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96 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 6 Working with Interdisciplinary Teams The current health-care climate is ripe with opportunities for conventional and complementary health-care providers to come together and take a central role in addressing the epidemic of pain. Clients are demanding access, physicians are listening, insurance companies are starting to cover services, and complementary approaches, such as massage, movement, and mindfulness disciplines, are becoming more evidence-based. In this transitional time, both conventional and complementary providers have a responsibility to improve communication and make the full complement of services available to clients. 1 Communication begins with documentation. Take a health history and chart each client session. SOAP charting can be very overwhelming if you are not accustomed to keeping written records. Electronic health records can simplify charting, prompting you to fill in the necessary information, and automatically populating graphs to produce outcome measures that demonstrate progress and enhance client retention. Sharing outcome measures and writing reports is a standard communication method in conventional health care. Learn to describe your techniques and scope of practice using biomedical language. Avoid jargon, and at the same time, educate referring providers on how your work specifically addresses pain, and how you educate clients to use self-care to regulate and manage their pain between sessions. Active coping strategies are associated with less reports of pain, less depression, less functional impairment, and higher general self-efficacy. 2 Self-care education is an important aspect of massage therapy to share with conventional health-care providers, since it is something they do not always have time to address. For us, it is second nature and easy to incorporate due to the length of time and the level of intimacy involved in our work. We can easily uncover what works and alter our care plan to meet the needs of each individual client. Notes 1. M. Brooks and D. L. Thompson, "Pathways to Integrative Clinical Care," in Integrative Pain Management: Massage Movement and Mindfulness Based Approaches, eds. D. L. Thompson and M. Brooks ( Edinburgh: Handspring Publishing, 2016 ). 2. G. K. Brown and P. M. Nicassio, "Development of a Questionnaire for the Assessment of Active and Passive Coping Strategies in Chronic Pain Patients," Pain 31, no. 1 (1987): 53 – 64. Develop your sense of awareness outside of work. Attend movement or meditation classes to learn about options to recommend, and discover practitioners you can trust with your clients. We can use the research to enhance our own skills, giving us techniques to use in sessions with complicated clients when we get frustrated or stuck. If you have a rigorous yoga practice, take a few beginner classes or gentle yoga classes to learn what modifications are possible and how to think about movement with a beginner's mind. Download mindfulness breathing or meditation apps to both increase your own awareness and practice vocal instructions for body scans that you can implement in practice. Spend an hour on the foam roller and explore gentle ways to use it, rather than going right to the iliotibial band because you can. My favorite technique to use with my chronic pain clients is to teach the ability to differentiate between what moves well and what doesn't, to notice where there is grace and where stiffness prevents graceful movement. This awareness came to me through my personal experiences using Feldenkrais to manage chronic pain. It enhanced my sense of awareness greatly, and to this day, I use what I learned with my chronic pain clients. For example, while working with the hips and the ribs, I gently and increasingly move them in different directions. Then, I ask