The Opioid Crisis Hits Home: An Acupuncturist's Inside Perspective of Addiction Treatment
My husband and I have four grown children, but we still sleep with a phone next to our night stand just in case they need us. But nothing could have prepared us for a 1 a.m.
Power of the Talk: A Simple Way to Attract New Patients
One of the most effective ways to bring patients in predictably, especially if you enjoy teaching, is by doing talks. Talks can also bring in another stream of income beyond just seeing more patients one on one.
Who's the "Father of Corrective Traction" in Chiropractic?
History teaches that a Presbyterian minister, Samuel Weed, coined the name for the profession of chiropractic from the Greek cheir for "hand" and praktos for "done."
How to Reduce Metabolic Endotoxemia
Approximately 50 percent of the Western population suffers from a condition known as metabolic endotoxemia (ME). The condition is characterized by increased serum endotoxin concentration during the first five hours of the post-prandial period.
The Medicine of Peace in a Land of Conflict
We often read about violence, despair, and political stalemate between Israelis and Palestinians. It's easy to feel overwhelmed and pessimistic. And yet there are Israelis and Palestinians working together to transform conflict into cooperation.
Weight Watchers Goes Wellness
Goodbye Weight Watchers, hello "WW." The company has changed its name to reflect its new WW brand not only on its website, but also on every aspect of its public expression, including every studio.
ACA, ICA at Odds Over H.R. 7157
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
Winter Joint Health: Looking at Seasonal Influences
One of the most common clinical issues I see during the winter season is joint / muscle pain. These issues often appear due to the activities of winter sports or may appear due to seasonal influences on old chronic injuries.
An East & West Perspective on Sleep
You, your patients, and people all over the world are sleeping less. In 1979 a team led by American psychiatrist Daniel Kripke did a large-scale study of over a million people, which indicated that most people slept between 7-8 hours.
Dehydration ... A Commonly Overlooked Etiology
Water covers 71 percent of the earth's surface. It's found in every living organism and is considered the "universal solvent," yet we take it for granted as the foundation for optimal health.
Historic Farm Bill Provisions Legalize Hemp ... and CBD?
Until recently, hemp was classified as a Schedule 1 drug per the federal Controlled Substances Act, putting it in the same class as marijuana (and heroin, by the way).
Electromagnetic Hypersensitivity and the Science of EMFs
Movement of planet Earth's molten iron core generates a weak static geomagnetic field that varies in strength over millennia but currently ranges from 0.25 to 0.65 gauss. This is the native field in which all life has evolved.
3 Tips to Get New Patients After a Talk
One of the most effective ways to bring in new patients predictably, especially when an acupuncturist enjoys teaching, is by doing talks. It can also bring in another stream of income, beyond just seeing more patients one-on-one.
Differentiating Qi Under the Needle (Part 2)
While classic sages have said a lot on this topic, I will share my own experience with the sensations under the needle with you. You, in turn, will also need to gain your own understanding of them through daily clinical observation, thinking, and practice.
Neuroscience 101: Understanding Opioid Addiction and How Chiropractic Can Help
Opioids now account for nearly two-thirds of all overdose-related deaths in the U.S. This insidious bane is no respecter of gender, age, race or ethnicity, with nearly all categories experiencing increases.
Case Study: Forefoot Pain
Patient presents with a history of forefoot pain. Discomfort has become worse in the past six months. He has difficulty completing his four-hour shifts as a part-time hairdresser.
Pain in the Butt (Pt. 1)
Many of my patients (and probably many of yours) come in with pain and/or tenderness in the buttock region. First, I assess where the painful and/or tender spots are located and what these points represent.
Flying Into the Year of the Pig: Making Way for the Impossible
The first of the new year has passed, and some of our New Year's resolutions may have already come and gone. Fortunately, we will celebrate the Chinese New Year this month, and will welcome in the Year of the Pig.
Quickie Seminar Adjustments Have No Place in Chiropractic
Recently, I observed chiropractors treating each other in the vendor area at the annual meeting of a chiropractic association. "Quickie" chiropractic adjustments and other hands-on procedures were administered without appropriate history taking, physical examination, diagnosis or informed consent.
The Role of TCM When Treating Mental Illnesses
Mental illness is common in the U.S., nearly 20 percent of adults live with a mental illness which vary in degree of severity—ranging from mild to moderate, to severe. It is not exaggerated to say that mental illness is an epidemic.
Simple Screening Tests for Stroke and Other Brain Lesions
The drift test, arm rolling and finger rolling are three useful assessments in the identification of upper motor neuron dysfunction.
Top Social Media Do's & Don'ts for Chiropractors
For years, health care practitioners have avoided embarking on the social media highway, primarily due to patient HIPAA privacy issues and the time needed to give the process due diligence.
Outcomes for Any Occasion
Outcome assessment tools (OATs) are a necessary part of documentation and patient care. They are used to show patient progress and help practitioners show changes as a result of their treatment interventions.
Quick Sacroiliac Assessment: Treating Different Types of Pain
The lower back is a generator for a number of types of pain. The lower back involves several different articulations – the lumbar spine with vertebral bodies, discs, and facets – the sacroiliac joints – and the lumbosacral junction.
Know Your Clinical Flags: 5 Different Colors to Consider
In health care, the term red flag is used to describe signs and symptoms that can indicate the presence of serious health conditions. These conditions generally carry an increased likelihood for serious complications, disability or even death.
October, 2004, Vol. 04, Issue 10
Understanding Domestic Violence: What Massage Therapists Should Know
By Rebecca J. Razo
Author's note: Since the majority of domestic violence victims are female, the pronoun "she" is used continuously throughout this article; this is not, however, intended to diminish incidences of abuse suffered by male victims.This article is for informational purposes and not a substitute for professional training or continuing education.
October is a magical time of year: Shorter days yield to cooler nights while the leaves turn color and fall gracefully from the trees, forming yellow, orange and red sidewalk mosaics. We buy bags of candy for the invasion of trick-or-treaters (hoping we don't eat it all ourselves before the big day arrives) and generally prepare for what is sure to be another busy holiday season.
What many people don't know, however, is that October also marks a less celebrated -- but no less relevant -- occasion: Domestic Violence Awareness Month, an event first organized in October 1987 by the National Coalition Against Domestic Violence for the purpose of focusing awareness on the crisis of domestic violence.1
Definition and Background
In Improving the Health Care Response to Domestic Violence: A Resource Manual for Health Care Providers, Warshaw and Ganley define domestic violence -- also known as intimate partner violence -- as "...a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, that adults or adolescents use against their intimate partners."2
As hard as it is to contemplate the implications of violence in the home, it is even harder for those whose reality includes living in constant fear of abuse by spouses or partners. Consider these startling statistics from the Family Violence Prevention Fund (FVPF):
As these statistics show, domestic violence is prevalent in the U.S.; moreover, its victims are both male and female, and it can be found in every race, ethnicity, culture, social structure and income bracket, as well as within heterosexual, homosexual and transgender relationships. There is no "typical" victim of domestic violence, and "... no causative link has been found between the characteristics of battered women and their victimization ... Being a victim of domestic violence is due to behaviors of the perpetrator, rather than the personal characteristics of the victim."2
In their book, , Ben Benjamin, PhD, and Cherie Sohnen-Moe write, "On the average, one of every five clients a [massage] practitioner sees has a history of some kind of trauma or abuse."
Although not every victim of abuse has necessarily been a victim of intimate partner violence, it is likely a massage therapist will, at some point, come into contact with a client who either is or has been subjected to domestic violence. And according to the FVPF, "A recent study found that 44 percent of victims of domestic violence talked to someone about the abuse; 37 percent of those women talked to their health care provider."5
Although massage therapists are not considered health care providers , the demand for massage therapy as an adjunctive health care treatment has been increasing. Thus, massage therapists might very well see the signs of abuse before these signs are visible to others.
Sheryl Heron, MD, MPH, is an associate professor and associate residency director at Emory University School of Medicine's Department of Emergency Medicine in Atlanta, Ga. She was appointed to the Georgia Commission on Family Violence in 2002, and has dedicated much of her career to domestic violence education and awareness.
When it comes to domestic violence, Dr. Heron believes in a coordinated community response -- that every facet of the community, including religious institutions, health care providers and service-oriented businesses (like massage) must address the issue in order for victims to have easy access to help. Dr. Heron believes that massage therapists are in a unique position to help victims, since many may seek massage as a way to heal.6
The Role of the Massage Therapist
There are a number of signs a massage therapist can look for to determine if a client is a victim of intimate partner violence, most notably, the presence of bruises, cuts and lacerations on the face, head and body, or in areas usually covered by clothing, including the back, chest, breasts, abdomen and extremities. Soft-tissue injuries, sprains, fractures, eye or ear trauma, complaints of injuries lacking visible evidence, chronic illness, injuries that do not appear to heal over time (suggesting repeated abuse), or injuries that do not coincide with a client's explanation of how the injury occurred, are also key indicators of violence.2,6
Unlike medical doctors and other health care professionals, massage therapists are not typically bound by mandatory reporting laws when abuse is discovered (check the laws in your state); however, Dr. Heron says there is nothing wrong with a massage therapist asking pointedly, but gently, if a client is a victim of intimate partner abuse.
"[Therapists] can tell their clients that they are not asking to probe or pry but that they are in line in the fight against domestic violence in their community," she suggests.6
The National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings suggests the following framing questions to help clients feel safe and comfortable about disclosing whether they are victims of intimate partner violence:
More direct questions include:
Should a client disclose that she is indeed a victim, massage therapists must listen and validate their client's experience without judging, laying blame, or pressuring the client to do something she is not ready for. Emphasize that the information the client shares is strictly confidential; however, try to negotiate with the client to document the disclosure of abuse in her patient chart.
Documentation of the victim's abuse could help her in court if her perpetrator is prosecuted; however, for safety reasons, it is important to chart only what the client wants documented about her injuries and/or experience. If a victim indicates she does not want the experience documented, Dr. Heron emphasizes the practitioner must respect her wishes."Say: 'I understand and respect that [choice].'"6
"Domestic violence is about power and control," Dr. Heron adds. She cautions therapists not to "exhibit another power/control situation. Victims must feel empowered." Dr. Heron affirms that listening without judgment "gives women a chance to make decisions about [their] lives without re-victimization."
Although Dr. Heron concedes that it can be frustrating for practitioners when victims decline help, she notes that if clients know their massage therapist has access to resources, they will know it is safe to return for help in the future. "You meet your clients where they are and give them autonomy with your knowledge of domestic violence," she says.6
So, what steps can massage therapists take to help victims of abuse?
For one, therapists can hang posters and display informational brochures in their rooms or offices (Educational resources are available for a nominal fee through the FVPF.) This conveys the message that the therapist is socially responsible and sensitive to the issue of domestic violence, which also opens the door for victims to confide in their therapist and/or seek help. Therapists should also have referral numbers to local or national violence hotlines, such as the National Domestic Violence Hotline (800-799-SAFE).
Focus on Education and Awareness
Although Dr. Heron believes that massage therapists and health care practitioners in general could benefit from more education in the area of domestic violence, she affirms there is more to education than practitioner awareness -- there is public awareness.
Tanya Brown, youngest sister of the late Nicole Brown Simpson, and a certified domestic violence counselor and co-founder of the Nicole Brown Charitable Foundation, agrees; moreover, Brown believes that education and awareness begin in the home.8
"Violence starts at home with shouting, yelling, screaming," she asserts. "We need to bring respect, trust and honesty back to our kitchen tables. How about getting to really know your kids? Have them sit with you...ask them, 'How was your day?' Have conversations. By doing this you are promoting a healthy environment for children."
Though Brown advocates awareness, she notes that outsiders should exercise caution when trying to help victims.
"Domestic violence is the most dangerous call for [police] officers to go on. I strongly suggest that you don't get involved directly with wanting to 'save' the victim. You, too, could be in danger. Have those hotline numbers ready. Ultimately, it is up to the [victim] to get themselves help. You just lead them to the resources."
Irrespective of whether victims have access to resources through their massage therapists, Dr. Heron makes one point clear: "Abuse is a crime. We all need to be informed, educated and committed."
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