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Craniosacral Therapy

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History & Development of Craniosacral Therapy

The first doctors trained in cranial care initially studied with W. G. Sutherland, DO [1] who was a pioneer cranial anatomist and clinician. A chiropractor named Nephi Cottam [2] developed and taught a method of craniopathy, however its methodology was different and has not been taught for decades. Sutherland called his work “Osteopathy in the Cranial Field" [3][4] and the Sutherland Cranial Teaching Foundation (SCTF) [5] was formed to continue his work.

Presently the STCF is still in existence and continues to this day. The Cranial Academy [6] is an offshoot of STCF starting up in the early 1960s. The Cranial Academy had goals of being innovative and teaching dentists and medical doctors cranial techniques. John E. Upledger, DO was one of the lead Cranial Academy researchers and split off in the late 1970s after writing his book Craniosacral Therapy. [7]

Craniosacral Therapy

Craniosacral therapy (CST) as taught by Dr. Upledger and his instructors is based upon his book.[7] He supports his premise of teaching CST to anyone regardless of their background or training, because he doesn't want the cranial work lost and he feels not enough people are practicing its methods. Over the past few decades Dr. Upledger has created a large number of masseuses and lay persons trained in CST. This has led to confusion by many patients who do not understand the difference between CST and osteopathic or SOT cranial interventions. He also has created a larger societal understanding of therapeutic applications affecting the head or cranium.[8]

In general, CST’s focus is on relaxing the person rather than actually making a clinical change in a specific type of clinical presentation. Due to CST practitioner’s lack of training in differential diagnosis, inability to assess pathology, and not knowing who and when to refer a patient, this has led to criticism levied against CST practitioners.[9]

Therefore with some clinical situations a gray area has been created where patients needing care from a doctor are left in the hands of a layperson without the knowledge of primary healthcare or knowing how to appropriately triage.

Osteopathic and SOT Chiropractic Cranial Doctors

In contrast to craniosacral therapists both osteopaths[10] and chiropractors [11] are trained in differential diagnosis, can assess pathology, and know when to refer. They offer primary care diagnosis and treatment and treat clinical conditions with specific clinical applications of cranial manipulative therapy.

Major Bertrand DeJarnette, DO, DC, a student of Sutherland brought concepts of osteopathic cranial evaluation and manipulation to chiropractic in his 1952 text "Sacro Occipital Technique of Chiropractic[12]." Later in the 1960s he started teaching his evaluation and treatment methods which culminated with his final cranial technique manual in 1980[13].

Osteopathic cranial doctors treat the whole craniospinal system, organs, and whole body, similarly to SOT chiropractors, but they tend to use more subtle palpation and sensing of pulsations to determine body imbalance. SOT cranial technique also uses active and passive cranial palpation evaluation assessments but often lean more towards an indicator‐based system with pain reflex points that change following therapeutic applications.

Chiropractors, Chiropractic Research and Cranial Methods of Care

As chiropractic attempts to build an evidence base of information we must be careful not to equate the chiropractor’s ability to function as a primary care healthcare provider with a lay person or masseuse. Therefore it is important in chiropractic literature that it utilizes terms such as chiropractic cranial manipulation, chiropractic cranial therapy, or SOT cranial therapy, instead of the term craniosacral therapy (CST).[14][8]

It is also highly suggested that chiropractors realize that it is preferred from a diagnostic and therapeutic position to study chiropractic cranial technique methods such as those taught by the Sacro Occipital Technique Organization (SOTO) – USA,[15] since they have taught cranial techniques and certified chiropractors, since its inception.


  1. Sutherland, WG (1967). Contributions of Thought. Yakima, WA: The Sutherland Cranial Teaching Foundation. pp. 1-254. 
  2. Cottam, C; Smith EM (1981). "The roots of cranial manipulation: Nephi Cottam and 'craniopathy'". Chiropr Hist 1 (1): 31‐5. 
  3. Sutherland, A (1962). With Thinking Fingers. Indianapolis, IN. 1962: The Cranial Academy. 
  4. Magoun, HI (1976). Osteopathy in the Cranial Field (Third Edition ed.). Indianapolis, IN: The Cranial Academy. 
  5. Sutherland Cranial Teaching Foundation (SCTF),, retrieved July 10, 2012 
  6. The Cranial Academy,, retrieved July 10, 2012 
  7. 7.0 7.1 Upledger, JE; Vredevoogd J (1983). Craniosacral Therapy. Seattle, WA: Easland Press. 
  8. 8.0 8.1 Blum, CL (May 2011). "An Overview of The Development of Chiropractic Cranial Therapy – Terminology Matters". J Pediatr Matern & Fam Health - Chirop: 23-5. 
  9. Holla, M; Ijland MM, van der Vliet AM, Edwards M, Verlaat CW (Apr 20000009). "[ Diseased infant after 'craniosacral' manipulation of the neck and spine (Article in Dutch)]". Ned Tijdschr Geneeskd 153 (17): 828‐31. 
  10. Osteopathic Medical Education,, retrieved July 10, 2012 
  11. Chiropractic Education,, retrieved July 10, 2012 
  12. DeJarnette, MB (1952). Sacro Occipital Technique of Chiropractic. Nebraska City, NB: Privately Published. pp. 252-96. 
  13. DeJarnette, MB (1980). Cranial Technique 1979-1980. Nebraska City, NB: Privately Published. 
  14. Blum, CL (Jun 2010). "Letter to the Editor: [Alcantara J, Doucet J. Improvement in a Pediatric Patient with Craniosynostosis Undergoing Chiropractic Care". J Pediatr Matern & Fam Health - Chirop: 97-8. 
  15. Sacro Occipital Technique Organization (SOTO) – USA,, retrieved July 10, 2012