resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
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.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
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."
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
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.
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.
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.
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?."
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
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.
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.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
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.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
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.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
July, 2013, Vol. 13, Issue 07
Ethical Considerations for Pediatric Massage
By Tina Allen, LMT, CPMMT, CPMT, CIMT
The practice of massage therapy is generally regulated throughout the U.S. with many states having standard guidelines and a method of licensing/registering massage therapists and practitioners.As a therapist, you must always adhere to the guidelines mandated within the area (geographic location) you are practicing. When working with pediatric populations, it is especially important to have a solid grasp of legal mandate, as well as ethical considerations due to the fact that not everyone has a clear understanding of pediatric massage therapy. Clarity and consistency will help develop a professional understanding of nurturing touch as an important part of every child's life.
Within a pediatric healthcare practice, privacy, safety and care is of the utmost importance. While these same qualities are important for all clients, children require a practice of extra special care. By learning and following a professional code of ethics, you will not only be able to better assist clients, their families and other healthcare providers through interactions, but will also ensure you are received as a professional service.
What are Ethics?
As healthcare providers, we are judged on our technical competence in our profession and the ability to build trust in others. In order to project this allure of pride and confidence in our field, we must have it within ourselves; when you practice ethically not only do you have more pride in yourself, but also your profession. Traditionally, ethics is defined as a philosophy which seeks to address questions about morality; concepts of good and bad, right and wrong. Ethics encompasses our moral principles that govern a person's or group's behavior, the correctness of specified conduct and the discipline of dealing with what is good and bad and with moral duty and obligation.
Is It Legal?
Understanding the legality of your actions is an important factor in the decision-making process. With child clients, we face another layer of legality due to requirements of consent from not only the pediatric client, but also their parents/guardians, and in some cases, their healthcare provider.
Is It Ethical?
Professional ethical behavior relates to your actions and being sure they are consistent with the standards established or practiced by others in the same profession. It is best to adopt a standard of ethics that serves your practice and clients well and stick to it.
Is It Fair?
This is an area that is subjective and many people have a different understanding of what they feel is fair. We base our beliefs and understanding on what we feel is fair, while another may feel differently or may have chosen to do something in another way. Always reflect on whether the decision you are making may result in harm or an arbitrary benefit. If this is the case, then it is not considered "fair." With each child and family we must practice the same care and regard to safety, boundaries and scope of practice, no matter what.
Children need clear boundaries, as do health providers. It is imperative that we understand and follow good professional and personal boundaries to establish the best care.
Within the guidelines of informed consent, a client/patient must be fully informed of the care you wish to provide so they may make an educated choice in receiving hands-on care. This is the client's legal and ethical right to direct what happens with their care plan, their body and to consent to, or refuse therapy. For children, this may involve their parents or healthcare provider's request for you to provide massage therapy. Typically, a child is not calling you to schedule an appointment, but when a child says no to any part of the massage, or wishes to have it change, this is to be respected, whether the massage is medically ordered or not.
Many children don't understand what massage is or how it might be beneficial. Having a good explanation of massage therapy in terms they understand, along with why massage might be beneficial, will help you to inform and receive an appropriate consent to begin or continue your session.
Always respect cultural, ethnic and religious beliefs of the patient and family and do not impose your own beliefs or values. "The United States is becoming increasingly culturally diverse and this trend is expected to continue throughout the 21st century. One does not have to look far to see this reality, especially in metropolitan areas. In some cities (e.g., Miami, Los Angeles) persons in business and others must be bilingual to communicate. With the increase in cultural diversity comes a responsibility for ethical thoughtfulness on how this diversity affects health care practice." (Ludwick & Silva, August 14, 2000)
Working with children in hospice and palliative care can be emotionally different than working with other pediatric patients/clients. Not only are you dealing with your own belief system, but you may be challenged with the question, "What will happen when I die?" Children of all ages may pose this question. First, recognize your beliefs may not mirror those of the child or their family, and it is not your place to "fix it" or even answer it directly. You might try using a reflective response of, "What do you think will happen?" Listen to their response with open ears and mind. Do not judge, do not place your beliefs onto them and do not try changing their mind to your beliefs. You can always respond with an answer of, "That is definitely possible," or "That sounds lovely." The reality is whatever your beliefs may be, we do not know what will happen if the child is to pass, but being present is essential for the child.
Other Situations to Consider
Navigating the waters of massage can be tricky when you are working with children. The question of who is the client may be raised during the session. While it may seem obvious, when you work with children with special healthcare needs, you are often interacting with tired and stressed parents or healthcare providers who may need a shoulder massage. It is crucial to ask yourself if this seems appropriate, should a second appointment be scheduled for the caregivers or is it ethical to provide massage for the parents when referred to work with pediatric patient?
To Drink or Not to Drink
Should I offer my client a drink of water at the end of the session? In this question, we are reflecting on a typical practice of many massage practitioners. Offering a drink of water at the end of the session is almost industry standard, but not when dealing with children. Children can have many different healthcare concerns and may not be in a position to make this decision on their own. If they are undergoing medical treatment or have a special healthcare plan, having a drink of water could be harmful. Anything taken by mouth needs to be done under proper advisement, which is not your decision to make. Accordingly, it is out of your scope to determine if water is appropriate before, during or after your hands-on session.
What if I see signs of abuse or neglect, or if my pediatric client tells me they are experiencing abuse or are feeling suicidal? These type of events need to be reported as soon as possible. By working with the public as a healthcare provider we are mandated to report these situations. Some children have no one else they can speak with, or feel comfortable to talk to, so you may be it. If you have concerns that are real and legitimate, making an anonymous call or reporting it to your supervisor in a healthcare setting is required. First, do no harm, which means you should report when you feel harm has come or will come to your client.
How do I assess appropriate boundaries if my client is not able to communicate with me? Often times, communication is largely non-verbal. Always look at your client's body language and recognize their unique engagement and disengagement cues. If you feel you are not able to read your client's cues, or if communication is difficult, than speak with the client/patient's immediate care providers to seek guidance on communication. Parents and healthcare staff communicate with the child under their care on a daily basis and it is not safe to assume that you will already know how to recognize each child's cues. Taking the time to meet them at their level and communicate with those around them is extremely important.
Is it alright for me to accept gifts from my clients or their family members? Generally speaking no, this is not acceptable. Think carefully about why you are being given the gift and how this will impact the relationship. Remember, clients and family members sometimes struggle with receiving the generous gift you are offering, but it is simply what we do as massage therapists. Children may color you a picture or card as a thank you for their massage and this is generally acceptable to receive. However, if they offer you their favorite stuffed animal, it is best for you to ask them to keep it safe until you return another time.
Working with pediatric patients and clients is rewarding and different than working with any adult population. Knowing how best to communicate, maintain boundaries and practice ethically makes all of the difference to the child, their family and their healthcare team.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.