The Therapeutic Order

Jul 18, 20210 comments

You may have read or heard about the therapeutic order relative to naturopathic medicine. So, what does this term mean? The Therapeutic Order serves as a guide as to how naturopathic principles are applied, and is based on the idea that the human body possesses an inherent drive to heal itself. Think of the therapeutic order as a kind of road map which helps the naturopath and patient work together to solve the patient’s illness. Keep in mind, the six principles of naturopathic medicine which we reviewed in an earlier post, will help you better understand the therapeutic order.


Healthcare red apple and medical stethoscope healthy lifestyle


In the mid-nineties,  Jared Zeff, ND, LAc, published, “The Process of Healing: A unifying theory of naturopathic medicine.” The theory presented the origin of chronic disease including toxemia; and proposed a system of applied clinical theory which are:

  1. the determinants of health which are inborn, behavioral, social, cultural, environmental and spiritual, as health supporting and promoting factors or as disturbing factors (obstacles to cure). Determinants of health are the “terrain” or the soil, from which healing, health or illness arises.
  2. the process of disease and a model of healing  which has three stages (1) disturbance, (2) ‘coction’ the process of attaining a more desirable condition (3) discharge/resolution.
  3. the four-level hierarchy of therapeutics which served as a way to formalize the therapeutic progression of healing.

The addition of three levels to the hierarchy, renaming it as the seven-level ‘Therapeutic Order,’ was proposed by Pamela Snider, ND, and Jared Zeff, ND, LAc. The therapeutic order was subsequently explored, refined and codified through a series of publications, faculty retreats, discussion, meetings, and through experience with students and student feedback.

Therapeutic order pyramid

Graphic: AANMC

The set of guidelines help a naturopathic doctor do three main things:

  1. Completely resolve the patient’s symptoms
  2. Address the underlying cause
  3. Use the least force necessary

The guidelines go from inside, out; from general strategies to more targeted therapies, and starting with the least to the most in ascending order from least to most invasive increasing in intervention to restore the patient’s health.

In next week’s post, we will review the seven levels of the therapeutic order.