Conceived by fashion designer Donna Karan, the Urban Zen Integrative Therapy programme merges medical and complementary therapies and trains professionals in its own effective style of sickness and preventative care. Julie Cramer reports

When renowned fashion designer Donna Karan launched her Urban Zen Integrative Therapy (UZIT) programme – a pioneering complementary therapy initiative aimed at helping acutely ill patients in health and social care settings – she had already faced the trauma of losing friends, colleagues and family members as a result of terminal illness.

As a rookie designer in the 70s, Karan went to work for Anne Klein in New York and was promptly handed the responsibility of finishing her new boss’s collection, as Klein had terminal breast cancer. That tragedy was the catalyst that helped launch Karan’s career, but it was also the beginning of many personal losses, including her best friend who died of breast and brain cancer, and her second husband, Stephen Weiss, who died of lung cancer in 2001.

Karan had always been a proponent of the healing powers of complementary therapies like reiki and acupuncture, and her own homes are known to be spa-like sanctuaries. She used what her husband called her ‘woo woo’ therapies to help him through the final years of his life, and after his death went on a quest to fill the gap missing between medical treatment of the patient’s disease, and sympathetic care of the individual.

Her search culminated in the creation of a 10-day Wellbeing Forum in 2007, to stimulate an exchange of ideas between patients, doctors, nurses, yoga instructors and alternative healthcare practitioners. Two years later, in 2009, the first UZIT training programme was born; since then almost 500 UZIT practitioners from both the medical and wellness worlds have been trained, with another 100 or so in the training system.

East meets west
UZIT’s mission is to integrate ancient healing techniques into Western medical practices, as well as spread this work further through yoga, spa and wellness centres. Its core modalities are yoga therapy, reiki, essential oil therapy, nutrition and contemplative end-of-life care and self-care (this last one being for the therapists’ personal development) and the curriculum is designed to treat the common symptoms of illness: pain, anxiety, nausea, insomnia and constipation (UZIT uses the acronym PANIC™) and exhaustion.

To date, its practitioners have carried out over 25,000 documented sessions in hospitals, outpatient care centres, support groups, private practices, corporate environments, nursing homes and medical schools.

One of the 2009 inaugural training therapists was Gillian Cilibrasi, who is now the UZIT programme director, charged with, among many other tasks, standardising the UZIT training and scaling the programme so it can touch more lives within the US and beyond.

Cilibrasi brings a perfect combination of wellness knowledge and business background to her role, having been a massage therapist for 15 years and a yoga teacher for a decade, in addition to having worked on all commercial aspects of a medical device start-up company. She’s owned one of the top health and wellness spas in the Hudson Valley, River Rock Health Spa, and still maintains a private clientele. And like Karan, she’s had her own experience of seeing a loved one become ill and die.

Cilibrasi says: “Several years ago, my stepfather was diagnosed with cancer in the May and he died in the December. He’d come home from chemotherapy and not want to eat. My sister, mother and I, who are all trained therapists, would give him acupuncture, prop him into a supported restorative pose and do energy work with him. He’d fall into a deep sleep and wake up famished.

“We could see how his quality of life improved and he was able to stay well enough to check off many things on his bucket list. When he died, we were at peace with his passing.”

Changing perceptions
It’s exactly this kind of practice and result that forms the basis of the UZIT programme. Cilibrasi admits it wasn’t always easy in the early days, as some areas of the medical profession remained staunchly sceptical – yet she says there were an equal number of medical institutions that “welcomed us with open arms”.

UZIT has very strong partnerships with major treatment centres such the Beth Israel Center in New York – the location of the first UZIT pilots in 2008 – and the UCLA Health System in California, as well as smaller community facilities such as Southampton Hospital in the Hamptons, which is now one of the strongest employers of UZIT practitioners across all departments.

“If you want to work with the medical profession, you have to be prepared to speak their language,” says Cilibrasi. “We’re meticulous in collecting outcome data and have several studies ready to go. You have to create evidence-based work to show how the therapies are working and how they can be used to best effect.

“One of our studies looked at a 24-bed floor at Beth Israel where UZIT was active. It showed a US$496 saving per patient on pain and nausea and anxiety meds alone. Over a year, that meant a saving of almost US$1m for the hospital, so you can see how it quickly adds up.

“A lot of our studies contain qualitative data, such as how patients’ pain scores have been affected or their perceived reduction in stress levels, but we also realise the importance of qualitative data and we have a large study pending from UCLA covering such markers.

“For example, one of ‘the crown jewels’ for hospitals is whether you can affect length of stay and the associated patient satisfaction and cost savings of that, and it’s something we’ll be able to quantify more in the future.”

Wellness army
UZIT works both by training medical practitioners in complementary therapies, and by putting experienced wellness practitioners into a medical setting. Wellness practitioners, such as those working in spa facilities and yoga studios, need to show a minimum of five years’ practice in their field before joining UZIT either on an intensive training programme (which includes clinical rotation hours) at studios such as Yoga Shanti in New York, Piedmont Yoga in California, and Yoga on High in Columbus, or else by taking part in longer, part-time training currently delivered at centres like YogaWorks studios across the US west coast.

Meanwhile Cilibrasi says UCLA is a great example of a top-down initiative where UZIT has worked entirely with existing medical staff. Around 140 of them have been trained to date – spread across a variety of departments such as oncology, nursing, rehab services, respiratory therapy and radiology. A further 50 staff will have been UZIT trained by summer 2015.

Layering therapies
So is there a magic formula to UZIT’s five chosen modalities, which have been put together with the help of Karan’s high-profile associates – yoga gurus such as Rodney Yee and Colleen Saidman-Yee? Cilibrasi simply says: “Those who work in spa or wellness settings know that a deep tissue massage is very healing, but if you then combine it with some energy work it becomes so much more powerful. So we layer the therapies as required, using either some or all of them.

“We wouldn’t normally use movement with someone at end-of-life care. We’re always careful to meet patients at their stage of the journey, to help bring them into the present moment, and not to assume we know what’s best for them.

“A great thing about the therapies is that they’re designed to be performed hands-on or hands-off with the same effect, as many wellness practitioners going into a medical setting may not be able to physically touch patients.”

Therapist self-care
Another interesting aspect of the UZIT programme is the prime emphasis it puts on the wellbeing of practitioners: the self-care and nutrition modalities are targeted at them. UZIT trainees are required to develop a daily yoga and meditation practice, to eat healthily, and be under the care of a personal mentor.

As someone who still actively practises in a private spa setting with yoga and massage, Cilibrasi is only too aware of the dangers of burnout that therapists and practitioners face. “I’ve seen many massage therapists burn out in 10 years or less because they haven’t set out with a strategy of self-care,” she says. “I’m still going strong after 15 years because I’m able to employ the strategies that we teach our trainees. I’ve made my home a very spa-like sanctuary where I can take care of myself – otherwise how will I ever be able to take care of others?

“Compassion fatigue is a real danger. UZIT practitioners especially will be going into very challenging settings where they may be required to spend long periods of time with patients who are very ill. They need to be able to deal with all situations as they show up, how to be with the living and the dying, and not impose their teachings on a patient or relative.”

UZIT expansion
Currently the UZIT programme, which is funded mostly by donations and board participation, is only available at selected US centres. Cilibrasi says the past five years have been spent consolidating the training and refining it, while the next five to 10 years will focus more on expansion around the US and beyond.

“We’ve been in talks with organisations in Europe, Japan and India about how we can expand the UZIT programme and work in different cultures, and several pilot projects that could be scaleable and exportable are currently in the early stages here in the US. We’ve also been taking our outreach work to places like Port-au-Prince in Haiti to further develop and enrich our programme.”

In addition, Cilibrasi says there’s now a very popular public programme available at partner wellness facilities around the US – various yoga studios where anyone can experience the UZIT modalities in public Urban Zen classes.

“We’ve actually been quite overwhelmed by how popular these programmes have been, often becoming the most attended classes at a facility – we’re talking about 40 people turning up to a class on a Saturday night in New York’s Soho!” she says. “So many people are looking for balance and healing in their lives. The guy next to you at work – you may have no idea what he’s going through or what kind of healing journey he may be on.”

While it’s not likely to happen in the immediate future, Cilibrasi nevertheless foresees a time when there will be standalone UZIT centres alongside hospitals, as well as in wellness settings such as spas and health clubs.

She says: “Our programme is a natural fit in both acute and preventative wellness settings. Our future growth will be fuelled by attracting more and more spa and wellness professionals to come and take our training and send this work further out into the world.

“As Donna always says: ‘Everyone will be a patient one day’ – but I truly believe that using the UZIT programme in both sickness and wellness care can make the journey better.”