How does the Alexander Technique lead to psychological and non-physical outcomes? A realist review

Abstract

Introduction: The focus of previous research on the Alexander Technique (AT), a psychophysical self-management approach, has mainly been in musical performance, physical change, and health outcomes such as pain. This rapid realist review aimed to understand psychological and non-physical outcomes of the AT, and how they may be generated. Methods: Using a rapid review approach, papers with relevance to non-physical outcomes were identified using backward and forward citation searching from two key systematic reviews and consultation with AT experts. Results:. Thirty six documents were included for analysis, which resulted in 8 evidence-informed theory statements on how and for whom non-physical outcomes can be generated by AT lessons. A variety of non-physical outcomes of the AT were found, including improved general wellbeing and increased confidence to address present and future challenges, as well as identifying that difficult emotions can arise in lessons. Two main causal pathways were identified – 1) improvements in physical wellbeing leading directly to psychological wellbeing; and 2) an experience of mind-body integration leading people to apply AT skills to non-physical situations. Conclusions:. The AT may be a useful approach in a range of settings for psychophysical, long-term outcomes, and further research is warranted. We suggest a number of recommendations for practice and further research, including for AT teacher training and the need for mixed-methods research in the AT, and factors which support a person to gain benefit, such as openness to self-management and support to attend regular lessons.