The ASA acknowledged that BIS had made amendments to the wording of claims in the ad following our previous adjudication. We noted, however, that some claims and references to conditions which had been found to breach the CAP Code had not been removed from the ad.

1. Upheld

We noted the ad included statements that its contents were based on the experiences of CST practitioners and clients rather than on scientific research, and that the references to specific conditions were not intended to imply or guarantee a cure for those, or other, conditions. We considered the references to conditions and health situations throughout the ad in context with those statements.

We acknowledged the ad made clear that its contents were not claims based on scientific research. However, we considered that, because it referred to its contents as a description of the experiences of practitioners and clients, consumers would understand the references to working with and helping specific named conditions, and more generally with, for example, situations, symptoms, traumas and injuries, to be factual statements relating to the experiences of CST practitioners and clients. We considered that consumers, including those who were familiar with complementary health approaches, would therefore understand those factual statements to be objective claims which were capable of substantiation. We considered that claims relating to experiences were akin to testimonials, and noted that CAP Code rule 3.47 required that claims which appeared in testimonials that were likely to be interpreted as factual must not mislead or be likely to mislead the consumer; we considered such claims must therefore be substantiated. We acknowledged the ad made clear BIS’ views with regard to the use of scientific trials of CST, but we noted CAP Code 12.1 required that where relevant, objective claims must be substantiated by evidence consisting of trials conducted on people.

We noted the statements in the ad to the effect that CST did not provide any guaranteed cures, and that the information provided in the ad should not be taken to mean that it could. However, we considered that such statements implied that whilst a cure for a condition was not guaranteed, it was possible that a condition could be cured by CST and, moreover, implied that conditions could be, at the least, alleviated by CST. We also considered that when taken in context with the overall impression created by the ad, consumers might understand that those statements had only been included as a result of pressure from the ASA, following a campaign against complementary health practitioners, and that BIS’s real position was that consumers should understand from their experiences, as well as those of other CST practitioners and CST clients, that CST could help to alleviate or cure conditions.

We noted that statements such as “So in cranio-sacral therapy we work with the individual, with an awareness of many levels of our being, rather than with conditions as such” and “As noted above we are really working with the whole person rather than the conditions” emphasised the approach of CST as a ‘whole person’ therapy, rather than one specifically directed at a presenting condition. However, we considered that the implication of such statements, as well as statements which explicitly stated that CST worked with conditions, such as “From this base we may work with many different situations and conditions” followed by a list of medical conditions, was that CST could help to alleviate or cure conditions.

We noted our previous adjudication highlighted the difference between subjective and objective claims, stating that the wording “... encouraging a feeling of well-being” was a sensory, impressionistic claim and we therefore did not object to it; we acknowledged the amended ad included other subjective statements such as “I feel it is especially significant that [CST] can also engage with our strength and help us in our body-based awareness to begin to remember and honour this in ourselves” and “A cranial session is always a place of honouring where we are right now, and for a new mother that may include just being allowed this time to recognise herself and her motherhood”. However, we also noted that the ad included statements such as “[CST] can be very appropriate and helpful to support the body after perhaps many years of gradually increasing symptoms”, which we considered consumers would understand to be an objective claim that CST could help to alleviate symptoms which had built up over a number of years.

We also noted the ad included statements which we considered combined both subjective and objective statements, and whilst we considered we would not object to the subjective aspects of those sentences should they appear in another context, the aspects which would be understood by consumers to be objective should not appear unless BIS held evidence to substantiate the claim. For example, we considered the overall impression given to consumers by the statement “So in cranio-sacral therapy we work with the individual, with an awareness of many levels of our being, rather than with conditions as such” was that although CST did not necessarily ‘target’ specific conditions or their symptoms, it could still help alleviate conditions or symptoms. However, we considered that if the advertiser removed the final part of the sentence so that it stated only “So in cranio-sacral therapy we work with the individual, with an awareness of many levels of our being” it would be interpreted as a wholly subjective statement and we would therefore not object to it.

We concluded that the references to specific medical conditions, as well as to CST resolving, providing relief of, supporting, helping and working with symptoms, traumas, situations, injuries, stresses, conditions, issues, shocks and tensions, supporting the body’s ability for innate healing, and building and restoring health, were implied claims that CST could help alleviate or cure medical conditions. We reviewed the references to sources which questioned the applicability and usefulness of RCTs as an evidence base for the efficacy of treatments, but understood that current generally accepted scientific opinion was that RCTs were an effective and appropriate way of evidencing the efficacy of drugs and therapies, including complementary health therapies. We therefore considered that health claims in advertising such as those which appeared in BIS’ advertising should be supported by a body of evidence consisting of trials conducted on people, which followed a recognised methodology that controlled for the placebo effect and for other factors unconnected with the proposed action of the therapy as a whole. Because we had not seen such evidence, we concluded the claims were unsubstantiated and misleading.

On this point, the ad breached CAP Code rules 3.1 (Misleading advertising), 3.7 (Substantiation), 3.11 (Exaggeration), 3.47 (Endorsements and Testimonials) and 12.1 (Medicines, medical devices, health-related products and beauty products).

2. Upheld

We noted the ad referred to specific medical conditions, including conditions for which medical supervision should be sought, such as whiplash, depression, migraines, menstrual disorders, TMJ (jaw joint) problems, tonsillitis, asthma, hyperactivity, autism and learning difficulties. We considered that consumers would understand the references to those conditions to mean that CST could alleviate or cure those conditions. We acknowledged that the ad twice included the statement “... nothing in this website is intended to discourage you from seeking medical advice where applicable”. However, we considered that, because consumers would understand that CST could alleviate or cure the named conditions, the references to conditions for which medical supervision should be sought could, nonetheless, discourage readers from seeking essential treatment for those conditions.

On this point, the ad breached CAP Code rule 12.2 (Medicines, medical devices, health-related products and beauty products).