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Massage Today
June, 2001, Vol. 01, Issue 06

How Do You Say "No" When Your Client Says "Yes"?

By Ruth Werner, LMP, NCTMB

Heads up, readers: we have some work to do! Put yourselves in the place of these bodyworkers:

  • Your client is on painkillers and muscle relaxants because he's recently been in a car accident. He wants a deep, precise, take-it-apart-and-put-it-back-together-again treatment on his neck.
  • Your pregnant client has one calf that's cold, puffy and clammy, while the other one is normal. She feels a deep ache in her cold leg, and she desperately wants you to "work it out."
  • Your client has a mole on his arm that satisfies all the criteria for a possible melanoma. You have repeatedly asked him to have it checked. He keeps promising to do it, but this is the 3rd month he's forgotten. It looks to you like his mole is getting bigger and deeper.

What do you do? What do you say? How do you handle it when your client says, "yes," but your instinct says, "no, no, NO"?

Massage therapists are better trained in contraindications today than we've ever been, and I'm proud to be part of that movement. Our clients depend on us to make informed decisions about whether Swedish massage or other types of bodywork are the best choices for their needs. Still, it is inevitable that some people who may be at risk may seek massage - and the responsibility for causing any harm rests squarely on the massage therapist. All of the scenarios described above are based on real-life situations in which clients could be injured or have their condition dangerously neglected. It could happen to any of us, at any time - in some instances, it already has.

I believe that getting good training in pathology in the context of massage and bodywork is the first step in being able to work with clients who aren't perfectly healthy. We must develop critical-thinking skills so that we can make wise choices about different types of bodywork in different situations. But the next step, often the harder step, is taking action on those choices when they may not be in agreement with our clients' wishes.

How do you do that? How do you say, "No, we can't do this today, because if we do you could end up in the hospital"?

So many obstacles are in our way: staying within our scope of practice; not wanting to lose clients; not wanting to make a mistake or overreact; not wanting to get sued; but above all, not wanting to inadvertently hurt someone!

I have some ideas about how to frame these difficult conversations with our clients (which I will share in my next column), but I work in a bit of a vacuum. I am not in a full-time practice, and I don't work in a setting in which I see a lot of people who may be ill. Instead, I spend the bulk of my professional hours teaching and writing. This is a topic that needs to be addressed by the people who are really doing it - that's you!

So here is your invitation - no, here is your assignment:

Think about the last time you had to change your plans with a client to adapt to his or her health situation. Maybe you couldn't do Swedish massage, but had to switch to something else. Maybe you had to avoid an area the client hoping to have worked on. Maybe you had to reschedule your appointment altogether. How did you do it? Did your client object? How did you handle it? Would you do it differently next time?

Send me a description of your experience. It doesn't have to be eloquent or fancy; it just has to be real. I'll edit it, and change the names to protect the innocent. I'll clear my final draft with you, and then it will appear in Massage Today so that we can all learn from your experience.

This column is meant to be a forum to share our success stories and, maybe more importantly, our mistakes for the benefit of all massage therapists. Be brave. Let us know how you handle this delicate issue. Allow us to learn from each other.

I'm looking forward to hearing from you. Until then, good health and happiness...

Click here for previous articles by Ruth Werner, LMP, NCTMB.


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