After successfully completing the three month program, he initiated weekly psychotherapy, during which he described an interest in natural healing, meditation, and spirituality. Concomitantly, he declined psychotropic medication. His psychotherapist referred him to the hospital-based Reiki training program where he was initiated to Reiki Level I. He began receiving weekly, one-hour Reiki treatments from clinic volunteers, and reported giving himself daily one-hour Reiki treatments at home. He told his physician and his psychotherapist that he found Reiki self-treatment extremely relaxing and enjoyable, and that it helped him to maintain his sobriety and work through his depression.

His physician initiated HAART in May 1998, two months after his Reiki initiation. He has maintained adherence to HAART and other prophylactic medications since that time, and reports he continues daily Reiki self-treatment. His CD4 count has increased to 340, and his viral load has decreased to 4,000. In his most recent medical exam, he was treated for a chronic sinus infection. He continues to report improved mood and energy level and his psoriasis has resolved. He discontinued psychotherapy in July 2000 and reports on-going abstinence from cocaine use. He recently started working part-time, and offers Reiki treatment at a local community-based organization serving PLWA.

Discussion
This case report describes an example of someone who has integrated Reiki training and treatment into his multi-disciplinary, hospital-based HIV treatment plan. This patient's ability to successfully address his psychiatric/substance abuse problems has enabled him to successfully utilize HAART and develop a social and financial support system.

Many factors other than Reiki contribute to this patient's treatment success (e.g. psychotherapy, substance abuse treatment, HAART, social work services). It is not possible to describe any direct medical benefits Reiki has provided this patient as he also uses a sophisticated combination of HAART and other prophylactic medications. However, both the patient's physician and former psychotherapist have repeatedly described the patient¹s belief that Reiki self-treatment is the single greatest factor contributing to his successful behavior change.

Although the CD4 count and viral load improved, the viral load remains detectable. Nonetheless, the patient is thriving according to quality of life and productivity assessments. This case demonstrates the potential value of integrating Reiki into conventional medical practice and points to the need for further discussion and research.

Robert Schmehr, CSW was the Director of Complementary Therapy at the HIV Center of St. Luke's Roosevelt Hospital in New York City. Mr. Schmehr is also a psychotherapist in private practice and a Reiki Level II practitioner.