Why Do Clients Keep Coming Back for Massage?

Why Do Clients Keep Coming Back for Massage?

Contributed by Sandra K. Anderson, BA, LMT, ABT; Beth; MK Brennan MS, RN, LMBT; Jolie Haun PhD EdS LMT

In this month's Massage Therapy Foundation (MTF) research review, we are reporting on a focus group study that explored the reasons clients continue to use massage therapy. The article was written for Complementary Therapies in Medicine in 2009, by a research team from New Zealand associated with the Southern Institute of Technology and the Centre for Physiotherapy Research.

As professional massage therapists and bodywork practitioners, we rely on a stable client base for income. We know that by providing client-centered treatments, a welcoming therapeutic atmosphere, as well as conducting ourselves professionally and ethically, clients are more likely to return. However, unless we explore clients' reasons for continued use, we may not know why they come back for massage.

Over the past few years, research supporting the psychological and physiological benefits of massage therapy has been on the rise. The authors thought it would be useful to gain clarity about the contributing factors for the popularity of massage from the clients' perspective. The goal of this research was to explore the reasons why (or "drivers") clients use, value and continue to seek massage therapy services.

Determining the reasons for repeated use of massage requires listening to the clients about their needs, insights and activities. Therefore, Smith et al chose to use the focus group methodology, which is a qualitative approach for studying participants' attitudes and perceptions. Telephone focus groups were conducted with current and repeat massage therapy clients throughout New Zealand.

Questions revolved around choosing massage therapy, the treatment experience, outcome and drivers for continued use. Focus interview questions included, but were not limited to:

  • What two words or key ideas come to mind when you think "massage therapy?"
  • What generally prompts you to go for a massage?
  • What effect or results do you receive from your massage sessions?
  • Does massage therapy have a long-term benefit for you? If yes, how does massage therapy add value to your life or situation?
  • Which ones are key in your decision to continue to have another (seek or re-initiate) MT?
  • Why would you choose to discontinue massage therapy?

Participants were male and female, 16 years of age or older. Participants were included if they had at least one massage within the previous three months or at least two massages within the previous six months. Participants were excluded if they received student massages, or if the massage was provided by another practitioner (e.g. physiotherapy, beauty therapist, or other CAM practitioner) since these types of massage were considered an adjunct to another therapy. No more than two clients from any one therapist were recruited and massage therapists as clients were excluded.

Three telephone focus groups were conducted in August, 2007. Groups included five to seven participants and lasted approximately an hour. A moderator with previous focus group experience facilitated the telephone focus groups, which followed a semi-structured format. All sessions were recorded, observed by another study author and then transcribed.

According to the article, during the focus groups, "Initially, each person was asked for their individual input; at other times, the line was open for anyone to answer first. The moderator provided opportunities for inclusion of all participants using a range of approaches including: probing questions, group discussion strategies and different points of view and experiences were sought. A speaker grid was used to record responses, and to cue and monitor participation. The moderator and assistant held a debriefing discussion after each session."

Results of the study showed four driving forces for continued use of massage:

  1. Massage therapy was used for health management, the expectation and result of positive outcomes.
  2. Their treatment goals were met.
  3. The occurrence of regular appointments.
  4. The "massage therapy culture" or the massage therapy experience was described as positive client—therapist relationships, effective touch and a proactive approach to health maintenance.

These results are in line with other studies that show massage therapy is considered part of wellness maintenance, placing value on the client's physical, psychological and emotional needs to achieve mental and physical balance.

Limitations to the study include possible bias resulting from the therapists selecting their own clients to participate, small sample size and low number of male participants. It should be noted qualitative research is not qualified by large sample sizes, but rather the depth and breadth of information gathered. The goal of qualitative research is to reach saturation, which can be achieved given the reported sample size of this research. However, since 95% of participants in this study were female, there is little information regarding what drives male clients to receive massage. In addition, the sample may not reflect individuals who had a negative experience with massage. Consecutive sampling to minimize therapist bias and including more male participants could improve methodology in future studies. It would also be interesting to replicate this study in North America to see if reasons for continued massage therapy use are consistent cross-culturally. Further, qualitative findings such as these, can inform a subsequent quantitative study to investigate how commonly these views and experiences are reported in a larger representative sample of massage therapy clients.

Overall, massage therapy is a client-centered wellness practice where clients desire results. However, clients report that they continue to seek treatment because of the beneficial experiential aspect of receiving massage therapy. This suggests that as massage therapy and bodywork practitioners, it is not only our skilled touch, but also our ability to provide a professional and hospitable environment that draws clients in and brings them back. Our professionalism sets the tone for our career longevity.

To learn more about the economic impact of CAM, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for CAM/CIM cost analysis studies.