge of adverse effects associated with nutritional supplementation Knowledge of contra-indications of therapeutic intervention Knowledge of drug-nutrient and nutrient-nutrient interactions Ability to access reference material on the effects of current conventional drug therapies and their withdrawal Knowledge and understanding of methods of preparing therapeutic intervention and management plans Knowledge of the correct preparations required for specific therapeutic intervention Demonstrated ability to access and interpret up-to-date information Interpersonal and questioning skills Ability to write referrals, appraisal letters for insurance companies and other documentation
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based/video assessment tools Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit can be assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain theoretical and practical components and examples covering a range of clinical situations.

UNIT VIII-A Apply literature research findings to clinical nutritional practice

Unit Descriptor

This unit describes the skills required to source and evaluate relevant information and apply findings to clinical nutritional practice. This unit requires high level knowledge of nutrition and its effect on a wide range of complex health conditions.

ELEMENT	PERFORMANCE CRITERIA
Manage information needs currency of information is assessed clinical information needs are defined information findings are recorded
Access information Contemporary primary and secondary sources of information are identified Established sources of information are identified Information is collected and collated
Evaluate information Primary and secondary sources of information are compared and contrasted Relevance of information to clinical therapeutic intervention strategy within a complementary and alternative health framework is established Relevant information is culled and prioritized Information findings are correlated with clinical presentation
Apply information to therapeutic intervention strategy Integrate information findings with existing therapeutic intervention strategy Implement relevant findings into clinical nutrition practice

RANGE OF VARIABLES

Clinical information needs:	Information on pathology of specific conditions/diseases Information on latest therapeutic intervention pathology options for specific conditions/diseases Research data on therapeutic intervention, symptoms, nutritional supplements Clinical information to assist in meeting specific client/patient health outcomes
Primary information sources:	Internet Medical journals Nutritional journals Libraries Research institutions Reference books Relevant texts
Secondary information sources:	Other journals Abstracts Popular media Conferences Presentations
Established information sources:	Clinical texts Reference works Recognized teachings
Evaluate refers to:	Establish the validity and credibility Establish relevance to meeting information needs Assess the level of industry recognition Assess usefulness Check references
Implement refers to:	Include new findings in clinical therapeutic intervention strategies Use information to reassess therapeutic intervention plans

EVIDENCE GUIDE

Critical aspects of evidence	Ability to work or model work which demonstrates an ability to apply the underpinning values and philosophies of naturopathy within clinical practice Demonstrated ability to identify and plan to meet information needs Demonstrated ability to identify and access a range of primary, secondary, new and established information sources Demonstrated ability to access and interpret up-to-date information Demonstrated ability to prioritize usefulness of information to therapeutic intervention of specific cases Ability to access and critically evaluate reference material on the effects of current conventional drug therapies and their withdrawal Demonstrated ability to identify and access relevant reference works and information sources Demonstrated ability to appropriately record details of information findings
Concurrent assessment and relationship with other units:	This unit must be undertaken after the completion of the unit: Provide naturopathic nutritional therapeutic intervention (Unit VIII) Provide the naturopathic therapeutic intervention
Underpinning knowledge and skills:	Ability to interpret common terminology used in statistical analysis Ability to recognize statistical terminology and understand the significance of common statistical analysis Knowledge of up-to-date information on nutrtional research Ability to extrapolate case study information to new cases Knowledge of research priorities Knowledge of research issues and their uses Ability to critically evaluate research Knowledge of relevant reference works and information sources Ability to access and critically evaluate reference material on the effects of current conventional drug therapies and their withdrawal Interpersonal and questioning skills Ability to communicate information through written or verbal media
Resource implications Resource requirements may include:	Relevant texts, nutritional manuals or research papers Relevant journals Relevant paper based/video assessment instruments Access to internet or on-line research information Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Oral questioning Presentations and discussion Case studies and scenarios Presentation of research review results Written questioning
Context of assessment	This unit is can be assessed in the workplace, in a classroom setting or in a distance learning context. Assessment will mostly contain theoretical components and examples covering a range of clinical situations

UNIT VIII-B Provide specialized Naturopathic nutritional care

Unit Descriptor

This unit describes the skills required to provide specialized nutritional supplements and/or foods for the therapeutic and prophylactic management of specific health outcomes. This unit requires high level knowledge of nutrition and its effect on a wide range of complex health conditions.

ELEMENT	PERFORMANCE CRITERIA
Identify nutritional needs for specific health outcomes Existing nutritional intake is determined Nutritional needs are analyzed Specific health outcome is identified
Plan the specialized therapeutic intervention Impact of changes to nutritional supplementation and/or changes to food intake are considered Nutritional approach to meet the specific health outcome is selected
Provide the specialized nutritional therapeutic intervention Specialized therapeutic intervention plan is implemented according to the various life stage, specific clinical condition, and/or personal health/fitness goals Consent for therapeutic intervention is ensured The strategy is fully explained to the client/patient and all inquiries responded to
Manage the specialized nutritional therapeutic intervention Factors which may intefere with the effectiveness of the strategy are taken into account for each dietary regime and nutritional recommendation Possible therapeutic intervention reactions are taken into acount for each dietary regimen and nutritional recommendation Contra-indications are taken into account for each dietary regimen and nutritional recommendation Reactions to therapeutic intervention (adverse or otherwise) are recognized and promptly responded to if necessary Assessments and recommendations are fully documented The therapeutic intervention plan is reviewed and continuing care negotiated with the client/patient

RANGE OF VARIABLES

Nutritional needs refers to:	Needs arising from a specific health condition Requirements to meet specific health outcomes’prevention/prophylactic care Needs arising from analysis of Anthropometric and biochemical data
Specific health outcome may include:	Weight loss Palliation/prevention/prophylaxis and/or managment of specific health conditions Relief from specific symptoms
Specialized Nutritional therapeutic intervention:	Appropriate dosage of nutritional supplements Supplementation through foods Modifications to eating and/or lifestyle patterns Detoxification or elimination regimes
Various life stage may include:	Childhood Adolescence Male and female adulthood Geriatric
Consent for therapeutic intervention includes:	Informed consent according to local and national regulations and guidelines Consent from appropriate adult in the case of a minor
Factors which interfere with the effectiveness of therapeutic intervention may include:	Other medical therapeutic intervention being undertaken Other medicinal dietary intervention Client/patient’s physical and psychological readiness and/or wellness Cultural factors Contraindications to nutritional supplementation or certain dietary changes (ie modified protein intake) Post therapeutic intervention activity

EVIDENCE GUIDE

Critical aspects of evidence:	Ability to work or model work which demonstrates an ability to apply the underpinning values and principles of clinical nutrition within clinical practice Demonstrated ability to identify and access a range of primary, secondary, new and established information sources Demonstrated ability to determine the nutritional needs of clients/patients with specific health conditions or health/fitness goals Demonstrated ability to correctly identify information needs Demonstrated ability to appropriately record details of information findings
Concurrent assessment and relationship with other units:	This unit to be undertaken after completion of the unit provide naturopathic nutritional therapeutic intervention (Unit VIII)
Underpinning knowledge and skills:	Knowledge of less common disease states and functional problems of particular groups in society with specific needs including, but not limited to: infants, children, adolescents, elderly, peri- and post menopausal, pregnant and lactating women Knowledge and understanding of the specialized nutritional needs of particular groups in society (e.g. infants, children, adolescent, elderly, peri- and post-menopausal, pregnant and lactating women, recreational and elite athlete/sportspersons) Knowledge and understanding of scheduled nutritional supplements, including reasons for scheduling Knowledge and understanding of the less common nutritional supplements used for each system/condition, including their active principles and biochemical mechanism of action Knowledge of how to select best therapeutic intervention/medicine within best current practice Knowlege of the principles of formulation (including dosage and duration of therapeutic intervention) Knowledge of appropriate choice of supplements required to achieve specific outcomes Knowledge of supplementary measures in the managment of optimal health (e.g. counselling, lifestyle, exercise) Knowledge of the possible responses to therapeutic interventions Knowledge of contra-indications to therapeutic intervention Knowledge of nutrient-drug, food-drug interactions Knowledge of nutrient toxicity Knowledge of advanced biochemistry of food and nuttrients Knowledge of metabolic pathway imbalances Knowledge of nutritional approaches to disease management with regard to therapeutic diets Knowledge of pharmacological uses and dosages of nutritional supplements Knowledge of blood analysis and biochemical tests to assess vitamin and mineral levels Knowledge of issues such as IV (parenteral) administration of vitamins and minerals Knowledge of chelation therapy Ability to identify high risk patients in relation to risk of complications, severity of disease process, lifestyle factors and their impact on therapeutic intervention strategies, time-frame of therapeutic intervention, and other factors Knowledge of dietary requirements for different cultural and religious groups Ability to access and critically evaluate reference material on the effects of current conventional drug therapies and their withdrawal Interpersonal and questioning skills
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant journals Relevant texts or medical manuals Relevant paper-based/video assessment instruments Access to internet or on-line research information Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

UNIT HLTNAT IX Provide acute Homeopathic therapeutic intervention

Descriptor

This unit describes the skills required to administer a limited range of homeopathic remedies for acute conditions within naturopathic framework

ELEMENT	PERFORMANCE CRITERIA
Manage acute therapeutic intervention using homeopathic remedies within a naturopathic framework Factors which may interfere with the effectiveness of the therapeutic intervention are explained Mode of administration and management of the therapeutic intervention to the client/patient is explained Client/patient is requested to monitor responses and contact practitioner as required Consent for therapeutic intervention is ensured Homeopathic remedies are provided using homeopathic assessment techniques, within a naturopathic framework Responses to therapeutic intervention are recognized and promptly attended to, if necessary Time, location and purpose of future sessions are clearly explained to the client/patient Recommendations are fully documented
Advise the client/patient Client/patient is educated in relevant and practical techniques for promotion and maintenance of optimum health Client/patient queries are answered with clarity, using the appropriate language Appropriate interpersonal skills are used when explaining therapeutic intervention plans and recommendations to the client/patient Client/patient independence and responsibility in therapeutic intervention are promoted wherever possible
Review therapeutic intervention Progress is evaluated with the client/patient Homeopathic questioning is used to confirm appropriateness of homeopathic therapeutic intervention and quality of therapeutic intervention response Effects of previous therapeutic intervention are identified and recorded Previous therapeutic intervention plan is reviewed Changes to the plan are negotiated with the client/patient to ensure optimal outcomes Need for ongoing and/or additional therapeutic intervention is evaluated Where constitutional prescribing with homeopathy is identified as useful, the client/patient is referred to a homeopath Where chronic prescribing with homeopathy is identified as useful, the client/patient is referred to a homeopath Homotoxicologic Detoxifications Drainage may be applied by a Naturopath MD/Medical Naturopath

RANGE OF VARIABLES

Factors which interfere with the effectiveness of therapeutic intervention may include:	Dental work Eating or smoking within ten to twenty minutes before or after therapeutic intervention Other medical therapeutic intervention being undertaken Client/patient’s physical and psychological readiness and/or wellness Cultural factors Contra-indications to therapeutic intervention Post therapeutic intervention activity
Mode of administration may include:	Olfactory Sublingual Cutaneous Via fluid medium – alcohol or water Via pillules Via powder Via plussing method
Consent for therapeutic intervention refers to:	Informed consent according to the local and national regulations and legal guidelines
Homeopathic remedies refers to:	Low potency single remedies for acute conditions
Providing a homeopathic remedy within a naturopathic framework refers to:	The infrequent repetition of appropriate acute single remedies according to the law of similars Complexes, based on naturopathic case taking principles
Homeopathic diagnostic techniques refers to:	Homeopathic acute case taking and questioning Consideration of individualisation of the prescription
Responses may include:	Allergy Intensification of symptoms Cure Amelioration Therapeutic aggravation Non-therapeutic aggravation Palliation Suppression Proving No response
Attendance to responses may include:	No change in therapeutic intervention Change of posology Referral of the client/patient to a homeopath or other health care provider Discussing reaction with the client/patient Adjusting therapeutic intervention, if necessary Seeking appropriate expertise Adhering to clinic guidelines for response to accidents and emergencies Use of First Aid procedures according to Philippine National Red Cross or other apropriate First Aid training institutions Accessing local emergency services
Advise the client/patient refers to:	Referring client/patient to other information sources Providing relevant literature or information materials Providing advice regarding self-care Advising client/patient of suggested resources Providing details which help fully inform patient/client of relevant information Providing of referrals to other health professionals Availability of products required or suggested for therapeutic intervention
Relevant and practical techniques that promote and maintain optimal health may include:	Removal of obstacles to cure Nutritional adjustments Exercise Lifestyle modifications
Homeopathic questioning includes:	Presenting symptoms Duration of symptoms Location of symptoms Sensations Modalities Concomitants
Effects of previous therapeutic intervention may include:	Patient is better Patient is worse Case is being suppressed No change/wrong remedy given Patient is proving remedy New state is emerging Disease is progressing
On-going and/or additional therapeutic intervention may include:	Repetition of the first remedy Change of potency Change of posology Change of remedy Intercurrent remedy Waiting Placebo Referral to a homeopath
A chronic condition may include:	Conditions of longer than approximately six months duration Conditions that are not self-terminating An acute manifestation of a chronic disease

EVIDENCE GUIDE

Critical aspects of assessment:	Therapeutic intervention plans are implemented to achieve optimal health, rehabilitation, or to improve quality of life. These involve: -Therapeutic intervention of a range of acute conditions -Use of homeopathic questioning -Incorporation of the philosophies of homeopathy into naturopathic practice -Demonstration of the application of commonly used therapeutic intervention practices -Therapeutic intervention according to the individual, the condition and the presence of complicating factors. It must be the safest, most efficacious method that is also cost effective to the patient -Provision of acute homeopathic therapeutic intervention -Use of advice/ counselling as a therapeutic intervention method, where competence exists -A case requiring referral to a homeopath, or other health care professional -Preparation of the client/patient for therapeutic intervention according to naturopathic practice -Complete documentation of all recommendations and client/patient responses -Review of therapeutic intervention plan Demonstrated ability to explain any perceived risks and possible remedy responses Demonstrated ability to negotiate the management of therapeutic intervention with the client/patient’s current therapies Demonstrated ability to identify and analyze remedy response to previous therapeutic interventions Demonstrated ability to negotiate strategies to overcome any obstacles to cure Knowledge of the role of homeopaths, other complementary health professionals and support services Demonstrated ability to utilize a range of repertories Demonstrated ability to utilize at least two of the most commonly used Homeopathic materia medica
Concurrent assessment and relationship with other units:	Communicate effectively with clients Provide the naturopathic therapeutic intervention Work effectively within the health industry
Underpinning knowledge and skills:	The central philiosophies and beliefs of homeopathic practice, to include the law of similars, the minimum dose, individualisation of the prescription, single remedy prescribing and removal of obstacles to cure Knowledge of the similarities and differences between naturopathic and homeopathic therapeutic intervention Ability to recognize the need for constitutional homeopathic prescribing Knowledge of administration and storage procedures associated with homeopathic remedies Knowledge of therapeutic intervention options other than homeopathic Ability to manage time throughout consultation and therapeutic intervention Ability to write referrals, appraisal letters for insurance companies and other documentation Knowledge of legal and regulatory implications of therapeutic intervention Ability to use equipment and resources competently and safely Ability to communicate effectively with client/patient Knowledge of medical reports and diagnostic procedures Knowledge of the possible responses to the homeopathic remedy(ies) and contra-indications to therapeutic intervention Knowledge of perceived risks and remedy responses Knowledge of the pathogenesis of the remedies administered Ability to access reference material on the effects of current conventional drug therapies and their withdrawal Basic knowledge of materia medica, to include polycrests and other acute remedies Knowledge of pathophysiology and disease processes Basic knowledge of the various approaches to prescribing including consideration of: -Totality of characteristic symptoms -Keynote characteristic symptom -Central theme of a remedy -Constitutional basis -Miasmatic indications -Etiology -Use of organopathics -Prophylactic use -Ladder-like prescribing -Tautopathy -Isopathy Knowledge of potency choices Knowledge of case analysis and managment according to naturopathic principles Knowledge of obstacles to cure Ability to administer medicines Knowledge of the capabilities and limitations of homeopathic therapeutic intervention, within a naturopathic framework Knowledge of anatomy and physiology of the body systems Knowledge of signs and symptoms of disease and disorder/dysfunction Knowledge of the disease process and the natural history of disease Ability to apply differential assessment Ability to manage medical emergencies Knowledge and understanding of types of further investigation available Knowledge of the contribution of the different schools of thought and historical theories of homeopathic clinical practice
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Relevant texts or medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Demonstration model/client
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

UNIT X Prepare and dispense Herbal and Traditional Medicine and Health

Supplements

Unit descriptor

This unit describes the skills required to prepare and dispense herbal and traditional medicine and health supplements. The preparation and dispensing of said herbal and health supplements should be done by a pharmacist. (Note: Refer to Pharmacy Law)

ELEMENT	PERFORMANCE CRITERIA
Recognize common herbs and nutritional ingredients for use in individual prescriptions Common herbs are identified in their natural habitat Common herbs are identified in their dried form Nutritional ingredients are identified
Prepare herbal and nutritional medicines Pharmaceutical ingredients and equipment are identified and prepared Medicine is prepared according to the guidelines and methodology of the modality Medicine is prepared according to clinic practice guidelines Care is done to prevent contamination of the medicine Medicine is labelled and stored correctly
Dispense the medicine Dispensing ingredients and equipment are identified and prepared Required herbal medicine is dispensed in the form and quantity stipulated by the prescription/order Care is done to prevent contamination of the medicine Medicine is labelled correctly Instructions for taking the medicines are provided to the client/patient Factors which have an effect on storage are identified and explained Medicine is dispensed according to clinic practice guidelines
Control stock Required materials are obtained from acceptable sources The pharmacy is kept well stocked according to clinic practice guidelines Factors which have an effect on storage are identified Materials are stored according to clinic practice guidelines An alcohol register is maintained according to government regulations
Complete Documentation Workplace information is recorded in the appropriate format Materials are labelled correctly

RANGE OF VARIABLES

Common herbs mean at least 100 herbs which must include but are not limited to: (See attached list of common Philippine herbs)	Achillea millefolium Allium sativum Althea officinalis Angelica archangelica Apium graveolens Arnica montana Avena sativa Calendula officinalis Capsella bursa-pastoris Crataegus monogyna and/or oxycanthoides Filipendula ulmaria Foeniculum vulgare Galium aparine Hypericum perforatum Inula helenium Lavandula angustifolia Matricaria recutita Mentha x piperita Plantago lanceolata Rosmarinus officinalis Rubeus idaeus Rumex crispus Salvia officinalis Sambucus nigra Silybum marianum Stellaria media Taraxacum officinale Thymus vulgaris Urtica dioica Verbascum thapsus
Common herbs must include a minimum of 3 herbs from each specific action category ie	Anodyne Adaptogen Alterative Analgesic Antihelmentic Anti-infective Anti-inflammatory Antiseptic Antispasmodic Antitussive Antiviral Aperient Aphrodisiac Astringent Bitter Cardioactive Carminative Cholagogue Circulatory stimulant Demulcent Diaphoretic Diuretic Eliminative Emetic Emmenagogue Expectorant Febrifuge Galactogogue Hepatic Laxative Nervine Relaxant Rubefacient Sedative Stimulant Stomachic Tonic Vasodilator Vermifuge Vulnerary
Nutritional ingredients may include:	Vitamins Minerals Amino acids Omega oils Celloids Tissue salts Other nutritional extracts or substances
Pharmaceutical ingredients and equipment may include but are not limited to:	Various raw or prepared herbs Nutritional supplements Different extraction medium which may include: -Water -Vinegar -Wine -Alcohol -Ether -Glycerol -Oil Lactose powder or globules Medicating alcohol Distilled water Mortar and pestle Clean containers Measuring instruments Percolator, press and blender Containers Scoops Labels Protective clothing
Guidelines and methodology refers to:	Published methodology in peer reviewed literature and/or official pharmacopoeia where appropriate Methodology as described in writing by the prescribing practitioner Legal restrictions Therapeutic goods act and regulations Health and safety; labelling requirements Methodology specific to preparing nutritional supplements and medicines
Dispensing ingredients and equipment may include but is not limited to:	Various raw or prepared herbs Nutritional supplements Measuring instruments Containers Scoops Labels Protective clothing
The form of the medicine may include but is not limited to:	Creams Capsules Emulsions Ointments Suppositories Tinctures Extracts Powders Globules Pilules Tablets Pessaries
Care is done to prevent contamination means:	One medicine is dispensed at one time Medicines are made and prepared over an impervious surface Objects that come in contact with the medicine are cleaned or discarded Medicines which come in contact with contaminants are discarded The work space is well ventilated Direct contact between the practitioner and ingredients is avoided
Clinic practice guidelines may include:	OHS guidelines Quality system guidelines Dispensing procedure Hygiene and waste guidelines Stock and storage procedures
Instructions for taking the medicine refer to:	Mode of administration, e.g. external or internal Frequency of administration Factors which may interfere with the medicine, e.g. consumption of food, alcohol or tobacco concurrent use of allopathic medications The need to report incidences to the prescribing practitioner
Acceptable sources includes:	Herbal medicines manufacturers listed in the Philippine Food and Drug Administration (FDA) Collected and prepared from Overseas manufacturers of herbal medicines compliant with Philippine FDA Guidelines Natural sources after ascertaining that the plant material is uncontaminated by pesticides or other contaminants
Labelled correctly means:	According to Philippine Food and Drug Administration (FDA) guidelines According to clinic requirements
Factors which may have an effect on the storage may include:	Heat above 50⁰C Prolonged exposure to heat over 30⁰C Prolonged exposure to sunlight
Workplace information may include:	Details of preparation and dispensing undertaken Stock documentation Details of person (s) conducting preparation and dispensing Dispensing information for prescriptions

EVIDENCE GUIDE

Critical aspects of assessment:	Demonstrated ability to correctly identify equipment and ingredients for herbal or nutritional medicine preparation and dispensing Demonstrated ability to identify herbal ingredients in raw form and/or natural habitat Demonstrated ability to identify herbal ingredients in their dried form where appropriate for medicine preparation Demonstrated ability to describe plant classifications Demonstrated ability to describe plant nomenclature Demonstrated ability to describe general plant anatomy Demonstrated ability to utilize general plant identification techniques Demonstrated ability to use botanical keys for plants Demonstrated ability to prepare medicines for patients in pharmaceutical forms (capsules, emulsions, creams, ointments, suppositories, etc.) Demonstrated ability to dispense medicines in accordance with official practice, clinic practice guidelines and relevant legislation Demonstrated ability to dispense medicines in a range of dosages Demonstrated ability to dispense medicines in accordance with the order/prescription Demonstrated ability to confirm supply of necessary materials and services to the dispensing process Demonstrated ability to confirm equipment status and condition Knowledge of hygiene and sanitation standards Demonstrated ability to access workplace information to identify requirements for the dispensing process Demonstrated ability to measure and segregate materials Demonstrated ability to pack and label dispensed materials Demonstrated ability to sort, collect, treat, recycle or dispose of waste Demonstrated ability to maintain work area to meet housekeeping standards Demonstrated ability to record workplace information Demonstrated ability to take corrective action in response to out-of-specification results or non-compliance Demonstrated ability to monitor the dispensing process and equipment operation to identify out-of-specification results or non-compliance. This may include: - Labelling - Stock flow/quantity - Measuring devices - Materials faults - Service faults And may include the ability to: - Clean and sanitise equipment - Carry out routine maintenance
Concurrent assessment and relationship with other units:	Contribute to the control of infection
Underpinning knowledge and skills:	Knowledge of herbal medicine pharmacy Knowledge of nutritional supplements, their various forms and uses Knowledge of factors that affect herbal and nutritional medicines in preparation and storage Knowledge of herbal medicine preparation from source materials Knowledge of herbal medicine dispensing principles and methods Knowledge of nutritional medicine dispensing principles and methods Knowledge of the preparation of dispensing media Knowledge of internal preparations-culinary plants, common herbal teas, and medicinal preparations and biochemic and bioenergetic remedies, cold extracts, cordials, decoctions, essences, herbal honeys, infusions, methaglyns, nutritional supplements, oxymels, powders, spagyric technique, succus, syrups, and tinctures Knowledge of chemical and physical incompatibilities Knowledge of external therapy products – both medicinal and domestic baths, bath oils, creams, dyes, fomentations, incenses, aromatheraphy products, compresses, ointments, perfumes, pomanders, potpourri, poultices, powders, sachets, and salves Knowledge of standards of dispensing procedures Knowledge of the non-medicinals ingredients used in the preparation of herbal medicines Knowledge of prescription of medicines: legal restrictions, FDA Act of 2009, Health and safety, labeling requirements; restricted substances, principles of manufacturing; quality control procedures Knowledge of how the dispensing process affects the end product Knowledge of quality characterestics to be achieved Knowledge of process specifications, procedures and operating parameters Knowledge of equipment and instrumentation components, purpose and operation Knowledge of significance and methods of monitoring control points within the dispensing process Knowledge of common causes of variation and corrective action required Knowledge of OHS hazards and controls Knowledge of waste handling requirements and procedures Knowledge of recording requirements and procedures Knowledge of methods of administration for herbal medicines
Resource implications Resource requirements may include:	An appropriately stocked and equipped clinic or simulated clinic environment Dispensing resources Relevant texts or medical manuals Relevant paper-based/video assessment instruments Appropriate assessment environment Skilled assessors
Method of assessment Assessment may include:	Practical demonstration Simulations Explanations of technique Oral questioning and discussion Case studies and scenarios
Context of assessment:	This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations.

[1] Republic Act 8423, Section 3

[2] Ibid, Section 5-6

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