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Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
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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