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State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
October, 2004, Vol. 04, Issue 10
Understanding Domestic Violence: What Massage Therapists Should Know
By Rebecca J. Razo
Author's note: Since the majority of domestic violence victims are female, the pronoun "she" is used continuously throughout this article; this is not, however, intended to diminish incidences of abuse suffered by male victims.This article is for informational purposes and not a substitute for professional training or continuing education.
October is a magical time of year: Shorter days yield to cooler nights while the leaves turn color and fall gracefully from the trees, forming yellow, orange and red sidewalk mosaics. We buy bags of candy for the invasion of trick-or-treaters (hoping we don't eat it all ourselves before the big day arrives) and generally prepare for what is sure to be another busy holiday season.
What many people don't know, however, is that October also marks a less celebrated -- but no less relevant -- occasion: Domestic Violence Awareness Month, an event first organized in October 1987 by the National Coalition Against Domestic Violence for the purpose of focusing awareness on the crisis of domestic violence.1
Definition and Background
In Improving the Health Care Response to Domestic Violence: A Resource Manual for Health Care Providers, Warshaw and Ganley define domestic violence -- also known as intimate partner violence -- as "...a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, that adults or adolescents use against their intimate partners."2
As hard as it is to contemplate the implications of violence in the home, it is even harder for those whose reality includes living in constant fear of abuse by spouses or partners. Consider these startling statistics from the Family Violence Prevention Fund (FVPF):
As these statistics show, domestic violence is prevalent in the U.S.; moreover, its victims are both male and female, and it can be found in every race, ethnicity, culture, social structure and income bracket, as well as within heterosexual, homosexual and transgender relationships. There is no "typical" victim of domestic violence, and "... no causative link has been found between the characteristics of battered women and their victimization ... Being a victim of domestic violence is due to behaviors of the perpetrator, rather than the personal characteristics of the victim."2
In their book, , Ben Benjamin, PhD, and Cherie Sohnen-Moe write, "On the average, one of every five clients a [massage] practitioner sees has a history of some kind of trauma or abuse."
Although not every victim of abuse has necessarily been a victim of intimate partner violence, it is likely a massage therapist will, at some point, come into contact with a client who either is or has been subjected to domestic violence. And according to the FVPF, "A recent study found that 44 percent of victims of domestic violence talked to someone about the abuse; 37 percent of those women talked to their health care provider."5
Although massage therapists are not considered health care providers , the demand for massage therapy as an adjunctive health care treatment has been increasing. Thus, massage therapists might very well see the signs of abuse before these signs are visible to others.
Sheryl Heron, MD, MPH, is an associate professor and associate residency director at Emory University School of Medicine's Department of Emergency Medicine in Atlanta, Ga. She was appointed to the Georgia Commission on Family Violence in 2002, and has dedicated much of her career to domestic violence education and awareness.
When it comes to domestic violence, Dr. Heron believes in a coordinated community response -- that every facet of the community, including religious institutions, health care providers and service-oriented businesses (like massage) must address the issue in order for victims to have easy access to help. Dr. Heron believes that massage therapists are in a unique position to help victims, since many may seek massage as a way to heal.6
The Role of the Massage Therapist
There are a number of signs a massage therapist can look for to determine if a client is a victim of intimate partner violence, most notably, the presence of bruises, cuts and lacerations on the face, head and body, or in areas usually covered by clothing, including the back, chest, breasts, abdomen and extremities. Soft-tissue injuries, sprains, fractures, eye or ear trauma, complaints of injuries lacking visible evidence, chronic illness, injuries that do not appear to heal over time (suggesting repeated abuse), or injuries that do not coincide with a client's explanation of how the injury occurred, are also key indicators of violence.2,6
Unlike medical doctors and other health care professionals, massage therapists are not typically bound by mandatory reporting laws when abuse is discovered (check the laws in your state); however, Dr. Heron says there is nothing wrong with a massage therapist asking pointedly, but gently, if a client is a victim of intimate partner abuse.
"[Therapists] can tell their clients that they are not asking to probe or pry but that they are in line in the fight against domestic violence in their community," she suggests.6
The National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings suggests the following framing questions to help clients feel safe and comfortable about disclosing whether they are victims of intimate partner violence:
More direct questions include:
Should a client disclose that she is indeed a victim, massage therapists must listen and validate their client's experience without judging, laying blame, or pressuring the client to do something she is not ready for. Emphasize that the information the client shares is strictly confidential; however, try to negotiate with the client to document the disclosure of abuse in her patient chart.
Documentation of the victim's abuse could help her in court if her perpetrator is prosecuted; however, for safety reasons, it is important to chart only what the client wants documented about her injuries and/or experience. If a victim indicates she does not want the experience documented, Dr. Heron emphasizes the practitioner must respect her wishes."Say: 'I understand and respect that [choice].'"6
"Domestic violence is about power and control," Dr. Heron adds. She cautions therapists not to "exhibit another power/control situation. Victims must feel empowered." Dr. Heron affirms that listening without judgment "gives women a chance to make decisions about [their] lives without re-victimization."
Although Dr. Heron concedes that it can be frustrating for practitioners when victims decline help, she notes that if clients know their massage therapist has access to resources, they will know it is safe to return for help in the future. "You meet your clients where they are and give them autonomy with your knowledge of domestic violence," she says.6
So, what steps can massage therapists take to help victims of abuse?
For one, therapists can hang posters and display informational brochures in their rooms or offices (Educational resources are available for a nominal fee through the FVPF.) This conveys the message that the therapist is socially responsible and sensitive to the issue of domestic violence, which also opens the door for victims to confide in their therapist and/or seek help. Therapists should also have referral numbers to local or national violence hotlines, such as the National Domestic Violence Hotline (800-799-SAFE).
Focus on Education and Awareness
Although Dr. Heron believes that massage therapists and health care practitioners in general could benefit from more education in the area of domestic violence, she affirms there is more to education than practitioner awareness -- there is public awareness.
Tanya Brown, youngest sister of the late Nicole Brown Simpson, and a certified domestic violence counselor and co-founder of the Nicole Brown Charitable Foundation, agrees; moreover, Brown believes that education and awareness begin in the home.8
"Violence starts at home with shouting, yelling, screaming," she asserts. "We need to bring respect, trust and honesty back to our kitchen tables. How about getting to really know your kids? Have them sit with you...ask them, 'How was your day?' Have conversations. By doing this you are promoting a healthy environment for children."
Though Brown advocates awareness, she notes that outsiders should exercise caution when trying to help victims.
"Domestic violence is the most dangerous call for [police] officers to go on. I strongly suggest that you don't get involved directly with wanting to 'save' the victim. You, too, could be in danger. Have those hotline numbers ready. Ultimately, it is up to the [victim] to get themselves help. You just lead them to the resources."
Irrespective of whether victims have access to resources through their massage therapists, Dr. Heron makes one point clear: "Abuse is a crime. We all need to be informed, educated and committed."
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