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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.
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.
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.
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.
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.
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.
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.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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.
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.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
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
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.
Click here for more information about Ben Benjamin, PhD.
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