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5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
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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