You might know our guest blogger today as the founder of the Online Therapy Institute. Her name is DeeAnna Nagel, LMHC BCC. However, in recent years, DeeAnna has expanded her focus to include founding the Online Aromatherapy Institute. She is also Managing Co-editor of TILT Magazine – Therapeutic Innovations in Light of Technology.
My interest in having DeeAnna join us today is related to her work in aromatherapy. After all, many of us in private practice already choose to use scented candles in our offices but have done very little research to really understand the evidence supporting the use of essential oils in support of our clinical work.
DeeAnna Nagel joins us today to share her thoughts on how to ethically integrate the use of essential oils into our clinical work.
________________
A Guest Post by DeeAnna Nagel, LMHC, BCC
Mainstreaming Essential Oils
If you are a mental health practitioner or otherwise identify yourself as a coach, helper or healer, you have probably heard 
of essential oils and/or aromatherapy. It seems essential oils are all the rage and some may be asking if this oils revolution is just a fad. I don’t think so- chances are, the use of essential oils to support health and wellness was a “fad” that is now mainstream and here to stay. But as with many mainstream approaches and ideas, mental health practitioners are often slow to embrace what may be perceived as new, different or alternative.
We are taught not to utilize modalities or approaches that are not backed by research that demonstrates efficacy. So, for the sake of simplicity, I will focus on lavender as the example oil for this blog post. Lavender is known for supporting enhanced mood. Many articles and studies exist as evidenced by Google Scholar search, “lavender essential oil” “mood”.
The Ethical Use of Essential Oils
So if we can establish that lavender is efficacious in enhancing a positive shift in mood does that mean we can or should be peddling lavender to our clients? Not so fast. In most instances it would be unethical to sell lavender essential oil to your clients. And if the essential oil company is a direct sales network marketing company, setting your client up with a wholesale account places you in a dual relationship with your client. I blogged about this about a year ago at Online Therapy Institute.
But I am a firm believer in utilizing the senses as much as possible in conjunction with traditional talk therapy. For years I practiced online therapy- and I encouraged in-person clients to engage in occasional text-based therapy through email or chat because the cognitive and sensory-motor stimulation of writing, combined with a therapeutic response from the therapist and talk dialogue enhanced the process for clients who were open to the possibilities. With that said, introducing scent into the therapeutic process can be very beneficial.
“But I am not an aromatherapist!”
Get Educated About the Use of Essential Oils
If you haven’t had training about the use of essential oils, I highly recommend prioritizing this as part of your continuing education/professional development arsenal. You don’t have to be an aromatherapist to begin using natural aromas in your work setting. Introducing lavender essential oil by cool-mist diffusing in a waiting room or in the consultation room is a very appropriate way to start. Unplug the fragrance plugins and remove those fragrant candles. Replace them with therapeutic grade essential oils that do not contain any chemicals or other catalyst/carrier ingredients.
There are other experiential ways you can introduce your clients to the use of essential oils that do not include selling a product directly to the client or working outside your scope of practice. I use essential oils daily and the process has been transformative for me. Your own personal use of quality essential oils is a perfect starting point.
Top Ten Ways to Introduce Essential Oils Into Your Practice
- Begin Using Essential Oils yourself, in your home and in your life- have your own immersive experience.
- Diffuse essential oils in your waiting room
- Diffuse essential oils in your consultation room
- Choose an oil that is familiar to many such as lavender, peppermint or lemon
- Using the three oils mentioned, diffuse them in combination- in a cool mist diffuser using ½ cup of water, use 2 drops each, lavender, peppermint, lemon
- Once you familiarize yourself with the basic oils and their therapeutic uses, ask your client if he/she would like to experience an oil by slowly bringing an open bottle of oil up to their nose
- Ask your client what the aromatic experience was like and process your client’s experience
- Educate your client about that particular essential oil
- Explain that essential oils can be used to support and enhance wellness much like other efforts toward wellness such as meditation, visualization, self-help books, and eating healthfully.
- Point your client to reliable resources for education and purchase should additional information be requested.
Do you use essential oils in your practice? I would love to hear your experiences!
__________________
About the Author: DeeAnna Nagel, LMHC BCC is a former psychotherapist turned wellness coach. 
In addition to client services, she also offers professional development courses and certifications to practitioners including Certified Intuitive Practitioner, Certified Aroma Coach and Reiki Master Teacher. You can find more about her services at Online Aromatherapy Institute.
Hello Deeanna,
I started using essential oils myself and then did research and found so many that help with mood relaxation and sleep. There are even those marketed to help with focus. I asked a Do Terra rep to come and speak to me and learned even more.
I now can sell the oils myself but chose to just buy them at wholesale so I can share them in my office space with interested clients. I have created a mist by filling a small spray bottle 3/4 full of water, a tablespoon of hydrogen peroxide (to help blend the oil and water), and maybe 5 drops of essential oil. I use pepper mint or lavender in the mist.
There are many blends that are great for mood – citrus and lemon are a couple. Wintergreen and mints are nice for stress management. I use them primarily in my office space to introduce meditation and breathing or to help manage strong feelings, to assist with grounding.
I also just introduce them for fun! I ask my client if they want to try an essential oil to help with their mood, if they say yes, I offer then 3 oils to wave under their nose and they can pick the one they like best. Then we both put a couple drops on our palms and rub them together (I’m kind of demonstrating this with them following along), then we take a deep breath with our palms over our nose, and then rub the oil with our palms on the back of our neck ( a mini self-massage). Then we resume our talk therapy – I usually ask them how they are feeling a minute or so later and if they liked it.
As you know teens like to try new things – I work mainly with teens – so it has been fun. I sold one bottle at cost to a client who requested to purchase it and it was a blend only offered by DoTerra. I find it fun, interesting, and offers a unique connection with holistic therapies that I can easily offer in my office.
I often offer psycho -education on the mind/body connection so this fits right in! Most people know about lavender being an oil that helps relax and many have tried it – so other oils are just an elaboration on that same idea. I ask about any allergies first just to be on the safe side! Thanks for sharing you post – it’s nice to know other counselors are trying it too!
Hi, Vivian! I’ve missed your voice here! Welcome back! And, thank you for sharing your own experience using essential oils! I appreciate hearing from you and others about your use.
I love that you point out how open teens are to trying new things such as this. It’s one of the gifts of youth, isn’t it – being open to different ways, possibilities, paths ?!
(I’ll be sharing this post and specifically your comment as a professional and non-intrusive way to share another aspect of your business in a comment without pitching and selling. I appreciate knowing that you offer these oils and I appreciate even more that you shared how you introduce them to your clients without hawking your products on my blog. That is a class act that gets you invited back, Vivian! The same, of course, is true for you DeeAnna! Thank you, thank you!)
DeeAnna, thank you so much for taking time to share this info with us today.
Here’s my anecdotal story to share: Years ago, I travel to Poughkeepsie, New York to get some training in Playback Theatre.
It was my first time to be among people from all over the world who were way more experienced than me in using this type of dramatherapy so I was totally intimidated.
At one of the breaks before we actually had to start acting in front of the entire class, a woman from Mexico brought out her little vial of essential oils and offered a few drops to me.
I thought she was a little too woo-woo for me to actually buy into her spiel about how calming these would be.
However, being a Southern girl wanting to be hospitable, I thought I would humor her and accept her offer.
Whoa! It was shocking how quickly those little drops calmed me down and helped me focus on “performing” in front of more seasoned peers!
A couple of days later, mid-afternoon energy slump, she offered a different oil to “pep me up” and POOF! Almost like magic, my energy spiked and I was READY to GO!
While I will admit to being highly suggestible, in general, I could hardly attribute the first experience to the power of suggestion.
What I do know is that I do not knot the evidence-base for the effectiveness of using essential oils except for my own experience – and that’s enough for me to say “It’s worth a try!”
I know that readers are going to be asking – and I want to know, too – are there different qualities of oils?
Tamara, thank you for the opportunity!
Yes indeed there are certainly differences in the quality of essential oils and while I represent Young Living Essential Oils for very specific reasons.
1. They have a Seed to Seal http://www.seedtoseal.com/ quality commitment and they can offer this kind of commitment because their oils are not 3rd party sourced. They own many farms around the world and where they do not own farms, they co-op so the farms are held to the standard.
2. The company is transparent. You can participate in harvests if you choose.
3. Their oils are “therapeutic grade”- and this is where it gets a little dicey- Young Living uses the term “therapeutic grade” and another company uses “certified therapeutic grade” and yet another company uses “clinical grade”- the bottom line- all three of these terms represent food grade essential oils.
That means when an oil is appropriate for ingestion or internal application- the bottle will have a supplement label. Most essential oils in health food stores are NOT food grade and will state “not for internal use” on the label.
If a bottle of essential oil has a label that states “Not for internal use” and it is an oil we know can be ingested, that likely means that either the oil has been adulterated with chemical/carrier additives, the oil has been processed in such as way as to lose it’s value as a food supplement, or the company has simply not gone to the effort and expense of adding an approved food supplement label or finally, the essential oils company may simply hold a different clinical orientation to aromatherapy, and does not endorse internal application.
There are other companies that offer quality pure essential oils. I have chosen a company that meets all my personal and professional criteria. Just remember! Check the label!
Thank you for the post. Essential oils are very popular around here. People are diffusing them, rubbing them, and even cooking with them.
I would be interested in hearing more about why a lavender plug in or candle is not recommended.
Hi, Mary! Thanks so much for joining the conversation today! I was wondering the very same thing!
I have burned orange or vanilla-scented candles during therapy since 1983.
I appreciate the ambiance that it helps create in my work but have always wondered why some people are amenable to essential oils but not to candles / plugins. (Obviously if someone is scent-sensitive, I don’t burn candles.)
Hopefully, DeeAnna or others who are more experienced in this area can speak to this issue . . . ?
Mary,
Any product that contains fragrance has chemical additives. Fragrance is created in a laboratory and while the package may claim inclusion of pure essential oils in the product (perfume, laundry detergent, candles, fragrance plugins, dryer sheets, etc) only a small amount of essential oils need be added to make the claim. These chemicals- many banned in other countries because of toxicity- are toxic for all of us but particularly for people with auto-immune and respiratory disorders.
There are many articles on the internet- this one is concise with references: http://www.organicauthority.com/99+Reasons+to+Stop+Wearing+Perfume+
That is why I always tell people that the best results with essential oils occurs when a total non-toxic lifestyle change accompanies the use of oils. Pure essential oils support the immune system. Toxic chemicals do not support the immune system and can cause many people to become symptomatic.
I hope that helps! And thank you for asking an important question.
DeeAnna
DeeAnna – thank you for staying engaged with this discussion. I try to have guest bloggers here to share – especially in areas that I am not well-versed. The down side to that is that I don’t always know about the veracity and evidence-base for that subject matter. Because we have a previous online relationship, I didn’t have the same level of concerns. However, I really appreciate you taking the time to educate us and provide references to support the info that you are providing. Not only does that show your own due diligence and desire to educate us, but it also enables us to pass that evidence and information on to others.
Absolutely my intent. There is so much information about essential oils on the internet- great and not so great- and as popularity for essential oils grow, those of us that can need to offer clarity whenever possible.
With that said, it was a “snow day” in New Jersey so a perfect time for me to engage!
I love this idea, however, I have some cautionary advice. I recently had exposure to a peppermint essential oil and had an adverse response to it. I also used a natural hair conditioner with peppermint oil in it and had the same reaction.
The vapor went into my sinuses but also down into my lungs. I had trouble talking and breathing all day. I felt as though I had pneumonia.
Tawnya,
I am sorry you had this experience. On rare occasions people are sensitive to essential oils as with anything. I hope the oils you were exposed to were 100% pure essential oils.
With that said, peppermint is one of the strongest essential oils and when I suggest people inhale (I do this regularly to support my respiratory system). [Note: This sentence was edited by Tamara Suttle at commenter’s request on 08-13-15.] I recommend one drop in the palm of the hand, rubbed together and bring slowly up to the nose- and the inhale a bit for initial reaction. On the skin, all oils should be tested first and diluted if you have sensitive skin. The wrist is good test spot.
Peppermint is powerful. For tea, I recommend a toothpick inserted into the bottle then into the cup with a 1/2 turn. That is usually a plentiful amount. The oils I recommend come with instructions on the label and the website.
Here is more information about peppermint essential oil:
http://www.mentalhealthonthewebblog.com/2014/03/05/oh-the-wonders-of-peppermint-essential-oil/
By the way, what you describe (if you read my earlier reply about chemicals and fragrances) is what I experience with chemical cleaning products.
Glad you are okay!
I have been using essential oils for many years and cannot imagine not having them in my life. They have been instrumental in improving my immune system as I live daily with MS. Like DeeAnna, I have taken the time to study and learn as much as I can about the different brands of oils and to really understand what the FDA considers pure versus what Young Living call therapeutic grade essential oils and the seed to seal process.
For me, it was vital to ensure that the oils I use do not have expiration dates, can be ingested whether I do or not as the skin is the largest organ in the body. If I cannot ingest, why would I want it on my skin. I had learned from years of using steroids and other drugs to treat the MS the damage chemicals can cause.
Without going into a very long story, my throat closed off one day during an IV infusion of steroids. At the time I was confined to a wheelchair and being able to walk was a distant memory. When this happened, my neurologist told my husband I to get my affairs in order as the treatments they were using could no longer be used.
I chose to do things differently and as I was weaned off 38 medications oral and IV, a friend suggested essential oils. What did I have to lose? It took time about 2 years, and with the help of some great rehabilitative pilates instructors,, essential oils and other healing modalities, I left the wheel chair and have continued to see improvement in MS. Has been an amazing journey back to health.
As I practice from an holistic prospective, being able to discuss the importance of body, mind and spirit and how poor nutrition, and chemicals used in products can affect our mental health, diffusing oils, using products in our office free of chemicals allows clients to see and learn. Having resources, scientific articles and practitioners credentialed in aromatherapy has also been important to me.
Clients that have benefited greatly have been the kids and adults with sensory issues. Clinicians in the office are able to dilute oils to faint scents, introduce children to oils by color and let them choose if they want to sniff or wear. Parents have been amazed at the progress we are making. Many adults with sensory issues are finding they do not have the negative effects with the essential oils we use compared to what they smell in health food stores, perfumes, and plug in wall decanters.
Like DeeAnna mentioned, I am aware of ethical concerns and dual roles in my office and with clients who may benefit from essential oils. As the center I own is a combination of counseling, coaching, nutrition and wellness coaching, massage therapists, PT, OT, chiropractic and energy workers, guidelines are posted and if I have counseling clients who use other clinicians in the office they know upfront that they cannot be in a downline that comes in contact with me if they want to purchase product.
Hi, Delphine! Thank you for dropping in to continue this conversation! I so appreciate you sharing your inspiring story with us! So happy for the positive changes in your health – not sure if MS goes into remission or ? but can only imagine the quality of life changes you have been through!
Your differentiation between what the “FDA calls pure” and Young Living’s labeling of “therapeutic grade essential oils and the seed to seal process” caught my attention. think your implication is that the latter deteriorate over time in quality but I’m not sure if there were other differences. I’m wondering if you / DeeAnna can share a little more about that . . . .
And, finally, I know I interact with you on Facebook but I thought you had a website elsewhere – but now cannot find it. I noticed that you did not include it with this comment. Do you still have one or was I mistaken? (Tried to Google you but didn’t find anything.)
Hi Tamara and Delphine,
I had mentioned before that essential oils that are “food grade” are termed diffrently by various companies, including therapeutic grade, certified therapeutic grade and clinical grade. At the end of the day, these phrases are internal stamps of approval that are an indicator to the consumer that the company is taking various steps to ensure quality. If you have seen the deodorant aisle lately, there are deodorants that are labeled “clinical strength.” There is no such thing as clinical strength so that is why I prefer to call any oil that can be ingested and holds the appropriate food supplement label- “food grade”- as that cuts across all companies. An oil is either food grade and labeled a food supplement or not.
What sets Young Living apart, in my opinion, is the fact that they own or co-op their farms. They are transparent as a company and if we are out of Frankincense (as an example) we are out. Frankincense will not go back in stock until the next harvest because Young Living will not source it via 3rd party suppliers.
Not all essential oils can be ingested- some oils like wintergreen difficult substances for the liver to process, so when an oil is not ingestible it does not always mean it isn’t safe to put on our skin. We can take in certain oils through the bloodstream via inhalation or through transdermal/topical application because the liver does not have to break it down. Some Young Living oils have a safety cap for that reason.
The only oils that “expire” are citrus oils as they are cold-pressed rather than steam distilled. Citrus oils will last a couple of years it is easy to tell when they are no good. Citrus oils are also photosensitive so being out in the sun after applying a citrus oil is not advised. There are precautions with oils as with anything else- aspirin, motrin, vapor rub– they all have precautions….
Delphine, thank you for sharing your story. Mine is similar – I have Stage IV Sarcoidosis and after years of managing, but wanting to feel better, I was introduced to essential oils. I still have sarcoidosis but my every day living is SO much better. The oils support me emotionally, spiritually and physically.
DA
Thanks, DeeAnna, for explaining all of this. When I went to the Young Living website, I did notice that were cautions listed about exposure to sunlight with some of the essential oils. This is all so interesting!
Tamara,
I am in the process of changing by business name and many other things. Old website is down and we are in the process of building a new one. There are many types of MS. I was diagnosed in 1983 with secondary progressive. It has been a journey and one the neurologist I see cannot figure out how I have improved this much. I do, it is the combination of body, mind and spirit. I will let you know once the website is good to go.
Thanks DeeAnna for clarifying the importance of seed to seal. That is what sold me and I continue to learn and have so much fun.
Love this post! I have been using and diffusing oils for my family and I for quite some time. Recently, I have begun to bring them into sessions and while it is still limited use the results have been very positive. I have client’s ask for a particular oil.
My first “professional” introduction to using essential oils was when I was a clinical training coordinator for a community mental health center. As a part of this position, creating retention programs for employees was a top priority. After surveying all staff it was apparent that stress and anxiety was a big issue (shocking isn’t it)? Anyway I presented a detailed retention program in a leadership team meeting and a part of it was to begin diffusing oils to lower stress levels along with other ideas. I talked about my use of oils and shared that I always carry a bottle of lavender (truth). The team was kind but laughed it off and did not appear to take this seriously at all. This was ok – I had other ideas. Funny ending- after the meeting almost everyone came by my office and asked to smell my lavender! I loved it, totally made my day.
I hope that clinicians will slowly and ethically introduce the use of oils to those who are open to it.
Thanks for the great post!
Jamie
Great story Jamie! I am glad you liked the information! I can’t say enough about how essential oils have enhanced my personal and professional life.
DeeAnna
Thanks! I wholeheartedly agree that essential oils have made vast improvements in my life! Love that you are sharing this wealth of information.
Jamie! This is such a great story! It’s funny, isn’t it, how so many of us have incidental and anecdotal stories to share related to essential oils! Surely this is an e-book waiting to be written for some enterprising professional!
Isn’t it a great story? I think it will always be my favorite story regarding professional use of essential oils. Everyone wanted my lavender when nobody else was around! It has been a general experience of mine over the years that people look at me a bit oddly when I come up with creative and WAY out of the box ideas, however, they often come back to me for more so it works for me. Off to diffuse some warming oils to melt all our ice. I may have to consider that e-book idea…interesting.
In this post, you said you sold a bottle of oil to a patient “at cost,” but in your post on your website, you said that you refer to other consultants for them to buy the oils from (where you do not profit).
I’m wondering, if you just sell the oils “at cost, ” then you wouldn’t be profiting from the sales, would you?
I understand that you should not let them join under you in a direct sales company.
Could you please comment on this? Thanks!
Im interested in this answer too!
I’m an LMFT who’s been using EO’s personally, and in my waiting rooms for about 18 months. I would LOVE to start making recommendations for oils as I have many clients who ask “what’s that smell? It smells so good.” I’m so nervous to recommend them or really talk about them and make specific oil suggestions out of fear of practicing outside the scope of my practice. This article is helpful but I would also LOVE just more information as well!
Ashley, I’m not an attorney and can’t offer legal advice; however, I do think you are wise to be questioning your scope of practice as it relates to the use of essential oils.
My suggestion is that if you are serious about pursuing work with these while practicing as an LMFT, you should contact your liability insurance professional and your professional association to discuss what and where the limits of your scope of practice actually exist – and if / how you can integrate this interest into your clinical work ethically and legally.
And, when you do that, please do drop back in to let us know what you have learned!
Best wishes on your journey!