resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
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.
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