Issue link: https://www.massageandbodyworkdigital.com/i/1338685
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 91 pack and some ultrasound, because [the] last time my neck was sore, what I got was a hot pack and ultrasound, and my neck got much better." So, include that with the other package, and say, "You know what, that sounds like a great idea. I'm very happy to finish with those. Once we get through a couple of things up front, then we'll make sure we finish with the hot pack and the ultrasound." TL: What if the client wants something that I don't particularly believe in as a practitioner, don't enjoy doing, or don't think helps? Is there still a benefit in me doing it, just because they want it or believe in it? MB: Well, even a provider who thinks they're a great actor will convey that they don't believe very strongly in what they're doing. I haven't done any of those studies, but I've read a couple where clients and patients are able to pick out which providers are giving the real treatment versus a placebo treatment just because of the body language and interacting and stuff like that. So, [even] if you don't believe in it, [your client may] still get benefit from their belief. They just won't get the added bonus of your belief, positivity, confidence, and those type of things. LISTENING Whitney Lowe: Til and I are both educators. Are there specific things we could focus on in educational programs to enhance the benefits of expectation? I know certainly it's a soft skill, and much more difficult to put in granular terms, but what kinds of things might we be able to focus on to improve those outcomes? There's a much greater emphasis needed in some of our training programs on these factors, which I think are significantly underemphasized in terms of their contribution to the outcomes. MB: I would agree. I think the metaphor that works for me is that I have never given a treatment in a blacked-out room, dressed all in black, with a mask on, and the client unconscious. If the mechanical effects of treatment were all that mattered, then doing treatment that way would work just as well as what we're talking about. I apologize I didn't research any of the training for other professionals. But say for example, therapeutic communication, which used to be a standard class in every PT program everywhere, got removed as people wanted more physiology and pharmacology and radiology. "What are we going to get rid of? It's just communication. We'll eliminate that." I think learning how to communicate well is of imperative performance. I'd also suggest things like making sure people are asking open-ended questions and actually caring. Recently I ran into someone I'd seen as a patient 20 years ago. We were catching up, and she was complaining about her shoulder—how she was doing all this exercise and doing all this manual therapy, but it just wasn't getting any better. I listened to her, and then said, "You know what, I have to go. I need you to just do a couple of these catch-the-rain exercises, feel it back there. Just work on that for a week and we can talk later." Read more about how our belief in our own work as practitioners can shape client results: "Is Your Work Valuable?" Til Luchau, Massage & Bodywork May/June 2018, page 100. Then, a week later I called her. She said, "I feel great. I have never felt so good. My shoulder is better." When I asked her, she said I was the first person who actually let her tell me about her frustrations with what was going on and suggested a change. So, I'm not saying that I'm awesome because of that, but I think just an episode of listening to her and saying, "OK, I hear you're really frustrated. There's lots of different ways to do this. How about we just try this alternative?" That was enough for her. TL: That's a great example. And Whitney, your question is great too, because it has a lot of implications for entry-level training for sure. Even at the continuing education or post-grad level, those of us who have been out there in the field working for a while can tend to think, "Yeah I got that. I know about that relationship stuff, I'm a natural, I've been doing this for X many decades." There's a lot of room for us all to get better in terms of understanding the alliance and the contextual possibilities and the power of expectations as well. DO CREDENTIALS ENHANCE RESULTS? WL: I'm curious to hear your opinion on this. I didn't see this picked up at all in any of your other research. In the massage therapy profession, massage might be administered by a physiotherapist with a great deal of academic