Massage & Bodywork

May/June 2013

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Most massage therapists work in tandem with other providers, getting referrals and recommendations from physicians, chiropractors, physical therapists, and nurses. improves function and quality of life with medium to high effect, even for patients with a long history of chronic back pain. Results were better than for monodisciplinary treatments, and treatment effects remained stable at a six-month follow-up.3 Recommendations have come out of these studies, including the optimal integrative model of care, which should involve a collaborative, interdisciplinary, and nonhierarchical team approach. All disciplines should be represented and contribute to the treatment plan discussions. The recommendations also say that patients who participate in their care tend to be more satisfied with their care and experience better outcomes. Multiple efficacious treatments introduce greater opportunity for patient choice. Therefore, to enable true patient-centered care, patients should be included in the integrative medicine (IM) team's decision-making process. Finally, care plans should remain fluid. Any chronic condition is episodic, and frequency of care and response time to treatment varies from individual to individual. Being willing and able to make changes to a care plan is a key characteristic of maximizing clinical outcomes. Massage's role on IM Teams Multidisciplinary approaches to care are not foreign to us. Most massage therapists work in tandem with other providers, getting referrals and recommendations from physicians, chiropractors, physical therapists, and nurses. Unfortunately, however, it is not common for massage therapists to be included in the treatment planning. It is critical, therefore, to insert our recommendations using standard communication pathways. Unless we are located in the same office, our best communication tools are our treatment notes and progress reports. Following conventional communication protocols can garner respect and increase referrals, as well as provide us with a mechanism for influencing the client's care plan and claiming a spot on the IM team. We have valuable information to share. Somatic therapists are at a distinct advantage when it comes to client choice and participation. Typical sessions are an hour long, giving us optimal time to get to know our clients and their preferences for treatment. Our training encourages frequent check-ins regarding comfort, music, scents, and treatment styles. We often know more about the needs and desires of a patient than many others on the health-care team. This is valuable information that can be shared via progress reports. Demonstrating our value may become the impetus for including us as active members of the IM team in the future. Perhaps the most beneficial aspect of our routine care, according to the research, is in providing self-care education. We spend time educating our clients on proper sitting and lifting techniques, help increase awareness regarding forward-head posture and wrist stress at the computer, and often suggest pillow supports for the neck and low back, topical pain relievers, and simple contractrelax exercises to support change. In a low-back study on which I was a consultant, massage therapists were prevented from providing stretching and awareness exercises because selfcare education was part of the control group. No one realized how difficult this would actually be! It is such an integral and natural component of a client-therapist relationship, discussing ideas about how to continue the benefits of massage in between sessions and customizing self-care routines. Needless to say, self-care education became a part of the massage therapy protocol in subsequent studies. The multidisciplinary protocols used in these studies include a variety of separate disciplines, such as structural modalities (chiropractic and osteopathic techniques), Eastern modalities (e.g., acupuncture and herbs), and mental-health therapies (e.g., behavioral counseling), but many of the recommended techniques www.abmp.com. See what benefits await you. 57

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