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Massage Today
April, 2001, Vol. 01, Issue 04

Employer Education

By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President

Hello readers, and thank you for your wonderful responses to the first article of my Dealing with Pathologies column in the January 2001 edition of Massage Today!

Several people wrote in with interesting questions that they wanted to bring to public discussion.

Some of these were fairly simple, like, "Is shingles contagious?" (Not if you've ever had chicken pox, but shingles can be extraordinarily painful, so take care!), and "What are the rules for working with high blood pressure?" (If it is manageable with diet and exercise, go to town; if it requires medication, use more caution with circulatory massage).

One of the most complex questions was raised by a massage therapist from the South, who wrote that she had worked for a short time in a salon. Her employer made all her appointments and controlled all the initial contact with her clients. The owner of the salon, not understanding the profound impact massage can have on health and disease, expected her to work with clients with a variety of conditions that could contraindicate Swedish massage: advanced atherosclerosis patients, clients with unexplained dizziness, and clients with unregulated diabetes. When the therapist repeatedly voiced her concerns, her employer didn't seem to grasp the seriousness of the problem. The working relationship was short-lived, and the therapist found another situation in which she could have more control over her choices.

How could this problem have been avoided? I see a need for three related areas of education:

1) Therapist-Employer Education

Any therapist who works as an employee has an obligation to meet the commitments outlined in that relationship, but those commitments need to be clearly stated from the beginning. This is obviously true for financial matters, but it also applies to how the therapist manages clients. In other words, massage therapists need to make clear that they may refuse to do circulatory massage with any client if they feel it is not in the client's best interest - regardless of whether the client or employer agrees. (And of course, therapists should also be able to refuse to give service to any client who abuses the client-therapist relationship; this is a safety issue.)

Many employers of massage therapists, especially those working in the "relaxation" aspect of the profession rather than in "clinical" settings, don't know the risks that circulatory massage may have. It is the therapist's job to educate these employers for the benefit of all their clients. For this purpose, it might be useful to make up a brief list outlining cautions and concerns for Swedish massage; circulatory and sensory disorders, contagious diseases, certain medications, and undiagnosed problems are all cause for concern. Of course, any such list needs a disclaimer explaining that decisions must be made on a case-by-case basis.

Other client management issues include being able to interview clients before they come for a first appointment; being able to take a thorough health history; and being able, when necessary, to consult with other members of a client's health care team.

The better we become at educating massage therapy employers about the risks and benefits of massage, the safer the profession will be for therapists and clients.

2) Therapist-Client Education

Another front-line education target is our clientele. Swedish massage is our industry standard. It is what most people expect when they pay money to receive massage. The vast majority of massage therapists use Swedish massage with most or all of their clients. However, we all know that whole worlds of bodywork have been developed that lack the circulatory impact Swedish massage has. When we, the therapists, are better able to educate our clientele about alternatives to Swedish massage that can yield outstanding benefits with minimal risks, we will have more options when people come to us with conditions that contraindicate Swedish massage.

I have found that when I discuss bodywork choices with clients, in terms of their own health and safety, they are usually open-minded about receiving work outside of their expectations. Not all clients will enjoy non-circulatory bodywork, however. Some may leave to find therapists who will do Swedish massage, regardless of their medical conditions. But every therapist needs to define boundaries for keeping clients safe. Beyond legalities and the threat of litigation, we need to keep the health and well being of our clientele first and foremost in our judgment.

3) Therapist Education

Finally, we ourselves have an obligation to be continually learning and adding to our skills. An old saying goes, "if all you have is a hammer, everything looks like a nail." If all you know is Swedish massage, every client looks like a good candidate for circulatory work! But if we have, in addition to our Swedish hammer, a craniosacral screwdriver, reflexology pliers, a Bowen technique drill... you get the picture. The more tools we have in our tool belt, the more versatile we can be. This benefits not only ourselves, keeping lively and interested in our work as we incorporate new skills, but also our clients, who will have therapists with skills that apply even when medical situations preclude circulatory massage.

More Questions

This whole issue of making decisions about bodywork when our clients are not completely healthy, brings up a few more questions I'd like to put to you:

How do you talk to your clients about their health? When you see or notice something that requires attention from a medical professional, what do you say or do? Have you ever had to send a client away because his or her medical situation was too precarious? How did you convey your concerns? Did you feel you did a good job?

Send me your feedback, along with any other questions about massage and pathology, and I'll discuss it in a future article in Massage Today! Until then, good health and happiness.


Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.

 

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