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July 29, 2007

Don't Be A Slave To Protocol

I have an unfortunate incident that happened between a client of mine and a peer in the field. It wasn't tragic or anything like that, just unfortunate for a client in pain and a peer struggling to grow a clientèle.

It started with one of my clients having back pain. My book was too full to accommodate them in a timely fashion, so I recommended several other therapists they could try. One was a new therapist in town who is struggling to grow their practice. Lucky for them, this new therapist's schedule was loose enough to fit the session in that day. My client arrived to the session, filled out the intake form, informed the therapist that they had low back pain and the session began.

When I went to massage school, the philosophy of the institution was that we as students had been issued a tool belt. Each class was a new tool to supply our tool belt. A strict protocol concerning which body part was to be massaged and in what order was not part of our education. However, a basic flow was suggested, but only for the purposes of keeping track of what had been worked on so that our effort was not redundant.

I suspect my peer, whom I am sure received a fine and ethical education, did not emerge from that same model. They start each session face up with work on the neck first. In fact, a question about what position a client should be in at the start of the massage came up on the National Certification Exam. It surprised me, because I almost always start my people face down so that I can end the massage with them supine. This gives their sinuses a chance to open and drain before they have to get off the table.

My client reported that they received a fine massage from this therapist. However, with only ten minutes left in the session, the therapist finally addressed their low back pain. My client would have liked to see most of the time spent working on the low back pain and less on the rest of the body. Most clients assume that when they patronize a professional, that person knows best and would never question their technique (even if it hurts them) or tell the therapist how to do their job.

Unfortunately, this therapist lost a potential client. Communication is key to a successful practice. Find out what the client wants or expects for the session. Check in frequently about pressure or whether the technique is effectively addressing their needs. Start the session addressing their primary concern and if clues in the body lead the therapist to related areas, that is acceptable. If you work around a problem area but not directly on it, explain your logic to the client ("I'm trying to relax the referred pain so that the core problem will be less painful to work in"). Before you move away from a problem area, check with the client and ask if they think you've addressed it adequately. If you move away from an area before the client thinks it's resolved explain why ("I'm concerned that if we overwork this area, you'll be miserable tomorrow. Let's see if the body heals itself somewhat now that we've got change started. If in four days you don't feel like it has resolved itself, lets get you back in for another session.") Honest, ethical communication is key to making clients feel that their needs are being met.

tags: massage massagetherapy wellness massage therapy bodywork health massage ethics massage practice building

Posted by linda at July 29, 2007 10:36 AM