resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
December, 2015, Vol. 15, Issue 12
Facilitating a Coaching Conversation
By Ben Benjamin, PhD
In previous articles, I've made the argument that in many instances, it's less useful to give a client advice than to provide coaching that helps them discover their own solutions.Here, I'm going to discuss one particular circumstance in which advice-giving is both very tempting and potentially very risky: responding to a client who's facing a major decision and asks you directly what you think they should do. The decision may be closely related to the work you're doing with them (e.g., deciding whether to give up a sport in which they've sustained multiple injuries), or it may have little or no connection (e.g., deciding to start or end a personal or professional relationship).
It's often hard to know what to say in such situations. For decisions that are very personal or far outside your scope of work (such as whether to file for divorce or make a risky investment), an outside referral (to a psychotherapist, financial consultant, or other professional) is probably in order. But in other cases, simply advising the person to speak to someone else may feel inadequate. Suppose the person is considering quitting their job. They've talked to you repeatedly about how much stress they experience at work, and it seems to be contributing to extreme muscle tension and chronic headaches. When the client says, "Tell me honestly — what do you think I should do?" What's the best response?
On the one hand, you probably care about the client's well-being and want to encourage them to reduce the stress in their life. You also don't want to be evasive or hold back the truth of what you think. So it may be tempting to say, "Absolutely, I think you should do it."
On the other hand, you don't know all the details of the situation and you're not a counselor (although clients with strong transference may treat you as though you were). Furthermore, this decision is so significant that it really needs to be driven by the client's own values, judgments, preferences, and desires. When people base critical life choices on the recommendations of external authorities — whether it's a massage therapist, psychotherapist, religious leader, boss, elder family member, or self-help guru — they don't get the opportunity to learn from their own mistakes and successes. That type of learning is critical for developing a strong internal compass, sense of competence, and capacity for making better decisions in the future.
Answering a direct request for decision-making advice isn't necessarily unethical, and it may even be the right thing to do in certain circumstances (for example, in a case of physical abuse). However, many times, you can do more good by having a coaching conversation instead. I've talked about coaching in general as incorporating several key guidelines: get permission for having the discussion; inquire and reflect more than you advocate; remain curious; and focus on solutions, rather than problems. There's one specific approach that I've found to be particularly helpful when coaching a client attempting to make a decision, especially when that decision involves just two or three clearly defined alternatives (such as taking an action vs. doing nothing). It can help the person to see aspects of a complex issue that they've overlooked, which — in combination with skillful questioning and reflection — often enables them to discover a creative, satisfying resolution. What follows is an example of how you might describe this method to a client and then put it into practice.
Client: "Tell me honestly — what do you think I should do? Should I quit my job or not?"
Therapist: "That's a hard question. This is a big decision, and I don't know enough to say what's going to be best for you. I do know of a decision-making method that's often useful in this kind of situation, and I'd be happy to walk you through it to help you get clearer on what you really want. Would that be helpful, or no?"
Client: "I was hoping you'd just tell me what to do! But okay, sure, we can try that method."
Therapist: "Okay, great. What I'll invite you to do is to first spend some time thinking about all the advantages of leaving your job. Focus just on the positives — on how that makes sense and could improve your life. Then you'll switch and instead consider all the advantages of staying in your job. Do you want to give this a try?"
Therapist: "Okay, so what's good about the idea of leaving your job?"
Client: "At the moment, everything about leaving seems good! I'm so exhausted and burnt out. I think if I got out of this situation, I'd be a lot happier and more relaxed."
Therapist: "Anything else that would be good?"
Client: "I'd have more time with my kids. My oldest will be going off to college next year, and I want to be more present for her while she's still here. Of course, I can't go without an income forever. I can't be unemployed six months from now. So maybe this is a really irresponsible idea, and I should just stay where I am."
Therapist: "So now you're getting into the downsides of leaving your job. Before we go there, is there anything else that's positive about leaving?"
Client: "Oh, right. Yeah, I think if I could pull it off, I'd end up healthier outside of this work environment. I'm not eating well or sleeping well, and I'm tense all the time."
Therapist: "So you're thinking getting out, or getting into a different work environment, would help you get healthier?" (Reflection/clarification.)
Client: "I do. In my last job, I took real lunch breaks so I'd get out and go for a walk. And I had time and energy to cook at home, so I was making healthier food for myself. I really think that away from this job, I'd lose 30 pounds and my overall health and well-being would increase dramatically."
Therapist: "Can you think of any other positives of leaving your job, or are you ready to look at what's good about staying?"
Client: "I'm ready to look at why I should stay. I know it's risky to just quit without having another job. I won't get unemployment, and if I can't find anything else we'll be in real financial trouble. At the same time, I'm so burnt out that the last thing I feel up to is a job search."
Therapist: "So, in terms of the positives of staying, it's the financial security?" (Reflection/clarification.)
Client: "That's right. I make a very competitive salary, and the benefits are good, too."
Therapist: "And beyond that, is there anything else on the plus side?"
Client: "Well, I do like the work I do. I feel like I'm making a real difference in the world. And I've gotten to meet a lot of amazing people."
Therapist: "That's interesting. It's sounding as though you like a lot of things about your job." (Reflection/clarification.)
Client: "I do — or at least I would, if the workload weren't so crazy."
Therapist: "And what would need to change for the workload to not be so crazy?"
Client: "Basically, I'd need to get an assistant. I had one in my last job. But this position doesn't have a budget for that."
Therapist: "So, if you could get an assistant, you might achieve some of those benefits you'd hoped to get from leaving your job?" (Reflection/clarification.)
Client: "Yeah, then it would be more like that last position, a lot more manageable."
Notice how a possible creative solution has begun to emerge — one that's different from either option the client had been considering before. The coach didn't suggest this idea, but just helped the client consider both sides of the issue (focusing just on the positives), reflect and clarify what was heard, and ask a key open-ended question ("What would need to change?"). Figuring out the details of a resolution would take a little more time, and this first idea (hiring an assistant) may end up not working out. But one way or another, this type of coaching conversation is likely to help the client achieve greater clarity. And it does so in a way that is much more empowering and motivating than simply telling them what to do.
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